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Sample records for abuse assessment screen

  1. Assessment of Substances Abuse in Burn Patients by Using Drug Abuse Screening Test

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    Kobra Gaseminegad

    2012-04-01

    Full Text Available There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20. We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P<0.05. The level of substance abuse was severe in 77% of users. No significant differences were found among the substances, with the exception of alcohol. Substance abuse is an important risk factor for burn patients. In addition, this study showed that DAST-20 is a valid screening measure for studies on burn patients.

  2. Screening Spouse Abusers for Child Abuse Potential.

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    Milner, Joel S.; Gold, Ruth G.

    1986-01-01

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

  3. Elder abuse telephone screen reliability and validity.

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    Buri, Hilary M; Daly, Jeanette M; Jogerst, Gerald J

    2009-01-01

    (a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.

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

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    Peak, Terry; Ascione, Frank; Doney, Jylisa

    2012-01-01

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

  5. Substance Abuse Screening

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    ... Alcohol Smoking, and Substance Involvement Screening Test, © 1997 World Health Organization, Department of Mental Health and Substance Dependence All rights are reserved by the World Health Organization. The document may, however, be freely reviewed, abstracted, ...

  6. An In-Depth Survey of the Screening and Assessment Practices of Highly Regarded Adolescent Substance Abuse Treatment Programs

    Science.gov (United States)

    Gans, Jeremy; Falco, Mathea; Schackman, Bruce R.; Winters, Ken C.

    2010-01-01

    Aims: To examine the quality of screening and assessment practices at some of the most highly regarded adolescent substance use treatment programs in the United States. Methods: Between March and September 2005, telephone surveys were administered to directors of highly regarded programs. Several different publications and databases were then used…

  7. Substance Abuse Screening and Treatment.

    Science.gov (United States)

    Tenegra, Johnny C; Leebold, Bobby

    2016-06-01

    One of the more prevalent and often undiagnosed problems seen by primary care clinicians is substance misuse. Resulting in increased morbidity and mortality, loss of productivity, and increased health care costs, substance misuse in our society remains a significant public health issue. Primary care physicians are on the front lines of medical care, and as such, are in a distinctive position to recognize potential problems in this area and assist. This article outlines office-based screening approaches and strategies for managing and treating this complex issue confronting primary care. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Systematic screening of child abuse in out-of-hours primary care

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    Schouten, MCM

    2017-01-01

    Child abuse is a serious global health problem. This thesis focused on – improving – the detection of child abuse in the out-of-hours primary care (OOH-PC). The main aim was to assess the diagnostic value of the screening instrument SPUTOVAMO-R2 for child abuse. We found that the detection rate of

  9. Screening for abuse and neglect of people with dementia.

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    Wiglesworth, Aileen; Mosqueda, Laura; Mulnard, Ruth; Liao, Solomon; Gibbs, Lisa; Fitzgerald, William

    2010-03-01

    To investigate characteristics of people with dementia and their caregivers (CGs) that are associated with mistreatment in order to inform clinicians about screening for mistreatment. A convenience sample of CG-care recipient (CR) dyads were assessed for literature-supported factors associated with mistreatment, and evidence of mistreatment for the prior year was collected. An expert panel considered the evidence and decided on occurrences of psychological abuse, physical abuse, and neglect based on criteria adopted before data collection. Participants' homes. One hundred twenty-nine persons with dementia and their CGs. CG and CR characteristics (demographic, health, and psychosocial variables), relationship characteristics, and three elder abuse and neglect detection instruments. Mistreatment was detected in 47.3%. Variables associated with different kinds and combinations of mistreatment types included the CG's anxiety, depressive symptoms, social contacts, perceived burden, emotional status, and role limitations due to emotional problems and the CR's psychological aggression and physical assault behaviors. The combination of CR's physical assault and psychological aggression provided the best sensitivity (75.4%) and specificity (70.6%) for elder mistreatment as defined by the expert panel. This finding has potential to be useful as a clinical screen for detecting mistreatment. The findings suggest important characteristics of older adults with dementia and their CGs that have potential for use in a clinical screening tool for elder mistreatment. Potential screening questions to be asked of CGs of people with dementia are suggested.

  10. Screening tools for identification of elder abuse: a systematic review.

    Science.gov (United States)

    Gallione, Chiara; Dal Molin, Alberto; Cristina, Fabio V B; Ferns, Hilary; Mattioli, Mark; Suardi, Barbara

    2017-08-01

    To review the efficacy and accuracy of tools administered to older people, intended to detect and measure elder abuse. The mistreatment of older people represents a widespread problem, with exponential growth risk, especially considering the progressive ageing of the world population. It could have serious consequences for the victim's health if not recognised early, denounced and stopped. Abuse is often undetected by service providers because there is a lack of awareness surrounding the magnitude of the problem. Education and formal training in the signs of abuse are also generally poorly developed, as are reporting procedures which would lead to further investigation. Systematic review. Comprehensive database searches of MEDLINE, Cochrane, EMBASE and Scopus were undertaken. Screening of 695 articles resulted in 11 included. Appraisal and analysis using PRISMA Statement and STROBE checklist were undertaken. Eleven screening tools have been presented: H-S/EAST, VASS, EASI, CASE, BASE, E-IOA, EAI, EPAS, CPEABS, OAPAM and OAFEM, all aimed at healthcare professional or, in some cases, expected to be specifically used by nurses. The fundamental function of any assessment instrument is to guide through a standardised screening process and to ensure that signs of abuse are not missed. Several tools have been tested; some have demonstrated a moderate to good internal consistency and some have been validated to allow an early identification. None have been evaluated against measurable violence or health outcomes. Nurses and all healthcare providers should screen patients routinely. However, we are not able to recommend a single tool as the selection and implementation has to be appropriate to the setting. Furthermore, the study population and the possibility of using multiple tools in combination should be taken into consideration, to assess all the aspects of violence. © 2017 John Wiley & Sons Ltd.

  11. Psychometric properties of the Vulnerability to Abuse Screening Scale for screening abuse of older adults

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    Raquel Batista Dantas

    Full Text Available ABSTRACT OBJECTIVE Adapt and evaluate the psychometric properties of the Vulnerability to Abuse Screening Scale to identify risk of domestic violence against older adults in Brazil. METHODS The instrument was adapted and validated in a sample of 151 older adults from a geriatric reference center in the municipality of Belo Horizonte, State of Minas Gerais, in 2014. We collected sociodemographic, clinical, and abuse-related information, and verified reliability by reproducibility in a sample of 55 older people, who underwent re-testing of the instrument seven days after the first application. Descriptive and comparative analyses were performed for all variables, with a significance level of 5%. The construct validity was analyzed by the principal components method with a tetrachoric correlation matrix, the reliability of the scale by the weighted Kappa (Kp statistic, and the internal consistency by the Kuder-Richardson estimator formula 20 (KR-20. RESULTS The average age of the participants was 72.1 years (DP = 6.96; 95%CI 70.94–73.17, with a maximum of 92 years, and they were predominantly female (76.2%; 95%CI 69.82–83.03. When analyzing the relationship between the scores of the Vulnerability to Abuse Screening Scale, categorized by presence (score > 3 or absence (score < 3 of vulnerability to abuse, with clinical and health conditions, we found statistically significant differences for self-perception of health (p = 0.002, depressive symptoms (p = 0.000, and presence of rheumatism (p = 0.003. There were no statistically significant differences between sexes. The Vulnerability to Abuse Screening Scale acceptably evaluated validity in the transcultural adaptation process, demonstrating dimensionality coherent with the original proposal (four factors. In the internal consistency analysis, the instrument presented good results (KR-20 = 0.69 and the reliability via reproducibility was considered excellent for the global scale (Kp = 0

  12. The use of SBIRT in substance abuse screening.

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    Ladegast, Sherrie

    2016-10-20

    There are many barriers to screening for alcohol and drug abuse. Screening, brief intervention, and referral to treatment (SBIRT) principles can be used in identifying and helping patients with substance abuse problems. This article introduces SBIRT, discusses barriers to implementation, and reviews current practice recommendations.

  13. Equivalência semântica da versão em português do instrumento Abuse Assessment Screen para rastrear a violência contra a mulher grávida Semantic equivalence of the Portuguese version of the Abuse Assessment Screen tool used for the screening of violence against pregnant women

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    Michael E Reichenheim

    2000-12-01

    Full Text Available INTRODUÇÃO: Programas de investigação epidemiológica e de ação no âmbito da violência familiar estão em franca ascensão, requerendo instrumentos de aferição adaptados e vertidos para o português. O objetivo do estudo é avaliar a equivalência semântica entre o original em inglês e duas versões para o português do instrumento Abuse Assessment Screen (AAS usado no rastreamento de casos de violência contra a mulher grávida e recomendar uma versão-síntese para uso corrente. MÉTODOS: O processo de avaliação de equivalência semântica envolveu quatro etapas: tradução, retradução, apreciação formal de equivalência e crítica final através de consultas com especialista na área temática. RESULTADOS: Para cada item do instrumento apresentam-se os resultados relativos às quatro etapas. O texto cobre cada passo do processo que levou à versão final. As duas versões mostraram-se bastante semelhantes, com 14 das 15 assertivas similares, embora a segunda versão tenha se mostrado mais adequada, ainda que para alguns itens tenha sido decidido juntar as duas versões ou mesmo utilizar um item oriundo da versão um. CONCLUSÃO: É importante usar mais de uma versão no processo, em várias etapas de avaliação e de crítica, e discutir a pertinência de se acrescentar uma etapa adicional de interlocução do instrumento com membros da população-alvo.INTRODUCTION: Research programs and actions regarding family violence have been growing steadily. Therefore, there's a need to develop data collection tools. In Brazil, further problems come up since tools that have been developed elsewhere need to be adapted and translated. This study focuses on the Abuse Assessment Screening (AAS used to detect violence against pregnant women. The objective is to evaluate the semantic equivalence between the original tool in English and two Portuguese versions, and propose a synthetic version to be used in the field. METHODS: The evaluation

  14. A national survey on the use of screening tools to detect physical child abuse.

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    Crichton, Kristin Garton; Cooper, Jennifer N; Minneci, Peter C; Groner, Jonathan I; Thackeray, Jonathan D; Deans, Katherine J

    2016-08-01

    Recognition of physical child abuse is imperative for ensuring children's safety. Screening tools (ST) may increase identification of physical abuse; however, the extent of their use is unknown. This study assessed use of STs for physical abuse in children's hospitals and determined attitudes regarding STs. A web-based survey was sent to child abuse program contacts at 103 children's hospitals. The survey assessed institutional use of a ST for physical abuse and characteristics of the ST used. Respondents were asked to identify benefits and liabilities of STs used or barriers to ST use. Seventy-two respondents (70 %) completed the survey; most (64 %) were child abuse pediatricians. Nine (13 %) respondents reported using a ST for physical abuse; STs varied in length, population, administration, and outcomes of a positive screen. Most respondents (86 %) using a ST felt that it increased detection of abuse. Barriers noted included lack of time for development and provider completion of a ST. While few respondents endorsed use of a ST for physical abuse, most believed that it increased detection of abuse. Future research should focus on development of a brief, uniform ST for physical abuse which may increase detection in at-risk children.

  15. Psychometric properties of the Vulnerability to Abuse Screening Scale for screening abuse of older adults.

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    Dantas, Raquel Batista; Oliveira, Graziella Lage; Silveira, Andréa Maria

    2017-04-10

    Adapt and evaluate the psychometric properties of the Vulnerability to Abuse Screening Scale to identify risk of domestic violence against older adults in Brazil. The instrument was adapted and validated in a sample of 151 older adults from a geriatric reference center in the municipality of Belo Horizonte, State of Minas Gerais, in 2014. We collected sociodemographic, clinical, and abuse-related information, and verified reliability by reproducibility in a sample of 55 older people, who underwent re-testing of the instrument seven days after the first application. Descriptive and comparative analyses were performed for all variables, with a significance level of 5%. The construct validity was analyzed by the principal components method with a tetrachoric correlation matrix, the reliability of the scale by the weighted Kappa (Kp) statistic, and the internal consistency by the Kuder-Richardson estimator formula 20 (KR-20). The average age of the participants was 72.1 years (DP = 6.96; 95%CI 70.94-73.17), with a maximum of 92 years, and they were predominantly female (76.2%; 95%CI 69.82-83.03). When analyzing the relationship between the scores of the Vulnerability to Abuse Screening Scale, categorized by presence (score > 3) or absence (score Escala Triagem de Vulnerabilidade ao Abuso (Vulnerability to Abuse Screening Scale - VASS) para identificar risco de violência doméstica contra idosos no Brasil. O instrumento foi adaptado e validado em uma amostra de 151 idosos de um centro de referência do idoso, do município de Belo Horizonte, MG, em 2014. Foram coletadas informações sociodemográficas, clínicas e relacionadas a abusos. A confiabilidade via reprodutibilidade foi verificada em uma amostra de 55 idosos, submetidos ao reteste do instrumento sete dias após a primeira aplicação. Foram realizadas análises descritivas e comparativas para todas as variáveis, com nível de significância de 5%. A validade de construto foi analisada pelo método de

  16. Brief screening for co-occurring disorders among women entering substance abuse treatment

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    Chernoff Miriam

    2006-09-01

    Full Text Available Abstract Background Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient at five treatment sites were screened at intake (N = 374. Results Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Conclusion Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment

  17. Screening and brief intervention for alcohol and other abuse.

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    Harris, Sion Kim; Louis-Jacques, Jennifer; Knight, John R

    2014-04-01

    Substance use is the most common health risk behavior among adolescents and is one of the greatest threats to their current and future health. Universal screening of adolescents in general medical settings can be instrumental in identifying substance use early, before further problems develop and when BIs are more likely to be effective. Screening in and of itself may have some therapeutic effect. Brief screening tools feasible for use by busy medical offices to quickly and reliably assess adolescent risk for a substance use disorder now are available. A recent study found that a physician-conducted CRAFFT screen interview required an average of 74 seconds to complete, whereas a computer self-administered version took an average of 49 seconds. The CRAFFT and AUDIT tools currently have the most evidence for validity among adolescents, whereas the validity of other widely used tools such as DAST-10, NIDA-modified ASSIST (Alcohol, Smoking and Substance Involvement Screening Test), and ultra-brief screens (AUDIT-C, single-item screens) has yet to be established for adolescents. Studies are needed to identify effective strategies to promote universal adolescent screening and the use of valid screening tools in general medical settings. One statewide (Massachusetts) study found that although most (86%) primary care physicians seeing adolescents reported screening adolescents for substance use annually, only 1 in 3 reported using a validated tool (the CRAFFT). The remaining physicians reporting using informal screening procedures, their own questionnaire, or the CAGE. Computerization of screening and integration into the electronic health record appear to be promising strategies to promote universal screening and standardized use of valid screening tools. Increasing adolescent screening rates necessitates supporting physicians' ability to respond effectively to the screen results. To that end, recent evidence-informed practice guides from the AAP and NIAAA provide a

  18. Screening for substance abuse risk in cancer patients using the Opioid Risk Tool and urine drug screen.

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    Barclay, Joshua S; Owens, Justine E; Blackhall, Leslie J

    2014-07-01

    The use of opioids for management of cancer-related pain has increased significantly and has been associated with a substantial rise in rates of substance abuse and diversion. There is a paucity of data not only on the prevalence of substance abuse in cancer patients, but also for issues of drug use and diversion in family caregivers. This study aimed to evaluate the frequency of risk factors for substance abuse and diversion, and abnormal urine drug screens in cancer patients receiving palliative care. A retrospective chart review was performed for patients with cancer who were seen in the University of Virginia Palliative Care Clinic during the month of September 2012. We evaluated Opioid Risk Tool variables and total scores, insurance status, and urine drug screen results. Of the 114 cancer patients seen in September 2012, the mean Opioid Risk Tool score was 3.79, with 43% of patients defined as medium to high risk. Age (16-45 years old, 23%) and a personal history of alcohol (23%) or illicit drugs (21%) were the most common risk factors identified. We obtained a urine drug screen on 40% of patients, noting abnormal findings in 45.65%. Opioids are an effective treatment for cancer-related pain, yet substantial risk for substance abuse exits in the cancer population. Screening tools, such as the Opioid Risk Tool, should be used as part of a complete patient assessment to balance risk with appropriate relief of suffering.

  19. Screening Drug, Alcohol and Substance Abuse the Psychometric Measures

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    Othman Mohamad Hashim

    2018-01-01

    Full Text Available Urinalysis was used in previous studies among higher institution students (n=16252 in Malaysia to answer the question of whether university students are involved in drug abuse. However, the use of urinalysis had faced some problems. The problems were related to human rights issues and the cost to perform the urinalysis was expensive and quite impossible to be implemented to a large population of university students. To overcome this problem, this study was conducted to examine the effectiveness of psychometric measures in screening drug, alcohol and substance abuse. The Substance Abuse Subtle Screening Inventory A2 (SASSI-A2 was used for this purpose. SASSI-A2 is a brief screening tool designed to identify individuals who have a high probability of having a substance use disorder, including both substance abuse and substance dependence. SASSI-A2 comprises of 72 items that are rated on a two point scale with response; true and false. SASSI-A2 was translated into Malay language and it was refined through a back-translation technique and focus group approach. Psychometric testing was undertaken on a sample of 750 university students from five public universities in Malaysia. All participants were aged between 19 and 20 years. Internal consistency coefficients were calculated for the total scale and its subscales. Chronbach's alpha obtained for SASSI-A2 was 0.72. This relatively high level of Chronbach's alpha showed relatively high level of reliability. The results demonstrated that the whole SASSI-A2 meets the fundamental measurement properties and can discriminate groups of higher institution students from high to low on the substance dependency variable. The accuracy of the test has been found to be unaffected by gender, ethnicity, age and years of education. Although more rigorous validation studies are needed, it is recommended that SASSI-A2 be considered for usage to higher institution students populations when a brief, objective, and

  20. Semiautomated radioimmunoassay for mass screening of drugs of abuse

    International Nuclear Information System (INIS)

    Sulkowski, T.S.; Lathrop, G.D.; Merritt, J.H.; Landez, J.H.; Noe, E.R.

    1975-01-01

    A rapid, semiautomated radioimmunoassay system for detection of morphine, barbiturates, and amphetamines is described. The assays are applicable to large drug abuse screening programs. The heart of the system is the automatic pipetting station which can accomplish 600 pipetting operations per hour. The method uses 15 to 30 μl for the amphetamine and combined morphine/barbiturate assays. A number of other drugs were tested for interference with the assays and the results are discussed

  1. Facilitators and barriers to screening for child abuse in the emergency department

    Science.gov (United States)

    2012-01-01

    Background To identify facilitators of, and barriers to, screening for child abuse in emergency departments (ED) through interviews with ED staff, members of the hospital Board, and related experts. Methods This qualitative study is based on semi-structured interviews with 27 professionals from seven Dutch hospitals (i.e. seven pediatricians, two surgeons, six ED nurses, six ED managers and six hospital Board members). The resulting list of facilitators/barriers was subsequently discussed with five experts in child abuse and one implementation expert. The results are ordered using the Child Abuse Framework of the Dutch Health Care Inspectorate that legally requires screening for child abuse. Results Lack of knowledge of child abuse, communication with parents in the case of suspected abuse, and lack of time for development of policy and cases are barriers for ED staff to screen for child abuse. For Board members, lack of means and time, and a high turnover of ED staff are impediments to improving their child abuse policy. Screening can be promoted by training ED staff to better recognize child abuse, improving communication skills, appointing an attendant specifically for child abuse, explicit support of the screening policy by management, and by national implementation of an approved protocol and validated screening instrument. Conclusions ED staff are motivated to work according to the Dutch Health Care Inspectorate requirements but experiences many barriers, particularly communication with parents of children suspected of being abused. Introduction of a national child abuse protocol can improve screening on child abuse at EDs. PMID:23092228

  2. Drug abuse in the workplace: employee screening techniques

    International Nuclear Information System (INIS)

    Buzzeo, R.W.

    1984-01-01

    Recent studies show that as many as three to five percent of the employees of a medium- to large-sized plant may be dependent on drugs as a way of life. The detrimental effects of drug abuse in the workplace can be measured in lost productivity, poor quality control and other areas at an annual cost to the American economy of $30 billion. However, a price tag cannot be attached to the lives affected by this unrelenting problem. The purpose of this paper is to provide an overview of the employee screening and hiring techniques available to industry to detect and eliminate potentially dangerous or fatal situations involving drug abuse in the workplace. The techniques are universal and can be effectively applied by the nuclear industry as well as other businesses to ensure that its work force is a reputable and reliable one

  3. Drug abuse in the workplace: employee screening techniques

    Energy Technology Data Exchange (ETDEWEB)

    Buzzeo, R.W.

    1984-07-01

    Recent studies show that as many as three to five percent of the employees of a medium- to large-sized plant may be dependent on drugs as a way of life. The detrimental effects of drug abuse in the workplace can be measured in lost productivity, poor quality control and other areas at an annual cost to the American economy of $30 billion. However, a price tag cannot be attached to the lives affected by this unrelenting problem. The purpose of this paper is to provide an overview of the employee screening and hiring techniques available to industry to detect and eliminate potentially dangerous or fatal situations involving drug abuse in the workplace. The techniques are universal and can be effectively applied by the nuclear industry as well as other businesses to ensure that its work force is a reputable and reliable one.

  4. The Substance Abuse Subtle Screening Inventory-3 and Stages of Change: A Screening Validity Study

    Science.gov (United States)

    Laux, John M.; Piazza, Nick J.; Salyers, Kathleen; Roseman, Christopher P.

    2012-01-01

    The sensitivity of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) was examined among substance-dependent adults enrolled in a family drug court. The SASSI-3 had a high sensitivity rate with this population, even across varying levels of motivation to change. (Contains 2 tables.)

  5. Underestimation of substance abuse in psychiatric patients by conventional hospital screening.

    Science.gov (United States)

    Reidy, Lisa J; Junquera, Patricia; Van Dijck, Karolien; Steele, Bernard W; Nemeroff, Charles B

    2014-12-01

    Psychiatric diagnosis mainly relies on behavioral signs and symptoms. Substance abuse can mimic the clinical presentation of primary psychiatric disorders and can also complicate the management of psychiatric patients. The reliability and accuracy of urine toxicology is a vital tool in the optimal treatment of these patients. Current demographics of substance abuse suggest that in addition to the most conventional drugs of abuse (e.g. cocaine, cannabis) that are of concern to treating physicians, prescription medications and new designer drugs also should be when evaluating patients who present with symptoms of psychosis/drug addiction or altered mental status. Urine samples from 220 psychiatric inpatients admitted to either an acute drug and alcohol unit or acute psychiatric unit were analyzed for drugs by the standard hospital assay (KIMS) and by a more sensitive ELISA and GC-MS basic drug screening protocol. The standard hospital toxicology (KIMS) was inferior to the ELISA and GC-MS methods in terms of both assay sensitivity and in detecting a broader number of drugs. The KIMS tests failed to identify opiates and amphetamine/methamphetamine in 50% of the patients. The KIMS screen did not identify zolpidem, buprenorphine and a number of synthetic drugs of abuse including cathinone and tryptamines. In order to reliably identify substance abuse in patients with altered mental status in inpatient settings, analytical methodologies with adequate assay sensitivity and range to detect the vast majority of commonly abused illicit drugs and prescription medications are required for optimal clinical assessment and treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Effects of Systematic Screening and Detection of Child Abuse in Emergency Departments

    NARCIS (Netherlands)

    Louwers, Eveline C. F. M.; Korfage, Ida J.; Affourtit, Marjo J.; Scheewe, Dop J. H.; van de Merwe, Marjolijn H.; Vooijs-Moulaert, Anne-Françoise S. R.; van den Elzen, Annette P. M.; Jongejan, Mieke H. T. M.; Ruige, Madelon; Manaï, Badies H. A. N.; Looman, Caspar W. N.; Bosschaart, Adriaan N.; Teeuw, Arianne H.; Moll, Henriëtte A.; de Koning, Harry J.

    2012-01-01

    OBJECTIVE: Although systematic screening for child abuse of children presenting at emergency departments might increase the detection rate, studies to support this are scarce. This study investigates whether introducing screening, and training of emergency department nurses, increases the detection

  7. Facilitators and barriers to screening for child abuse in the emergency department

    Directory of Open Access Journals (Sweden)

    Louwers Eveline CFM

    2012-10-01

    Full Text Available Abstract Background To identify facilitators of, and barriers to, screening for child abuse in emergency departments (ED through interviews with ED staff, members of the hospital Board, and related experts. Methods This qualitative study is based on semi-structured interviews with 27 professionals from seven Dutch hospitals (i.e. seven pediatricians, two surgeons, six ED nurses, six ED managers and six hospital Board members. The resulting list of facilitators/barriers was subsequently discussed with five experts in child abuse and one implementation expert. The results are ordered using the Child Abuse Framework of the Dutch Health Care Inspectorate that legally requires screening for child abuse. Results Lack of knowledge of child abuse, communication with parents in the case of suspected abuse, and lack of time for development of policy and cases are barriers for ED staff to screen for child abuse. For Board members, lack of means and time, and a high turnover of ED staff are impediments to improving their child abuse policy. Screening can be promoted by training ED staff to better recognize child abuse, improving communication skills, appointing an attendant specifically for child abuse, explicit support of the screening policy by management, and by national implementation of an approved protocol and validated screening instrument. Conclusions ED staff are motivated to work according to the Dutch Health Care Inspectorate requirements but experiences many barriers, particularly communication with parents of children suspected of being abused. Introduction of a national child abuse protocol can improve screening on child abuse at EDs.

  8. Clinical assessment of suspected child physical abuse

    International Nuclear Information System (INIS)

    Rohrer, T.

    2009-01-01

    Violence against children has many faces. Child physical abuse, neglect, sexual abuse and interparental violence can cause acute and permanent damage and affect children's development and their life plans in the long term. In industrialized nations almost 1 child in 10 is affected. Up to 10% of child physical abuse cases involve the central nervous system with 80% of these cases occurring during the first year of life. Worldwide more than 50,000 children die as a result of violence, abuse and neglect every year, according to the United Nations Children's Fund UNICEF. In Germany, there are about 120 cases of non-accidental head injury per year. In addition to the officially known cases there is a large grey area for all forms of violence. Recognition of these cases and the provision of help for the victims require an appropriate suspicion and understanding of the pertinent pathophysiology. Suspicion must be based on a well-documented medical history and multidisciplinary diagnostic assessment. Medical confidentiality prevents the disclosure of such information making early detection networks and guidelines for collaboration absolutely indispensable. (orig.) [de

  9. Oropharyngeal dysphagia: screening and assessment.

    Science.gov (United States)

    Speyer, Renée

    2013-12-01

    This article provides an overview of bedside screening and assessment tools in patients with oropharyngeal dysphagia including the diagnostic performance of screening tools; the gold standards in assessment of dysphagia (videofluoroscopic and fiberoptic endoscopic evaluation of swallowing); a variety of clinical assessment tools; patient self-evaluation questionnaires; and a list of supplementary methods. In addition, some methodologic issues are discussed, and the need for standardization of terminology, screening and assessment protocols, and the call for evidence-based clinical guidelines. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Chan, Ko Ling

    2012-01-01

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

  11. Systematic screening for child abuse at emergency departments

    OpenAIRE

    Louwers, Eveline (Eefje)

    2013-01-01

    textabstractChild abuse is a serious problem and has serious consequences for the victim, his or her environment and for society itself. It has been estimated that one in every 30 Dutch children is exposed to child abuse.1 While preventable morbidity and mortality of infectious diseases in childhood is enormously reduced over the past decades, unfortunately this has not been the case for the staggering statistics surrounding child abuse.2 Child abuse includes all forms of physical and emotion...

  12. Accuracy of a screening instrument to identify potential child abuse in emergency departments.

    Science.gov (United States)

    Louwers, Eveline C F M; Korfage, Ida J; Affourtit, Marjo J; Ruige, Madelon; van den Elzen, Annette P M; de Koning, Harry J; Moll, Henriëtte A

    2014-07-01

    Although screening for child abuse at emergency departments (EDs) increases the detection rate of potential child abuse, an accurate instrument is lacking. This study was designed to measure the accuracy of a screening instrument for detection of potential child abuse used in EDs. In a prospective cohort study at three Dutch EDs, a 6-item screening instrument for child abuse, Escape, was completed for each child visiting the ED. The data from the completed Escape instrument was used to calculate sensitivity, specificity, and the positive/negative predictive value per item. The clinical notes and conclusions of the screen instruments of all potentially abused children reported to the hospitals' Child Abuse Teams were collected and reviewed by an expert panel. A logistic regression model was used to evaluate the predictors of potential abuse. Completed Escape instruments were available for 18,275 ED visits. Forty-four of the 420 children with a positive screening result, and 11 of the 17,855 children with a negative result were identified as potentially abused. Sensitivity of the Escape instrument was 0.80 and specificity was 0.98. Univariate logistic regression showed that potentially abused children were significantly more likely to have had an aberrant answer to at least one of the items, OR=189.8, 95% CI [97.3, 370.4]. Most of the children at high risk for child abuse were detected through screening. The Escape instrument is a useful tool for ED staff to support the identification of those at high risk for child abuse. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Carmichael AN

    2016-06-01

    Full Text Available Ashley-Nicole Carmichael,1 Laura Morgan,1 Egidio Del Fabbro2 1School of Pharmacy, 2Division of Hematology, Oncology, and Palliative Care, Virginia Commonwealth University, Richmond, VA, USA Background: The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life. Aims: To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer. Our secondary aim is to offer the most current evidence of best clinical practice and suggest future directions for research. Materials and methods: Our integrative review included a literature search using the key terms “identification and assessment of opioid abuse in cancer”, “advanced cancer and opioid abuse”, “hospice and opioid abuse”, and “palliative care and opioid abuse”. PubMed, PsycInfo, and Embase were supplemented by a manual search. Results: We found 691 articles and eliminated 657, because they were predominantly noncancer populations or specifically excluded cancer patients. A total of 34 articles met our criteria, including case studies, case series, retrospective observational studies, and narrative reviews. The studies were categorized into screening questionnaires for opioid abuse or alcohol, urine drug screens to identify opioid misuse or abuse, prescription drug-monitoring programs, and the use of universal precautions. Conclusion: Screening questionnaires and urine drug screens indicated at least one in five patients with cancer may be at risk of opioid-use disorder. Several studies demonstrated associations between high-risk patients and clinical outcomes, such as aberrant behavior, prolonged opioid use, higher morphine-equivalent daily dose

  14. Systematic screening for child abuse at emergency departments

    NARCIS (Netherlands)

    E.C.F.M. Louwers (Eveline (Eefje))

    2013-01-01

    textabstractChild abuse is a serious problem and has serious consequences for the victim, his or her environment and for society itself. It has been estimated that one in every 30 Dutch children is exposed to child abuse.1 While preventable morbidity and mortality of infectious diseases in

  15. Equivalência semântica da versão em português do instrumento Abuse Assessment Screen para rastrear a violência contra a mulher grávida

    Directory of Open Access Journals (Sweden)

    Reichenheim Michael E

    2000-01-01

    Full Text Available INTRODUÇÃO: Programas de investigação epidemiológica e de ação no âmbito da violência familiar estão em franca ascensão, requerendo instrumentos de aferição adaptados e vertidos para o português. O objetivo do estudo é avaliar a equivalência semântica entre o original em inglês e duas versões para o português do instrumento Abuse Assessment Screen (AAS usado no rastreamento de casos de violência contra a mulher grávida e recomendar uma versão-síntese para uso corrente. MÉTODOS: O processo de avaliação de equivalência semântica envolveu quatro etapas: tradução, retradução, apreciação formal de equivalência e crítica final através de consultas com especialista na área temática. RESULTADOS: Para cada item do instrumento apresentam-se os resultados relativos às quatro etapas. O texto cobre cada passo do processo que levou à versão final. As duas versões mostraram-se bastante semelhantes, com 14 das 15 assertivas similares, embora a segunda versão tenha se mostrado mais adequada, ainda que para alguns itens tenha sido decidido juntar as duas versões ou mesmo utilizar um item oriundo da versão um. CONCLUSÃO: É importante usar mais de uma versão no processo, em várias etapas de avaliação e de crítica, e discutir a pertinência de se acrescentar uma etapa adicional de interlocução do instrumento com membros da população-alvo.

  16. Variability in expert assessments of child physical abuse likelihood.

    Science.gov (United States)

    Lindberg, Daniel Martin; Lindsell, Christopher John; Shapiro, Robert Allan

    2008-04-01

    In the absence of a gold standard, clinicians and researchers often categorize their opinions of the likelihood of inflicted injury using several ordinal scales. The objective of this protocol was to determine the reliability of expert ratings using several of these scales. Participants were pediatricians with substantial academic and clinical activity in the evaluation of children with concerns for physical abuse. The facts from several cases that were referred to 1 hospital's child abuse team were abstracted and recorded as in a multidisciplinary team conference. Participants viewed the recording and rated each case using several scales of child abuse likelihood. Participants (n = 22) showed broad variability for most cases on all scales. Variability was lowest for cases with the highest aggregate concern for abuse. One scale that included examples of cases fitting each category and standard reporting language to summarize results showed a modest (18%-23%) decrease in variability among participants. The interpretation of the categories used by the scales was more consistent. Cases were rarely rated as "definite abuse" when likelihood was estimated at abuse." Only 9 of 858 cases rated > or = 35% likelihood were rated as "reasonable concern for abuse." Assessments of child abuse likelihood often show broad variability between experts. Although a rating scale with patient examples and standard reporting language may decrease variability, clinicians and researchers should be cautious when interpreting abuse likelihood assessments from a single expert. These data support the peer-review or multidisciplinary team approach to child abuse assessments.

  17. Environmental impact assessment screening tool

    International Nuclear Information System (INIS)

    1995-05-01

    An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities

  18. Screening for drug and alcohol abuse among older adults using a modified version of the CAGE.

    Science.gov (United States)

    Hinkin, C H; Castellon, S A; Dickson-Fuhrman, E; Daum, G; Jaffe, J; Jarvik, L

    2001-01-01

    This study examined the sensitivity, specificity, and receiver operating characteristics (ROC) curves of a modified version of the CAGE, a screening measure used in the detection of older alcohol- and drug-abusing individuals. In a retrospective review of clinical records of 976 patients screened by a geriatric substance abuse program, the authors examined patients' responses on a modified version of the CAGE that included queries regarding drug use. The CAGE was administered to individuals age 50 or over draw from three diagnostic groups: alcohol abuse/dependence, drug abuse/dependence, and normal controls. Analysis of variance and discriminant function analyses revealed that the modified CAGE was able to discriminate both alcohol and drug abusers from controls. Analyses examining test sensitivity, specificity, and ROC curves revealed the CAGE to demonstrate excellent sensitivity but poor specificity. Omitting the "cut down'' item from the CAGE significantly improved specificity with only a modest drop in sensitivity. Given the ease of administration and sensitivity to both alcohol and drug abuse, these data suggest that the modified CAGE is well suited as a screening instrument for geriatric drug and alcohol abuse.

  19. A screening protocol for child abuse at out-of-hours primary care locations: a descriptive study.

    Science.gov (United States)

    Schouten, Maartje C M; van Stel, Henk F; Verheij, Theo J M; Nieuwenhuis, Edward E S; van de Putte, Elise M

    2016-11-08

    Child abuse is often unrecognized at out-of-hours primary care (OOH-PC) services. The aim of our study was to evaluate the clinical outcome of the screening instrument SPUTOVAMO-R2 for child abuse (checklist), followed by a structured approach (reporting code), at OOH-PC services. The reporting code with five steps should ensure consistent action in case of a suspicion. All children attending one of the five participating OOH-PC services in the region of Utrecht, the Netherlands, in a year time, were included. The checklist is an obligatory field in the electronic patient file and was filled in for all children. In case of a positive checklist, the steps in the reporting code were followed. Additionally, the case was evaluated in a multidisciplinary team to determine the probability of child abuse. The checklist was filled in for 50671 children; 108 (0.2 %) were positive. The multidisciplinary team diagnosed child abuse in 24 (22 %) of the 108 positive checklists, and no child abuse in 36 (33 %). Emotional neglect was the most frequent type of abuse diagnosed. For all abused children, care was implemented according to the protocol. The most frequent care given was a referral to the hospital (N = 7) or contact with child's own general practitioner (N = 6). A checklist followed by a reporting code guarantees consistent actions and care for children with a suspicion of child abuse. The percentage of positive checklists is lower than expected. Validity of the checklist should be assessed in a diagnostic study.

  20. Antibiotic-use screening evaluations (ABUSE) for physicians and patients: featuring prizes and penalties for physicians.

    Science.gov (United States)

    Lettau, L A

    2000-12-01

    The excessive use of antibiotics in the United States has been well documented and is a result of the knowledge base and behaviors of not only prescribing physicians but also patients and caregivers. An antibiotic-use screening evaluation (ABUSE) was developed for each group to promote better awareness among all parties as to ways that they may be overusing antibiotics. The ABUSE questionnaires also serve as tools for confidential self-scoring evaluation of the extent of personal antibiotic misuse

  1. The Value of a Checklist for Child Abuse in Out-of-Hours Primary Care: To Screen or Not to Screen.

    Science.gov (United States)

    Schouten, Maartje Cm; van Stel, Henk F; Verheij, Theo Jm; Houben, Michiel L; Russel, Ingrid Mb; Nieuwenhuis, Edward Es; van de Putte, Elise M

    2017-01-01

    To assess the diagnostic value of the screening instrument SPUTOVAMO-R2 (checklist, 5 questions) for child abuse at Out-of-hours Primary Care locations (OPC), by comparing the test outcome with information from Child Protection Services (CPS). Secondary, to determine whether reducing the length of the checklist compromises diagnostic value. All children (abuse (32.8%). The positive predictive value (PPV) of the checklist for child abuse was 8.3 (95% CI 3.9-15.2). The negative predictive value (NPV) was 99.1 (98.8-99.3), with 52 false negatives. When the length of the checklist was reduced to two questions closely related to the medical process (SPUTOVAMO-R3), the PPV was 9.1 (3.7-17.8) and the NPV 99.1 (98.7-99.3). These two questions are on the injury in relation to the history, and the interaction between child and parents. The checklist SPUTOVAMO-R2 has a low detection rate of child abuse within the OPC setting, and a high false positive rate. Therefore, we recommend to use the shortened checklist only as a tool to increase the awareness of child abuse and not as a diagnostic instrument.

  2. Screening for drug and alcohol abuse in a general medical population.

    Science.gov (United States)

    Tennant, F S; Day, C M; Ungerleider, J T

    1979-08-10

    One hundred fifty consecutive, first-visit, general medical patients were simply and inexpensively screened by questionnaire, personal inquiry, and physical examination for drug and alcohol abuse. Seventeen (11.3%) currently used psychoactive drugs, excluding alcohol, and ten (6.7%) used drugs or alcohol on a daily basis to the point that the patient considered it an abuse problem. The majority of the drug and alcohol users recognized their problem on a short questionnaire that was part of a medical intake form. Almost all of the recognized abusers of drugs or alcohol subsequently entered treatment of their problem.

  3. Child Abuse: The Value of Systematic Screening at Emergency Rooms

    NARCIS (Netherlands)

    Sittig, J.S.

    2015-01-01

    There is no conclusive evidence that diagnostic tools detect physical child abuse among children coming to emergency rooms (ERs), but his evidence is urgently needed because both false-positive and false-negative diagnoses have serious adverse effects. This thesis describes several aspects of the

  4. Risk assessment for drugs of abuse in the Dutch watercycle.

    NARCIS (Netherlands)

    van der Aa, M.; Bijlsma, L.; Emke, E.; Dijkman, E.; van Nuijs, A.L.N.; van de Ven, B.M.; Hernández, F.; Versteegh, A.; de Voogt, P.

    2013-01-01

    A screening campaign of drugs of abuse (DOA) and their relevant metabolites in the aqueous environment was performed in the Netherlands. The presence of DOA, together with the potential risks for the environment and the possible human exposure to these compounds through consumption of drinking water

  5. Screening for common mental disorders and substance abuse among temporary hired cleaners in Egyptian Governmental Hospitals, Zagazig City, Sharqia Governorate.

    Science.gov (United States)

    Abbas, R A; Hammam, R A M; El-Gohary, S S; Sabik, L M E; Hunter, M S

    2013-01-01

    Informal employment is common in developing countries, including Egypt. This type of employment may have significant consequences on mental health. To determine the prevalence and risk factors of common mental disorders and substance abuse among temporary hired hospital cleaners. A cross-sectional study was conducted on 242 adult temporary cleaners and 209 permanent cleaners working in 4 governmental hospitals in Zagazig City, Sharqia Governorate, Egypt. All participants were invited to complete a structured questionnaire through a semi-structured interview which included the self-reporting questionnaire 20 items (SRQ-20) and the work stress scale. Assessment of drug use included urine-based screening tests for common substances abused. The prevalence of job stress, common mental disorders and substance abuse, particularly tramadol and cannabis (Bango), was significantly higher in the studied temporary cleaners compared to permanent cleaners. Risk factors associated with increased susceptibility of the temporary cleaners to common mental disorders were family history of substance abuse, high crowding index, history of physical illness, low educational level, and smoking; while being unmarried, male sex, family history of mental disorder, age ≥40 years, smoking, and length of service ≥8 years, were associated with substance abuse among the same group. Temporary hired hospital cleaners suffered from impaired mental health more than permanent cleaners. Therefore, expanding the coverage of current laws and occupational safety and health standards to cover workers in the informal sector especially in developing countries is recommended.

  6. Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study

    Science.gov (United States)

    Dinpanah, Hossein; Akbarzadeh Pasha, Abazar

    2017-01-01

    Introduction: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED). Method: The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard. Screening performance characteristics of Escape were calculated using STATA 21. Results: 6120 children with the mean age of 2.19 ± 1.12 years were screened (52.7% girls). 137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5%) children were confirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive values of this test with 95% CI were 100 (87.6 – 100), 98.3 (97.9 – 98.6), 25.5 (18.6 – 33.8), 100 (99.9 – 100), 0.34 (0.25 – 0.46), and 0 (0 – NAN), respectively. Area under the ROC curve was 99.2 (98.9 – 99.4). Conclusion: It seems that Escape is a suitable screening instrument for detection of at risk cases of child abuse presenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which is in the excellent range. PMID:28286815

  7. Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study.

    Science.gov (United States)

    Dinpanah, Hossein; Akbarzadeh Pasha, Abazar

    2017-01-01

    Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED). The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard. Screening performance characteristics of Escape were calculated using STATA 21. 6120 children with the mean age of 2.19 ± 1.12 years were screened (52.7% girls). 137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5%) children were confirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive values of this test with 95% CI were 100 (87.6 - 100), 98.3 (97.9 - 98.6), 25.5 (18.6 - 33.8), 100 (99.9 - 100), 0.34 (0.25 - 0.46), and 0 (0 - NAN), respectively. Area under the ROC curve was 99.2 (98.9 - 99.4). It seems that Escape is a suitable screening instrument for detection of at risk cases of child abuse presenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which is in the excellent range.

  8. Assessing Outpatient Drug Abuse Treatment Programs.

    Science.gov (United States)

    Tims, Frank M.; And Others

    1992-01-01

    Data about outpatient treatment unit follow-up evaluations drawn from selected evaluation items in the recent National Drug Abuse Treatment Survey are reported. Directors and supervisors of 670 units completed surveys describing the follow-up studies. The majority of programs collecting follow-up data used the information for program change. (SLD)

  9. Facilitators and barriers to screening for child abuse in the emergency department

    NARCIS (Netherlands)

    E.C.F.M. Louwers (Eveline (Eefje)); I.J. Korfage (Ida); M.J. Affourtit (Marjo); H.J. de Koning (Harry); H.A. Moll (Henriëtte)

    2012-01-01

    textabstractBackground: To identify facilitators of, and barriers to, screening for child abuse in emergency departments (ED) through interviews with ED staff, members of the hospital Board, and related experts.Methods: This qualitative study is based on semi-structured interviews with 27

  10. Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study

    Directory of Open Access Journals (Sweden)

    Hossein Dinpanah

    2017-01-01

    Full Text Available Introduction: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracyis of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrumentin triage of at risk cases of child abuse presenting to emergency department (ED. Methods: The present diagnosticaccuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years,using convenience sampling. Confirmation by the child abuse team (pediatrician, a socialworker, and a forensicphysician was considered as the gold standard. Screening performance characteristics of Escape were calculatedusing STATA 21. Results: 6120 children with the mean age of 2.19 § 1.12 years were screened (52.7% girls.137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5% children wereconfirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive andnegative predictive values of this test with 95% CI were 100 (87.6 – 100, 98.3 (97.9 – 98.6, 25.5 (18.6 – 33.8, 100(99.9 – 100, 0.34 (0.25 – 0.46, and 0 (0 – NAN, respectively. Area under the ROC curve was 99.2 (98.9 – 99.4.Conclusion: It seems that Escape is a suitable screening instrument for detection of at risk cases of child abusepresenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which isin the excellent range.

  11. Screening for Partner Violence Among Family Mediation Clients: Differentiating Types of Abuse.

    Science.gov (United States)

    Cleak, Helen; Schofield, Margot J; Axelsen, Lauren; Bickerdike, Andrew

    2018-04-01

    Family mediation is mandated in Australia for couples in dispute over separation and parenting as a first step in dispute resolution, except where there is a history of intimate partner violence. However, validation of effective well-differentiated partner violence screening instruments suitable for mediation settings is at an early phase of development. This study contributes to calls for better violence screening instruments in the mediation context to detect a differentiated range of abusive behaviors by examining the reliability and validity of both established scales, and newly developed scales that measured intimate partner violence by partner and by self. The study also aimed to examine relationships between types of abuse, and between gender and types of abuse. A third aim was to examine associations between types of abuse and other relationship indicators such as acrimony and parenting alliance. The data reported here are part of a larger mixed method, naturalistic longitudinal study of clients attending nine family mediation centers in Victoria, Australia. The current analyses on baseline cross-sectional screening data confirmed the reliability of three subscales of the Conflict Tactics Scale (CTS2), and the reliability and validity of three new scales measuring intimidation, controlling and jealous behavior, and financial control. Most clients disclosed a history of at least one type of violence by partner: 95% reported psychological aggression, 72% controlling and jealous behavior, 50% financial control, and 35% physical assault. Higher rates of abuse perpetration were reported by partner versus by self, and gender differences were identified. There were strong associations between certain patterns of psychologically abusive behavior and both acrimony and parenting alliance. The implications for family mediation services and future research are discussed.

  12. Abuse

    Science.gov (United States)

    ... make friends. Abuse is a significant cause of depression in young people. Some teens can only feel better by doing things that could hurt them like cutting or abusing drugs or alcohol. They might even attempt suicide. It's common for those who have been abused ...

  13. The Value of a Checklist for Child Abuse in Out-of-Hours Primary Care: To Screen or Not to Screen.

    Directory of Open Access Journals (Sweden)

    Maartje Cm Schouten

    Full Text Available To assess the diagnostic value of the screening instrument SPUTOVAMO-R2 (checklist, 5 questions for child abuse at Out-of-hours Primary Care locations (OPC, by comparing the test outcome with information from Child Protection Services (CPS. Secondary, to determine whether reducing the length of the checklist compromises diagnostic value.All children (<18 years attending one of the participating OPCs in the region of Utrecht, the Netherlands, in a year time, were included. The checklist is an obligatory field in the electronic patient file. CPS provided data on all checklist positives and a sample of 5500 checklist negatives (dataset. The checklist outcome was compared with a report to CPS in 10 months follow up after the OPC visit.The checklist was filled in for 50671 children; 108 (0.2% checklists were positive. Within the dataset, 61 children were reported to CPS, with emotional neglect as the most frequent type of abuse (32.8%. The positive predictive value (PPV of the checklist for child abuse was 8.3 (95% CI 3.9-15.2. The negative predictive value (NPV was 99.1 (98.8-99.3, with 52 false negatives. When the length of the checklist was reduced to two questions closely related to the medical process (SPUTOVAMO-R3, the PPV was 9.1 (3.7-17.8 and the NPV 99.1 (98.7-99.3. These two questions are on the injury in relation to the history, and the interaction between child and parents.The checklist SPUTOVAMO-R2 has a low detection rate of child abuse within the OPC setting, and a high false positive rate. Therefore, we recommend to use the shortened checklist only as a tool to increase the awareness of child abuse and not as a diagnostic instrument.

  14. Early detection and prevention of domestic violence using the Women Abuse Screening Tool (WAST) in primary health care clinics in Malaysia.

    Science.gov (United States)

    Yut-Lin, Wong; Othman, Sajaratulnisah

    2008-01-01

    Despite being an emergent major public health problem, little research has been done on domestic violence from the perspectives of early detection and prevention. Thus, this cross-sectional study was conducted to identify domestic violence among female adult patients attending health centers at the primary care level and to determine the relationship between social correlates of adult patients and domestic violence screening and subsequent help/health-seeking behavior if abused. Face-to-face interviews were conducted with 710 female adult patients from 8 health centers in Selangor who matched the inclusion criteria and consented to participate in the study, using a structured questionnaire that included adaptation of a validated 8-item Women Abuse Screening Tool (WAST). Statistical tests showed significant differences in ethnicity, income, and education between those screened positive and those screened negative for domestic violence. Of the participants, 92.4% reported that during consultations, doctors had never asked them whether they were abused by their husband/partner. Yet, 67.3% said they would voluntarily tell the doctor if they were abused by their husband/partner. The findings indicate that primary care has an important role in identifying domestic violence by applying the WAST screening tool, or an appropriate adaptation, with women patients during routine visits to the various health centers. Such assessment for abuse could be secondary prevention for the abused women, but more important, it will serve as primary prevention for nonabused women. This approach not only will complement the existing 1-stop crisis center policy by the Ministry of Health that copes with crisis intervention but also will spearhead efforts toward prevention of domestic violence in Malaysia.

  15. Abuse

    Science.gov (United States)

    ... someone else Sexual abuse: touching, fondling or any sexual activity when the person is unable to understand, unwilling to consent, threatened or physically forced Willful deprivation: willfully denying ...

  16. Rapid Assessment of Drugs of Abuse.

    Science.gov (United States)

    Wiencek, Joesph R; Colby, Jennifer M; Nichols, James H

    Laboratory testing for drugs of abuse has become standard practice in many settings both forensic and clinical. Urine is the predominant specimen, but other specimens are possible including hair, nails, sweat, and oral fluid. Point-of-care test kits provide for rapid analysis at the site where specimens are collected allowing for immediate action on the results. POCT is based on immunochromatography where the drug in the patient's sample competes with drug and antibody conjugates in the test to develop or block the development of a colored line. Most POCTs are visually interpreted in a few minutes. The potential for false positives is possible due to drug cross-reactivity with the antibodies in the test. False negatives are also possible due to dilution of the sample and the potential for adulteration or sample substitution by the patient. POCT shows more variability than central laboratory testing because of the variety of operators involved in the testing process, but POCT has good agreement for most tests with mass spectrometry provided comparable cutoffs and cross-reactivity of drugs/metabolites are considered. Validation of the test performance with the intended operators will identify potential interferences and operational issues before implementing the test in routine practice. POCT offers faster turnaround of test results provided the limitations and challenges of the test are considered. © 2017 Elsevier Inc. All rights reserved.

  17. Development of guidelines for the assessment of abuse in women ...

    African Journals Online (AJOL)

    AIDS in Malawi. W Chilemba, NC Van Wyk, R Leech. Abstract. The aim of the study was to develop guidelines for the assessment of abuse in women living with HIV/AIDS in Malawi. In phase one of the research, the experiences of these ...

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

    Science.gov (United States)

    Mahony, David

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

    Child sexual abuse occurring in a child- or youth-serving institution or organization has attracted great public and scientific attention. In light of the particular personal and offense-related characteristics of men who have abused children within such an institution or organization, it is of special importance to evaluate the predictive performance of currently applied risk assessment instruments in this offender population. Therefore, the present study assessed the risk ratings and predictive performance of four risk assessment instruments and one instrument assessing protective factors concerning any, violent and sexual recidivism in child sexual abusers working with children (CSA-W) in comparison with extra-familial child sexual abusers (CSA-E) and intra-familial child sexual abusers (CSA-I). The results indicate that CSA-W mostly recidivate with a sexual offense. Although all included risk measures seem to function with CSA-W, the Static-99 seems to be the instrument that performs best in predicting sexual recidivism in CSA-W. CSA-W had the most protective factors measured with the Structured Assessment of PROtective Factors (SAPROF). While the SAPROF could not predict desistance from recidivism in CSA-W, it predicted desistance from any recidivism in all CSA. As CSA-W frequently hold many indicators for pedophilic sexual interests but only a few for antisocial tendencies, it can be suggested that CSA-W are at an increased risk for sexual recidivism and thus risk measures especially designed for sexual recidivism work best in CSA-W. Nevertheless, CSA-W also hold many protective factors; however, their impact on CSA-W is not clear yet and needs further study. © The Author(s) 2014.

  20. Testing the woman abuse screening tool to identify intimate partner violence in Indonesia.

    Science.gov (United States)

    Iskandar, Livia; Braun, Kathryn L; Katz, Alan R

    2015-04-01

    Intimate Partner Violence (IPV) is a global public health problem. IPV prevalence in Indonesia has been estimated to be less than 1%, based on reported cases. It is likely that IPV prevalence is underreported in Indonesia, as it is in many other countries. Screening for IPV has been found to increase IPV identification, but no screening tools are in use in Indonesia. The aim of this study was to test the translated Woman Abuse Screening Tool (WAST) for detecting IPV in Indonesia. The WAST was tested against a diagnostic interview by a trained psychologist on 240 women attending two Primary Health Centers in Jakarta. IPV prevalence and the reliability, sensitivity, and specificity of the WAST were estimated. Prevalence of IPV by diagnostic interview was 36.3%, much higher than published estimates. The most common forms of IPV identified were psychological (85%) and physical abuse (24%). Internal reliability of the WAST was high (α = .801). A WAST score of 13 (out of 24) is the recommended cutoff for identifying IPV, but only 17% of the Indonesian sample scored 13 or higher. Test sensitivity of the WAST with a cutoff score of 13 was only 41.9%, with a specificity of 96.8%. With a cutoff score of 10, the sensitivity improved to 84.9%, while the specificity decreased to 61.0%. Use of the WAST with a cutoff score of 10 provides good sensitivity and reasonable specificity and would provide a much-needed screening tool for use in Indonesia. Although a lower cutoff would yield a greater proportion of false positives, most of the true cases would be identified, increasing the possibility that women experiencing abuse would receive needed assistance. © The Author(s) 2014.

  1. Assessment of Drug Abuse in Iran’s Prisons

    Directory of Open Access Journals (Sweden)

    Jafar Bolhari

    2003-08-01

    Full Text Available Drugs are consumed in all prisons throughout the world in such a way that the matter has turned into a challenging issue for the governments. The current research seeks to determine the level of the spread of drug abuse among prison inmates in the country’s prisons. To name the other objectives pursued by this research one can refer to the distinction of demographic features of the abusers, determining the type of drugs distributed, the method of consumption in prisons, existence of high-risk behaviors and its level among prison inmates as well as taking into consideration the spread of mental disorders along with drug abuse. Such a research has been carried out in the form of a qualitative and quantitative study. The collection of the required data in the qualitative study was conducted by using detailed questionnaires and through interviews in four groups comprising male and female inmates who have committed drug-related crimes or other offences, prison wards as well as prison authorities. In the quantitative study that was conducted on male inmates questionnaires related to demographic and general specifications, the assessment of the situation of drug abuse and individuals’ view towards drug abuse as well as SCL-90-R were used. The group under study includes all prison inmates, prison wards and prison authorities in Iran. The individuals under study were selected from prisons in five different provinces using the cluster sample-taking and random methods. The number of individuals in the sample reached 1436 people. In order to clarify the outcome, frequency tables, mode, mediam, mean, standard deviation as well as X & Z tests were used. The result of the research implies that the comparison of drug abuse before and after entering the prison indicates a meaningful relationship.Meanwhile no meaningful difference was observed among age groups.

  2. Comorbidity of Drug Abuse in Adolescents: Screening for Depression, Attention Deficit/Hyperactivity Disorder, and Conduct Disorder

    Directory of Open Access Journals (Sweden)

    Ali Reza Jazayeri

    2000-07-01

    Full Text Available Objective: To screen comorbidity with substance abuse in adolescents. Among different disorders, 3 disorders of attention deficit/hyperactivity disorder (ADHD, conduct disorder, and depression were studied in a sample of Iranian adolescents.   Materials & Methods: A total of 33 substance abusers, 35 criminal substance abusers, 34 non-substance abusers were selected from Tehran correctional and rehabilitation center for adolescents and 33 normal subjects (girl and boy were studied from schools of Tehran south using Achenbach youth self-report questionnaire (YSR (Achenbach, 1991, demographic and history of drug abuse questionnaire (designed by researchers. Results: There was a significant different regarding attention deficit/hyperactivity disorder between two groups of substance abuser and non-substance abuser, but the difference was not significant between boys and girls. Regarding conduct disorder, there was a significant difference between two sexes. In boys, there was a significant difference between substance abusers and normal groups. In depression disorder, the difference between two sexes was significant regarding boys differences were observed between three groups selected from correctional and rehabilitation center and normal group regarding girls, there was a significant difference between substance abusers with criminals and normal group. Conclusion: Apparently, these 3 disorders have shown significant difference between two sexes. ADHD pattern was the same in two sexes. There was a significant difference between two sexes with regard to depression and conduct disorder. In both sexes, ADHD was not correlated with substance abuse. The conduct disorder was not related to substance abuse in both sexes and depression disorder was only related to substance abuse in girls. Considering the youth self-report test (YSR, there is a special mental profile for substance abusers, which separates them from non-substance abusers.

  3. Endocrine Disruptor Screening Program Tier 1 Assessments

    Science.gov (United States)

    EPA has completed weight-of-evidence (WoE) assessments under the Endocrine Distruptor Screening Program (EDSP) for 52 pesticides included in the final list of chemicals for Tier 1 screening. See weight of evidence reports and data evaluation records.

  4. Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease.

    Science.gov (United States)

    Melchiorre, Maria Gabriella; Di Rosa, Mirko; Barbabella, Francesco; Barbini, Norma; Lattanzio, Fabrizia; Chiatti, Carlos

    2017-01-01

    Introduction . Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives . To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods . The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results . The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions . The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.

  5. Drug Abuse Screening with Exhaled Breath and Oral Fluid in Adults with Substance Use Disorder.

    Science.gov (United States)

    Arvidsson, Michel; Ullah, Shahid; Franck, Johan; Dahl, Marja-Liisa; Beck, Olof

    2018-03-25

    In the treatment of substance use disorder regular laboratory-based testing has the dual purpose of monitoring compliance to the prescribed medication and the abstention from medically non-motivated substances (i.e. drug abuse screening). The principal specimen for testing is urine, but collection of urine has some disadvantages, e.g. being more time-consuming and more intrusive compared to other matrices, and there is also the risk of adulteration. This project aims to compare exhaled breath and oral fluid as alternative matrices for drug abuse screening in patients with substance use disorder. All 51 subjects included in the study were enrolled at the Drug Addiction Emergency Unit in Stockholm. Exhaled breath, oral fluid and urine samples were collected together with a self-report. Out of all 117 self-reported drug intakes during the previous week 72% were confirmed in urine, 73 % in oral fluid and 39 % in exhaled breath. In 31% of the subjects, additional substances other than those self-reported were detected analytically. For the purpose of substance abuse screening urine had the highest detection rate for buprenorphine, cannabis and benzodiazepines, while oral fluid had the highest detection rate for amphetamines and methadone. Exhaled breath showed the highest detection rate of all matrices for cocaine. To identify significant differences in detection rates between the matrices future studies with larger sampling sizes are needed. Both OF and EB are viable alternative specimens to urine depending on the circumstances and purpose of the testing. This article is protected by copyright. All rights reserved.

  6. Using the alcohol, smoking and Substance Involvement Screening Test (ASSIST) to determine substance abuse prevalence in the RI trauma population.

    Science.gov (United States)

    Rogers, Ralph; Baird, Janette; He, Jun Kit; Adams, Charles; Mello, Michael

    2014-02-03

    Level I trauma centers are required to provide screening and brief interventions for alcohol abuse. The World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a validated screening measure for all substances of abuse. This study is the first to use the ASSIST to screen a trauma population. A cross-sectional screening study using the ASSIST was conducted which included all patients admitted to the trauma service at Rhode Island Hospital during July and August 2012 who met inclusion criteria. The ASSIST categorized 25% of participants as needing a brief intervention for alcohol and an additional 6.3% as needing more intensive treatment. At least a brief intervention was indicated for at least one other substance besides alcohol in 37% of participants. The ability of the ASSIST to identify misuse of multiple substances makes it a good candidate for the screening measure used by trauma centers.

  7. Empirical validation of the CRAFFT Abuse Screening Test in a Spanish sample.

    Science.gov (United States)

    Rial, Antonio; Kim-Harris, Sion; Knight, John R; Araujo, Manuel; Gómez, Patricia; Braña, Teresa; Varela, Jesús; Golpe, Sandra

    2018-01-15

    The CRAFFT Substance Abuse Screening Instrument, developed by the Center for Adolescents Substance Abuse Research (CeASAR) (Knight et al., 1999), is a screening tool for high-risk alcohol and drug risk consumption designed for use with adolescents. Since its publication it has been the subject of translations and validations in different countries, populations and contexts that have demonstrated its enormous potential. However, there is still no empirical validation study that would ensure its good psychometric performance in Spain. The aim of this paper is to develop an adapted version of the CRAFFT in Spanish and to analyze its psychometric properties in a sample of Spanish adolescents. For this purpose an individual interview was conducted on 312 adolescents aged between 12 and 18 years of age (M = 15.01; SD = 1.83) from the Galician community. The interview included a part of the Adolescent Diagnostic Interview (ADI) and the Problem Oriented Screening Instrument for Teenagers (POSIT). The results obtained, similar to those found in other countries, allow us to report that the Spanish version of the CRAFFT has a good psychometric behaviorproperties. It was found to have a satisfactory internal consistency with a Cronbach’s alpha value of .74. In terms of sensitivity and specificity, values of 74.4% and 96.4% respectively, were obtained and the area under the ROC curve was .946. The Spanish version of the CRAFFT is made available to researchers and professionals in the field of addictive behaviors, so that it can be used with the necessary psychometric guarantees.

  8. Assessing the efficacy of cancer screening

    Directory of Open Access Journals (Sweden)

    Gemma Jacklyn

    2017-07-01

    Full Text Available Background: Population-based cancer screening has been established for several types of cancer in Australia and internationally. Screening may perform differently in practice from randomised controlled trials, which makes evaluating programs complex. Materials and methods: We discuss how to assess the evidence of benefits and harms of cancer screening, including the main biases that can mislead clinicians and policy makers (such as volunteer, lead-time, length-time and overdiagnosis bias. We also discuss ways in which communication of risks can inform or mislead the community. Results: The evaluation of cancer screening programs should involve balancing the benefits and harms. When considering the overall worth of an intervention and allocation of scarce health resources, decisions should focus on the net benefits and be informed by systematic reviews. Communication of screening outcomes can be misleading. Many messages highlight the benefits while downplaying the harms, and often use relative risks and 5-year survival to persuade people to screen rather than support informed choice. Lessons learned: An evidence based approach is essential when evaluating and communicating the benefits and harms of cancer screening, to minimise misleading biases and the reliance on intuition.

  9. Animal abuse and exposure to interparental violence in Italy: assessing the cycle of Violence in youngsters.

    NARCIS (Netherlands)

    Baldry, A.C.

    2003-01-01

    Abuse against animals is an indicator of children's maladjustment associated with domestic violence. This study empirically assesses the effects of exposure to interparental violence on animal abuse in 1,392 Italian youth aged 9 to 17. Results indicate that half of all youth ever abused animals,

  10. Animal abuse and exposure to interparental violence in Italy: assessing the cycle of violence in youngsters

    NARCIS (Netherlands)

    Baldry, A.C.

    2004-01-01

    Abuse against animals is an indicator of children's maladjustment associated with domestic violence. This study empirically assesses the effects of exposure to interparental violence on animal abuse in 1,392 Italian youth aged 9 to 17. Results indicate that half of all youth ever abused animals,

  11. The relationship between mothers' child abuse potential and current mental health symptoms: implications for screening and referral.

    Science.gov (United States)

    Rinehart, Deborah J; Becker, Marion A; Buckley, Pamela R; Dailey, Kathy; Reichardt, Charles S; Graeber, Carla; VanDeMark, Nancy R; Brown, Ellen

    2005-01-01

    This analysis examined data from mothers at 2 of the 9 sites participating in Substance Abuse and Mental Health Services Administration's (SAMHSA's) national Women Co-occurring Disorders and Violence Study (WCDVS). According to previous literature, it was hypothesized that women in the WCDVS would be at high risk of perpetrating child abuse. This research examined mothers' potential for physical child abuse and assessed the association between child abuse potential, current mental health symptoms, alcohol and drug use severity, and trauma. Results revealed that participants had significant potential for child abuse. Hierarchical regression analyses revealed that current mental health symptoms were the strongest predictor of mothers' scores on the Child Abuse Potential (CAP) Inventory. This study highlights the important relationships between commonly used instruments across the mental health, substance, and child welfare fields and the potential dual use of these instruments. Implications for policy and practice are discussed.

  12. Adaptation, reliability, and validity study of the Hwalek-SengstockElder Abuse Screening Test (H-S/EAST): a Turkish version

    Science.gov (United States)

    Özçakar, Nilgün; Toprak Ergönen, Akça; Kartal, Mehtap; Baydur, Hakan

    2017-12-19

    Background/aim: The most important issues in elder abuse and neglect are lack of awareness and difficulties in determining the situation. Our aim is to determine the reliability and validity of the Turkish version of the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST).Materials and methods: The H-S/EAST (15-itemed, three-dimensional: direct abuse, characteristics of vulnerability, and potentially abusive situation) was translated according to the guidelines and experts evaluated it for content validity and cultural adaptation. Participants' (n = 252) mean age was 73.4 ± 6.4 years and 58.3% were female. The World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) and the Barthel Index were used for validity. Cronbach's alpha for internal consistency, exploratory factor analysis for content validity, t-test for construct validity, and discriminant ability were used. SPSS 15.0 was used for analysis and statistical significance was P test-retest reliability, internal consistency coefficient values for direct abuse, characteristics of vulnerability, and potentially abusive situation were 0.88, 0.73, and 0.80, respectively. Cronbach's alpha for internal consistency of the H-S/EAST was 0.741. Exploratory factor analysis obtained 5 factors, and explained variance was 61.8%. Cut-off value was 6, and sensitivity, specificity, and area under the ROC curve were 76.9%, 96.2%, and 0.938, respectively.Conclusion: The Turkish version of the H-S/EAST can be used as a reliable, valid clinical tool for the assessment of elder abuse.

  13. Semantic validation of the ISPCAN Child Abuse Screening Tools (ICAST in Brazilian Portuguese

    Directory of Open Access Journals (Sweden)

    Ana Ligia da Silva Silveira

    Full Text Available Abstract Objective: The International Society for the Prevention of Child Abuse and Neglect (ISPCAN Child Abuse Screening Tools (ICAST is a battery of questionnaires created by the World Health Organization, the United Nations and ISPCAN for researching maltreatment in childhood. This study aims to translate, to adapt and to validate the semantic equivalence of all items on the three questionnaires: ICAST-C (ICAST version for Children, ICAST-R (Retrospective Interview and ICAST-P (ICAST version for Parents. Methods: The process of translation and semantic validation comprised five methodological steps: 1 translation; 2 back-translation; 3 correction and semantic adaptation; 4 validation of content by professional experts in the area of abuse in childhood; and 5 a study of their acceptability to a sample of the target population, using a verbal rating scale. Results: In the evaluation of the expert committee, there was need to adapt several words for the Brazilian population while maintaining semantic and conceptual equivalence. In the ICAST-C acceptability study, children exhibited some difficulty understanding 7 of the items (out of 69 questions. For ICAST-P, parents reported a lack of clarity in 5 items (out of 57 questions. These issues were resolved and the Brazilian version of ICAST 3.0 was concluded. Conclusion: The ICAST battery is an internationally recognized tool and the process of translation into Portuguese and semantic adaptation was performed successfully. The final version proved to be easily understandable and semantic validation results were adequate. This battery has proved useful in investigation of childhood maltreatment.

  14. Evaluation of the AC-OK mental health and substance abuse screening measure in an international sample of Latino immigrants.

    Science.gov (United States)

    Chavez, Ligia M; Shrout, Patrick E; Wang, Ye; Collazos, Francisco; Carmona, Rodrigo; Alegría, Margarita

    2017-11-01

    Early detection and intervention in primary care is integral to behavioral health. Valid, practical screening assessments are scarce, particularly for non-English speaking populations. We address this need by evaluating the psychometric properties of the Spanish version of the AC-OK Screen for Co-occurring Disorders for first and second generation immigrant Latinos in Massachusetts, USA, and Madrid and Barcelona, Spain. 567 Latino participants were recruited in waiting areas of clinics or by referral from Primary Care, Mental Health, Substance Use, and HIV Treatment Clinics, as well as Community Agencies. We use confirmatory factor analyses to evaluate the factor structure, correlation analysis to examine concurrent and discriminant validity, and receiver operating curves (ROC) to determine the ability of the AC-OK to approximate a composite of established instruments designed to measure depression, generalized anxiety, post-traumatic stress disorder symptoms, alcohol, and drugs (including benzodiazepines) as external criteria. The original two factor structure was replicated in samples of Latino respondents in the US and Spain. Correlations with other measures followed the expected pattern. In both the US and Spain, ROC analyses suggested that the AC-OK scale was an adequate approximation to other specific measures of mental health (ROC=0.90) and substance abuse problems (ROC=0.83). The Spanish version of the AC-OK Screen has good to excellent psychometric properties in both its subscales. These findings are robust across sites, gender, and type of clinic. We recommend its use for clinical research and for routine screening at treatment centers. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Honma, Satoru; Wakamatsu, Hidetoshi; Ueda, Reiko

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

  16. Screening Homeless Youth for Histories of Abuse: Prevalence, Enduring Effects, and Interest in Treatment

    Science.gov (United States)

    Keeshin, Brooks R.; Campbell, Kristine

    2011-01-01

    Objectives: To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse. Methods: Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in…

  17. Simultaneous screening and quantification of 52 common pharmaceuticals and drugs of abuse in hair using UPLC-TOF-MS

    DEFF Research Database (Denmark)

    Nielsen, Marie Katrine Klose; Johansen, Sys Stybe; Dalsgaard, Petur Weihe

    2010-01-01

    An UPLC-TOF-MS method for simultaneous screening and quantification of 52 drugs in hair was developed and validated. The selected drugs represent the most common classes of pharmaceuticals and drugs of abuse such as amphetamines, analgesics, antidepressants, antipsychotics, benzodiazepines, cocaine...

  18. Development of a screening MRI for infants at risk for abusive head trauma

    International Nuclear Information System (INIS)

    Flom, Lynda; Panigrahy, Ashok; Fromkin, Janet; Tyler-Kabara, Elizabeth; Berger, Rachel P.

    2016-01-01

    Abusive head trauma (AHT) is an important cause of morbidity in infants. Identifying which well-appearing infants are at risk for AHT and need neuroimaging is challenging, and concern about radiation exposure limits the use of head CT. Availability of an MRI protocol that is highly sensitive for intracranial hemorrhage would allow for AHT screening of well-appearing infants without exposing them to radiation. To develop a screening MRI protocol to identify intracranial hemorrhage in well-appearing infants at risk for AHT. Infants enrolled in a parent study of well-appearing infants at increased risk for AHT were eligible for the current study if they underwent both head CT and conventional brain MRI. A derivation cohort of nine infants with AHT was used to identify sequences that provided the highest sensitivity for intracranial hemorrhage. A validation cohort of 78 infants including both controls with normal neuroimaging and cases with AHT was used to evaluate the accuracy of the selected sequences. Three pulse sequences - axial T2, axial gradient recalled echo (GRE) and coronal T1-W inversion recovery - were 100% sensitive for intracranial hemorrhage in the derivation cohort. The same sequences were 100% sensitive (25/25) and 83% specific (44/53) for intracranial hemorrhage in the validation cohort. A screening MRI protocol including axial T2, axial GRE and coronal T1-W inversion recovery sequences is highly sensitive for intracranial hemorrhage and may be useful as a screening tool to differentiate well-appearing infants at risk for AHT who should undergo head CT from those who can safely be discharged without head CT. Additional research is needed to evaluate the feasibility of this approach in clinical practice. (orig.)

  19. Development of a screening MRI for infants at risk for abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Flom, Lynda; Panigrahy, Ashok [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Fromkin, Janet [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Tyler-Kabara, Elizabeth [University of Pittsburgh, Department of Neurosurgery, Children' s Hospital of Pittsburgh of UPMC, McGowan Institute for Regenerative Medicine, Pittsburgh, PA (United States); Berger, Rachel P. [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Pittsburgh, Safar Center for Resuscitation Research, Pittsburgh, PA (United States)

    2016-04-15

    Abusive head trauma (AHT) is an important cause of morbidity in infants. Identifying which well-appearing infants are at risk for AHT and need neuroimaging is challenging, and concern about radiation exposure limits the use of head CT. Availability of an MRI protocol that is highly sensitive for intracranial hemorrhage would allow for AHT screening of well-appearing infants without exposing them to radiation. To develop a screening MRI protocol to identify intracranial hemorrhage in well-appearing infants at risk for AHT. Infants enrolled in a parent study of well-appearing infants at increased risk for AHT were eligible for the current study if they underwent both head CT and conventional brain MRI. A derivation cohort of nine infants with AHT was used to identify sequences that provided the highest sensitivity for intracranial hemorrhage. A validation cohort of 78 infants including both controls with normal neuroimaging and cases with AHT was used to evaluate the accuracy of the selected sequences. Three pulse sequences - axial T2, axial gradient recalled echo (GRE) and coronal T1-W inversion recovery - were 100% sensitive for intracranial hemorrhage in the derivation cohort. The same sequences were 100% sensitive (25/25) and 83% specific (44/53) for intracranial hemorrhage in the validation cohort. A screening MRI protocol including axial T2, axial GRE and coronal T1-W inversion recovery sequences is highly sensitive for intracranial hemorrhage and may be useful as a screening tool to differentiate well-appearing infants at risk for AHT who should undergo head CT from those who can safely be discharged without head CT. Additional research is needed to evaluate the feasibility of this approach in clinical practice. (orig.)

  20. Diagnostic accuracy of a two-item Drug Abuse Screening Test (DAST-2).

    Science.gov (United States)

    Tiet, Quyen Q; Leyva, Yani E; Moos, Rudolf H; Smith, Brandy

    2017-11-01

    Drug use is prevalent and costly to society, but individuals with drug use disorders (DUDs) are under-diagnosed and under-treated, particularly in primary care (PC) settings. Drug screening instruments have been developed to identify patients with DUDs and facilitate treatment. The Drug Abuse Screening Test (DAST) is one of the most well-known drug screening instruments. However, similar to many such instruments, it is too long for routine use in busy PC settings. This study developed and validated a briefer and more practical DAST for busy PC settings. We recruited 1300 PC patients in two Department of Veterans Affairs (VA) clinics. Participants responded to a structured diagnostic interview. We randomly selected half of the sample to develop and the other half to validate the new instrument. We employed signal detection techniques to select the best DAST items to identify DUDs (based on the MINI) and negative consequences of drug use (measured by the Inventory of Drug Use Consequences). Performance indicators were calculated. The two-item DAST (DAST-2) was 97% sensitive and 91% specific for DUDs in the development sample and 95% sensitive and 89% specific in the validation sample. It was highly sensitive and specific for DUD and negative consequences of drug use in subgroups of patients, including gender, age, race/ethnicity, marital status, educational level, and posttraumatic stress disorder status. The DAST-2 is an appropriate drug screening instrument for routine use in PC settings in the VA and may be applicable in broader range of PC clinics. Published by Elsevier Ltd.

  1. The 'grey' assessment practice of IA screening

    DEFF Research Database (Denmark)

    Bidstrup, Morten

    2017-01-01

    practice, which influences the outcomes of formal screening procedures through consideration of impacts on neighbours and spatial zones of protection. Grey IA is to some extent motivated by the opportunity to save the resources required for full-scale IA, but an additional ‘green’ rationale also exists......Research focusing on the practices surrounding screening in Impact Assessment (IA) is limited. Yet, it has been found that development proposals sometimes are adjusted through an informal dialog with IA practitioners prior to or during screening. Such practice is often referred to as ‘grey IA....... Grey IA may influence the effectiveness of IA systems, but further research is needed before any conclusions can be made....

  2. Improving the Clinical Pharmacologic Assessment of Abuse Potential: Part 2: Optimizing the Design of Human Abuse Potential Studies.

    Science.gov (United States)

    Sellers, Edward M

    2018-04-01

    This article discusses the conduct of a human abuse potential study as outlined in the Food and Drug Administration Final Guidance to Industry on Assessment of Abuse Potential. In addition, areas where alternative approaches should be considered are proposed. The design, end points, conduct, and interpretation of the human abuse potential study were reviewed, analyzed, and placed in the context of current scientific knowledge and best practices to mitigate regulatory risk and expedite drug development. The guidance is based on regulatory needs and current scientific practices. However, the reliability and utility of such studies can be improved with better subject selection, data collection, standardization of data collection and staff training, and a better understanding of the measurement properties of the dependent measures. The guidance provides a useful framework for conduct of human abuse potential studies. However, design assumptions, poor choice of end points, failure to consider alternate approaches, and limited experience with interpretation can result in an inadequate study or one that does not fairly represent the abuse potential of a new chemical entity. Methodologic development is needed to strengthen the regulatory framework. The Food and Drug Administration or the National Institutes on Drug Abuse could take a targeted initiative to encourage this work.

  3. Age Invariance of the Cannabis Abuse Screening Test in a Probabilistic Sample of Cannabis Users.

    Science.gov (United States)

    Legleye, Stéphane; Rouquette, Alexandra

    2018-03-01

    The Cannabis abuse screening test (CAST) is a short test used for screening those with problematic cannabis use. Recently, its invariance toward age was tested in an Israeli sample of cannabis users, but this study had some sample and methodological limitations: it was conducted in a volunteer sample aged 18-40 and considered the CAST items as continuous variables, although they are based on 5-point Likert scales. We thus tested the CAST invariance toward age (15-24, 25-34, and 35-64 years old) using a French probabilistic sample of 1,351 past-year cannabis users aged 15-64 and using appropriate methods for categorical items and survey weights. Factors retained (non-recreational use and problems) were the same as those mentioned in previous studies. Scalar invariance held for the "problems" factor but only partial scalar invariance was supported for the "non-recreational use" factor. Caution is thus needed when the CAST score is compared across age groups. © 2018 S. Karger AG, Basel.

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

    Directory of Open Access Journals (Sweden)

    Martin H Teicher

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

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

    Science.gov (United States)

    Rocha, Beatriz A

    2013-09-01

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

  6. Multiple protein biomarker assessment for recombinant bovine somatotropin (rbST abuse in cattle.

    Directory of Open Access Journals (Sweden)

    Susann K J Ludwig

    Full Text Available Biomarker profiling, as a rapid screening approach for detection of hormone abuse, requires well selected candidate biomarkers and a thorough in vivo biomarker evaluation as previously done for detection of growth hormone doping in athletes. The bovine equivalent of growth hormone, called recombinant bovine somatotropin (rbST is (illegally administered to enhance milk production in dairy cows. In this study, first a generic sample pre-treatment and 4-plex flow cytometric immunoassay (FCIA were developed for simultaneous measurement of four candidate biomarkers selected from literature: insulin-like growth factor 1 (IGF-1, its binding protein 2 (IGFBP2, osteocalcin and endogenously produced antibodies against rbST. Next, bovine serum samples from two extensive controlled rbST animal treatment studies were used for in vivo validation and biomarker evaluation. Finally, advanced statistic tools were tested for the assessment of biomarker combination quality aiming to correctly identify rbST-treated animals. The statistical prediction tool k-nearest neighbours using a combination of the biomarkers osteocalcin and endogenously produced antibodies against rbST proved to be very reliable and correctly predicted 95% of the treated samples starting from the second rbST injection until the end of the treatment period and even thereafter. With the same biomarker combination, only 12% of untreated animals appeared false-positive. This reliability meets the requirements of Commission Decision 2002/657/EC for screening methods in veterinary control. From the results of this multidisciplinary study, it is concluded that the osteocalcin - anti-rbST-antibodies combination represent fit-for-purpose biomarkers for screening of rbST abuse in dairy cattle and can be reliably measured in both the developed 4-plex FCIA as well as in a cost-effective 2-plex microsphere-based binding assay. This screening method can be incorporated in routine veterinary monitoring

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

    Directory of Open Access Journals (Sweden)

    Robert N. Jamison

    2011-01-01

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

  8. Administration of Childhood Physical and Childhood Sexual Abuse Screens in Adolescents and Young Adults: a Literature Review.

    Science.gov (United States)

    Diaz, Angela; Peake, Ken

    Childhood physical and sexual abuse can have a negative impact on adolescents and young adults. Although effective interventions that can ameliorate both the short- and long-term negative impacts are available, many adolescent and young adult victims remain without help: They rarely self-identify as victims, and health care providers generally fail to inquire about a history of childhood abuse, especially in the absence of physical signs. The health care field lacks an understanding of effective methods for the identification of childhood abuse. To address this knowledge gap, this paper focuses on a systematic review of the literature for studies comparing modes of administration of measures to identify a history of childhood physical and sexual abuse in adolescents and young adults. A systematic review of the literature published in English in peer-reviewed journals between January 1, 1994, and December 31, 2014 was conducted to identify studies that compared 2 or more modes of administration using the same measure to identify a history of childhood physical and sexual abuse in adolescent and young adult populations. Studies that compared 2 or more different measures for identifying abuse were not included in this review because the focus of the review was to isolate the effects of the mode of administration. Only 1 study that met review criteria was found. It was conducted among female college students in a university setting. No studies were identified that compared modes of administration used to elicit disclosure of a history of childhood abuse among adolescents. There remains an urgent need to conduct evaluations of methods to identify childhood physical and sexual abuse including the mode of administration of screens in young people. It is recommended that future studies include diverse populations and randomized and quasi-experimental approaches. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  9. Selection and utilization of assessment instruments in substance abuse treatment trials: the National Drug Abuse Treatment Clinical Trials Network experience

    Directory of Open Access Journals (Sweden)

    Rosa C

    2012-07-01

    Full Text Available Carmen Rosa, Udi Ghitza, Betty TaiCenter for the Clinical Trials Network, National Institute on Drug Abuse, Bethesda, MD, USAAbstract: Based on recommendations from a US Institute of Medicine report, the National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN in 1999, to accelerate the translation of science-based addiction treatment research into community-based practice, and to improve the quality of addiction treatment, using science as the vehicle. One of the CTN's primary tasks is to serve as a platform to forge bi-directional communications and collaborations between providers and scientists, to enhance the relevance of research, which generates empirical results that impact practice. Among many obstacles in moving research into real-world settings, this commentary mainly describes challenges and iterative experiences in regard to how the CTN develops its research protocols, with focus on how the CTN study teams select and utilize assessment instruments, which can reasonably balance the interests of both research scientists and practicing providers when applied in CTN trials. This commentary also discusses the process by which the CTN further selects a core set of common assessment instruments that may be applied across all trials, to allow easier cross-study analyses of comparable data.Keywords: addiction, assessment, drug abuse treatment, drug dependence, NIDA Clinical Trials Network, substance use disorder

  10. Animal abuse and exposure to interparental violence in Italy: assessing the cycle of violence in youngsters

    OpenAIRE

    Baldry, A.C.

    2004-01-01

    Abuse against animals is an indicator of children's maladjustment associated with domestic violence. This study empirically assesses the effects of exposure to interparental violence on animal abuse in 1,392 Italian youth aged 9 to 17. Results indicate that half of all youth ever abused animals, with boys more often involved than girls. Almost half of the whole sample has been exposed to violence by fathers against mothers or by mothers against fathers, with no gender differences. Results are...

  11. The Cannabis Abuse Screening Test and the DSM-5 in the general population: Optimal thresholds and underlying common structure using multiple factor analysis.

    Science.gov (United States)

    Legleye, Stéphane

    2017-11-10

    The Cannabis Abuse Screening Test (CAST) aims at screening the problematic use of cannabis. It has never been validated against the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and its relationships with this latter have never been studied. We used a probabilistic telephone survey collected in 2014 (1351 past-year cannabis users aged 15-64) implementing the CAST and a DSM-5 adaptation of the Munich Composite International Diagnostic Interview assessing cannabis use disorders. Data were weighted, and CAST items were considered categorical. Factorial structures were assessed with confirmatory factor analyses; the relationships between the instruments were studied with multiple factor analysis (MFA). One factor for the DSM-5 and two correlated factors for the CAST were the best confirmatory factor analyses solutions. The CAST thresholds for screening moderate/severe and severe cannabis use disorders were 5 (sensitivity = 78.2% and specificity = 79.6%) and 8 (sensitivity = 86.0% and specificity = 86.7%), respectively. The MFA identified two orthogonal dimensions: The first was equally shared by both instruments; the second was the second CAST dimension (extreme frequencies of use before midday and alone, memory problems, and reproaches from friends/family). The CAST structure and screening properties were confirmed. The MFA explains its screening performances by its first dimension and identified the problematic patterns (the second dimension) that are not captured by the DSM-5. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Species for the screening assessment. Columbia River Comprehensive Impact Assessment

    International Nuclear Information System (INIS)

    Becker, J.M.; Brandt, C.A.; Dauble, D.D.; Maughan, A.D.; O'Neil, T.K.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Comprehensive Impact Assessment was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of the risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to the environment. The objective of the ecological risk assessment is to determine whether contaminants from the Columbia River pose a significant threat to selected receptor species that exist in the river and riparian communities of the study area. This report (1) identifies the receptor species selected for the screening assessment of ecological risk and (2) describes the selection process. The species selection process consisted of two tiers. In Tier 1, a master species list was developed that included many plant and animal species known to occur in the aquatic and riparian systems of the Columbia River between Priest Rapids Dam and the Columbia River estuary. This master list was reduced to 368 species that occur in the study area (Priest Rapids Dam to McNary Dam). In Tier 2, the 181 Tier 1 species were qualitatively ranked based on a scoring of their potential exposure and sensitivity to contaminants using a conceptual exposure model for the study area

  13. An assessment of Internet Abuse in Nigeria | Ezema | West African ...

    African Journals Online (AJOL)

    Is behavior that has been labeled Internet abuse symptomatic of other problems such as depression, sexual disorders, or loneliness in Nigeria? What are alternative explanations for this phenomenon? Is there adequate research to support Internet abuse as a distinct disorder? Key words: Internet, Packet Switching, World ...

  14. Substance Abuse Prevention, Assessment, and Treatment for Lesbian, Gay, Bisexual, and Transgender Youth.

    Science.gov (United States)

    Aromin, Romulo Alcalde

    2016-12-01

    Knowing how to manage substance abuse in all youth is an important aspect of pediatric care, including providing clinically appropriate anticipatory guidance, monitoring, assessment, and treatment. Although most lesbian, gay, bisexual, and transgender (LGBT) youth do not abuse substances, as a group they experience unique challenges in self-identity development that put them at an increased risk for substance abuse. This article addresses prevention and management of substance use in LGBT youth relevant to pediatrics and allied professions as an aspect of their overall health care. It reviews basic information about substance abuse in youth and special considerations for LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. The value of paediatric assessment in historic child sexual abuse.

    Science.gov (United States)

    Al-Jilaihawi, Sarah; Borg, Kevin; Maguire, Sabine; Hodes, Deborah

    2017-06-01

    A perception exists that there are few benefits of a paediatric assessment in historic child sexual abuse (CSA), as the likelihood of finding forensic evidence is low. To determine the value of a comprehensive paediatric assessment in a dedicated clinic for children and young people who present following suspicion or allegation of historic CSA. All children with suspected or alleged historic CSA, defined as >7 days after the last episode of sexual assault in pubertal girls, or >3 days for prepubertal girls and all boys, were assessed in a specialised paediatric clinic. Clinic data were collected prospectively between October 2009 and November 2014 and through retrospective case note review. Among the 249 children who presented with possible historic CSA, ages ranged from 0 to 17 years (median 7, SD 4.3). Of these children, 141 (57%) had a medical concern(s) related to the referral reason, 78 (31%) had an unrelated medical concern(s) and 55 (22%) had emotional or behavioural concerns requiring onward referral, while 18 (7%) children had physical signs supportive of CSA. Findings referable to social care were identified in 26 cases (10%), the police in 6 cases and 15 (6%) parents required professional help for anxiety symptoms. This study highlights the value of a comprehensive paediatric assessment in a dedicated clinic for cases of suspected or alleged historic CSA, by identifying a broad variety of unmet health needs in this group. The findings have important implications for the child, their families and the multiagency team. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Assessment of the quality of the childhood physical abuse measure in the National Population Health Survey.

    Science.gov (United States)

    Shields, Margot; Hovdestad, Wendy; Tonmyr, Lil

    2015-05-01

    The long-term health consequences of childhood physical abuse are often studied using retrospective self-reports collected from adults. This study assesses the quality of a question on childhood physical abuse in the National Population Health Survey (NPHS). All NPHS respondents aged 18 or older (n = 15,027) were asked a question about childhood physical abuse in cycles 1 (1994/1995), 7 (2006/2007) and 8 (2008/2009). The reliability of this question was assessed over these periods. Associations between response patterns to the abuse item and health conditions that are related to childhood physical abuse were examined. Across all NPHS cycles, very few respondents refused to answer or replied "don't know" to the item on childhood physical abuse. Reliability, as measured by Cohen's kappa statistic, was "substantial" for the two-year interval between cycles 7 and 8, and "moderate" for the 12- and 14-year intervals from cycle 1. Kappa estimates were similar when examined by various demographic factors. Compared with consistent deniers, respondents who consistently affirmed childhood physical abuse and those who provided inconsistent responses had increased odds of depression, fair or poor self-perceived health, disability, migraine, and heart disease. Despite some limitations, the NPHS question on childhood physical abuse allows researchers to investigate long-term health consequences of abuse.

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

    Science.gov (United States)

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

    2008-01-01

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

  18. Assessing the Persuasiveness of Drug Abuse Information. Drug Abuse Information Research Project.

    Science.gov (United States)

    McEwen, William J.; Wittbold, George H.

    The magnitude of the effect television has on young people's lives makes it an important source of drug abuse information, but there is a question as to whether or not such information is persuasive. Some studies indicate that viewer response to anti-drug television commercials falls into four judgmental dimensions: relevant persuasion, negative…

  19. Sexual abuse of boys.

    Science.gov (United States)

    Valente, Sharon M

    2005-01-01

    Sexual abuse in childhood can disable self-esteem, self-concept, relationships, and ability to trust. It can also leave psychological trauma that compromises a boy's confidence in adults. While some boys who willingly participate may adjust to sexual abuse, many others face complications, such as reduced quality of life, impaired social relationships, less than optimal daily functioning, and self-destructive behavior. These problems can respond to treatment if detected. In this paper, we examine the prevalence, characteristics, psychological consequences, treatment, and coping patterns of boys who have been sexually abused and their failure to disclose abuse unless asked during a therapeutic encounter. Nurses have a responsibility to detect the clues to sexual abuse, diagnose the psychological consequences, and advocate for protection and treatment. Computerized literature search of the Medline and PsychInfo literature and books on sexual abuse of boys. Psychological responses to abuse such as anxiety, denial, self-hypnosis, dissociation, and self-mutilation are common. Coping strategies may include being the angry avenger, the passive victim, rescuer, daredevil, or conformist. Sexual abuse may precipitate runaway behavior, chronic use of sick days, poor school or job performance, costly medical, emergency and or mental health visits. In worst cases, the boy may decide that life is not worth living and plan suicide. The nurse has a key role to play in screening, assessing, and treating sexual abuse children.

  20. Multiple Protein Biomarker Assessment for Recombinant Bovine Somatotropin (rbST) Abuse in Cattle

    NARCIS (Netherlands)

    Ludwig, S.K.J.; Smits, N.G.E.; Veer, van der G.; Bremer, M.G.E.G.; Nielen, M.W.F.

    2012-01-01

    Biomarker profiling, as a rapid screening approach for detection of hormone abuse, requires well selected candidate biomarkers and a thorough in vivo biomarker evaluation as previously done for detection of growth hormone doping in athletes. The bovine equivalent of growth hormone, called

  1. Dopamine transporter density of the basal ganglia assessed with I-123 IPT SPECT in methamphetamine abusers

    International Nuclear Information System (INIS)

    Lee, Joo Ryung; Ahn, Byeong Cheol; Kewm, Do Hun

    2005-01-01

    Functional imaging of dopamine transporter (DAT) defines integrity of the dopaminergic system, and DAT is the target site of drugs of abuse such as cocaine and methamphetamine. Functional imaging the DAT may be a sensitive and selective indicator of neurotoxic change by the drug. The aim of the present study is to evaluate the clinical implications of qualitative/quantitative analyses of dopamine transporter imaging in methamphetamine abusers. Six detoxified methamphetamine abusers (abuser group) and 4 volunteers (control group) were enrolled in this study. Brain MRI was performed in all of abuser group. Abuser group underwent psychiatric and depression assessment using brief psychiatric rating scale (BPRS) and Hamilton depression rating scale (HAMD), respectively. All of the subjects underwent I-123 IPT SPECT (IPT SPECT). IPT SPECT image was analysed with visual qualitative method and quantitative method using basal ganglia dopamine transporter (DAT) specific/non-specific binding ratio (SBR). Comparison of DAT SBR between abuser and control groups was performed. We also performed correlation tests between psychiatric and depression assessment results and DAT SBR in abuser group. All of abuser group showed normal MRI finding, but had residual psychiatric and depressive symptoms, and psychiatric and depressive symptom scores were exactly correlated (r=1.0, ρ =0.005) each other. Five of them showed abnormal finding on qualitative visual I-123 IPT SPECT. Abuser group had lower basal ganglia DAT SBR than that of control (2.38 ± 0.20 vs 3.04 ± 0.27, ρ =0.000). Psychiatric and depressive symptoms were negatively well correlated with basal ganglia DAT SBR (r=-0.908, ρ =0.012, r=-0.924, ρ =0.009) This results suggest that dopamine transporter imaging using I-123 IPT SPECT may be used to evaluate dopaminergic system of the basal ganglia and the clinical status in methamphetamine abusers

  2. Dopamine transporter density of the basal ganglia assessed with I-123 IPT SPECT in methamphetamine abusers

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joo Ryung; Ahn, Byeong Cheol [Kyungpook National University Medical School, Daegu (Korea, Republic of); Kewm, Do Hun [National Bugok Mental Hospital, Changryung (Korea, Republic of)] (and others)

    2005-10-15

    Functional imaging of dopamine transporter (DAT) defines integrity of the dopaminergic system, and DAT is the target site of drugs of abuse such as cocaine and methamphetamine. Functional imaging the DAT may be a sensitive and selective indicator of neurotoxic change by the drug. The aim of the present study is to evaluate the clinical implications of qualitative/quantitative analyses of dopamine transporter imaging in methamphetamine abusers. Six detoxified methamphetamine abusers (abuser group) and 4 volunteers (control group) were enrolled in this study. Brain MRI was performed in all of abuser group. Abuser group underwent psychiatric and depression assessment using brief psychiatric rating scale (BPRS) and Hamilton depression rating scale (HAMD), respectively. All of the subjects underwent I-123 IPT SPECT (IPT SPECT). IPT SPECT image was analysed with visual qualitative method and quantitative method using basal ganglia dopamine transporter (DAT) specific/non-specific binding ratio (SBR). Comparison of DAT SBR between abuser and control groups was performed. We also performed correlation tests between psychiatric and depression assessment results and DAT SBR in abuser group. All of abuser group showed normal MRI finding, but had residual psychiatric and depressive symptoms, and psychiatric and depressive symptom scores were exactly correlated (r=1.0, {rho} =0.005) each other. Five of them showed abnormal finding on qualitative visual I-123 IPT SPECT. Abuser group had lower basal ganglia DAT SBR than that of control (2.38 {+-} 0.20 vs 3.04 {+-} 0.27, {rho} =0.000). Psychiatric and depressive symptoms were negatively well correlated with basal ganglia DAT SBR (r=-0.908, {rho} =0.012, r=-0.924, {rho} =0.009) This results suggest that dopamine transporter imaging using I-123 IPT SPECT may be used to evaluate dopaminergic system of the basal ganglia and the clinical status in methamphetamine abusers.

  3. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  4. 75 FR 4400 - Draft Guidance for Industry on Assessment of Abuse Potential of Drugs; Availability

    Science.gov (United States)

    2010-01-27

    ..., and Cosmetic Act, an abuse potential assessment is part of the general evaluation of the safety and..., prescribing, advertising, manufacturing, promotion, marketing, and use in the practice of medicine. Not...

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

    Science.gov (United States)

    Copur, Mazlum; Turkcan, Ahmet; Erdogmus, Meral

    2005-04-01

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

  6. Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse.

    Science.gov (United States)

    Babor, Thomas F; McRee, Bonnie G; Kassebaum, Patricia A; Grimaldi, Paul L; Ahmed, Kazi; Bray, Jeremy

    2007-01-01

    Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive and integrated approach to the delivery of early intervention and treatment services through universal screening for persons with substance use disorders and those at risk. This paper describes research on the components of SBIRT conducted during the past 25 years, including the development of screening tests, clinical trials of brief interventions and implementation research. Beginning in the 1980s, concerted efforts were made in the US and at the World Health Organization to provide an evidence base for alcohol screening and brief intervention in primary health care settings. With the development of reliable and accurate screening tests for alcohol, more than a hundred clinical trials were conducted to evaluate the efficacy and cost effectiveness of alcohol screening and brief intervention in primary care, emergency departments and trauma centers. With the accumulation of positive evidence, implementation research on alcohol SBI was begun in the 1990s, followed by trials of similar methods for other substances (e.g., illicit drugs, tobacco, prescription drugs) and by national demonstration programs in the US and other countries. The results of these efforts demonstrate the cumulative benefit of translational research on health care delivery systems and substance abuse policy. That SBIRT yields short-term improvements in individuals' health is irrefutable; long-term effects on population health have not yet been demonstrated, but simulation models suggest that the benefits could be substantial.

  7. A comparison of an opioid abuse screening tool and prescription drug monitoring data in the emergency department.

    Science.gov (United States)

    Weiner, Scott G; Horton, Laura C; Green, Traci C; Butler, Stephen F

    2016-02-01

    This study aimed to: (a) determine the percentage of ED patients receiving prescriptions for opioid pain medications that meet the criteria for "high-risk for abuse potential" on the Screener and Opioid Assessment for Patients with Pain (SOAPP(®)-R), (b) determine the percentage of patients with high-risk behavior on the state prescription drug monitoring program (PDMP) database, (c) compare the SOAPP-R with data from the PDMP, and (d) determine psychometric properties of SOAPP-R for ED patients Convenience sample of ED patients who were being considered for discharge with a prescription for an opioid pain medication. Subjects completed SOAPP-R on an electronic tablet and PDMP data was obtained. Scores on SOAPP-R ≥ 18 were defined as "at-risk", and PDMP data showing both ≥ 4 opioid prescriptions and ≥ 4 providers in 12 months was considered the criterion standard for high-risk behavior. 82 patients (88.2%) provided consent. 32.9% (n=27) were determined to be "at-risk" (score ≥ 18) by SOAPP-R. 15.9% (n=13) subjects met PDMP criteria and 53.9% (n=7) of those had SOAPP-R scores ≥ 18 (sensitivity 54%, specificity 71%, positive predictive value 26%, negative predictive value 89%). The association of an at-risk SOAPP-R score and PDMP high-risk criteria was an adjusted odds ratio of 1.39 (95% confidence interval 0.73-3.68). In our population, about one-third of patients being considered for discharge with an opioid prescription scored "at-risk" on SOAPP-R and 15.9% met the PDMP high-risk criteria. The high negative predictive value of SOAPP-R indicates it may be a useful screening tool for the ED patient population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. An assessment of Internet Abuse in Nigeria Abstract

    African Journals Online (AJOL)

    crimes, see things they ought not to see and chat with people of questionable character[1]. Thus parents ought to take precautions to see that their children do not abuse the internet access. On the other hand there are people who use the internet for nefarious activities and they strike to win converts among the unwary.

  9. Assessment of physical child abuse risk in parents with children referred to child and adolescent psychiatry

    OpenAIRE

    Looveren, Van, Natalie; Glazemakers, Inge; Grootel, Van, Linda; Fransen, Erik; West, Van, Dirk

    2017-01-01

    Abstract: Given the vulnerability of the child psychiatric population, this study examined whether parenting a child referred to a child and adolescent psychiatry department leads to a higher risk of physical child abuse and if that risk is associated with a specific child psychopathology. The clinical sample consisted of caregivers with a six-to-11-year-old child who consulted child and adolescent psychiatry for a psychiatric assessment. The Dutch Child Abuse Potential Inventory (CAPI), soci...

  10. New psychoactive substances as part of polydrug abuse within opioid maintenance treatment revealed by comprehensive high-resolution mass spectrometric urine drug screening.

    Science.gov (United States)

    Heikman, Pertti; Sundström, Mira; Pelander, Anna; Ojanperä, Ilkka

    2016-01-01

    At present, polydrug abuse comprises, besides traditional illicit drugs, new psychoactive substances (NPS) and non-prescribed psychotropic medicines (N-PPM). Polydrug abuse was comprehensively evaluated among opioid-dependent patients undergoing opioid maintenance treatment (OMT). Two hundred consecutively collected urine samples from 82 OMT patients (52 male) treated with methadone or buprenorphine-naloxone medication were studied using a liquid chromatography/time-of-flight mass spectrometry screening method. The method enables simultaneous detection of hundreds of abused substances covering the traditional drugs of abuse and many NPS as well as N-PPM. Ninety-two (45.8%) samples were positive for the abused substances. Benzodiazepines (29.0%), amphetamines (19.5%), cannabinoids (17.0%), NPS (13.0%), N-PPM (9.0%), and opioids (9.0%) were detected in different combinations. The simultaneous occurrence of up to three groups of abused substances was common (40.0%), and in one sample, all six groups were found. The stimulant NPS alpha-pyrrolidinovalerophenone was found in 10.0% and the sedative N-PPM pregabalin in 4.0% of the samples. The patients were seldom aware of what particular NPS they had abused. A widespread occurrence of abused substances beyond the ordinary was revealed. Identifying these patients is essential as polydrug abuse is a safety risk to the patient and may cause attrition from OMT. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Screening, Brief Intervention and Referral to Treatment: implications of SAMHSA's SBIRT initiative for substance abuse policy and practice.

    Science.gov (United States)

    Babor, Thomas F; Del Boca, Frances; Bray, Jeremy W

    2017-02-01

    This paper describes the major findings and public health implications of a cross-site evaluation of a national Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program funded by the US Substance Abuse and Mental Health Services Administration (SAMHSA). Eleven multi-site programs in two cohorts of SAMHSA grant recipients were each funded for 5 years to promote the adoption and sustained implementation of SBIRT. The SBIRT cross-site evaluation used a multi-method evaluation design to provide comprehensive information on the processes, outcomes and costs of SBIRT as implemented in a variety of medical and community settings. SBIRT programs in the two evaluated SAMHSA cohorts screened more than 1 million patients/clients. SBIRT implementation was facilitated by committed leadership and the use of substance use specialists, rather than medical generalists, to deliver services. Although the quasi-experimental nature of the outcome evaluation does not permit causal inferences, pre-post differences were clinically meaningful and statistically significant for almost every measure of substance use. Greater intervention intensity was associated with larger decreases in substance use. Both brief intervention and brief treatment were associated with positive outcomes, but brief intervention was more cost-effective for most substances. Sixty-nine (67%) of the original performance sites adapted and redesigned SBIRT service delivery after initial grant funding ended. Four factors influenced SBIRT sustainability: presence of program champions, availability of funding, systemic change and effective management of SBIRT provider challenges. The US Substance Abuse and Mental Health Services Administration's Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program was adapted successfully to the needs of early identification efforts for hazardous use of alcohol and illicit drugs. SBIRT is an innovative way to integrate the

  12. Evaluation of three rapid oral fluid test devices on the screening of multiple drugs of abuse including ketamine.

    Science.gov (United States)

    Tang, Magdalene H Y; Ching, C K; Poon, Simon; Chan, Suzanne S S; Ng, W Y; Lam, M; Wong, C K; Pao, Ronnie; Lau, Angus; Mak, Tony W L

    2018-05-01

    Rapid oral fluid testing (ROFT) devices have been extensively evaluated for their ability to detect common drugs of abuse; however, the performance of such devices on simultaneous screening for ketamine has been scarcely investigated. The present study evaluated three ROFT devices (DrugWipe ® 6S, Ora-Check ® and SalivaScreen ® ) on the detection of ketamine, opiates, methamphetamine, cannabis, cocaine and MDMA. A liquid chromatography tandem mass spectrometry (LCMS) assay was firstly established and validated for confirmation analysis of the six types of drugs and/or their metabolites. In the field test, the three ROFT devices were tested on subjects recruited from substance abuse clinics/rehabilitation centre. Oral fluid was also collected using Quantisal ® for confirmation analysis. A total of 549 samples were collected in the study. LCMS analysis on 491 samples revealed the following drugs: codeine (55%), morphine (49%), heroin (40%), methamphetamine (35%), THC (8%), ketamine (4%) and cocaine (2%). No MDMA-positive cases were observed. Results showed that the overall specificity and accuracy were satisfactory and met the DRUID standard of >80% for all 3 devices. Ora-Check ® had poor sensitivities (ketamine 36%, methamphetamine 63%, opiates 53%, cocaine 60%, THC 0%). DrugWipe ® 6S showed good sensitivities in the methamphetamine (83%) and opiates (93%) tests but performed relatively poorly for ketamine (41%), cocaine (43%) and THC (22%). SalivaScreen ® also demonstrated good sensitivities in the methamphetamine (83%) and opiates (100%) tests, and had the highest sensitivity for ketamine (76%) and cocaine (71%); however, it failed to detect any of the 28 THC-positive cases. The test completion rate (proportion of tests completed with quality control passed) were: 52% (Ora-Check ® ), 78% (SalivaScreen ® ) and 99% (DrugWipe ® 6S). Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Reliability and validity of screening instruments for drug and alcohol abuse in adults seeking evaluation for attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    McCann, B S; Simpson, T L; Ries, R; Roy-Byrne, P

    2000-01-01

    A growing number of adults are seeking evaluation for Attention-Deficit/Hyperactivity Disorder (ADHD). Screening for substance use disorders should be included as part of any comprehensive ADHD evaluation. We describe the validity and reliability of the Drug Abuse Screening Test (DAST) and the Alcohol Use Disorders Identification Test (AUDIT) in adults seeking evaluation for ADHD. Internal reliability estimates were excellent for both instruments. Scores on the DAST and AUDIT were higher among patients with a DSM-IV diagnosis of current drug abuse or dependence or current alcohol abuse or dependence, respectively. A cutoff score of 6 or above appears to be optimal for identifying individuals who are current drug abusers. A cutoff score of 6 or above on the AUDIT is suggested for detection of current alcohol abuse in this population. Comparable rates of substance use disorders were observed in ADHD and non-ADHD patients. Both measures are valid and reliable instruments for screening for alcohol and drug abuse among adults seeking evaluation for ADHD.

  14. Primary care management of alcohol use disorder and at-risk drinking: Part 1: screening and assessment.

    Science.gov (United States)

    Spithoff, Sheryl; Kahan, Meldon

    2015-06-01

    To provide primary care physicians with evidence-based information and advice on the screening and assessment of at-risk drinking and alcohol use disorder (AUD). A companion article outlines the management of at-risk drinking and AUD. We conducted a nonsystematic literature review, using search terms on primary care, AUD, alcohol dependence, alcohol abuse, alcohol misuse, unhealthy drinking, and primary care screening, identification, and assessment. Family physicians should screen all patients at least yearly for unhealthy drinking with a validated screening test. Screen patients who present with medical or psychosocial problems that might be related to alcohol use. Determine if patients who have positive screening results are at-risk drinkers or have AUD. If patients have AUD, categorize it as mild, moderate, or severe using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, criteria. Share this diagnosis with the patient and offer assistance. Do a further assessment for patients with AUD. Screen for other substance use, concurrent disorders, and trauma. Determine whether there is a need to report to child protection services or the Ministry of Transportation. Determine the need for medical management of alcohol withdrawal. Conduct a brief physical examination and order laboratory tests to assess complete blood count and liver transaminase levels, including γ-glutamyl transpeptidase. Primary care is well suited to screening and assessment of alcohol misuse. Copyright© the College of Family Physicians of Canada.

  15. Introduction to the Development of the ISPCAN Child Abuse Screening Tools

    Science.gov (United States)

    Runyan, Desmond K.; Dunne, Michael P.; Zolotor, Adam J.

    2009-01-01

    The "World Report on Children and Violence", (Pinheiro, 2006) was produced at the request of the UN Secretary General and the UN General Assembly. This report recommended improvement in research on child abuse. ISPCAN representatives took this charge and developed 3 new instruments. We describe this background and introduce three new measures…

  16. Trichobezoar in Vagina: Assessment for Child Sexual Abuse and Diagnostic Result of Forensic Science.

    Science.gov (United States)

    Bağ, Özlem; Acar, Buğra Han; Öztürk, Şenol; Alşen, Sevay; Ecevit, Çiğdem

    2017-03-01

    Vaginal discharge and bleeding in children require a through and thoughtful evaluation to diagnose the underlying problem including infections, sexual abuse, and vaginal foreign bodies. We report a 6-year-old girl presenting with bloody vaginal discharge, carefully evaluated for sexual abuse, and finally diagnosed as a vaginal foreign body after vaginoscopy. A rolling hair ball was extracted from the vagina and was diagnosed as trichobezoar pathologically without any endo-ecto-mesodermal residual tissue. The hair ball was genetically detected and diagnosed to belong herself by containing no foreign structure. Child sexual abuse was ruled out by forensic interview at CAC and report of forensic science that reported genetic structure belonging to the child. Medicolegal assessment helped in final diagnosis to exclude child sexual abuse. © 2016 American Academy of Forensic Sciences.

  17. Multiple Protein Biomarker Assessment for Recombinant Bovine Somatotropin (rbST) Abuse in Cattle

    OpenAIRE

    Ludwig, Susann K. J.; Smits, Nathalie G. E.; van der Veer, Grishja; Bremer, Maria G. E. G.; Nielen, Michel W. F.

    2012-01-01

    Biomarker profiling, as a rapid screening approach for detection of hormone abuse, requires well selected candidate biomarkers and a thorough in vivo biomarker evaluation as previously done for detection of growth hormone doping in athletes. The bovine equivalent of growth hormone, called recombinant bovine somatotropin (rbST) is (il)legally administered to enhance milk production in dairy cows. In this study, first a generic sample pre-treatment and 4-plex flow cytometric immunoassay (FCIA) ...

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

    Science.gov (United States)

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

    2007-01-01

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

  19. Highly sensitive capillary electrophoresis-mass spectrometry for rapid screening and accurate quantitation of drugs of abuse in urine.

    Science.gov (United States)

    Kohler, Isabelle; Schappler, Julie; Rudaz, Serge

    2013-05-30

    The combination of capillary electrophoresis (CE) and mass spectrometry (MS) is particularly well adapted to bioanalysis due to its high separation efficiency, selectivity, and sensitivity; its short analytical time; and its low solvent and sample consumption. For clinical and forensic toxicology, a two-step analysis is usually performed: first, a screening step for compound identification, and second, confirmation and/or accurate quantitation in cases of presumed positive results. In this study, a fast and sensitive CE-MS workflow was developed for the screening and quantitation of drugs of abuse in urine samples. A CE with a time-of-flight MS (CE-TOF/MS) screening method was developed using a simple urine dilution and on-line sample preconcentration with pH-mediated stacking. The sample stacking allowed for a high loading capacity (20.5% of the capillary length), leading to limits of detection as low as 2 ng mL(-1) for drugs of abuse. Compound quantitation of positive samples was performed by CE-MS/MS with a triple quadrupole MS equipped with an adapted triple-tube sprayer and an electrospray ionization (ESI) source. The CE-ESI-MS/MS method was validated for two model compounds, cocaine (COC) and methadone (MTD), according to the Guidance of the Food and Drug Administration. The quantitative performance was evaluated for selectivity, response function, the lower limit of quantitation, trueness, precision, and accuracy. COC and MTD detection in urine samples was determined to be accurate over the range of 10-1000 ng mL(-1) and 21-1000 ng mL(-1), respectively. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Esbec, Enrique; Echeburúa, Enrique

    2016-03-02

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

  1. Using urbanization profiles to assess screening performance

    NARCIS (Netherlands)

    Boon, ME; Kok, LP

    The large Dutch data sets acquired as a result of population-based cervical smear screening programs can be further exploited to obtain an urbanization-weighted score to gain insight into the quality of the performance of the individual cytology laboratories. Based on the first four digits of the

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

    Although frustration has long been implicated in promoting aggression, the potential for poor frustration tolerance to function as a risk factor for physical child abuse risk has received minimal attention. Instead, much of the extant literature has examined the role of anger in physical abuse risk, relying on self-reports of the experience or expression of anger, despite the fact that this methodology is often acknowledged as vulnerable to bias. Therefore, the present investigation examined whether a more implicit, analog assessment of frustration tolerance specifically relevant to parenting would reveal an association with various markers of elevated physical child abuse risk in a series of samples that varied with regard to age, parenting status, and abuse risk. An analog task was designed to evoke parenting-relevant frustration: the task involved completing an unsolvable task while listening to a crying baby or a toddler's temper tantrum; time scores were generated to gauge participants' persistence in the task when encountering such frustration. Across these studies, low frustration tolerance was associated with increased physical child abuse potential, greater use of parent-child aggression in discipline encounters, dysfunctional disciplinary style, support for physical discipline use and physical discipline escalation, and increased heart rate. Future research directions that could better inform intervention and prevention programs are discussed, including working to clarify the processes underlying frustration intolerance and potential interactive influences that may exacerbate physical child abuse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Typologies of prescription opioid use in a large sample of adults assessed for substance abuse treatment.

    Directory of Open Access Journals (Sweden)

    Traci C Green

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

  5. Assessment of socioeconomic consequences of drug abuse in the Ural federal district

    Directory of Open Access Journals (Sweden)

    Inessa Aleksandrovna Gurban

    2013-06-01

    Full Text Available The paper considers issues of the assessment of the socioeconomic consequences of drug abuse in today’s conditions, which have the following features — the approaching of drug-dealers to legalize the drug market, develop the illegal drug market and their analogs and derivatives by the introduction of modern production technologies and distribution of psychoactive agents. Key tendencies observed in the contemporary world in the field of dynamics of the drug market development, which are reflected in the regions of Russia including the Ural Federal District are revealed. The procedure of assessment of socioeconomic expenses of drug abuse including assessment of drug consumers’ expenses and their surrounding people; and also; maintenance costs of the state bodies supervising drug trafficking; expenses for health care and other social expenses connected to drug use; damage to individuals of drug abuse distribution; expenses of private institutions and establishments; socioeconomic impact of drug abuse distribution. The technique uses a tool allowing to carry out a calculation (a heroin equivalent, i.e. the drugs withdrawn by law enforcement agencies and the subsequent calculation of the corresponding number of consumers of each type of drug. This method is aimed at increasing the accuracy of estimates received. On the basis of results calculated according to offered technique, the shares of socioeconomic expenses of drug abuse concerning the income of the cumulative consolidated budget and a gross regional product of the Ural Federal District are defined.

  6. Assessing Quality of Care and Elder Abuse in Nursing Homes via Google Reviews.

    Science.gov (United States)

    Mowery, Jared; Andrei, Amanda; Le, Elizabeth; Jian, Jing; Ward, Megan

    2016-01-01

    It is challenging to assess the quality of care and detect elder abuse in nursing homes, since patients may be incapable of reporting quality issues or abuse themselves, and resources for sending inspectors are limited. This study correlates Google reviews of nursing homes with Centers for Medicare and Medicaid Services (CMS) inspection results in the Nursing Home Compare (NHC) data set, to quantify the extent to which the reviews reflect the quality of care and the presence of elder abuse. A total of 16,160 reviews were collected, spanning 7,170 nursing homes. Two approaches were tested: using the average rating as an overall estimate of the quality of care at a nursing home, and using the average scores from a maximum entropy classifier trained to recognize indications of elder abuse. The classifier achieved an F-measure of 0.81, with precision 0.74 and recall 0.89. The correlation for the classifier is weak but statistically significant: = 0.13, P rating correlations approach approximately 0.65 when the effective average number of reviews per provider is increased by aggregating similar providers. These results indicate that an analysis of Google reviews of nursing homes can be used to detect indications of elder abuse with high precision and to assess the quality of care, but only when a sufficient number of reviews are available.

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

    Science.gov (United States)

    Leavitt, F; Labott, S M

    1998-11-01

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

  8. Preclinical assessment of the abuse potential of the orexin receptor antagonist, suvorexant.

    Science.gov (United States)

    Born, Stephanie; Gauvin, David V; Mukherjee, Suman; Briscoe, Richard

    2017-06-01

    Suvorexant (Belsomra ® ) is a dual orexin receptor antagonist approved for the treatment of insomnia. Because of its pharmacology within the central nervous system, intended therapeutic indication, and first-in-class status, an assessment of suvorexant abuse liability potential was required prior to marketing approval. The nonclinical abuse liability potential studies for suvorexant included: 1) rat drug-dependence model to assess physical dependence following abrupt cessation; 2) rat drug-discrimination model to examine the potential similarity of the interoceptive or subjective effects of suvorexant to those elicited by zolpidem and morphine; 3) self-administration model to assess the relative reinforcing efficacy of suvorexant in rhesus monkeys conditioned to self-administer methohexital. No significant signs of spontaneous drug withdrawal or 'discontinuation syndrome' were observed in rats following abrupt discontinuation of suvorexant. Suvorexant did not elicit complete cross-generalization to either a zolpidem or morphine training/reference stimuli in rats, and suvorexant was devoid of behavioral evidence of positive reinforcing efficacy in monkeys. These nonclinical findings suggested that suvorexant will have low abuse potential in humans. In the final regulatory risk assessment, suvorexant was placed into Schedule IV, likely due to its first-in-class status, its sedative properties, and the outcome of the clinical abuse potential assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. The validity and reliability of the Mandarin Chinese version of the drug abuse screening test among adolescents in Taiwan.

    Science.gov (United States)

    Liao, Jung-Yu; Chi, Hsueh-Yun; Guo, Jong-Long; Huang, Chiu-Mieh; Shih, Shu-Fang

    2017-06-06

    This study aimed to investigate the validity and reliability of the Mandarin Chinese version of the Drug Abuse Screening Test (DAST-20) among adolescents, as well as examining the test's predictability with regard to the actual level of drug abuse. A total of 100 adolescent participants were recruited with their consent, in which 49 were current drug users and 51 were non-users. Based on the frequency of their drug use, participants who had used drugs at least once every week during the past year were classified as regular users (34 participants); participants who had not reached the regular use frequency of once every week during the past year were classified as occasional users (15 participants). All of the participants were required to answer a sociodemographic questionnaire, and undergo a DAST-20 (Mandarin Chinese version). The DAST-20, which has a high reliability with a Cronbach's alpha of 0.88, and a construct validity accounting for 61.87% of the variance. The area under the receiver operating characteristics (ROC) curve was 0.96 between the users and nonusers, and 0.93 between the occasional users and non-occasional users. A cut-off of three points could identify 93.5% of the drug users and 88.9% of nonusers, whereas a cut-off of six points could identify 85.3% of the regular users and 92.4% of non-regular users. The DAST-20 was the strongest predictor of adolescents who were regular users, occasional users, and non-users after controlling for other potential covariates. The Mandarin Chinese version of the DAST is simple to use and has a satisfactory validity and reliability. It is an effective screening tool for drug users among adolescents.

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

    Science.gov (United States)

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

    2016-07-01

    The study examined whether the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (DC: 0-3R; ZERO TO THREE, 2005) Parent-Infant Relationship Global Assessment Scale (PIR-GAS) is applicable to six European countries and contributes to the identification of caregiver-infant/toddler dyads with abusive relationship patterns. The sample consisted of 115 dyads with children's ages ranging from 1 to 47 months. Sixty-four dyads were recruited from community settings without known violence problems, and 51 dyads were recruited from clinical settings and already had been identified with violence problems or as being at risk for violence problems. To classify the dyads on the PIR-GAS categories, caregiver-child interactions were video-recorded and coded with observational scales appropriate for child age. To test whether the PIR-GAS allows for reliable identification of dyads with abusive relationship patterns, PIR-GAS ratings were compared with scores on the the International Society for the Prevention of Child Abuse and Neglect's (ISPCAN) Child Abuse Screening Tool-Parental Version (ICAST-P; D.K. Runyan et al., ), a questionnaire measuring abusive parental disciplinary practices. It was found that PIR-GAS ratings differentiated between the general and the clinical sample, and the dyads with abusive patterns of relationship were identified by both the PIR-GAS and the ICAST-P. Interrater reliability for the PIR-GAS ranged from moderate to excellent. The value of a broader use of tools such as the DC: 0-3R to promote early identification of families at risk for infant and toddler abuse and neglect is discussed. © 2016 Michigan Association for Infant Mental Health.

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

    Science.gov (United States)

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

    2010-01-01

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

  12. Radioimmunoassay screening and GC/MS confirmation of whole blood samples for drugs of abuse

    Energy Technology Data Exchange (ETDEWEB)

    Spiehler, V.R.; Sedgwick, P.

    From 1981 to 1984, an average of 300 radioimmunoassay screens on whole blood were performed each week in the authors laboratory. Most samples were screened for opiates phencyclidine and its analogs, barbiturates, and cocaine or its metabolite benzoylecgonine. A commercially available radioimmunoassay was used with modifications to facilitate screening of whole blood. Increasing sample size increased the sensitivity of the assay. Changing reagent concentration (1:1 dilution), incubation time, sample matrix (water, urine, or blood), or fraction counted (precipitate or supernatant) did not affect the utility of the standard curve or the sensitivity of the assay. All positive results for phencyclidine, opiates, cocaine, and related compounds were confirmed by GC/MA. Barbiturate positives were confirmed by UV spectrophotometry.

  13. Assessing drug abusers with the Millon Clinical Multiaxial Inventory: a review.

    Science.gov (United States)

    Craig, R J; Weinberg, D

    1992-01-01

    This paper reviews studies that used the Millon Clinical Multiaxial Inventory with drug abusers. Although the test has been used with over 2000 such patients in the published literature, there is still a dearth of basic research with the MCMI with this population. Preliminary evidence suggests that the Personality Disorder Scales are quite useful to assess personality styles of drug abusers, but the Clinical Syndrome Scales present some problems. Specifically, the Drug Dependence Scale has had difficulty in reliably "detecting" drug addicted individuals who were in treatment for drug abuse. However, a reliable modal MCMI profile among this population seems to exist, although cluster research suggests several subtypes, each with different personality styles. MCMI computer-narrative reports may overdiagnose paranoid disorder and under diagnose antisocial disorders among this population.

  14. Play Room as an psychological assessment method in cases of alleged child sexual abuse

    DEFF Research Database (Denmark)

    Hagelskjær, Marie

    2017-01-01

    This article presents an example of how psychoanalytic theory can be implemented in practice. The aim is to introduce and discuss the semi-projective material ‘Play Room’ which was originally developed to support prevention of sexual abuse among vulnerable children in Denmark. However, a recent...... study has shown that, when measured with a scale called Ability to Answer, children exposed to sexual abuse talked about the illustrations in Play Room in a significantly different way than did a clinical sample and a normal control group. The finding indicates the potential for expanding the scope...... of Play Room from prevention into clinical assessment, in cases of alleged child sexual abuse. Taking its starting point in the theory of Jean Laplanche, this article will discuss how psychoanalytic concepts such as seduction, translation, asymmetry, absence, and listening to listening can be used...

  15. Visual Impairment Screening Assessment (VISA) tool: pilot validation.

    Science.gov (United States)

    Rowe, Fiona J; Hepworth, Lauren R; Hanna, Kerry L; Howard, Claire

    2018-03-06

    To report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors. Prospective case cohort comparative study. Stroke units at two secondary care hospitals and one tertiary centre. 116 stroke survivors were screened, 62 by naïve and 54 by non-naïve screeners. Both the VISA screening tool and the comprehensive specialist vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. Full completion of VISA tool and specialist vision assessment was achieved for 89 stroke survivors. Missing data for one or more sections typically related to patient's inability to complete the assessment. Sensitivity and specificity of the VISA screening tool were 90.24% and 85.29%, respectively; the positive and negative predictive values were 93.67% and 78.36%, respectively. Overall agreement was significant; k=0.736. Lowest agreement was found for screening of eye movement and visual inattention deficits. This early validation of the VISA screening tool shows promise in improving detection accuracy for clinicians involved in stroke care who are not specialists in vision problems and lack formal eye training, with potential to lead to more prompt referral with fewer false positives and negatives. Pilot validation indicates acceptability of the VISA tool for screening of visual impairment in stroke survivors. Sensitivity and specificity were high indicating the potential accuracy of the VISA tool for screening purposes. Results of this study have guided the revision of the VISA screening tool ahead of full clinical validation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Condom use assessment of persons in drug abuse treatment.

    Science.gov (United States)

    Ross, Dana; Schumacher, Joseph E

    2004-12-01

    The purpose of this study was to objectively and quantitatively assess individual skill level of male condom use. This study developed a reliable and face valid assessment of correct male condom use based on Centers for Disease Control and Prevention criteria. Participants (N= 163) were recruited from persons in treatment for cocaine addiction. Condom use was assessed on the basis of correct completion of eight discrete steps. An overall score of 40% correct condom use indicated the need for training in this sample. Assessment showed training needs especially related to steps involving reduction of ejaculate leakage and steps related to potential hazards of nonoxynol-9 use. Frequency of condom use was also assessed; there was no correlation between frequency of condom use and condom use skill. Drug addiction treatment programs are encouraged to incorporate HIV risk reduction programs that teach condom use skills and use the CUDOS as an empirical measure of condom skill acquisition.

  17. Screening-Level Ecological Risk Assessment Methods, Revision 3

    Energy Technology Data Exchange (ETDEWEB)

    Mirenda, Richard J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2012-08-16

    This document provides guidance for screening-level assessments of potential adverse impacts to ecological resources from release of environmental contaminants at the Los Alamos National Laboratory (LANL or the Laboratory). The methods presented are based on two objectives, namely: to provide a basis for reaching consensus with regulators, managers, and other interested parties on how to conduct screening-level ecological risk investigations at the Laboratory; and to provide guidance for ecological risk assessors under the Environmental Programs (EP) Directorate. This guidance promotes consistency, rigor, and defensibility in ecological screening investigations and in reporting those investigation results. The purpose of the screening assessment is to provide information to the risk managers so informed riskmanagement decisions can be made. This document provides examples of recommendations and possible risk-management strategies.

  18. Screening assessment and requirements for a comprehensive assessment: Volume 1, Draft. Columbia River comprehensive impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    To evaluate the impact to the Columbia River from the Hanford Site-derived contaminants, the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, tribal, stockholder, and public involvement, the CRCIA Management Team was formed in August 1995. The Team agreed to conduct CRCIA using a phased approach. The initial phase, includes two components: 1) a screening assessment to evaluate the potential impact to the river, resulting from current levels of Hanford-derived contaminants in order to support decisions on Interim Remedial Measures, and 2) a definition of the essential work remaining to provide an acceptable comprehensive river impact assessment. The screening assessment is described in Part I of this report. The essential work remaining is Part II of this report. The objective of the screening assessment is to identify areas where the greatest potential exists for adverse effects on humans or the environment. Part I of this report discusses the scope, technical approach, and results of the screening assessment. Part II defines a new paradigm for predecisional participation by those affected by Hanford cleanup decisions.

  19. Screening assessment and requirements for a comprehensive assessment: Volume 1, Draft. Columbia River comprehensive impact assessment

    International Nuclear Information System (INIS)

    1997-04-01

    To evaluate the impact to the Columbia River from the Hanford Site-derived contaminants, the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, tribal, stockholder, and public involvement, the CRCIA Management Team was formed in August 1995. The Team agreed to conduct CRCIA using a phased approach. The initial phase, includes two components: 1) a screening assessment to evaluate the potential impact to the river, resulting from current levels of Hanford-derived contaminants in order to support decisions on Interim Remedial Measures, and 2) a definition of the essential work remaining to provide an acceptable comprehensive river impact assessment. The screening assessment is described in Part I of this report. The essential work remaining is Part II of this report. The objective of the screening assessment is to identify areas where the greatest potential exists for adverse effects on humans or the environment. Part I of this report discusses the scope, technical approach, and results of the screening assessment. Part II defines a new paradigm for predecisional participation by those affected by Hanford cleanup decisions

  20. A Training Course for Psychologists: Learning to Assess (Alleged) Sexual Abuse Among Victims and Perpetrators Who Have Intellectual Disabilities.

    Science.gov (United States)

    Embregts, Petri J C M; Heestermans, Marianne; van den Bogaard, Kim J H M

    2017-01-01

    People with intellectual disabilities (ID) are at greater risk of being a victim of sexual abuse and may also be more predisposed to perpetrating sexual abuse. Although the prevalence of sexual abuse among people with ID is difficult to determine, it is clear that there are serious consequences for both victims and perpetrators, and professional support is needed. Psychologists play an important role in the assessment of sexual abuse in both victims and perpetrators and require specific knowledge and skills to execute the assessments. We therefore developed a training course for psychologists aimed at increasing their (applied) knowledge of sexual abuse and the related assessment process in people with ID. In a five-day training course, sessions focusing on theories about diagnostic models were combined with sessions focusing on the assessment of sexual abuse of victims and perpetrators. The effectiveness of the training course was determined in terms of (applied) knowledge via the administration of a study-specific questionnaire including a hypothetical case vignette before, immediately after, and six months after completion of the course. The results show that the knowledge of the psychologists related to sexual abuse and the assessment process for sexual abuse increased significantly, and remained above pre-test level at six-month follow-up. These results are promising, but more research is needed to see if the increased (applied) knowledge in turn leads to application in practice and better care for both victims and perpetrators.

  1. Chemical Risk Assessment Screening Tool of a Global Chemical Company

    OpenAIRE

    Evelyn Tjoe-Nij; Christophe Rochin; Nathalie Berne; Alessandro Sassi; Antoine Leplay

    2018-01-01

    Background: This paper describes a simple-to-use and reliable screening tool called Critical Task Exposure Screening (CTES), developed by a chemical company. The tool assesses if the exposure to a chemical for a task is likely to be within acceptable levels. Methods: CTES is a Microsoft Excel tool, where the inhalation risk score is calculated by relating the exposure estimate to the corresponding occupational exposure limit (OEL) or occupational exposure band (OEB). The inhalation exposure i...

  2. Substance abuse screening and brief intervention for adolescents in primary care.

    Science.gov (United States)

    Pitts, Sarah; Shrier, Lydia A

    2014-10-01

    Adolescent substance use is common and is associated with serious mental, physical, and social risks, warranting systematic screening in the primary care setting. It is important for clinicians to become familiar with Screening, Brief Intervention, and Referral to Treatment (SBIRT), including administration of validated screening tools to identify level of risk associated with substance use and application of appropriate brief interventions. Positive reinforcement and brief advice is indicated for those adolescents with no or minimal risk for a substance use disorder. Providing a brief intervention using motivational interviewing strategies with subsequent close clinical follow-up is warranted when an adolescent meets criteria for a mild to moderate substance use disorder. Referral to treatment is recommended in cases of severe substance use. Immediate action, including breaking confidentiality, may be necessary when an adolescent's behavior raises acute safety concerns. Making time to interview adolescents alone is essential. It is also important to review the limitations of confidentiality with patients and parents/guardians and offer them strategies to discuss sensitive issues with their adolescents. Available resources for adolescents, parents/guardians, and clinicians regarding the risks of adolescent substance use and evidence-based treatment options can be used to support implementation of SBIRT in adolescent primary care. Copyright 2014, SLACK Incorporated.

  3. Phytochemical screening and antimicrobial assessment of Abutilon ...

    African Journals Online (AJOL)

    Three medicinal plants - Abutilon mauritianum, Bacopa monnifera and Datura stramonium were assessed for phytochemical components and antimicrobial activity. The results revealed that all the three plant extracts contained saponins, tannins and alkaloids. Only Datura stramonium contained glycosides. The plants exert ...

  4. Fast and Highly Selective LC-MS/MS Screening for THC and 16 Other Abused Drugs and Metabolites in Human Hair to Monitor Patients for Drug Abuse

    NARCIS (Netherlands)

    Koster, Remco A.; Alffenaar, Jan-Willem C.; Greijdanus, Ben; VanDerNagel, Joanneke E. L.; Uges, Donald R. A.

    Background:To facilitate the monitoring of drug abuse by patients, a method was developed and validated for the analysis of amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, methylenedioxyamphetamine, methylenedioxyethylamphetamine, methylphenidate, cocaine, benzoylecgonine, morphine,

  5. Testing the assumption of measurement invariance in the SAMHSA mental health and alcohol abuse stigma assessment in older adults

    NARCIS (Netherlands)

    King-Kallimanis, B.L.; Oort, F.J.; Lynn, N.; Schonfeld, L.

    2012-01-01

    This study examined the assumption of measurement invariance of the SAMSHA Mental Health and Alcohol Abuse Stigma Assessment. This is necessary to make valid comparisons across time and groups. The data come from the Primary Care Research in Substance Abuse and Mental Health for Elderly trial, a

  6. Testing the Assumption of Measurement Invariance in the SAMHSA Mental Health and Alcohol Abuse Stigma Assessment in Older Adults

    NARCIS (Netherlands)

    King-Kallimanis, Bellinda L.; Oort, Frans J.; Lynn, Nancy; Schonfeld, Lawrence

    2012-01-01

    This study examined the assumption of measurement invariance of the SAMSHA Mental Health and Alcohol Abuse Stigma Assessment. This is necessary to make valid comparisons across time and groups. The data come from the Primary Care Research in Substance Abuse and Mental Health for Elderly trial, a

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

    Science.gov (United States)

    Everson, Mark D.; Faller, Kathleen Coulborn

    2012-01-01

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

  8. Validity and reliability of the Turkish version of CRAFFT Substance Abuse Screening Test among adolescents

    Directory of Open Access Journals (Sweden)

    Kandemir H

    2015-06-01

    Full Text Available Hasan Kandemir,1 Ömer Aydemir,2 Suat Ekinci,3 Salih Selek,4 Sultan B Kandemir,5 Hüseyin Bayazit61Department of Child and Adolescent Psychiatry, School of Medicine, Harran University, Sanliurfa, 2Department of Psychiatry, School of Medicine, Celal Bayar University, Manisa, 3Balikli Rum Hospital, Istanbul, 4Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas, USA; 5Department of Psychiatry, Balikligol State Hospital, Sanliurfa, 6Department of Psychiatry, School of Medicine, Harran University, Sanliurfa, TurkeyAim: This study aimed to validate the CRAFFT diagnostic test, against the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Axis 1-based diagnostic inventory in a Turkish population of adolescents.Method: The 124 adolescents who were 15–18 years old were enrolled to this study. CRAFFT was self-administered. Interviews took approximately 30 minutes, including the DSM-IV diagnostic interview for alcohol/drug dependence.Results: The mean age of subjects was 16.653 years (minimum: 15 years, maximum: 18 years. A score of 2 or higher in part B was found to be optimal for detecting youths with substance dependence problems (sensitivity: 0.82; specificity: 0.88 and it was sufficiently discriminative.Conclusion: The CRAFFT is a valid and reliable instrument for identifying Turkish-speaking youths at risk for substance use disorders.Keywords: CRAFFT, substance abuse, validity, Turkish, adolescent

  9. Developing an Assessment (Tool) for Touch Screen Devices.

    Science.gov (United States)

    Danial-Saad, Alexandra; Chiari, Lorenzo

    2017-01-01

    Touch screen devices have become prevalent in our lives. Assistive technology experts working with people with disabilities face difficulty in understanding and assessing the problems experienced by individuals with disabilities in operating touch screen devices. This paper presents the processes of collecting and creating the required knowledge needed for assessing the user's skills for operating various touch screen devices, in order to develop an application for assessing the user's abilities and limitations. A six step procedure was used to collect and validate the required knowledge for the assessment from a multidisciplinary team. To determine the agreement levels between the experts, content validity was calculated. To test correlation between the experts from the different disciplines, a comparison was made between the discipline groups and their choice of specific skills/measurements. The final number of domains and skills/measurements was 15 domains and 50 skills/measurements. The result of Cronbach's α test for the final assessment questionnaire (50 skills/measurements) was 0.94, which indicates a high degree of reliability. The results of Kruskal-Wallis test showed the lack of any significant difference between agreements of the clinicians and the technicians groups, but significant differences were found between the educators and the clinicians groups. Each of the skills appearing in the final questionnaire was illustrated in a flowchart in preparation for developing the assessment (tool) for using touch screen devices.

  10. Assessment of Tapentadol API Abuse Liability With the Researched Abuse, Diversion and Addiction-Related Surveillance System.

    Science.gov (United States)

    Vosburg, Suzanne K; Severtson, S Geoffrey; Dart, Richard C; Cicero, Theodore J; Kurtz, Steven P; Parrino, Mark W; Green, Jody L

    2018-04-01

    Tapentadol, a Schedule II opioid with a combination of µ-opioid activity and norepinephrine reuptake inhibition, is used for the management of moderate to severe acute and chronic pain. Its dual mechanism of action is thought to reduce opioid-related side effects that can complicate pain management. Since approval, tapentadol has been tracked across multiple outcomes suggesting abuse liability, and a pattern of relatively low, although not absent, abuse liability has been found. This retrospective cohort study further details the abuse liability of tapentadol as an active pharmaceutical ingredient (API) when immediate-release as well as extended-release formulations were on the market together (fourth quarter of 2011 to second quarter of 2016). Tapentadol (API) was compared with tramadol, hydrocodone, morphine, oxycodone, hydromorphone, and oxymorphone across Poison Center, Drug Diversion, and Treatment Center Programs Combined data streams from the Researched Abuse, Diversion and Addiction-Related Surveillance system. Findings suggest the public health burden related to tapentadol to date is low, but present. Event rates of abuse per population-level denominators were significantly lower than all other opioids examined. However, when adjusted for drug availability, event rates of abuse were lower than most Schedule II opioids studied, but were not the lowest. Disentangling these 2 sets of findings further by examining various opioid formulations, such as extended-release and the role of abuse-deterrent formulations, is warranted. This article presents the results from an examination of tapentadol API across the Researched Abuse, Diversion and Addiction-Related Surveillance System: a broad and carefully designed postmarketing mosaic. Data to date from Poison Center, Drug Diversion, and Treatment Centers combined suggest a low, but present public health burden related to tapentadol. Copyright © 2018. Published by Elsevier Inc.

  11. [Clinical Practice Guide for Early Detection, Diagnosis and Treatment of the Acute Intoxication Phase in Patients with Alcohol Abuse or Dependence: Part I: Screening, Early Detection and Risk Factors in Patients with Alcohol Abuse or Dependence].

    Science.gov (United States)

    de la Espriella Guerrero, Ricardo; de la Hoz Bradford, Ana María; Gómez-Restrepo, Carlos; Zárate, Alina Uribe-Holguín; Menéndez, Miguel Cote; Barré, Michelle Cortés; Rentería, Ana María Cano; Hernández, Delia Cristina

    2012-12-01

    Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. 70 % of people under risk of having alcohol problems go undetected in medical practice, a fact that underlines the need for specific screening measures allowing early detection leading to timely treatment. This article presents evidence gathered by alcohol abuse and dependence screening as well as by risk factor identification and screening. It also presents evidence concerning withdrawal symptoms, delirium tremens and Wernicke's encephalopathy in order to promote early detection and timely treatment. Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. Evidence was found and recommendations were made for the pertinent screening and search of risk factors, in order to perform a diagnosis and carry out a timely management of alcohol abuse, dependence and ensuing complications: withdrawal syndrome, delirium tremens and Wernicke's encephalopathy. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

    Science.gov (United States)

    Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

    2015-01-01

    To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

  13. Assessment of the Diagnostic Potential of Clinotech TB Screen Test ...

    African Journals Online (AJOL)

    The Clinotech TB Screen test, a 3rd generation multi-antigen rapid chromatographic immunoassay for detection of IgG antibodies in serum against recombinant protein antigens 38kDa, 16kDa and 6kDa, was assessed for its diagnostic potential for diagnosis of active pulmonary TB in routine TB control programme in Abia ...

  14. Psychometric properties of the Turkish versions of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in the prison setting.

    Science.gov (United States)

    Evren, Cuneyt; Ogel, Kultegin; Evren, Bilge; Bozkurt, Muge

    2014-01-01

    The aim of this study was to evaluate psychometric properties of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in prisoners with (n = 124) or without (n = 78) drug use disorder. Participants were evaluated with the DUDIT, the DAST-10, and the Addiction Profile Index-Short (API-S). The DUDIT and the DAST-10 were found to be psychometrically sound drug abuse screening measures with high convergent validity when compared with each other (r = 0.86), and API-S (r = 0.88 and r = 0.84, respectively), and to have a Cronbach's α of 0.93 and 0.87, respectively. In addition, a single component accounted for 58.28% of total variance for DUDIT, whereas this was 47.10% for DAST-10. The DUDIT had sensitivity and specificity scores of 0.95 and 0.79, respectively, when using the optimal cut-off score of 10, whereas these scores were 0.88 and 0.74 for the DAST-10 when using the optimal cut-off score of 4. Additionally, both the DUDIT and the DAST-10 showed good discriminant validity as they differentiated prisoners with drug use disorder from those without. Findings support the Turkish versions of both the DUDIT and the DAST-10 as reliable and valid drug abuse screening instruments that measure unidimensional constructs.

  15. Alcohol Use Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Alcohol Use Screening (AUDIT-C) - Instructions The following questions ... this tool, there is also text-only version . Alcohol Use Screening (AUDIT-C) - Manual Instructions The following ...

  16. Longitudinal assessment of the effects of drug and alcohol abuse on HIV-1 treatment outcomes in an urban clinic.

    Science.gov (United States)

    Lucas, Gregory M; Gebo, Kelly A; Chaisson, Richard E; Moore, Richard D

    2002-03-29

    To assess the temporal association of changes in substance abuse with antiretroviral therapy use and adherence, HIV-1 RNA suppression, and CD4 cell count changes in patients attending an urban clinic. Prospective cohort study. Six-hundred and ninety-five HIV-1-infected individuals, who completed two or more semi-annual standardized surveys and in whom antiretroviral therapy was indicated, were included in the analysis. Surveys addressed antiretroviral therapy use and adherence, and use of illicit drugs and alcohol. Substance abuse was defined as active heroin, cocaine, or heavy alcohol use in the 6 months preceding survey. The units of analysis were consecutive pairs of surveys (couplets) in individual participants. Couplets in which participants denied substance abuse in both surveys were compared to couplets in which participants switched from non-use to substance abuse, and couplets in which participants reported substance abuse in both surveys were compared to couplets where participants switched from substance abuse to non-use. Switching from non-use to substance abuse was strongly associated with worsening antiretroviral therapy use and adherence, less frequent HIV-1 RNA suppression, and blunted CD4 cell increases, compared to remaining free of substance abuse. Alternatively, switching from substance abuse to non-use was strongly associated with improvements in antiretroviral therapy use and adherence, and HIV-1 treatment outcomes, compared to persisting with substance abuse. This longitudinal study highlights the dynamic nature of substance abuse and its temporal association with the effectiveness of HIV-1 treatment in patients attending an inner-city clinic.

  17. Assessing Intimate Partner Abuse: Associated Factors and Health Consequences among Jordanian Women.

    Science.gov (United States)

    Safadi, Reema R; Daibes, Mayada A; Haidar, Waheda H; Al-Nawafleh, Ahmad H; Constantino, Rose E

    2018-04-01

    In this cross-sectional study, we assessed levels and types of psychological and physical intimate partner abuse (IPA), and the association of IPA with socio-demographic factors and health consequences. The Abusive Behavior Inventory was completed by 471 Jordanian women. IPA was higher among older women who were: of older age, of younger age at marriage, married to unemployed spouses, living in urban residence, and of lower educational level. IPA was associated with most of the health problems except dental injuries and burns. We recommend educational programs that raise women's awareness to their rights to education, free choices in marital age, and policies that mitigate IPA in Jordan and similar patriarchal societies.

  18. ASSESSMENT OF PAIN AND SUFFERING IN CHILD ABUSE AND HOMICIDE VICTIMS: SUGGESTIONS FOR SOCIAL WORK PRACTICE

    Directory of Open Access Journals (Sweden)

    Albertyn, René

    2014-11-01

    Full Text Available Child abuse and homicide are on the increase worldwide. Often the burden falls upon social workers to argue the case of victims without being able to quantify the pain the children have suffered. A case study approach was used in which a High Court case was utilised as base to describe the proposed methodology to assess the level of pain, post-mortem, a victim could have gone through. The application was a four-step methodology constructed by using paediatric pain assessment. This study found that there is a need for the development of post-mortem pain scales to aid social workers.

  19. Urinary screening for methylphenidate (Ritalin) abuse: a comparison of liquid chromatography-tandem mass spectrometry, gas chromatography-mass spectrometry, and immunoassay methods.

    Science.gov (United States)

    Eichhorst, J; Etter, M; Lepage, J; Lehotay, D C

    2004-03-01

    To develop a routine method for detecting methylphenidate (Ritalin) use among drug abusers using liquid chromatography-tandem mass spectrometry (LC/MS/MS). The new methodology was designed to replace less reliable and/or more expensive and time-consuming techniques (GC/MS and ELISA) currently employed in our laboratory, and to provide a combined one-step screening and confirmation LC/MS/MS method. Because methylphenidate abuse is very prevalent in Saskatchewan, there is a demand to provide high volume urine screening both to detect abuse, and to monitor compliance. Random urine samples sent for drugs of abuse testing, standards, and controls were diluted 1:100 in methanol. Diluted specimens were injected directly into an Agilent 1100 liquid chromatograph coupled to a Sciex API 2000 mass spectrometer. The method utilized selected reaction monitoring (SRM) as well as an electrospray ionization source (EIS) to detect both urinary methylphenidate and the more prevalent metabolite, ritalinic acid (RA). There appeared to be little or no sacrifice in sensitivity because the higher dilutions exhibited much less matrix effect. Limit of quantitation (LOQ) for methylphenidate was 100 nM and 500 nM for RA. Linear calibration curves from 100 to 1000 nM for Ritalin and 500 to 5000 nM for RA were acquired. Imprecision of spiked and true specimens did not exceed 10% and at the LOQ, it was less than 20%. A rapid, sensitive, reliable, and highly specific method by LC/MS/MS for detecting methylphenidate and its metabolite, RA, were developed. Both the cost and performance of the LC/MS/MS method were superior to GC/MS or ELISA, and it allows use of a single rapid procedure for both screening and confirmation.

  20. Chemical Risk Assessment Screening Tool of a Global Chemical Company

    Directory of Open Access Journals (Sweden)

    Evelyn Tjoe-Nij

    2018-03-01

    Full Text Available Background: This paper describes a simple-to-use and reliable screening tool called Critical Task Exposure Screening (CTES, developed by a chemical company. The tool assesses if the exposure to a chemical for a task is likely to be within acceptable levels. Methods: CTES is a Microsoft Excel tool, where the inhalation risk score is calculated by relating the exposure estimate to the corresponding occupational exposure limit (OEL or occupational exposure band (OEB. The inhalation exposure is estimated for tasks by preassigned ART1.5 activity classes and modifying factors. Results: CTES requires few inputs. The toxicological data, including OELs, OEBs, and vapor pressure are read from a database. Once the substance is selected, the user specifies its concentration and then chooses the task description and its duration. CTES has three outputs that may trigger follow-up: (1 inhalation risk score; (2 identification of the skin hazard with the skin warnings for local and systemic adverse effects; and (3 status for carcinogenic, mutagenic, or reprotoxic effects. Conclusion: The tool provides an effective way to rapidly screen low-concern tasks, and quickly identifies certain tasks involving substances that will need further review with, nevertheless, the appropriate conservatism. This tool shows that the higher-tier ART1.5 inhalation exposure assessment model can be included effectively in a screening tool. After 2 years of worldwide extensive use within the company, CTES is well perceived by the users, including the shop floor management, and it fulfills its target of screening tool. Keywords: occupational exposure, risk assessment, risk management

  1. Binding-site assessment by virtual fragment screening.

    Directory of Open Access Journals (Sweden)

    Niu Huang

    2010-04-01

    Full Text Available The accurate prediction of protein druggability (propensity to bind high-affinity drug-like small molecules would greatly benefit the fields of chemical genomics and drug discovery. We have developed a novel approach to quantitatively assess protein druggability by computationally screening a fragment-like compound library. In analogy to NMR-based fragment screening, we dock approximately 11,000 fragments against a given binding site and compute a computational hit rate based on the fraction of molecules that exceed an empirically chosen score cutoff. We perform a large-scale evaluation of the approach on four datasets, totaling 152 binding sites. We demonstrate that computed hit rates correlate with hit rates measured experimentally in a previously published NMR-based screening method. Secondly, we show that the in silico fragment screening method can be used to distinguish known druggable and non-druggable targets, including both enzymes and protein-protein interaction sites. Finally, we explore the sensitivity of the results to different receptor conformations, including flexible protein-protein interaction sites. Besides its original aim to assess druggability of different protein targets, this method could be used to identifying druggable conformations of flexible binding site for lead discovery, and suggesting strategies for growing or joining initial fragment hits to obtain more potent inhibitors.

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

    Science.gov (United States)

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

    2001-01-01

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

  3. Assessment of Substance Abuse Behaviors in Adolescents’: Integration of Self-Control into Extended Parallel Process Model

    Directory of Open Access Journals (Sweden)

    K Witte

    2005-04-01

    Full Text Available Introduction: An effective preventive health education program on drug abuse can be delivered by applying behavior change theories in a complementary fashion. Methods: The aim of this study was to assess the effectiveness of integrating self-control into Extended Parallel Process Model in drug substance abuse behaviors. A sample of 189 governmental high school students participated in this survey. Information was collected individually by completing researcher designed questionnaire and a urinary rapid immuno-chromatography test for opium and marijuana. Results: The results of the study show that 6.9% of students used drugs (especially opium and marijuana and also peer pressure was determinant factor for using drugs. Moreover the EPPM theoretical variables of perceived severity and perceived self-efficacy with self-control are predictive factors to behavior intention against substance abuse. In this manner, self-control had a significant effect on protective motivation and perceived efficacy. Low self- control was a predictive factor of drug abuse and low self-control students had drug abuse experience. Conclusion: The results of this study suggest that an integration of self-control into EPPM can be effective in expressing and designing primary preventive programs against drug abuse, and assessing abused behavior and deviance behaviors among adolescent population, especially risk seekers

  4. Quality assessment in prospective nuchal translucency screening for Down syndrome

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Christiansen, M; Sundberg, K

    2001-01-01

    OBJECTIVES: To develop and apply a quality control system in a Down syndrome screening study using nuchal translucency as an interventional marker. METHODS: In a prospective Down syndrome screening study fetal nuchal translucency thickness was measured in 9236 of the 10 045 examined pregnancies....... For quality assessment two models were introduced: firstly, image-scoring evaluation of the nuchal translucency thickness measurements and secondly, establishment of the distributions of nuchal translucency multiples of the median over time and the influence of intervention. RESULTS: The observer variability...... evaluation of the distribution of the nuchal translucency multiples of the median seems to be a good method to assess the quality for a center and may also be used to identify individual examiners deviating from the mean performance. The image-scoring methods we introduced cannot be recommended for quality...

  5. Fast and highly selective LC-MS/MS screening for THC and 16 other abused drugs and metabolites in human hair to monitor patients for drug abuse.

    Science.gov (United States)

    Koster, Remco A; Alffenaar, Jan-Willem C; Greijdanus, Ben; VanDernagel, Joanneke E L; Uges, Donald R A

    2014-04-01

    To facilitate the monitoring of drug abuse by patients, a method was developed and validated for the analysis of amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, methylenedioxyamphetamine, methylenedioxyethylamphetamine, methylphenidate, cocaine, benzoylecgonine, morphine, codeine, heroin, 6-monoacteylmorphine, methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), delta-9-tetrahydrocannabinol (THC), nicotine, and cotinine in human hair. The hair preparation method contains a 3-step wash procedure with dichloromethane followed by a simultaneous hair pulverization and extraction procedure with disposable metal balls. The developed liquid chromatography tandem mass spectrometry method uses a single injection to detect and confirm all 17 abused drugs, including THC, within 4.8 minutes. Nicotine was validated with a linear range of 800-25,000 pg/mg hair, and all other substances were validated with a linear range of 30.0-2500 pg/mg hair. For inaccuracy and imprecision, the overall bias did not exceed -8.2% and the overall coefficient of variation did not exceed 17.7%. Autosampler stability was proven for 48 hours at 10°C for all substances. Analytical cutoff concentrations were defined for each substance at the lowest validated inaccuracy and imprecision concentration with a bias and coefficient of variation within 15% and qualifier/quantifier ratios within 20% of the set ratio. The analytical cutoff concentrations were 200 pg/mg for codeine and 80.0 pg/mg for 6-MAM, heroin, EDDP, and THC. The analytical cutoff concentration for nicotine was 800 pg/mg and for all other validated substances 30.0 pg/mg. This method was successfully applied to analyze hair samples from patients who were monitored for drug abuse. Hair samples of 47 subjects (segmented into 129 samples) showed 3,4-methylenedioxymethamphetamine, methylphenidate, cocaine, benzoylecgonine, codeine, methadone, EDDP, THC, nicotine, and cotinine above the analytical cutoff. The

  6. The Assessment Of Cognitive Emotion Regulation Strategies And Emotional Schemas In Men With Substance Abuse, Abstinent And Normal Individuals

    Directory of Open Access Journals (Sweden)

    Ali Ghaednia Jahromi

    2016-12-01

    Full Text Available Background and Objective: Substance abuse is a chronic recurring disorder who needs to manage therapy over time. The goal of current study was to assess the cognitive emotion regulation strategies and emotional schemas in men with substance abuse, abstinent and normal individuals.Materials and Methods: In the form of a causal-comparative design, using available sampling method 30 men with substance abuse, 30 abstinent and 30 normal individuals were selected and after matching on the base of age, education and the substance they used were assessed via cognitive emotion regulation questionnaire and emotional schemas questionnaire. Multivariate analysis of variance was used to compare the three groups.Results: In self-blame (P=0.0004 and catastrophizing (P=0.0008 maladaptive cognitive emotion regulation strategies, the scores of individuals with substance abuse were higher than abstinent and normal individuals and in rumination (P=0.0007 individuals with substance abuse and abstinent obtained higher score in comparison with normal individuals. In refocusing on planning (P=0.0005 and positive reappraisal (P=0.00 adaptive strategies, normal individuals and abstinent in comparison with individuals with substance abuse obtained higher scores. In mental rumination (P=0.0008, blame (P=0.0008 and simplistic view of emotions (P=0.0009 individuals with substance abuse, abstinent had higher scores in comparison with normal individuals. In guilt (P=0.008 and uncontrolled (P=0.006 emotional schemas, individuals with substance abuse in comparison with normal individuals obtained higher scores.Conclusion: No effective emotional schemas and emotion regulation strategies can play a key role in substance abuse initiation, maintenance and relapse.

  7. Screening Level Risk Assessment for the New Waste Calcining Facility

    Energy Technology Data Exchange (ETDEWEB)

    M. L. Abbott; K. N. Keck; R. E. Schindler; R. L. VanHorn; N. L. Hampton; M. B. Heiser

    1999-05-01

    This screening level risk assessment evaluates potential adverse human health and ecological impacts resulting from continued operations of the calciner at the New Waste Calcining Facility (NWCF) at the Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Engineering and Environmental Laboratory (INEEL). The assessment was conducted in accordance with the Environmental Protection Agency (EPA) report, Guidance for Performing Screening Level Risk Analyses at Combustion Facilities Burning Hazardous Waste. This screening guidance is intended to give a conservative estimate of the potential risks to determine whether a more refined assessment is warranted. The NWCF uses a fluidized-bed combustor to solidify (calcine) liquid radioactive mixed waste from the INTEC Tank Farm facility. Calciner off volatilized metal species, trace organic compounds, and low-levels of radionuclides. Conservative stack emission rates were calculated based on maximum waste solution feed samples, conservative assumptions for off gas partitioning of metals and organics, stack gas sampling for mercury, and conservative measurements of contaminant removal (decontamination factors) in the off gas treatment system. Stack emissions were modeled using the ISC3 air dispersion model to predict maximum particulate and vapor air concentrations and ground deposition rates. Results demonstrate that NWCF emissions calculated from best-available process knowledge would result in maximum onsite and offsite health and ecological impacts that are less then EPA-established criteria for operation of a combustion facility.

  8. Abuse liability assessment of tobacco products including potential reduced exposure products.

    Science.gov (United States)

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

    2009-12-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  10. Assessing potential health effects from municipal sludge incinerators: screening methodology

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, L.; Bruins, J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.; Rubin, A.

    1987-04-01

    This paper describes a risk assessment methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e., facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium.

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

    Science.gov (United States)

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

    2014-05-01

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

  12. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  13. Improving the Clinical Pharmacologic Assessment of Abuse Potential: Part 1: Regulatory Context and Risk Management.

    Science.gov (United States)

    Sellers, Edward M

    2018-02-01

    This article brings to the attention of drug developers the Food and Drug Administration's (FDA's) recent final Guidance to Industry on Assessment of Abuse Potential and provides practical suggestions about compliance with the Guidance. The Guidance areas are reviewed, analyzed, and placed in the context of current scientific knowledge and best practices to mitigate regulatory risk. The Guidance provides substantial new detail on what needs to be done at all stages of drug development for central nervous system-active drugs. However, because many psychopharmacologic agents have unique preclinical and clinical features, the plan for each agent needs to be not only carefully prepared but also reviewed and approved by the FDA. Examples are provided where assumptions about interpretation of the Guidance can delay development. If the expertise and experience needed for assessing abuse potential during drug development do not exist within a company, external preclinical and clinical expert should be involved. Consultation with the FDA is encouraged and important because the specific requirements for each drug will vary.

  14. Feasibility of Screening for Preschool Behavioral and Emotional Problems in Primary Care Using the Early Childhood Screening Assessment.

    Science.gov (United States)

    Fallucco, Elise M; Robertson Blackmore, Emma; Bejarano, Carolina M; Wysocki, Tim; Kozikowski, Chelsea B; Gleason, Mary Margaret

    2016-03-22

    The American Academy of Pediatrics recommends screening young children for behavioral and emotional problems (BEP) during primary care visits. Because of time constraints, few primary care providers (PCPs) use standardized screening tools to detect BEP. The Early Childhood Screening Assessment (ECSA) is a brief screening tool developed specifically to meet the needs of pediatric primary care providers (PCPs). The ECSA has established psychometric properties, but the feasibility and acceptability of the ECSA have not been established. This study examines the degree to which PCPs would incorporate ECSA screening and how PCPs value the ECSA as a tool to detect children with BEP. Twenty-seven pediatric PCPs were trained to implement ECSA screening. Six months after training, 96% of PCPs reported that the ECSA was practical for use at well-visits, 70% were still screening and 89% agreed that it helped detect more cases of BEP than by routine history-taking alone. © The Author(s) 2016.

  15. Assessing behavioral patterns of Internet addiction and drug abuse among high school students

    Directory of Open Access Journals (Sweden)

    Nemati Z

    2017-01-01

    Full Text Available Zeinab Nemati, Hossein Matlabi Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Background: Internet addiction and drug abuse isolate adolescents from their family and friends and cause damage to their health, relations, emotions, and spirit. In the society, adolescents’ addiction extracts high cost on health care, educational failure and mental health services. Objectives: The aim of this study was to assess the behavioral patterns of Internet and drug addiction among urban and rural students in Urmia, Iran. Methods: A sectional and descriptive–analytical approach with stratified sampling method was employed to recruit 385 high school students from urban and rural areas. The Internet Addiction Test (IAT and the Addiction Acknowledgement Scale (AAS were used for data collection. Results: The total score of Internet addiction among the students was 41.72 ± 17.41. Approximately two-third of the students were not addicted to the Internet. The mean score of the AAS was 1.87 ± 1.23 among boys and 1.75 ± 1.31 among girls. Moreover, 8.31% of the students were prone to abusing substances. A statistically significant relationship was found between mother’s literacy level and Internet addiction behavior of students (p=0.009. Conclusion: Concentrating on adolescents’ behavioral patterns and their tendency toward misusing Internet and drugs is a notable procedure. Therefore, focusing on adolescents’ health and institutionalizing appropriate training programs for adolescents and their families are vital. Keywords: Internet, drug abuse, adolescence, addiction, behavior

  16. Prevalence and risk factors of abuse among community dwelling elderly of Guwahati City, Assam

    Directory of Open Access Journals (Sweden)

    Anku Moni Saikia

    2015-01-01

    Full Text Available Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST. Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population.

  17. Comparative validity of depression assessment scales for screening poststroke depression.

    Science.gov (United States)

    Kang, Hee-Ju; Stewart, Robert; Kim, Jae-Min; Jang, Ji-Eun; Kim, Seon-Young; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Park, Man-Seok; Cho, Ki-Hyun; Yoon, Jin-Sang

    2013-05-01

    This study aimed to compare screening properties of four assessment scales for poststroke depression (PSD) at 2 weeks and 1 year after index stroke, and investigated factors contributing to misclassification. A total of 423 patients were evaluated 2 weeks after stroke and 288 (68%) were followed 1 year later, and were diagnosed as having major and minor PSD applying DSM-IV criteria gold standards. The Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale-depression subscale (HADS-D), Hamilton Rating Scale for Depression (HAMD), and Montgomery-Asberg Depression Rating Scale (MADRS) were administered. The balance of sensitivity and specificity was assessed using receiver operating characteristics (ROC) analysis. Discriminating abilities of all the scales for major and all PSD were good (area under ROC values 0.88-0.93 and 0.88-0.92 at 2 weeks; and 0.93-0.96 and 0.89-0.91 at 1 year, respectively). Misclassification was influenced by demographic characteristics and stroke severity particularly for the BDI and HAMD, was more marked for all PSD than for major PSD, and was more prominent at 2 weeks than at 1 year after stroke. Patients with only mild to moderate stroke severity were included. Although there were no marked differences in the screening abilities for PSD between the scales, differences were found in factors influencing misclassification. Assessment scales with less somatic items may be recommended for the screening of PSD, particularly at the acute phase of stroke. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Clinical assessment of suspected child physical abuse; Klinischer Verdacht auf Kindesmisshandlung

    Energy Technology Data Exchange (ETDEWEB)

    Rohrer, T. [Universitaetsklinikum des Saarlandes, Klinik fuer Allgemeine Paediatrie und Neonatologie, Homburg/Saar (Germany)

    2009-10-15

    Violence against children has many faces. Child physical abuse, neglect, sexual abuse and interparental violence can cause acute and permanent damage and affect children's development and their life plans in the long term. In industrialized nations almost 1 child in 10 is affected. Up to 10% of child physical abuse cases involve the central nervous system with 80% of these cases occurring during the first year of life. Worldwide more than 50,000 children die as a result of violence, abuse and neglect every year, according to the United Nations Children's Fund UNICEF. In Germany, there are about 120 cases of non-accidental head injury per year. In addition to the officially known cases there is a large grey area for all forms of violence. Recognition of these cases and the provision of help for the victims require an appropriate suspicion and understanding of the pertinent pathophysiology. Suspicion must be based on a well-documented medical history and multidisciplinary diagnostic assessment. Medical confidentiality prevents the disclosure of such information making early detection networks and guidelines for collaboration absolutely indispensable. (orig.) [German] Gewalt gegen Kinder hat viele Gesichter: Kindesmisshandlung, Vernachlaessigung, sexueller Missbrauch und elterliche Partnerschaftsgewalt koennen bei Kindern und Jugendlichen zu akuten und bleibenden Schaeden fuehren und ihre Entwicklung und Lebensentwuerfe nachhaltig beeinflussen. Betroffen ist in Industrienationen fast jedes zehnte Kind. Bis zu 10% der Kindesmisshandlungen betreffen das zentrale Nervensystem. Von diesen ereignen sich ca. 80% im ersten Lebensjahr. Weltweit sterben nach Angaben der Kinderhilfsorganisation UNICEF jaehrlich ueber 50.000 Kinder an den Folgen von Gewalt, Missbrauch und Vernachlaessigung. In Deutschland ereignen sich pro Jahr ca. 120 Faelle an nichtakzidentellen Kopfverletzungen. Den oeffentlich bekannten Faellen steht eine hohe Dunkelziffer aller Formen von Gewalt

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

    Science.gov (United States)

    Cockbain, Ella; Brayley, Helen; Sullivan, Joe

    2014-07-01

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

  20. Assessing behavioral patterns of Internet addiction and drug abuse among high school students.

    Science.gov (United States)

    Nemati, Zeinab; Matlabi, Hossein

    2017-01-01

    Internet addiction and drug abuse isolate adolescents from their family and friends and cause damage to their health, relations, emotions, and spirit. In the society, adolescents' addiction extracts high cost on health care, educational failure and mental health services. The aim of this study was to assess the behavioral patterns of Internet and drug addiction among urban and rural students in Urmia, Iran. A sectional and descriptive-analytical approach with stratified sampling method was employed to recruit 385 high school students from urban and rural areas. The Internet Addiction Test (IAT) and the Addiction Acknowledgement Scale (AAS) were used for data collection. The total score of Internet addiction among the students was 41.72 ± 17.41. Approximately two-third of the students were not addicted to the Internet. The mean score of the AAS was 1.87 ± 1.23 among boys and 1.75 ± 1.31 among girls. Moreover, 8.31% of the students were prone to abusing substances. A statistically significant relationship was found between mother's literacy level and Internet addiction behavior of students ( p =0.009). Concentrating on adolescents' behavioral patterns and their tendency toward misusing Internet and drugs is a notable procedure. Therefore, focusing on adolescents' health and institutionalizing appropriate training programs for adolescents and their families are vital.

  1. Validation of a behavioral economic purchase task for assessing drug abuse liability.

    Science.gov (United States)

    MacKillop, James; Goldenson, Nicholas I; Kirkpatrick, Matthew G; Leventhal, Adam M

    2018-01-05

    Behavioral economic purchase tasks quantify drug demand (i.e. reinforcing value of a drug) and have been used extensively to assess the value of various drugs among current users. However, purchase tasks have been rarely used with unfamiliar drugs to address a compound's abuse liability, and the current study sought to validate the paradigm in this capacity. Using a double-blind placebo-controlled within-subjects drug challenge design, the study evaluated differential drug demand on an experimental drug purchase task for a 20 mg dose of oral D-amphetamine (versus placebo), a prototypic psychostimulant, in 98 stimulant-naïve participants. Compared with placebo, amphetamine significantly increased intensity, breakpoint and O max , and significantly decreased elasticity. Mechanistic analyses revealed that O max and breakpoint mediated the relationship between subjective drug effects and 'willingness to take again', a putative indicator of liability via motivation for future drug-seeking behavior. These findings validate the purchase task paradigm for quantifying the reinforcing value and, in turn, abuse liability of unfamiliar compounds, providing a foundation for a variety of future applications. © 2018 Society for the Study of Addiction.

  2. Screening for and Prevalence of HIV and Hepatitis C among an Outpatient Urban Sample of People with Serious Mental Illness and Co-Occurring Substance Abuse

    Science.gov (United States)

    Himelhoch, Seth; Goldberg, Richard; Calmes, Christine; Medoff, Deborah; Slade, Eric; Dixon, Lisa; Gallucci, Gerard; Rosenberg, Stanley

    2011-01-01

    Background: To assess rates of screening and testing of HIV and HCV among those with serious mental illness and co-occurring substance use disorders. Methods: One hundred fifty-three people with serious mental illness and co-occurring substance use disorders completed measures and were screened for HIV and HCV. Results: Six percent were HIV…

  3. Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River.

  4. Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

    International Nuclear Information System (INIS)

    Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River

  5. Incremental Sampling Methodology: Applications for Background Screening Assessments.

    Science.gov (United States)

    Pooler, Penelope S; Goodrum, Philip E; Crumbling, Deana; Stuchal, Leah D; Roberts, Stephen M

    2018-01-01

    This article presents the findings from a numerical simulation study that was conducted to evaluate the performance of alternative statistical analysis methods for background screening assessments when data sets are generated with incremental sampling methods (ISMs). A wide range of background and site conditions are represented in order to test different ISM sampling designs. Both hypothesis tests and upper tolerance limit (UTL) screening methods were implemented following U.S. Environmental Protection Agency (USEPA) guidance for specifying error rates. The simulations show that hypothesis testing using two-sample t-tests can meet standard performance criteria under a wide range of conditions, even with relatively small sample sizes. Key factors that affect the performance include unequal population variances and small absolute differences in population means. UTL methods are generally not recommended due to conceptual limitations in the technique when applied to ISM data sets from single decision units and due to insufficient power given standard statistical sample sizes from ISM. © 2017 Society for Risk Analysis.

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  8. [Assessment of malaria screening management in blood donation control in the French Military Blood Institute].

    Science.gov (United States)

    Pouget, T; Garcia-Hejl, C; Bouzard, S; Roche, C; Sailliol, A; Martinaud, C

    2014-06-01

    The French Military Blood Institute is responsible for the entire blood supply chain in the French Armed Forces. Considering, the high exposition rate of military to malaria risk, blood donation screening of plasmodium infection must be as efficient as possible. The main aim of our study was to assess our malaria testing strategy based on a single Elisa test compared with a two-step strategy implying immunofluorescence testing as confirmation test. The second goal was to describe characteristic of malaria Elisa positive donors. We conducted a prospective study: every malaria Elisa positive test was implemented by immunofluorescence testing and demographical data were recorded as usual by our medical software. We showed a significant risk of malaria ELISA positive tests among donor born in endemic area and we estimate the number of abusively 3-year rejected donors. However, based on our estimations, the two-step strategy is not relevant since the number of additionally collected blood products will be low. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Development of a questionnaire to assess drug abuse among high school students of Isfahan province, Iran: An action research

    Directory of Open Access Journals (Sweden)

    Nahid Geramian

    2014-01-01

    Conclusions: According to the obtained results, the designed questionnaire is capable to assess the drug abuse status among high school students of Isfahan Province. Regarding the importance of teenage years in forming the future behaviors of adolescents and the opportunities provided at schools, it is prudent to pay more attention to interventions in this age group in order to increase their knowledge and correct their attitude toward illegal drugs and strengthening their confidence in this regard. These interventions can have an important role in decreasing the rate of drug abuse in this age group and consequently in the whole community.

  10. Pesticide Cumulative Risk Assessment: Framework for Screening Analysis

    Science.gov (United States)

    This document provides guidance on how to screen groups of pesticides for cumulative evaluation using a two-step approach: begin with evaluation of available toxicological information and, if necessary, follow up with a risk-based screening approach.

  11. Basic ultrasound training assessment in the initial abdominal trauma screening

    Directory of Open Access Journals (Sweden)

    LUAN GERALDO OCAÑA OLIVEIRA

    2018-02-01

    Full Text Available ABSTRACT Objective: to verify the efficiency and usefulness of basic ultrasound training in trauma (FAST - Focused Assessment with Sonography in Trauma for emergency physicians in the primary evaluation of abdominal trauma. Methods: a longitudinal and observational study was carried out from 2015 to 2017, with 11 emergency physicians from Hospital Universitário do Oeste do Paraná, submitted to ultrasound training in emergency and trauma (USET® - SBAIT. FAST results started to be collected two months after the course. These were compared with a composite score of complementary exams and surgical findings. Information was stored in a Microsoft Excel program database and submitted to statistical analysis. Results: FAST was performed in 120 patients. In the study, 38.4% of the assessed patients had a shock index ≥0.9. The composite score detected 40 patients with free peritoneal fluid, whereas FAST detected 27 cases. The method sensitivity was 67.5%, specificity was 98.7%, the positive predictive value was 96.4%, the negative predictive value was 85.39% and accuracy was 88%. All those with a positive FAST had a shock index ≥0.9. Fifteen patients with positive FAST and signs of instability were immediately submitted to surgery. Conclusions: the basic training of emergency physicians in FAST showed efficiency and usefulness in abdominal trauma assessment. Due to its low cost and easy implementation, this modality should be considered as a screening strategy for patients with abdominal trauma in health systems.

  12. Virtual reality applications for diagnosis, risk assessment and therapy of child abusers.

    Science.gov (United States)

    Fromberger, Peter; Jordan, Kirsten; Müller, Jürgen L

    2018-03-01

    Despite the successful application of virtual reality (VR) in a wide variety of mental disorders and the obvious potentials that VR provides, the use of VR in the context of criminology and forensic psychology is sparse. For forensic mental health professionals, VR provides some advantages that outrun general advantages of VR, e.g., ecological validity and controllability of social situations. Most important seems to be the unique possibility to expose offenders and to train coping skills in virtual situations, which are able to elicit disorder-relevant behavior-without endangering others. VR has already been used for the assessment of deviant sexual interests, for testing the ability to transfer learned coping skills communicated during treatment to behavior, and for risk assessment of child abusers. This article reviews and discusses these innovative research projects with regard to their impact on current clinical practice regarding risk assessment and treatment as well as other implementations of VR applications in forensic mental health. Finally, ethical guidelines for VR research in forensic mental health are provided. Copyright © 2018 John Wiley & Sons, Ltd.

  13. Data for the screening assessment. Volume 1: Text, Columbia River Comprehensive Impact Assessment

    International Nuclear Information System (INIS)

    Miley, T.B.; O'Neil, T.K.; Gilbert, R.O.; Klevgard, L.A.; Walters, T.B.

    1996-06-01

    The Columbia River is a critical resource for residents of the Pacific Northwest. This resource drew the Manhattan Project's planners to the site now called Hanford to produce nuclear weapon materials. Production of those materials has left behind a legacy of chemical and radioactive contamination and materials that have, are, and will continue to pose a threat to the Columbia river for the foreseeable future. To evaluate the impact to the river from this Hanford-derived contamination, the US Department of Energy, US Environmental Protection Agency, and State of Washington Department of Ecology (the Tri-Party agencies) initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, stakeholder, tribal, and public involvement, the CRCIA Management Team was formed in August 1995. A major CRCIA Team decision was to organize CRCIA into phases, with additional phases to be identified as warranted after completion of the initial phase. The initial phase is comprised of two parts: (1) a screening assessment to evaluate the current impact to the river resulting from Hanford-derived contamination and (2) identification of requirements considered necessary by the CRCIA Management Team for a comprehensive assessment of impact to the river. The purpose of the screening assessment is to support cleanup decisions. The scope of the screening assessment is to evaluate the current risk to humans and the environment resulting from Hanford-derived contaminants. The screening assessment has the primary components of: identifying contaminants to be assessed; identifying a variety of exposure scenarios to evaluate human contaminant exposure; identifying a variety of other species to evaluate ecological contaminant exposure; and assessing risks posed by exposure of humans and other species to the contaminants

  14. Screening for Common Mental Disorders and Substance Abuse among Temporary Hired Cleaners in Egyptian Governmental Hospitals, Zagazig City, Sharqia Governorate

    OpenAIRE

    RA Abbas; RAM Hammam; SS El-Gohary; LME Sabik; MS Hunter

    2012-01-01

    Background: Informal employment is common in developing countries, including Egypt. This type of employment may have significant consequences on mental health. Objectives: To determine the prevalence and risk factors of common mental disorders and substance abuse among temporary hired hospital cleaners. Methods: A cross-sectional study was conducted on 242 adult temporary cleaners and 209 permanent cleaners working in 4 governmental hospitals in Zagazig City, Sharqia Governorate, Egyp...

  15. Is early detection of abused children possible?: a systematic review of the diagnostic accuracy of the identification of abused children.

    Science.gov (United States)

    Bailhache, Marion; Leroy, Valériane; Pillet, Pascal; Salmi, Louis-Rachid

    2013-12-05

    Early detection of abused children could help decrease mortality and morbidity related to this major public health problem. Several authors have proposed tools to screen for child maltreatment. The aim of this systematic review was to examine the evidence on accuracy of tools proposed to identify abused children before their death and assess if any were adapted to screening. We searched in PUBMED, PsycINFO, SCOPUS, FRANCIS and PASCAL for studies estimating diagnostic accuracy of tools identifying neglect, or physical, psychological or sexual abuse of children, published in English or French from 1961 to April 2012. We extracted selected information about study design, patient populations, assessment methods, and the accuracy parameters. Study quality was assessed using QUADAS criteria. A total of 2 280 articles were identified. Thirteen studies were selected, of which seven dealt with physical abuse, four with sexual abuse, one with emotional abuse, and one with any abuse and physical neglect. Study quality was low, even when not considering the lack of gold standard for detection of abused children. In 11 studies, instruments identified abused children only when they had clinical symptoms. Sensitivity of tests varied between 0.26 (95% confidence interval [0.17-0.36]) and 0.97 [0.84-1], and specificity between 0.51 [0.39-0.63] and 1 [0.95-1]. The sensitivity was greater than 90% only for three tests: the absence of scalp swelling to identify children victims of inflicted head injury; a decision tool to identify physically-abused children among those hospitalized in a Pediatric Intensive Care Unit; and a parental interview integrating twelve child symptoms to identify sexually-abused children. When the sensitivity was high, the specificity was always smaller than 90%. In 2012, there is low-quality evidence on the accuracy of instruments for identifying abused children. Identified tools were not adapted to screening because of low sensitivity and late identification

  16. Construction of an Occupational Therapy Screenings Assessment for elderly medical patients

    DEFF Research Database (Denmark)

    Holsbæk, Jonas

    there for demands a validated Occupational Therapy Screening Assessment, that fast and easy can tell if more Occupational Therapy is needed. Aim: The aim of the study is to develop a Screening Assessment which can be used in the Occupational Therapist practice screening Hospitalized Elderly medical inpatients...... by means of the Content Validity Index (CVI) – Questionaire. Result: The result was a Screening Assessment and a Manual, which was built up using ICF and the ADL-Taxonomy as References. The Screening Instrument should be a support for the working Occupational Therapist in their Clinical Reasoning. CVI...

  17. Development and psychometric testing the Health of Body, Mind and Spirit Scale for assessing individuals who have drug abuse histories.

    Science.gov (United States)

    Sun, Fan-Ko; Chiang, Chun-Ying; Lu, Chu-Yun; Yu, Pei-Jane; Liao, Tzu-Chiao; Lan, Chu-Mei

    2018-03-01

    To develop the Health of Body, Mind and Spirit Scale (HBMSS), which was designed to assess drug abusers' health condition. Helping drug abusers to become healthy is important to healthcare professionals. However, no instrument exists to assess drug abusers' state of health. A cross-sectional questionnaire survey was implemented to examine the validity of the HBMSS. Data were collected from 2015-2016 at one drug abuse prevention centre in Taiwan. Participants (N = 320) who had abused drugs were invited to complete a preliminary 64-item version of the HBMSS. An item analysis, criterion-related validity analysis (using the Relapse Prediction Scale [RPS] score), split-half reliability testing and confirmatory factor analysis (CFA) were conducted to examine the psychometric properties of the HBMSS. The final version of the HBMSS contained 15 items that were divided into three subscales: the health of the body, mind and spirit. Cronbach's α and split-half reliability coefficients were all above .85. The factor loading of each item was between .74-.95. The HBMSS had satisfactory criterion-related validity with the RPS score (r = -.50, p < .001). A second-order CFA was conducted on the HBMSS. The fit indexes were good, χ 2  = 184.060, df = 94, χ 2 /df = 1.958 (p = .000). The entire HBMSS and the subscales had satisfactory reliability and validity. Healthcare professionals could use the HBMSS to evaluate the condition of the health of individuals with a drug abuse history. © 2017 John Wiley & Sons Ltd.

  18. Combating child abuse: the role of a dentist.

    Science.gov (United States)

    Mathur, Shivani; Chopra, Rahul

    2013-01-01

    Child abuse has serious physical and psychosocial consequences which adversely affect the health and overall well-being of a child. However, in a developing country like India there has been no knowledge of the extent, magnitude and trends of the problem. This study reviews the overall scenario of child abuse in India as well as the role of the dentist in recognising and thereby combating this problem. Among health professionals, dentists are probably in the most favourable position to recognise child abuse, with opportunities to observe and assess not only the physical and the psychological condition of the children, but also the family environment. The high frequency of facial injuries associated with physical abuse places the dentist at the forefront of professionals to detect and treat an abused child. Screening for maltreatment should be an integral part of any clinical examination performed on a child. Although many injuries are not caused by abuse, dentists should always be suspicious of traumatic injuries. The dental professional's role in child abuse and neglect is to know the current state law regarding reporting child abuse and to follow the law. Awareness, identification, documentation and notification should be carried out by the dentist. Paediatric dentists can provide valuable information and assistance to physicians about oral and dental aspects of child abuse and neglect. Such efforts will strengthen the ability to prevent and detect child abuse and neglect and enhance care and protection for the children.

  19. An abuse of risk assessment: how regulatory agencies improperly adopted LNT for cancer risk assessment.

    Science.gov (United States)

    Calabrese, Edward J

    2015-04-01

    The Genetics Panel of the National Academy of Sciences' Committee on Biological Effects of Atomic Radiation (BEAR) recommended the adoption of the linear dose-response model in 1956, abandoning the threshold dose-response for genetic risk assessments. This recommendation was quickly generalized to include somatic cells for cancer risk assessment and later was instrumental in the adoption of linearity for carcinogen risk assessment by the Environmental Protection Agency. The Genetics Panel failed to provide any scientific assessment to support this recommendation and refused to do so when later challenged by other leading scientists. Thus, the linearity model used in cancer risk assessment was based on ideology rather than science and originated with the recommendation of the NAS BEAR Committee Genetics Panel. Historical documentation in support of these conclusions is provided in the transcripts of the Panel meetings and in previously unexamined correspondence among Panel members.

  20. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine

    Directory of Open Access Journals (Sweden)

    Siam Mohamed G

    2009-04-01

    Full Text Available Abstract Background Laboratory tests for routine drug of abuse and toxicology (DOA/Tox screening, often used in emergency medicine, generally utilize antibody-based tests (immunoassays to detect classes of drugs such as amphetamines, barbiturates, benzodiazepines, opiates, and tricyclic antidepressants, or individual drugs such as cocaine, methadone, and phencyclidine. A key factor in assay sensitivity and specificity is the drugs or drug metabolites that were used as antigenic targets to generate the assay antibodies. All DOA/Tox screening immunoassays can be limited by false positives caused by cross-reactivity from structurally related compounds. For immunoassays targeted at a particular class of drugs, there can also be false negatives if there is failure to detect some drugs or their metabolites within that class. Methods Molecular similarity analysis, a computational method commonly used in drug discovery, was used to calculate structural similarity of a wide range of clinically relevant compounds (prescription and over-the-counter medications, illicit drugs, and clinically significant metabolites to the target ('antigenic' molecules of DOA/Tox screening tests. These results were compared with cross-reactivity data in the package inserts of immunoassays marketed for clinical testing. The causes for false positives for phencyclidine and tricyclic antidepressant screening immunoassays were investigated at the authors' medical center using gas chromatography/mass spectrometry as a confirmatory method. Results The results illustrate three major challenges for routine DOA/Tox screening immunoassays used in emergency medicine. First, for some classes of drugs, the structural diversity of common drugs within each class has been increasing, thereby making it difficult for a single assay to detect all compounds without compromising specificity. Second, for some screening assays, common 'out-of-class' drugs may be structurally similar to the target

  1. Development and weighting of a life cycle assessment screening model

    Science.gov (United States)

    Bates, Wayne E.; O'Shaughnessy, James; Johnson, Sharon A.; Sisson, Richard

    2004-02-01

    Nearly all life cycle assessment tools available today are high priced, comprehensive and quantitative models requiring a significant amount of data collection and data input. In addition, most of the available software packages require a great deal of training time to learn how to operate the model software. Even after this time investment, results are not guaranteed because of the number of estimations and assumptions often necessary to run the model. As a result, product development, design teams and environmental specialists need a simplified tool that will allow for the qualitative evaluation and "screening" of various design options. This paper presents the development and design of a generic, qualitative life cycle screening model and demonstrates its applicability and ease of use. The model uses qualitative environmental, health and safety factors, based on site or product-specific issues, to sensitize the overall results for a given set of conditions. The paper also evaluates the impact of different population input ranking values on model output. The final analysis is based on site or product-specific variables. The user can then evaluate various design changes and the apparent impact or improvement on the environment, health and safety, compliance cost and overall corporate liability. Major input parameters can be varied, and factors such as materials use, pollution prevention, waste minimization, worker safety, product life, environmental impacts, return of investment, and recycle are evaluated. The flexibility of the model format will be discussed in order to demonstrate the applicability and usefulness within nearly any industry sector. Finally, an example using audience input value scores will be compared to other population input results.

  2. PATHOS: a brief screening application for assessing sexual addiction.

    Science.gov (United States)

    Carnes, Patrick J; Green, Bradley A; Merlo, Lisa J; Polles, Alexis; Carnes, Stefanie; Gold, Mark S

    2012-03-01

    Sexual addiction is estimated to afflict up to 3% to 6% of the population. However, many clinicians lack clear criteria for detecting potential cases. The present studies were conducted to assess the effectiveness of a brief sexual addiction screening instrument (ie, PATHOS Questionnaire) to correctly classify patients being treated for sex addiction and healthy volunteers. In study 1, a 6-item questionnaire, which utilizes the mnemonic "PATHOS," was examined in regard to sensitivity and specificity using a sample combining patients being treated for sex addiction and healthy volunteers (970 men/80.2% patients; 938 women/63.8% patients). In study 2, a cross-validation sample of 672 men (93% patients) and 241 women (35.3% patients) completed the PATHOS screener. Results of receiver operating characteristics analyses in study 1 demonstrated that the PATHOS captured 92.6% of the area under the curve and achieved 88.3% sensitivity and 81.6% specificity for classifying the male sample (n = 963) as patients and healthy subjects using a cutoff score of 3. Similarly, the PATHOS captured 90.2% of the area under the curve and, with a cutoff of 3, achieved 80.9% sensitivity and 87.2% specificity for the female sample (n = 808). In study 2, results of receiver operating characteristics analyses indicated that the PATHOS captured 85.1% of the area under the curve, with sensitivity of 70.7% and specificity of 86.9% for men (cutoff of 3). For women, the PATHOS captured 80.9% of the area under the curve and achieved 69.7% sensitivity and 85.1% specificity with the cutoff of 3. These studies provide support for the use of the PATHOS as a screening instrument to detect potential sexual addiction cases in clinical settings.

  3. The use of IQ assessment in astronaut screening and evaluation.

    Science.gov (United States)

    Bishop, S L; Faulk, D; Santy, P A

    1996-12-01

    The screening and evaluation of astronaut candidates usually includes measures of cognitive and intellectual capacity. Questions of ceiling effects and discriminability when evaluating individuals assumed to be of above average intelligence should be considered. The current study examines ceiling effects and discriminability on IQ assessment between pilots vs. mission specialists and men vs. women in the selection of astronaut candidates. IQ scores on 104 male and female Shuttle astronaut candidates as measured by the Multidimensional Aptitude Battery (MAB) were analyzed via factor analyses and tests of differences between genders, selection status, and job types. Total group, gender, and job type specificity and sensitivity and overall percent correctly classified were assessed on selected vs. unselected classification. Exploratory and confirmatory factor analyses failed to replicate the proposed factor configuration prompting reconfigured domain scores. Analyses of differences between gender, selection, and job categories found different results when using reconfigured IQ scores compared to the original formulation. The 10 subscales performed better than overall domain scores in sensitivity, specificity, and as significant predictors of individuals selected. Both versions of Verbal, Performance, and Full Scale IQ scores performed similarly regarding sensitivity and specificity. The reconfigured scores were better predictors of selection. Evidence for sensitivity, specificity, and classification prediction was better for subscales than overall domain scores. Some consideration to using reconfigured domain scores should be given to increase instrument utility.

  4. Introduction: mass screening, health technology assessment, and health policy in some European countries.

    NARCIS (Netherlands)

    Oortwijn, W.J.; Banta, H.D.; Cranovsky, R.

    2001-01-01

    OBJECTIVE: The series of papers in this issue was developed to examine the use of health technology assessment in policies toward prevention-specifically toward mass screening-in European countries. The papers actually examined three screening strategies: mammography screening for breast cancer,

  5. Maternal hair and neonatal meconium to assess gestational consumption and prenatal exposure to drugs of abuse and psychoactive drugs.

    Science.gov (United States)

    Cortes, Laura; Almeida, Laura; Sabra, Sally; Muniesa, Marta; Busardo, Francesco Paolo; Garcia-Algar, Oscar; Gomez-Roig, Maria Dolores

    2018-04-05

    In the last two decades, the consumption of drugs of abuse among women of childbearing age has experienced a significant increase and results from analyses of surveys concerning maternal intake of psychoactive prescription drugs during pregnancy indicate that the rates of intake are increasing each year. Analyses of biological matrices such as maternal hair and neonatal meconium have recently been used for assessment of gestational consumption and consequent prenatal exposure to drugs of abuse in high-risk groups of women METHODS: Maternal hair and neonatal meconium were analyzed by validated chromatographic mass spectrometric methodologies to disclose gestational use of drugs of abuse and psychoactive prescription drugs and consequent prenatal exposure in a cohort of 513 mother-newborn dyads at the Sant Joan de Déu Barcelona Hospital, Spain, during 2012- 2013. A total of 3.9% the women reported drugs of abuse or prescription psychoactive drug consumption at any time during pregnancy. The prevalence of gestational consumption and consequent prenatal exposure to drugs of abuse (e.g. cannabis, cocaine and MDMA) was 1.2% in maternal hair and 0.4% in meconium; that of psychoactive prescription drugs (e.g. venlafaxine, citalopram, fluoxetine, clomipramine) was 1.7% in maternal hair and 1.2% in meconium. The prevalence of drugs of abuse and prescription psychoactive drug consumption was lower in our specific cohort of Spanish pregnant women than in other cohorts such as those from U.S. or Denmark. Analysis of materno-fetal matrices provides a viable alternative to study prenatal exposure to these substances and develop specific social and health intervention recommendations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. The Role of Sexual Abuse and Dysfunctional Attitudes in Perceived Stress and Negative Mood in Pregnant Adolescents: An Ecological Momentary Assessment Study.

    Science.gov (United States)

    Walsh, Kate; Basu, Archana; Monk, Catherine

    2015-10-01

    Latinas have the highest rates of adolescent pregnancy in the United States. Identifying means to improve the well-being of these young women is critical. The current study examined whether a history of child sexual abuse-itself a risk factor for adolescent pregnancy-was associated with more perceived stress and negative mood over the course of pregnancy and whether dysfunctional attitudes explained these associations. This mixed methods study involved laboratory-based assessments of perceived stress, sexual abuse history, and dysfunctional attitudes, as well as Ecological Momentary Assessments (EMA) of mood states every 30 minutes during a 24-hour period once during each trimester of pregnancy. Pregnant adolescents (N = 204, 85% Latina). EMA mood states and laboratory-based retrospective self-reports of perceived stress. One in 4 pregnant adolescents had a history of sexual abuse. Sexually abused adolescents reported greater perceived stress during the first trimester relative to those without, though the groups did not differ on EMA negative mood ratings. Dysfunctional attitudes explained associations between sexual abuse and perceived stress. Sexual abuse was indirectly associated with the intercept and slope of negative mood through dysfunctional attitudes. Findings were circumscribed to sexual abuse and not other types of child abuse. Identifying sexually abused pregnant adolescents and providing support and cognitive therapy to target dysfunctional beliefs may decrease stress during the first trimester as well as negative affect throughout pregnancy. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  7. Rapid wide-scope screening of drugs of abuse, prescription drugs with potential for abuse and their metabolites in influent and effluent urban wastewater by ultrahigh pressure liquid chromatography-quadrupole-time-of-flight-mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, Felix, E-mail: felix.hernandez@qfa.uji.es [Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, E-12071 Castellon (Spain); Bijlsma, Lubertus, E-mail: bijlsma@guest.uji.es [Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, E-12071 Castellon (Spain); Sancho, Juan V.; Diaz, Ramon; Ibanez, Maria [Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, E-12071 Castellon (Spain)

    2011-01-17

    This work illustrates the potential of hybrid quadrupole-time-of-flight mass spectrometry (QTOF MS) coupled to ultrahigh pressure liquid chromatography (UHPLC) to investigate the presence of drugs of abuse in wastewater. After solid-phase extraction with Oasis MCX cartridges, seventy-six illicit drugs, prescription drugs with potential for abuse, and metabolites were investigated in the samples by TOF MS using electrospray interface under positive ionization mode, with MS data acquired over an m/z range of 50-1000 Da. For 11 compounds, reference standards were available, and experimental data (e.g., retention time and fragmentation data) could be obtained, facilitating a more confident identification. The use of a QTOF instrument enabled the simultaneous application of two acquisition functions with different collision energies: a low energy (LE) function, where none or poor fragmentation took place, and a high energy (HE) function, where fragmentation in the collision cell was promoted. This approach, known as MS{sup E}, enabled the simultaneous acquisition of full-spectrum accurate mass data of both protonated molecules and fragment ions in a single injection, providing relevant information that facilitates the rapid detection and reliable identification of these emerging contaminants in the sample matrices analyzed. In addition, isomeric compounds, like the opiates, morphine and norcodeine, could be discriminated by their specific fragments observed in HE TOF MS spectra, without the need of reference standards. UHPLC-QTOF MS was proven to be a powerful and efficient technique for rapid wide-scope screening and identification of many relevant drugs in complex matrices, such as influent and effluent urban wastewater.

  8. Rapid wide-scope screening of drugs of abuse, prescription drugs with potential for abuse and their metabolites in influent and effluent urban wastewater by ultrahigh pressure liquid chromatography-quadrupole-time-of-flight-mass spectrometry

    International Nuclear Information System (INIS)

    Hernandez, Felix; Bijlsma, Lubertus; Sancho, Juan V.; Diaz, Ramon; Ibanez, Maria

    2011-01-01

    This work illustrates the potential of hybrid quadrupole-time-of-flight mass spectrometry (QTOF MS) coupled to ultrahigh pressure liquid chromatography (UHPLC) to investigate the presence of drugs of abuse in wastewater. After solid-phase extraction with Oasis MCX cartridges, seventy-six illicit drugs, prescription drugs with potential for abuse, and metabolites were investigated in the samples by TOF MS using electrospray interface under positive ionization mode, with MS data acquired over an m/z range of 50-1000 Da. For 11 compounds, reference standards were available, and experimental data (e.g., retention time and fragmentation data) could be obtained, facilitating a more confident identification. The use of a QTOF instrument enabled the simultaneous application of two acquisition functions with different collision energies: a low energy (LE) function, where none or poor fragmentation took place, and a high energy (HE) function, where fragmentation in the collision cell was promoted. This approach, known as MS E , enabled the simultaneous acquisition of full-spectrum accurate mass data of both protonated molecules and fragment ions in a single injection, providing relevant information that facilitates the rapid detection and reliable identification of these emerging contaminants in the sample matrices analyzed. In addition, isomeric compounds, like the opiates, morphine and norcodeine, could be discriminated by their specific fragments observed in HE TOF MS spectra, without the need of reference standards. UHPLC-QTOF MS was proven to be a powerful and efficient technique for rapid wide-scope screening and identification of many relevant drugs in complex matrices, such as influent and effluent urban wastewater.

  9. Screening for potential child maltreatment in parents of a newborn baby : The predictive validity of an Instrument for early identification of Parents At Risk for child Abuse and Neglect (IPARAN)

    NARCIS (Netherlands)

    van der Put, Claudia E.; Bouwmeester-Landweer, Merian B.R.; Landsmeer-Beker, Eleonore A.; Wit, Jan M.; Dekker, Friedo W.; Kousemaker, N. Pieter J.; Baartman, Herman E.M.

    2017-01-01

    For preventive purposes it is important to be able to identify families with a high risk of child maltreatment at an early stage. Therefore we developed an actuarial instrument for screening families with a newborn baby, the Instrument for identification of Parents At Risk for child Abuse and

  10. Human abuse liability assessment of oxycodone combined with ultra-low-dose naltrexone.

    Science.gov (United States)

    Tompkins, David Andrew; Lanier, Ryan K; Harrison, Joseph A; Strain, Eric C; Bigelow, George E

    2010-07-01

    Prescription opioid abuse has risen dramatically in the United States as clinicians have increased opioid prescribing for alleviation of both acute and chronic pain. Opioid analgesics with decreased risk for abuse are needed. Preclinical and clinical studies have shown that opioids combined with ultra-low-dose naltrexone (NTX) may have increased analgesic potency and have suggested reduced abuse or dependence liability. This study addressed whether addition of ultra-low-dose naltrexone might decrease the abuse liability of oxycodone (OXY) in humans. This double-blind, placebo-controlled study systematically examined the subjective and physiological effects of combining oral OXY and ultra-low NTX doses in 14 experienced opioid abusers. Seven acute drug conditions given at least 5 days apart were compared in a within-subject crossover design: placebo, OXY 20 mg, OXY 40 mg, plus each of the active OXY doses combined with 0.0001 and 0.001 mg NTX. The methods were sensitive to detecting opioid effects on abuse liability indices, with significant differences between all OXY conditions and placebo as well as between 20 and 40 mg OXY doses on positive subjective ratings (e.g., "I feel a good drug effect" or "I like the drug"), on observer- and participant-rated opioid agonist effects, and on a drug-versus-money value rating. There were no significant differences or evident trends associated with the addition of either NTX dose on any abuse liability indices. The addition of ultra-low-dose NTX to OXY did not decrease abuse liability of acutely administered OXY in experienced opioid abusers.

  11. Protein tethering enables rapid and label-free SERS platform for screening drugs of abuse (Conference Presentation)

    Science.gov (United States)

    Siddhanta, Soumik; Wróbel, Maciej S.; Barman, Ishan

    2017-02-01

    A quick, cost-effective method for detection of drugs of abuse in biological fluids would be of great value in healthcare, law enforcement, and home testing applications. The alarming rise in narcotics abuse has led to considerable focus on developing potent and versatile analytical tools that can address this societal problem. While laboratory testing plays a key role in the current detection of drug misuse and the evaluation of patients with drug induced intoxication, these typically require expensive reagents and trained personnel, and may take hours to complete. Thus, a significant unmet need is to engineer a facile method that can rapidly detect drugs with little sample preparation, especially the bound fraction that is typically dominant in the blood stream. Here we report an approach that combines the exquisite sensitivity of surface enhanced Raman spectroscopy (SERS) and a facile protein tethering mechanism to reliably detect four different classes of drugs, barbiturate, benzodiazepine, amphetamine and benzoylecgonine. The proposed approach harnesses the reliable and specific attachment of proteins to both drugs and nanoparticle to facilitate the enhancement of spectral markers that are sensitive to the presence of the drugs. In conjunction with chemometric tools, we have shown the ability to quantify these drugs lower than levels achievable by existing clinical immunoassays. Through molecular docking simulations, we also probe the mechanistic underpinnings of the protein tethering approach, opening the door to detection of a broad class of narcotics in biological fluids within a few minutes as well as for groundwater analysis and toxin detection.

  12. Assessment and Screening of the Risk Factors in Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Jaspinder Kaur

    2014-07-01

    Full Text Available Metabolic syndrome (MetS is chronic inflammatory epidemic state contributing to total and cardiovascular mortality. The current study planned to assess and screen risk factors for MetS and its components. A cross-sectional study conducted to assess age, gender, social status, employment, education, family history, physical activity, dietary habits, alcohol, sleep, body mass index and stress as determinants of MetS. The results were analyzed by Chi Square test with statistical significance of p value <0.05. The frequency of MetS was 17.38% as per modified National Cholesterol Education Program–Adult Treatment Panel III criteria. Females (57.38%, age >50 years (86.90%; p < 0.05, middle socioeconomic status (70.50%, illiteracy (39.35%, and unemployment (81.97%; p < 0.05 were found contributing though to different extents. Subjects with a sedentary lifestyle (72.14%, positive family history (42.63%, omnivore diet (47.55%, stress (78.69%; p < 0.05, insomnia (29.51% and increased BMI (83.62%; p < 0.001 had shown predisposition to MetS. However, the protective role of alcohol (38.28%, an active lifestyle (36.21%, vegetarian diet (62.07% and adequate sleep (73.11% was observed. A significant hypertension (98.37%; p < 0.001, dyslipidemia (77.05%; p < 0.001, dysglycemia (75.41%; p < 0.001 and obesity (59.02%; p < 0.001 was reported in MetS. Common concerns of female gender, increasing age and BMI, sedentary lifestyle, stress and positive family history should be considered for early identification and appropriate intervention to fight the growing MetS epidemic.

  13. Assessment of the Associations of Depression With Elder Abuse Among the Elderly in Kashan City, Iran

    Directory of Open Access Journals (Sweden)

    Zahra Khalili

    2016-01-01

    Conclusion: The study results indicate the importance and necessity of providing health care services and support for the identification of depressed elderly victims of abuse and prevention to solve this problem and improve their situation.

  14. Design of a Screen Based Simulation for Training and Automated Assessment of Teamwork Skills

    Science.gov (United States)

    2017-08-01

    training, assessment, screen-based simulation, communication, leadership, situation monitoring, mutual support, psychological safety 16. SECURITY...feedback. Teamwork training, assessment, screen-based simulation, communication, leadership, situation monitoring, mutual support, psychological safety...themes were gathered from the interviews including introduction styles from team members, roles/structure of teams, psychological safety to encourage

  15. Preclinical abuse liability assessment of ABT-126, an agonist at the α7 nicotinic acetylcholine receptor (nAChR).

    Science.gov (United States)

    Hudzik, Thomas J; Basso, Ana M; Lynch, James J; Bracken, William M; Mohler, Eric G; Kohlhaas, Kathy L; Xu, Hongyu; Haig, George; Gault, Laura

    2017-07-01

    ABT-126 is a nicotinic acetylcholine receptor (nAChR) agonist that is selective for the α7 subtype of the receptor. nAChRs are thought to play a role in a variety of neurocognitive processes and have been a pharmacologic target for disorders with cognitive impairment, including schizophrenia and Alzheimer's disease. As part of the preclinical safety package for ABT-126, its potential for abuse was assessed. While the involvement of the α4β2 subtype of the nicotinic receptor in the addictive properties of nicotine has been demonstrated, the role of the α7 receptor has been studied much less extensively. A number of preclinical assays of abuse potential including open-field, drug discrimination and self-administration were employed in male rats. ABT-126 had modest effects on locomotor activity in the open-field assay. In nicotine and d-amphetamine drug discrimination assays, ABT-126 administration failed to produce appreciable d-amphetamine-like or nicotine-like responding, suggesting that its interoceptive effects are distinct from those of these drugs of abuse. In rats trained to self-administer cocaine, substitution with ABT-126 was similar to substitution with saline, indicating that it lacks reinforcing effects. No evidence of physical dependence was noted following subchronic administration. Overall, these data suggest that ABT-126 has a low potential for abuse. Together with other literature on this drug class, it appears that drugs that selectively activate α7 nAChRs are not likely to result in abuse or dependence. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Identification of Abuse and Health Consequences for Military and Civilian Women

    National Research Council Canada - National Science Library

    Campbell, Jacquelyn

    1999-01-01

    ...% of the screened women reported lifetime emotional abuse. Analyses of the cases and controls are currently underway to explore the health consequences of partner abuse and preferences for partner abuse screening...

  17. Rapid screening for drugs of abuse in biological fluids by ultra high performance liquid chromatography/Orbitrap mass spectrometry.

    Science.gov (United States)

    Jagerdeo, Eshwar; Schaff, Jason E

    2016-08-01

    We present a UPLC(®)-High Resolution Mass Spectrometric method to simultaneously screen for nineteen benzodiazepines, twelve opiates, cocaine and three metabolites, and three "Z-drug" hypnotic sedatives in both blood and urine specimens. Sample processing consists of a high-speed, high-temperature enzymatic hydrolysis for urine samples followed by a rapid supported liquid extraction (SLE). The combination of ultra-high resolution chromatography with high resolution mass spectrometry allows all 38 analytes to be uniquely detected with a ten minute analytical run. Limits of detection for all target analytes are 3ng/mL or better, with only 0.3mL of specimen used for analysis. The combination of low sample volume with fast processing and analysis makes this method a suitable replacement for immunoassay screening of the targeted drug classes, while providing far superior specificity and better limits of detection than can routinely be obtained by immunoassay. Published by Elsevier B.V.

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

    Science.gov (United States)

    Looman, Jan; Abracen, Jeffrey

    2011-01-01

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

  19. Assessing trauma, substance abuse, and mental health in a sample of homeless men.

    Science.gov (United States)

    Kim, Mimi M; Ford, Julian D; Howard, Daniel L; Bradford, Daniel W

    2010-02-01

    This study examined the impact of physical and sexual trauma on a sample of 239 homeless men. Study participants completed a self-administered survey that collected data on demographics, exposure to psychological trauma, physical health and mental health problems, and substance use or misuse. Binomial logistic regression analyses were used to examine the relative significance of demographic factors and the four types of trauma exposure associated with three outcomes: mental health, substance abuse, and physical health problems. The authors found that trauma history was significantly associated with more mental health problems but was not associated with substance abuse problems for homeless men. This study reinforces service providers' perceptions that because many homeless men experience the long-term, deleterious effects of not only current stressors, but also abuse and victimization that often begin in childhood, homeless men are a subpopulation in need of proactive prevention services that emphasize long-term continuity of care rather than sporadic crisis-based services. Study findings suggest that mentally ill, homeless men need proactive services that address the sequelae of abuse with care that is specialized and distinctly different from care for homeless adults with substance abuse or physical health care issues.

  20. Assessment of Unsuspected Exposure to Drugs of Abuse in Children from a Mediterranean City by Hair Testing

    Directory of Open Access Journals (Sweden)

    Simona Pichini

    2014-02-01

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

  1. ["Screening" in special situations. Assessing predictive genetic screening for hereditary breast and colorectal cancer].

    Science.gov (United States)

    Jonas, Susanna; Wild, Claudia; Schamberger, Chantal

    2003-02-01

    The aim of this health technology assessment was to analyse the current scientific and genetic counselling on predictive genetic testing for hereditary breast and colorectal cancer. Predictive genetic testing will be available for several common diseases in the future and questions related to financial issues and quality standards will be raised. This report is based on a systematic/nonsystematic literature search in several databases (e.g. EmBase, Medline, Cochrane Library) and on a specific health technology assessment report (CCOHTA) and review (American Gastroenterological Ass.), respectively. Laboratory test methods, early detection methods and the benefit from prophylactic interventions were analysed and social consequences interpreted. Breast and colorectal cancer are counted among the most frequently cancer diseases. Most of them are based on random accumulation of risk factors, 5-10% show a familial determination. A hereditary modified gene is responsible for the increased cancer risk. In these families, high tumour frequency, young age at diagnosis and multiple primary tumours are remarkable. GENETIC DIAGNOSIS: Sequence analysis is the gold standard. Denaturing high performance liquid chromatography is a quick alternative method. The identification of the responsible gene defect in an affected family member is important. If the test result is positive there is an uncertainty whether the disease will develop or not, when and in which degree, which is founded in the geno-/phenotype correlation. The individual risk estimation is based upon empirical evidence. The test results affect the whole family. Currently, primary prevention is possible for familial adenomatous polyposis (celecoxib, prophylactic colectomy) and for hereditary mamma carcinoma (prophylactic mastectomy). The so-called preventive medical check-ups are early detection examinations. The evidence about early detection methods for colorectal cancer is better than for breast cancer. Prophylactic

  2. Partner, workplace, and stranger abuse during pregnancy in Germany.

    Science.gov (United States)

    Stöckl, Heidi; Hertlein, Linda; Friese, Klaus; Stöckl, Doris

    2010-11-01

    To investigate the prevalence, perpetrators, sociodemographic correlates, and health impacts of psychological, physical, and sexual abuse during pregnancy among women attending a maternity ward in Germany. A written questionnaire was given to pregnant women in a maternity ward of a university hospital in Munich. Abuse during pregnancy was assessed using the Abuse Assessment Screen. Of 552 women, 401 completed the questionnaire for a response rate of 72.6%. The prevalence of psychological, physical, or sexual abuse during pregnancy by any perpetrator was 6.7% (n = 27); the main perpetrators were women's partners and work colleagues. After controlling for the effect of age, psychological, physical, or sexual abuse during pregnancy was significantly associated with a history of abuse, low education level of the woman and the father of her child, short relationship duration, unintended pregnancy, financial problems caused by the pregnancy, having more than 3 children, and insufficient social support. Women who reported abuse during pregnancy were significantly more likely to smoke and to have adverse maternal health outcomes. Psychological, physical, or sexual abuse during pregnancy was experienced by 1 in 15 women who attended a maternity ward in Munich and adversely affected maternal health outcomes. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Routine Self-administered, Touch-Screen Computer Based Suicidal Ideation Assessment Linked to Automated Response Team Notification in an HIV Primary Care Setting

    Science.gov (United States)

    Lawrence, Sarah T.; Willig, James H.; Crane, Heidi M.; Ye, Jiatao; Aban, Inmaculada; Lober, William; Nevin, Christa R.; Batey, D. Scott; Mugavero, Michael J.; McCullumsmith, Cheryl; Wright, Charles; Kitahata, Mari; Raper, James L.; Saag, Micheal S.; Schumacher, Joseph E.

    2010-01-01

    Summary The implementation of routine computer-based screening for suicidal ideation and other psychosocial domains through standardized patient reported outcome instruments in two high volume urban HIV clinics is described. Factors associated with an increased risk of self-reported suicidal ideation were determined. Background HIV/AIDS continues to be associated with an under-recognized risk for suicidal ideation, attempted as well as completed suicide. Suicidal ideation represents an important predictor for subsequent attempted and completed suicide. We sought to implement routine screening of suicidal ideation and associated conditions using computerized patient reported outcome (PRO) assessments. Methods Two geographically distinct academic HIV primary care clinics enrolled patients attending scheduled visits from 12/2005 to 2/2009. Touch-screen-based, computerized PRO assessments were implemented into routine clinical care. Substance abuse (ASSIST), alcohol consumption (AUDIT-C), depression (PHQ-9) and anxiety (PHQ-A) were assessed. The PHQ-9 assesses the frequency of suicidal ideation in the preceding two weeks. A response of “nearly every day” triggered an automated page to pre-determined clinic personnel who completed more detailed self-harm assessments. Results Overall 1,216 (UAB= 740; UW= 476) patients completed initial PRO assessment during the study period. Patients were white (53%; n=646), predominantly males (79%; n=959) with a mean age of 44 (± 10). Among surveyed patients, 170 (14%) endorsed some level of suicidal ideation, while 33 (3%) admitted suicidal ideation nearly every day. In multivariable analysis, suicidal ideation risk was lower with advancing age (OR=0.74 per 10 years;95%CI=0.58-0.96) and was increased with current substance abuse (OR=1.88;95%CI=1.03-3.44) and more severe depression (OR=3.91 moderate;95%CI=2.12-7.22; OR=25.55 severe;95%CI=12.73-51.30). Discussion Suicidal ideation was associated with current substance abuse and

  5. Substance abuse and HIV risk behaviours amongst primary health ...

    African Journals Online (AJOL)

    Substance abuse and HIV risk behaviours amongst primary health care service users in Cape Town. ... African Journal of Psychiatry ... We assessed substance use with the Alcohol, Smoking and Substance Involvement Screening Test, and HIV risk with items addressing injection drug use, blood-sharing rituals, and sexual ...

  6. Irregular antibodies: an assessment of routine prenatal screening.

    Science.gov (United States)

    Solola, A; Sibai, B; Mason, J M

    1983-01-01

    In a review of the antenatal-postnatal records of 6062 patients attending the prenatal clinic at a large university perinatal center during 1980, 8.3% of the pregnant patients seen were Rho(D) negative and 91.7% were Rho(D) positive. Through routine antibody screening of all patients, 115 were found to have irregular antibodies which would otherwise not have been detected. Fifteen of these patients were Rho(D) negative, but they would have been included for antibody screening due to their Rho(D) negative status. Of the remaining 100 Rho(D) positive patients, clinically significant antibodies were observed in six patients; however, no maternal morbidity or hemolytic disease of the newborn was reported. Antecedent maternal risk factors for development of irregular antibodies were not sufficiently selective for predicting outcomes of such pregnancies. Furthermore, the only four patients with irregular antibodies requiring blood transfusion were cross-matched without difficulties. Findings suggest that screening all patients for irregular antibodies cannot be justified due to the prohibitive costs involved. However, because of the racially homogeneous population studied, variations in the frequency of red blood cell genotypes between racial groups, and the irregular pattern of occurrence of irregular antibodies, the authors believe that further studies on the clinical impact and cost-effectiveness of screening all antenatal patients for presence of irregular antibodies are necessary.

  7. Assessment of psychological barriers to cervical cancer screening ...

    African Journals Online (AJOL)

    EB

    among women in Kumasi, Ghana using a mixed methods approach. *Williams M1 .... market, pharmacies, trotro (public transportation) stops, and from the ..... Malaysia. Asian Pac. J. Cancer Prev. 2009;10(5):747–. 752. 27. Lin S-J. Factors influencing the uptake of screening services for breast and cervical cancer in Taiwan.

  8. Assessment of psychological barriers to cervical cancer screening ...

    African Journals Online (AJOL)

    EB

    acetic acid wash are widely available throughout Ghana, yet less that 3% of Ghanaian women get a cervical cancer screening at regular ... Results: The results of the quantitative analysis indicated that cancer patients where not more likely to have greater knowledge of cancer ... School of Public Health, Ryals Public Health.

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

    Science.gov (United States)

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

    2011-01-01

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

  10. Assessment of lifetime physical and sexual abuse in treated alcoholics Validity of the Addiction Severity Index

    NARCIS (Netherlands)

    Langeland, Willie; Draijer, Nel; van den Brink, Wim

    2003-01-01

    We examined the validity of the Addiction Severity Index (ASI) regarding the identification of lifetime physical and sexual abuse histories using the Structured Trauma Interview (STI) as external criterion in alcohol-dependent patients (n = 144). Compared to the STI, the ASI showed a lower incidence

  11. Health technology assessment and screening in The Netherlands: case studies of mammography in breast cancer, PSA screening in prostate cancer, and ultrasound in normal pregnancy.

    NARCIS (Netherlands)

    Banta, H.D.; Oortwijn, W.J.

    2001-01-01

    OBJECTIVE: To review the assessment and implementation of three screening methods: mammography for breast cancer, screening for prostate cancer, and routine use of ultrasound in pregnancy. METHODS: To review policy documents and published papers dealing with prevention and screening in the

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

    Science.gov (United States)

    Dolan, Mairead; Whitworth, Helen

    2013-01-01

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

  13. [Systematic detection of physical child abuse at emergency rooms].

    Science.gov (United States)

    Sittig, J S; Uiterwaal, C S P M; Moons, K G M; Russel, I M B; Nievelstein, R A J; Nieuwenhuis, E E S; van de Putte, E M

    2016-01-01

    The aim of our diagnostic accuracy study Child Abuse Inventory at Emergency Rooms (CHAIN-ER) was to establish whether a widely used checklist accurately detects or excludes physical abuse among children presenting to ERs with physical injury. A large multicentre study with a 6-month follow-up in 4 ERs in The Netherlands. Participants were 4290 children aged 0-7 years, attending the ER because of physical injury. All children were systematically tested with an easy-to-use child abuse checklist (index test). A national expert panel (reference standard) retrospectively assessed all children with positive screens and a 15% random sample of the children with negative screens for physical abuse, using additional information, namely, an injury history taken by a paediatrician, information provided by the general practitioner, youth doctor and social services by structured questionnaires, and 6-month follow-up information. Our main outcome measure was physical child abuse; secondary outcome measure was injury due to neglect and need for help. 4253/4290 (99%) parents agreed to follow-up. At a prevalence of 0.07% (3/4253) for inflicted injury by expert panel decision, the positive predictive value of the checklist was 0.03 (95% CI 0.006 to 0.085), and the negative predictive value 1.0 (0.994 to 1.0). There was 100% (93 to 100) agreement about inflicted injury in children, with positive screens between the expert panel and child abuse experts. Rare cases of inflicted injury among preschool children presenting at ERs for injury are very likely captured by easy-to-use checklists, but at very high false-positive rates. Subsequent assessment by child abuse experts can be safely restricted to children with positive screens at very low risk of missing cases of inflicted injury. Because of the high false positive rate, we do advise careful prior consideration of cost-effectiveness and clinical and societal implications before de novo implementation.

  14. Adaptação transcultural para o português (Brasil da Vulnerability to Abuse Screening Scale (VASS para rastreio da violência contra idosos

    Directory of Open Access Journals (Sweden)

    Rodrigo da Silva Maia

    2014-07-01

    Full Text Available A literatura aponta a insuficiência de instrumentos disponibilizados em português para a detecção da violência contra idosos. Assim, parece oportuno disponibilizar versões lusófonas de ferramentas advindas de outras culturas. A Vulnerability to Abuse Screening Scale (VASS contém 12 itens que constatam o risco à violência contra idosos. Este trabalho objetivou promover a adaptação transcultural para o Brasil da VASS. Verificou-se que o conceito utilizado para a construção do instrumento, bem como seus itens mostram-se adequados à investigação do fenômeno. Evidenciou-se boa equivalência semântica entre os itens das retrotraduções e do instrumento original, especialmente quanto aos resultados de T1 – R1. Os juízes optaram pelo uso de 11 itens de T1 à versão-síntese. A equivalência operacional mostrou-se satisfatória. Em geral, os resultados apresentados mostram-se aceitáveis. Destaca-se que o instrumento ainda não apresentou resultados satisfatórios que indiquem viabilidade de seu uso. Conclui-se que é necessário revisar, replicar o instrumento para a verificação da validade.

  15. Assessing the Fragile X Syndrome Newborn Screening Landscape.

    Science.gov (United States)

    Riley, Catharine; Wheeler, Anne

    2017-06-01

    Fragile X syndrome (FXS) is the most common known inherited form of intellectual disability. Early identification is an important step in linking FXS individuals with appropriate and timely medical and social services. Newborn screening (NBS) is 1 approach that has been used for other conditions to facilitate early identification. A literature review was conducted to identify issues, barriers, challenges, and approaches to addressing challenges related to NBS for FXS. Search terms included: fragile X syndrome, FMR1, newborn screening, screening, and genetic testing. To supplement the literature review, 9 key informant interviews were conducted. Information gathered through these interviews supplemented what was identified in the literature. Information from both the literature review and supplemental interviews was reviewed by 3 researchers who discussed and came to consensus on thematic areas and categorization of issues. The barriers and challenges related to NBS for FXS identified in the literature and by experts and stakeholders are categorized into 5 thematic areas: public health burden, treatment, timing, screening/testing methodologies, and translating results. Summaries of these issues and barriers are provided, along with potential approaches to addressing them. The issues and barriers described in this article highlight limited areas of knowledge that need be addressed to improve our understanding of FXS and the potential benefit of NBS. The landscape of NBS for FXS could be influenced by a series of research findings over time or a larger breakthrough that demonstrates an effective targeted treatment that has to be implemented early in life. Copyright © 2017 by the American Academy of Pediatrics.

  16. NoiseMaker: simulated screens for statistical assessment.

    Science.gov (United States)

    Kwan, Phoenix; Birmingham, Amanda

    2010-10-01

    High-throughput screening (HTS) is a common technique for both drug discovery and basic research, but researchers often struggle with how best to derive hits from HTS data. While a wide range of hit identification techniques exist, little information is available about their sensitivity and specificity, especially in comparison to each other. To address this, we have developed the open-source NoiseMaker software tool for generation of realistically noisy virtual screens. By applying potential hit identification methods to NoiseMaker-simulated data and determining how many of the pre-defined true hits are recovered (as well as how many known non-hits are misidentified as hits), one can draw conclusions about the likely performance of these techniques on real data containing unknown true hits. Such simulations apply to a range of screens, such as those using small molecules, siRNAs, shRNAs, miRNA mimics or inhibitors, or gene over-expression; we demonstrate this utility by using it to explain apparently conflicting reports about the performance of the B score hit identification method. NoiseMaker is written in C#, an ECMA and ISO standard language with compilers for multiple operating systems. Source code, a Windows installer and complete unit tests are available at http://sourceforge.net/projects/noisemaker. Full documentation and support are provided via an extensive help file and tool-tips, and the developers welcome user suggestions.

  17. Child Abuse

    Science.gov (United States)

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

  18. Assessment of Navy Alcohol and Drug Abuse Education and Training Curricula, Revision Requirements

    Science.gov (United States)

    1986-02-01

    Spouse and Child Abuse) Gestalt Therapy Crisis Intervention A-24 Technical Report 86-003 Grief Counseling Short-Term Client Systems Reality...for professionals Receive patients with treatment appointments Record significant behavior of patients during treatment Administer Bender Gestalt ...patient psychotherapy Assist in conducting patient reality therapy B-41 Technical Report 86-003 Table B-15 (Continued) Number 042 043 044 045 047

  19. Assessing behavioral patterns of Internet addiction and drug abuse among high school students

    OpenAIRE

    Nemati, Zeinab; Matlabi, Hossein

    2017-01-01

    Zeinab Nemati, Hossein Matlabi Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Background: Internet addiction and drug abuse isolate adolescents from their family and friends and cause damage to their health, relations, emotions, and spirit. In the society, adolescents’ addiction extracts high cost on health care, educational failure and mental health services. Objectives: The aim of this study wa...

  20. Application of four bacterial screening procedures to assess changes in the toxicity of chemicals in mixtures

    Energy Technology Data Exchange (ETDEWEB)

    Dutka, B.J.; Kwan, K.K.

    1982-10-01

    Four microbiological acute toxicity screening test methods with Microtox, Spirillum volutans, Pseudomonas fluorescens and Aeromonas hydrophila were compared using solutions of mixed toxic chemicals. Each toxicity screening test appeared to have its own sensitivity pattern and it would appear unwise to try to assess the presence of toxicants in waters or effluents by a single species test. The battery approach, encompassing two or three genera and involving two to four species, is recommended to assess the potential presence of toxicants more thoroughly.

  1. Abuse liability assessment of an e-cigarette refill liquid using intracranial self-stimulation and self-administration models in rats

    Science.gov (United States)

    LeSage, MG; Staley, M; Muelken, P; Smethells, JR; Stepanov, I; Vogel, RI; Pentel, PR; Harris, AC

    2016-01-01

    Background The popularity of electronic cigarettes (ECs) has increased dramatically despite their unknown health consequences. Because the abuse liability of ECs is one of the leading concerns of the Food and Drug Administration (FDA), models to assess it are urgently needed to inform FDA regulatory decisions regarding these products. The purpose of this study was to assess the relative abuse liability of an EC liquid compared to nicotine alone in rats. Because this EC liquid contains non-nicotine constituents that may enhance its abuse liability, we hypothesized that it would have greater abuse liability than nicotine alone. Methods Nicotine alone and nicotine dose-equivalent concentrations of EC liquid were compared in terms of their acute effects on intracranial self-stimulation (ICSS) thresholds, acquisition of self-administration, reinforcing efficacy (i.e., elasticity of demand), blockade of these behavioral effects by mecamylamine, nicotine pharmacokinetics and nicotinic acetylcholine receptor binding and activation. Results There were no significant differences between formulations on any measure, except that EC liquid produced less of an elevation in ICSS thresholds at high nicotine doses. Conclusions Collectively, these findings suggest that the relative abuse liability of this EC liquid is similar to that of nicotine alone in terms of its reinforcing and reinforcement-enhancing effects, but that it may have less aversive/anhedonic effects at high doses. The present methods may be useful for assessing the abuse liability of other ECs to inform potential FDA regulation of those products. PMID:27627814

  2. Development of short-form measures to assess four types of elder mistreatment: Findings from an evidence-based study of APS elder abuse substantiation decisions.

    Science.gov (United States)

    Beach, Scott R; Liu, Pi-Ju; DeLiema, Marguerite; Iris, Madelyn; Howe, Melissa J K; Conrad, Kendon J

    2017-01-01

    Improving the standardization and efficiency of adult protective services (APS) investigations is a top priority in APS practice. Using data from the Elder Abuse Decision Support System (EADSS), we developed short-form measures of four types of elder abuse: financial, emotional/psychological, physical, and neglect. The EADSS data set contains 948 elder abuse cases (age 60+) with yes/no abuse substantiation decisions for each abuse type following a 30-day investigation. Item sensitivity/specificity analyses were conducted on long-form items with the substantiation decision for each abuse type as the criterion. Validity was further tested using receiver-operator characteristic (ROC) curve analysis, correlation with long forms and internal consistency. The four resulting short-form measures, containing 36 of the 82 original items, have validity similar to the original long forms. These short forms can be used to standardize and increase efficiency of APS investigations, and may also offer researchers new options for brief elder abuse assessments.

  3. Individual risk assessment and information technology to optimise screening frequency for diabetic retinopathy.

    Science.gov (United States)

    Aspelund, T; Thornórisdóttir, O; Olafsdottir, E; Gudmundsdottir, A; Einarsdóttir, A B; Mehlsen, J; Einarsson, S; Pálsson, O; Einarsson, G; Bek, T; Stefánsson, E

    2011-10-01

    The aim of this study was to reduce the frequency of diabetic eye-screening visits, while maintaining safety, by using information technology and individualised risk assessment to determine screening intervals. A mathematical algorithm was created based on epidemiological data on risk factors for diabetic retinopathy. Through a website, www.risk.is , the algorithm receives clinical data, including type and duration of diabetes, HbA(1c) or mean blood glucose, blood pressure and the presence and grade of retinopathy. These data are used to calculate risk for sight-threatening retinopathy for each individual's worse eye over time. A risk margin is defined and the algorithm recommends the screening interval for each patient with standardised risk of developing sight-threatening retinopathy (STR) within the screening interval. We set the risk margin so that the same number of patients develop STR within the screening interval with either fixed annual screening or our individualised screening system. The database for diabetic retinopathy at the Department of Ophthalmology, Aarhus University Hospital, Denmark, was used to empirically test the efficacy of the algorithm. Clinical data exist for 5,199 patients for 20 years and this allows testing of the algorithm in a prospective manner. In the Danish diabetes database, the algorithm recommends screening intervals ranging from 6 to 60 months with a mean of 29 months. This is 59% fewer visits than with fixed annual screening. This amounts to 41 annual visits per 100 patients. Information technology based on epidemiological data may facilitate individualised determination of screening intervals for diabetic eye disease. Empirical testing suggests that this approach may be less expensive than conventional annual screening, while not compromising safety. The algorithm determines individual risk and the screening interval is individually determined based on each person's risk profile. The algorithm has potential to save on

  4. Assessment of abuse liability of Tramadol among experienced drug users: Double-blind crossover randomized controlled trial.

    Science.gov (United States)

    Das, Mrinmay; Jain, Raka; Dhawan, Anju; Kaur, Amandeep

    Tramadol is a widely used opioid analgesic. Different preclinical, clinical, and postmarketing surveillance studies show conflicting results regarding abuse potential of this drug. A randomized double-blind complete crossover study was conducted at National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi. Total subjects were 10, comprising total 120 observations (each subject assessed at baseline, 5, 45, and 240 minutes). Subjects with history of substance abuse were included after detoxification and informed consent. Assessment was done using modified single dose opiate questionnaire, morphine benzedrine group (MBG), pentobarbital chlorpromazine alcohol group (PCAG), and two bipolar visual analogue scales (VAS) after administration of three drugs-Tramadol (100 mg), Buprenorphine (0.6 mg), and Placebo (Normal Saline) intramuscularly, at 5-day interval. In intra-group analysis, there was statistically significant increase in scores of all four scales from baseline to all three time points after Tramadol and Buprenorphine administration. In inter-group analysis, statistically higher scores were seen for Buprenorphine in comparison to Tramadol at 5, 45, and 240 minutes for MBG scale; the score was significantly higher for Buprenorphine in VAS for pleasurable effect at 45 and 240 minutes, but not at baseline and 5 minutes. There was no significant difference in score at any point of time between Tramadol and Buprenorphine in PCAG scale and VAS for sedative/alertness effect. The scores were statistically insignificant in case of Placebo. All the subjects liked Buprenorphine most and then Tramadol followed by Placebo. Tramadol has abuse potential (even in therapeutic doses) more than Placebo but less than or comparable to Buprenorphine.

  5. Assessing the utility and limitations of high throughput virtual screening

    Directory of Open Access Journals (Sweden)

    Paul Daniel Phillips

    2016-05-01

    Full Text Available Due to low cost, speed, and unmatched ability to explore large numbers of compounds, high throughput virtual screening and molecular docking engines have become widely utilized by computational scientists. It is generally accepted that docking engines, such as AutoDock, produce reliable qualitative results for ligand-macromolecular receptor binding, and molecular docking results are commonly reported in literature in the absence of complementary wet lab experimental data. In this investigation, three variants of the sixteen amino acid peptide, α-conotoxin MII, were docked to a homology model of the a3β2-nicotinic acetylcholine receptor. DockoMatic version 2.0 was used to perform a virtual screen of each peptide ligand to the receptor for ten docking trials consisting of 100 AutoDock cycles per trial. The results were analyzed for both variation in the calculated binding energy obtained from AutoDock, and the orientation of bound peptide within the receptor. The results show that, while no clear correlation exists between consistent ligand binding pose and the calculated binding energy, AutoDock is able to determine a consistent positioning of bound peptide in the majority of trials when at least ten trials were evaluated.

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

    Science.gov (United States)

    Allen, Brian

    2011-01-01

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

  7. Rapid screening of abused drugs by direct analysis in real time (DART) coupled to time-of-flight mass spectrometry (TOF-MS) combined with ion mobility spectrometry (IMS).

    Science.gov (United States)

    Lian, Ru; Wu, Zhongping; Lv, Xiaobao; Rao, Yulan; Li, Haiyang; Li, Jinghua; Wang, Rong; Ni, Chunfang; Zhang, Yurong

    2017-10-01

    Increasing in cases involving drugs of abuse leads to heavy burden for law enforcement agencies, exacerbating demand for rapid screening technique. In this study, atmospheric pressure ionization technologies including direct analysis in real time (DART) ion source coupled to a time-of-flight mass spectrometer (DART-TOF-MS)as well asdopant-assisted positive photoionization ion mobility spectrometry (DAPP-IMS) without radioactivity were utilized together as the powerful analytical tool for the rapid screening and identification of 53 abused drugs.The limits of detection (LOD) were 0.05-2μg/mL when using DART-TOF-MS and 0.02-2μg when using DAPP-IMS which could satisfy the actual requirement in forensic science laboratory. The advantages of this method included fast response, high-throughput potential, high specificity, and minimal sample preparation. A screening library of reduced mobility (K 0 ), accurate mass of informative precursor ion ([M+H] + ) and fragment ions was established respectively by employing a bench-top DAPP-IMS and TOF-MS in-source collision induced dissociation (CID) mode. Then the standardized screening procedure was developed with criteria for the confirmation of positive result. A total of 50 seized drug samples provided by local forensic laboratory we reanalyzed to testify the utility of the method. This study suggests that a method combing DART-TOF-MS and DAPP-IMS is promising for the rapid screening and identification of abused drugs with minimal sample preparation and absence of chromatography. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Correlation Between Intimate Partner Violence Victimization and Risk of Substance Abuse and Depression among African-American Women Seen in an Urban Emergency Department

    Directory of Open Access Journals (Sweden)

    Houry, Debra

    2010-08-01

    Full Text Available Objective: To assess rates of substance abuse (including tobacco, alcohol, and drug abuse as well as rates of intimate partner violence (IPV among African-American women seen in an urban Emergency Department (ED. Methods: Eligible participants included all African-American women between the ages of 21-55 years old who were seen in an urban ED for any complaint, and who were triaged to the waiting room. Eligible women who consented to participate were taken to complete a computer-based survey that focused on demographic information and general health questions as well as standardized instruments including the Index of Spouse Abuse (ISA, the Tolerance, Worried, Eye openers, Amnesia, K(Cut down (TWEAK screen for alcohol abuse, Drug Abuse Screening Test (DAST20, and Hooked on Nicotine Checklist (HONC. This analysis uses results from a larger study evaluating the effects of providing patients with targeted educational literature based on the results of their screening. Results: 610 women were surveyed. Among these, 85 women (13.9% screened positive for IPV. Women who screened positive for IPV were significantly more likely to also screen positive for tobacco abuse (56% vs. 37.5%, p< 0.001, alcohol abuse (47.1% vs. 23.2%, p < 0.001, and drug abuse (44.7% vs. 9.5%, p<0.001. Women who screened positive for IPV were also more likely to screen positive for depression and to report social isolation. Conclusion: African-American women seen in the ED, who screen positive for IPV, are at significantly higher risk of drug, alcohol, tobacco abuse, depression and social isolation than women who do not screen positive for IPV. These findings have important implications for ED-based and community-based social services for women who are victims of intimate partner violence. [West J Emerg Med. 2010; 11(3: 253-257.

  9. Screening for malnutrition among nursing home residents - a comparative analysis of the mini nutritional assessment, the nutritional risk screening, and the malnutrition universal screening tool.

    Science.gov (United States)

    Diekmann, R; Winning, K; Uter, W; Kaiser, M J; Sieber, C C; Volkert, D; Bauer, J M

    2013-04-01

    The European Society for Clinical Nutrition and Metabolism (ESPEN) has recommended the Mini Nutritional Assessment (MNA®), the Nutritional Risk Screening 2002 (NRS), and the Malnutrition Universal Screening Tool (MUST) for nutritional screening in various settings and age groups. While in recent years all three tools have been applied to nursing home residents, there is still no consensus on the most appropriate screening tool in this specific setting. The present study aims at comparing the MNA, the NRS, and the MUST with regard to applicability, categorization of nutritional status, and predictive value in the nursing home setting. MNA, NRS, and MUST were performed on 200 residents from two municipal nursing homes in Nuremberg, Germany. Follow-up data on infection, hospitalization, and mortality were collected after six and again after twelve months. Among 200 residents (mean age 85.5 ± 7.8 years) the MNA could be completed in 188 (94.0%) and the NRS and MUST in 198 (99.0%) residents. The prevalence of 'malnutrition' according to the MNA was 15.4%. The prevalence of 'risk of malnutrition' (NRS) and 'high risk of malnutrition' (MUST), respectively, was 8.6% for both tools. The individual categorization of nutritional status showed poor agreement between NRS and MUST on the one hand and MNA on the other. For all tools a significant association between nutritional status and mortality was demonstrated during follow-up as classification in 'malnourished', respectively 'high risk of malnutrition' or 'nutritional risk', was significantly associated with increased hazard ratios. However, the MNA showed the best predictive value for survival among well-nourished residents. The evaluation of nutritional status in nursing home residents by MNA, NRS, and MUST shows significant differences. This observation may be of clinical relevance as nutritional intervention is usually based on screening results. As the items of the MNA reflect particularities of the nursing home

  10. Assessing the effects of Families for Safe Dates, a family-based teen dating abuse prevention program.

    Science.gov (United States)

    Foshee, Vangie A; McNaughton Reyes, Heath Luz; Ennett, Susan T; Cance, Jessica D; Bauman, Karl E; Bowling, J Michael

    2012-10-01

    To examine the effects of a family-based teen dating abuse prevention program, Families for Safe Dates, primarily on outcomes related to testing the conceptual underpinnings of the program including (1) factors motivating and facilitating caregiver engagement in teen dating abuse prevention activities, and 2) risk factors for teen dating abuse, and secondarily on dating abuse behaviors. Families were recruited nationwide using listed telephone numbers. Caregivers and teens completed baseline and 3-month follow-up telephone interviews (n = 324). Families randomly allocated to treatment condition received the Families for Safe Dates program including six mailed activity booklets followed-up by health educator telephone calls. There were significant (teen dating abuse prevention activities including caregiver perceived severity of dating abuse, response efficacy for preventing dating abuse, self-efficacy for talking about dating abuse, knowledge of dating abuse, acceptance of dating abuse, communication skills with the teen, and belief in the importance of involvement in their male (but not female) teen's dating. The latter effect was the only one moderated by sex of the teen. The targeted risk factor affected by the program was teen acceptance of dating abuse. Treatment was also significantly associated with less physical dating abuse victimization. Modifications to the program are warranted, but overall, the findings are very favorable for the first family-based teen dating abuse prevention program to be evaluated. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. The ‘grey’ assessment practice of IA screening: Prevalence, influence and applied rationale

    International Nuclear Information System (INIS)

    Bidstrup, Morten

    2017-01-01

    Research focusing on the practices surrounding screening in Impact Assessment (IA) is limited. Yet, it has been found that development proposals sometimes are adjusted through an informal dialog with IA practitioners prior to or during screening. Such practice is often referred to as ‘grey IA’ in Denmark. This article explores the prevalence, influence and applied rationale of grey IA. Through a questionnaire, data was collected from 121 IA practitioners working within the fields of environmental impact assessment and strategic environmental assessment. It was found that grey IA is a common practice, which influences the outcomes of formal screening procedures through consideration of impacts on neighbours and spatial zones of protection. Grey IA is to some extent motivated by the opportunity to save the resources required for full-scale IA, but an additional ‘green’ rationale also exists. Grey IA may influence the effectiveness of IA systems, but further research is needed before any conclusions can be made. - Highlights: • Screening procedures may function as an informal, ‘grey’ assessment. • Grey assessment is common and influences formal screening outcomes. • Grey assessment is motivated by an opportunity to cut IA costs. • Yet, an environmental, ‘green’ rationale for grey assessment also exists.

  12. Risk assessment of parents' concerns at 18 months in preventive child health care predicted child abuse and neglect.

    Science.gov (United States)

    Staal, Ingrid I E; Hermanns, Jo M A; Schrijvers, Augustinus J P; van Stel, Henk F

    2013-07-01

    As child maltreatment has a major impact, prevention and early detection of parenting problems are of great importance. We have developed a structured interview which uses parents' concerns for a joint needs assessment by parents and a child health care nurse, followed by a professional judgment on the risk level of future parenting and developmental problems: the Structured Problem Analysis of Raising Kids (SPARK). Previous results have shown that the risk assessment of the SPARK is associated with risk factors for child maltreatment. This study reports the predictive value of the SPARK for reports on high impact parenting problems and child abuse and neglect. Cross-sectional study with a 1.5-year follow-up based on 1,850 18-month old children, living in Zeeland, a province of the Netherlands. Data on the SPARK were obtained in the period of June 2007 to March 2008. Outcomes of the SPARK were in October 2009 compared to reports of the Advice and Reporting Centers for Child Abuse and Neglect (ARCAN) and Youth Care Agency (YCA). Univariate and multivariate logistic regression analysis was done using the risk assessment, parents' concerns, the perceived need for support and known risk factors as predictors. The overall risk assessment of the SPARK is the strongest predictor for reports to ARCAN and YCA in the 1.5 years after completing the SPARK (odds ratio of high versus low risk: 16.3 [95% confidence interval: 5.2-50.8]. Controlling for the risk assessment, only the sum of known risk factors and an unemployed father remained as significant predictors. The reported groups differ significantly from the children without a report with regard to family characteristics, but not with regard to child characteristics. A structured assessment of the concerns and care needs of toddlers' parents by a child health care nurse is a valuable predictor of reports on child abuse and neglect and serious parenting problems in toddlers. Systematically exploring and evaluating parental

  13. Beyond Screen Time: Assessing Recreational Sedentary Behavior among Adolescent Girls

    Directory of Open Access Journals (Sweden)

    Katherine W. Bauer

    2012-01-01

    Full Text Available Most studies of sedentary behavior have focused on television use or screen time. This study aims to examine adolescent girls' participation in a variety of recreational sedentary behaviors (e.g., talking on the phone and hanging around, and their association with physical activity (PA, dietary behaviors, and body mass index. Data were from a sample of 283 adolescent girls. Recreational sedentary behavior, PA, and dietary behaviors were self-reported, and girls' height and weight were measured. Over 95% of girls engaged in at least one recreational sedentary behavior during the recall period. Watching television and hanging around were the most common behaviors. Watching television, using the Internet, and hanging around were associated with less PA; watching television, hanging around, and talking on the phone were associated with less healthful dietary behaviors. No associations were found with body mass index. Interventions may benefit from capitalizing on and intervening upon girls' common recreational sedentary behaviors.

  14. Rapid Assessment of Contrast Sensitivity with Mobile Touch-screens

    Science.gov (United States)

    Mulligan, Jeffrey B.

    2013-01-01

    The availability of low-cost high-quality touch-screen displays in modern mobile devices has created opportunities for new approaches to routine visual measurements. Here we describe a novel method in which subjects use a finger swipe to indicate the transition from visible to invisible on a grating which is swept in both contrast and frequency. Because a single image can be swiped in about a second, it is practical to use a series of images to zoom in on particular ranges of contrast or frequency, both to increase the accuracy of the measurements and to obtain an estimate of the reliability of the subject. Sensitivities to chromatic and spatio-temporal modulations are easily measured using the same method. We will demonstrate a prototype for Apple Computer's iPad-iPod-iPhone family of devices, implemented using an open-source scripting environment known as QuIP (QUick Image Processing,

  15. Physical symptoms in very young children assessed for sexual abuse: a mixed method analysis from the ASAC study.

    Science.gov (United States)

    Vrolijk-Bosschaart, Thekla F; Brilleslijper-Kater, Sonja N; Widdershoven, Guy A; Teeuw, Arianne Rian H; Verlinden, Eva; Voskes, Yolande; van Duin, Esther M; Verhoeff, Arnoud P; Benninga, Marc A; Lindauer, Ramón J L

    2017-10-01

    So far, a recognizable pattern of clinical symptoms for child sexual abuse (CSA), especially in young male children, is lacking. To improve early recognition of CSA, we reviewed physical complaints, physical examination, and tests on sexually transmitted infections (STIs) in confirmed victims (predominantly preschool boys) of CSA from the Amsterdam sexual abuse case (ASAC). We retrospectively analyzed the outcomes of the primary assessment using mixed methods: descriptive analysis of physical complaints, physical exams, and STI tests from medical files and a qualitative analysis on expert's interpretations of physical complaints and children's behavior during physical examination. We included 54 confirmed CSA victims, median age 3.2 (0-6) years, 43 boys (80%), and 11 girls (20%). Physical complaints were reported in 50%, of which gastrointestinal and anogenital complaints were most common. None of the children showed CSA-specific genital signs at physical examination. Most prominent finding during physical examination was a deviant behavioral response (anxiety, withdrawal, too outgoing) in 15 children (28%), especially in children who experienced anal/vaginal penetration. Testing for STIs was negative. Physical complaints and physical signs at examinations were non-specific for CSA. Deviant behavioral reactions during physical examination were the most prominent finding. Precise observation of a child's behavior during physical examination is needed. What is known • Child sexual abuse (CSA) affects many children on both the short and the long term but remains unrecognized in most cases. • So far, there is a lack of studies on symptom patterns of CSA in male, preschool children. What is new • None of the children showed CSA-specific findings at physical and anogenital examination; STIs were not found in the confirmed victims of CSA. • The most prominent finding was the deviant behavioral response of the children examined, especially in children who

  16. Current Impact and Application of Abuse-Deterrent Opioid Formulations in Clinical Practice.

    Science.gov (United States)

    Lee, Ya-Han; Brown, Daniel L; Chen, Hsiang-Yin

    2017-11-01

    Abuse-deterrent formulations (ADFs) represent one novel strategy for curbing the potential of opioid abuse. We aim to compare and contrast the characteristics and applications of current abuse-deterrent opioid products in clinical practice. Literature searches were conducted in databases (Pubmed Medline, International Pharmaceutical Abstracts, Google Scholar) and official reports. Relevant data were screened and organized into: 1) epidemiology of opioid abuse, 2) mitigation strategies for reducing opioid abuse, 3) development of ADFs, and 4) clinical experience with these formulations. Increasing trends of opioid abuse and misuse have been reported globally. There are 5 types of abuse-deterrent opioid products: physical chemical barrier, combined agonist/antagonist, sequestered aversive agent, prodrug, and novel delivery system. The advantages and disadvantages of the 5 options are discussed in this review. A total of 9 products with abuse-deterrent labels have been approved by the Food and Drug Administration (FDA). The rates of abuse, diversion, and overdose deaths of these new products are also discussed. A framework for collecting in-time data on the efficacy, benefit and risk ratio, and cost-effectiveness of these new products is suggested to facilitate their optimal use. The present review did not utilize systematic review standards or meta-analytic techniques, given the large heterogeneity of data and outcomes reviewed. ADFs provide an option for inhibiting the abuse or misuse of oral opioid products by hindering extraction of the active ingredient, preventing alternative routes of administration, or causing aversion. Their relatively high costs, uncertain insurance policies, and limited data on pharmacoeconomics warrant collaborative monitoring and assessment by government agencies, pharmaceutical manufacturers, and data analysis services to define their therapeutic role in the future. Opioid abuse, abuse-deterrent formulations, ADF, post-marketing, FDA

  17. Predictive validity of the BRASS index in screening patients with post-discharge problems. Blaylock Risk Assessment Screening Score.

    Science.gov (United States)

    Mistiaen, P; Duijnhouwer, E; Prins-Hoekstra, A; Ros, W; Blaylock, A

    1999-11-01

    Discharge planning is a nursing intervention that aims to ensure continuity of care; it consists of several steps of which selecting patients in need of it is the first one. The Blaylock Risk Assessment Screening Score (BRASS) index is a risk screening instrument which can be used early after admission to identify those patients in need of discharge planning. To test the predictive validity of the BRASS index in screening patients with post-discharge problems. Prospective longitudinal design with prediction instrument measured at admission, and outcomes measured at discharge and 7 and 30 days after discharge. length of stay, discharge destination, status after discharge. BRASS index, Problems after discharge Questionnaire, Nottingham Health Profile, COOP/WONCA charts. 503 elderly patients were screened at admission with the BRASS index. Length of stay and discharge destination were measured at discharge in these same patients. Outcomes after discharge were gathered only in patients who were discharged home and with length of stay of more than 3 days (n=226); outcomes were measured by postal questionnaires at day 7 and day 30 after discharge. patients identified by the BRASS index as high risk are frequently not discharged home and have a longer length of stay. The BRASS scores correlate significantly with the outcome scores after discharge: the higher the BRASS score, the higher the difficulty score after discharge on all domains. However, the sensitivity of the BRASS index is rather low. This study demonstrates that the BRASS index is a good predictor instrument for indicating patients who are not discharged home, that the BRASS scores correlate significantly with problems experienced after discharge and that it has high specificity to predict patients with problems after discharge. Clinical use, however, is limited due to the low sensitivity. The BRASS index is a promising case-finding instrument for discharge planning, but needs further development.

  18. Assessing prescription drug abuse using functional principal component analysis (FPCA) of wastewater data.

    Science.gov (United States)

    Salvatore, Stefania; Røislien, Jo; Baz-Lomba, Jose A; Bramness, Jørgen G

    2017-03-01

    Wastewater-based epidemiology is an alternative method for estimating the collective drug use in a community. We applied functional data analysis, a statistical framework developed for analysing curve data, to investigate weekly temporal patterns in wastewater measurements of three prescription drugs with known abuse potential: methadone, oxazepam and methylphenidate, comparing them to positive and negative control drugs. Sewage samples were collected in February 2014 from a wastewater treatment plant in Oslo, Norway. The weekly pattern of each drug was extracted by fitting of generalized additive models, using trigonometric functions to model the cyclic behaviour. From the weekly component, the main temporal features were then extracted using functional principal component analysis. Results are presented through the functional principal components (FPCs) and corresponding FPC scores. Clinically, the most important weekly feature of the wastewater-based epidemiology data was the second FPC, representing the difference between average midweek level and a peak during the weekend, representing possible recreational use of a drug in the weekend. Estimated scores on this FPC indicated recreational use of methylphenidate, with a high weekend peak, but not for methadone and oxazepam. The functional principal component analysis uncovered clinically important temporal features of the weekly patterns of the use of prescription drugs detected from wastewater analysis. This may be used as a post-marketing surveillance method to monitor prescription drugs with abuse potential. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. A training course for psychologists : Learning to assess (alleged) sexual abuse among victims and perpetrators who have intellectual disabilities

    NARCIS (Netherlands)

    Embregts, P.J.C.M.; Heestermans, M.; van den Bogaard, K.J.H.M.

    People with intellectual disabilities (ID) are at greater risk of being a victim of sexual abuse and may also be more predisposed to perpetrating sexual abuse. Although the prevalence of sexual abuse among people with ID is difficult to determine, it is clear that there are serious consequences for

  20. Screening for potential child maltreatment in parents of a newborn baby: The predictive validity of an Instrument for early identification of Parents At Risk for child Abuse and Neglect (IPARAN).

    Science.gov (United States)

    van der Put, Claudia E; Bouwmeester-Landweer, Merian B R; Landsmeer-Beker, Eleonore A; Wit, Jan M; Dekker, Friedo W; Kousemaker, N Pieter J; Baartman, Herman E M

    2017-08-01

    For preventive purposes it is important to be able to identify families with a high risk of child maltreatment at an early stage. Therefore we developed an actuarial instrument for screening families with a newborn baby, the Instrument for identification of Parents At Risk for child Abuse and Neglect (IPARAN). The aim of this study was to assess the predictive validity of the IPARAN and to examine whether combining actuarial and clinical methods leads to an improvement of the predictive validity. We examined the predictive validity by calculating several performance indicators (i.e., sensitivity, specificity and the Area Under the receiver operating characteristic Curve [AUC]) in a sample of 4692 Dutch families with newborns. The outcome measure was a report of child maltreatment at Child Protection Services during a follow-up of 3 years. For 17 children (.4%) a report of maltreatment was registered. The predictive validity of the IPARAN was significantly better than chance (AUC=.700, 95% CI [.567-.832]), in contrast to a low value for clinical judgement of nurses of the Youth Health Care Centers (AUC=.591, 95% CI [.422-.759]). The combination of the IPARAN and clinical judgement resulted in the highest predictive validity (AUC=.720, 95% CI [.593-.847]), however, the difference between the methods did not reach statistical significance. The good predictive validity of the IPARAN in combination with clinical judgment of the nurse enables professionals to assess risks at an early stage and to make referrals to early intervention programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Validación de la versión corta del Woman Abuse Screening Tool para su uso en atención primaria en España Validation of the short version of the Woman Abuse Screening Tool for use in primary care in Spain

    Directory of Open Access Journals (Sweden)

    Juncal Plazaola-Castaño

    2008-10-01

    Full Text Available Objetivo: Examinar la validez de criterio de la versión corta en español del Woman Abuse Screening Tool (WAST para identificar a las mujeres maltratadas entre las que acuden a los servicios de atención primaria en España. Material y métodos: Estudio transversal en dos centros de atención primaria de Granada. Se estudiaron 390 mujeres entre 18 y 70 años de edad asistentes a estos centros. Se utilizó el Index of Spouse Abuse (ISA como patrón de referencia. Resultados: Se utilizaron dos criterios de puntuación. Según el primero, cabe destacar que 132 mujeres (33,8% dieron positivo en el cribado. La sensibilidad fue del 91,4%, la especificidad del 76,2%, el valor predictivo positivo del 40,2% y el negativo del 98,1%. Cinco mujeres con una puntuación negativa en el cribado obtuvieron una puntuación positiva en el ISA (falsos negativos. Setenta y nueve mujeres obtuvieron una puntuación positiva en el WAST, con una puntuación negativa en el ISA (falsos positivos. Conclusiones: Estos resultados coinciden con los valores de sensibilidad y especificidad obtenidos en la validación del instrumento en mujeres hispanohablantes de Estados Unidos, que también recomiendan la utilización del primer criterio de puntuación. La versión corta en español del WAST es un instrumento adecuado para los profesionales en la detección temprana de la violencia de género en el ámbito sanitario español, aunque la baja especificidad hace que deba utilizarse con cautela.Objective: To examine the criterion validity of the Spanish short version of the Woman Abuse Screening Tool (WAST to identify battered women among those attending primary health care services in Spain. Material and methods: We performed a cross-sectional study in two primary care centers in Granada. A total of 390 women between 18 and 70 years old were studied. The Index of Spouse Abuse (ISA was used as the gold standard. Results: Two score criteria were used. Using the first criterion

  2. Postpartum nurses' perceptions of barriers to screening for intimate partner violence: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Guillery Margaret E

    2012-02-01

    Full Text Available Abstract Background Intimate partner violence (IPV is a human rights violation that is pervasive worldwide, and is particularly critical for women during the reproductive period. IPV includes physical, sexual and emotional abuse. Nurses on in-patient postpartum units are well-positioned to screen women for IPV, yet low screening rates suggest that barriers to screening exist. The purpose of this study was to (a identify the frequency of screening for IPV, (b the most important barriers to screening, (c the relationship between the barriers to screening and the frequency of screening for types of abuse, and (d to identify other factors that contribute to the frequency of screening for IPV. Methods In 2008, we conducted a cross-sectional survey of 96 nurses from postpartum inpatient units in three Canadian urban hospitals. The survey included the Barriers to Abuse Assessment Tool (BAAT, adapted for postpartum nurses (PPN. Ordinary least squares (OLS regression models were used to predict barriers to screening for each type of IPV. Results The frequency of screening varied by the type of abuse with highest screening rates found for physical and emotional abuse. According to the BAAT-PPN, lack of knowledge was the most important barrier to screening. The BAAT-PPN total score was negatively correlated with screening for physical, sexual, and emotional abuse. Using OLS regression models and after controlling for demographic characteristics, the BAAT-PPN explained 14%, 12%, and 11% of the variance in screening for physical, sexual and emotional abuse, respectively. Fluency in the language of the patient was negatively correlated with screening for each type of abuse. When added as Step 3 to OLS regression models, language fluency was associated with an additional decrease in the likelihood of screening for physical (beta coefficient = -.38, P P = .05, and emotional abuse (beta coefficient = -.48, P Conclusions Our findings support an inverse

  3. The role of bone scintigraphy in the evaluation of the suspected abused child

    International Nuclear Information System (INIS)

    Sty, J.R.; Starshak, R.J.

    1983-01-01

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused

  4. Abusive Relationships

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Abusive Relationships KidsHealth / For Teens / Abusive Relationships Print en español Relaciones de maltrato Healthy Relationships = Respect & Trust Healthy relationships involve respect, trust, and ...

  5. Drug Abuse

    Science.gov (United States)

    ... and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug ...

  6. Pattern of buprenorphine abuse among opioid abusers in Nepal.

    Science.gov (United States)

    Aich, Tapas Kumar; Dhungana, Manoj; Khanal, Roshija

    2010-07-01

    Although buprenorphine abusers are a common clinical entity, literature on them is rare in Nepal. To assess whether injectable opioid abusers are any different a subgroup vis-a-vis brown sugar abusers in relation to their demographic and clinical profiles. Seventy-six opioid abusers, who were admitted over a period of one year, in our de-addiction center, were included in the present study. They were divided into two groups based on the history of the presence or absence of buprenorphine injection abuse in them. The demographic and clinical profiles of these two groups were studied and compared. The most characteristic opioid abuse pattern was the abuse of brown sugar through inhalation (chasing). A total of 32 (42.1%) among them had a history of injectable drug abuse (IDU). Most characteristic buprenorphine abuse pattern seen was an evolution from injectable buprenorphine to triple injection to brown sugar abuse (Reverse Transition). Injection buprenorphine abusers, who attended our clinic, were older in age and had a history of a longer duration of abuse than their counterparts who abused opioid drugs through the inhalational route only. Their lifetime diagnosis revealed a polysubstance abuse pattern. They were more unstable, impulsive, and disorganized in their behavior pattern, suggestive of the presence of inadequate personality traits. There were high instances of injection-related side effects in the form of the presence of thrombophlebitis, HIV positivity, and clinical AIDS in them. Findings of the current research indicate the presence of a subgroup of patient population among opioid abusers with a history of injectable buprenorphine abuse, with characteristic personality traits, pattern of drug abuse, and associated physical complications resulting from it.

  7. Improving Pathways to Assessment and Care for Infants of Substance Abusing Mothers: Are We Getting It Right?

    Directory of Open Access Journals (Sweden)

    Joanna Alexander

    2015-03-01

    Full Text Available There is documented correlation between parental substance abuse, child maltreatment, and poor outcomes. In two health districts in Sydney, Australia (Site A and B, specialised clinics were established to provide comprehensive assessments for infants of substance abusing mothers (ISAM. We aimed to determine whether there was a difference in outcomes between infants who attended clinic versus those who did not; and to identify differences in the pathways to care between sites. We analysed child protection reports and available health markers of all ISAM referrals in 2011. We held stakeholder meetings with services involved with ISAM in both sites; to describe service components; strengths and weaknesses of pathways. Fifty-five per cent (11/20 attended clinic in Site A; 80% (25/31 in Site B. Three-quarters of ISAM had at least one referral to child welfare; child protection service involvement was more common in those who attended. Immunisation status was lower than the national Australian average; approximately half were seen by community nursing services. Gaps in services, lack of database, and differences in pathways between sites were identified. Attending clinics correlates with child protection service involvement and may afford health protection. Transparent communication, service integration, and shared learning can improve outcomes for this vulnerable group.

  8. Assessing severity of delirium by the Delirium Observation Screening Scale

    NARCIS (Netherlands)

    Scheffer, Alice C.; van Munster, Barbara C.; Schuurmans, Marieke J.; de Rooij, Sophia E.

    Objective: Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. Assessment of the severity of delirium is important for adjusting medication. The minimal dose of medication is preferable to prevent side effects. Only few nurse based severity measures are available.

  9. Effectiveness of Inhalant Abuse Legislation.

    Science.gov (United States)

    Batis, Jeffery C

    2017-01-28

    Since peaking in the 1990s, inhalant abuse has steadily decreased over the past two decades. Concurrently, nearly every state has passed legislation aimed at minimizing inhalant abuse. While males have historically been more likely to abuse inhalants than females, there is no longer a sex effect in self-reported rates of inhalant abuse. The objective of the present study is to evaluate the effect of anti-inhalant abuse legislation on self-reported rates of inhalant abuse, in high school age males and females. Beginning in 1993, the CDC's biannual Youth Risk Behavior Surveillance Survey asked respondents if they have ever used inhalants to get high. Data from these surveys were collected, along with the date of passage of anti-inhalant abuse legislation in 46 of 50 states. ANOVAs were conducted to assess the effect of legislation on self-reported inhalant abuse rates. There were no significant main effects or interactions that demonstrated that inhalant abuse rates decreased in males or females following passage of legislation aimed at decreasing inhalant abuse. Conclusion/Importance: To date, 46 of 50 states have passed laws aimed at minimizing inhalant abuse, and while inhalant abuse rates have been decreasing for the past two decades, there is no evidence that this decline is related to enactment of these laws. Further research is needed to determine the cause of the decrease in inhalant abuse. The laws may benefit from amendments to include options for treatment.

  10. Biodiversity impact assessment (BIA+) - methodological framework for screening biodiversity.

    Science.gov (United States)

    Winter, Lisa; Pflugmacher, Stephan; Berger, Markus; Finkbeiner, Matthias

    2018-03-01

    For the past 20 years, the life cycle assessment (LCA) community has sought to integrate impacts on biodiversity into the LCA framework. However, existing impact assessment methods still fail to do so comprehensively because they quantify only a few impacts related to specific species and regions. This paper proposes a methodological framework that will allow LCA practitioners to assess currently missing impacts on biodiversity on a global scale. Building on existing models that seek to quantify the impacts of human activities on biodiversity, the herein proposed methodological framework consists of 2 components: a habitat factor for 14 major habitat types and the impact on the biodiversity status in those major habitat types. The habitat factor is calculated by means of indicators that characterize each habitat. The biodiversity status depends on parameters from impact categories. The impact functions, relating these different parameters to a given response in the biodiversity status, rely on expert judgments. To ensure the applicability for LCA practitioners, the components of the framework can be regionalized on a country scale for which LCA inventory data is more readily available. The weighting factors for the 14 major habitat types range from 0.63 to 1.82. By means of area weighting of the major habitat types in a country, country-specific weighting factors are calculated. In order to demonstrate the main part of the framework, examples of impact functions are given for the categories "freshwater eutrophication" and "freshwater ecotoxicity" in 1 major habitat type. The results confirm suitability of the methodological framework. The major advantages are the framework's user-friendliness, given that data can be used from LCA databases directly, and the complete inclusion of all levels of biodiversity (genetic, species, and ecosystem). It is applicable for the whole world and a wide range of impact categories. Integr Environ Assess Manag 2018;14:282-297.

  11. PATHOS: a quick screening method for assessing sexual addiction.

    Science.gov (United States)

    Johnson, Pennie; Cashwell, Craig S; Cress, Jim; Barber, Tim; Dunn, Mary Clayton

    2013-01-01

    Pastors may understand that sex addiction exists and are frequently faced with people who need non-clinical and clinical services for the addiction. However, the pastoral counselors have no quick reliable method of assessing them. The purpose of this article is to define sexual addiction and provide information about a tool called PATHOS that can be used in clinical and non-clinical settings to identify potential sex addicts.

  12. Child sexual abuse.

    Science.gov (United States)

    Johnson, Charles Felzen

    Child sexual abuse is a worldwide concern. It is an insidious, persistent, and serious problem that, depending on the population studied and definition used, affects 2-62% of women and 3-16% of men as victims. Pain and tissue injury from child sexual abuse can completely heal in time, but psychological and medical consequences can persist through adulthood. Associated sexually transmitted diseases (such as HIV) and suicide attempts can be fatal. All physicians who treat children should be aware of the manifestations and consequences of child sexual abuse, and should be familiar with normal and abnormal genital and anal anatomy of children. This aim is best accomplished through training and routine examination of the anus and genitalia of children. Because as many as 96% of children assessed for suspected sexual abuse will have normal genital and anal examinations, a forensic interview by a trained professional must be relied on to document suspicion of abuse.

  13. Screening tool development for health impact assessment of large administrative structural changes

    DEFF Research Database (Denmark)

    Ravn, Anne Katrine; Nicolaisen, Henriette; Linnrose, Karina

    2008-01-01

    available on the Internet and in the scientific literature, in many cases lack of access to those tools creates a barrier to the use of HIA. RESULTS: Denmark is undergoing a major structural change in state administration, moving many responsibilities from the state to the local level. Newly constructed......AIMS: Screening is the first, extremely important step of health impact assessment (HIA) methodology. It contributes to the decision to conduct or not conduct a full assessment, and predefines the main fields of interest of the assessment. METHODS: Although there are examples of screening tools...... councils are faced with challenges regarding their responsibilities in health promotion and other fields, and this has opened a window for the introduction of HIA at a local level. Owing to the lack of experience with HIA in Denmark, screening tools are lacking and are frequently requested by councils...

  14. Child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Dorst, J.P.

    1982-08-01

    Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleeding or visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse.

  15. Child abuse

    International Nuclear Information System (INIS)

    Dorst, J.P.; Johns Hopkins Medical Institutions, Baltimore, MD

    1982-01-01

    Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleed, ar visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse. (orig.)

  16. Implementation of Depression Screening and Global Health Assessment in Pediatric Subspecialty Clinics.

    Science.gov (United States)

    Iturralde, Esti; Adams, Rebecca N; Barley, Regan C; Bensen, Rachel; Christofferson, Megan; Hanes, Sarah J; Maahs, David M; Milla, Carlos; Naranjo, Diana; Shah, Avni C; Tanenbaum, Molly L; Veeravalli, Sruthi; Park, K T; Hood, Korey K

    2017-11-01

    Adolescents with chronic illness face greater risk of psychosocial difficulties, complicating disease management. Despite increased calls to screen for patient-reported outcomes, clinical implementation has lagged. Using quality improvement methods, this study aimed to investigate the feasibility of standardized screening for depression and assessment of global health and to determine recommended behavioral health follow-up, across three pediatric subspecialty clinics. A total of 109 patients aged 12-22 years (median = 16.6) who were attending outpatient visits for treatment of diabetes (80% type 1), inflammatory bowel disease, or cystic fibrosis completed the 9-item Patient Health Questionnaire (PHQ-9) depression and Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health measures on electronic tablets. Patients screening positive on the PHQ-9 received same-day behavioral health assessment and regular phone check-ins to facilitate necessary follow-up care. Overall, 89% of 122 identified patients completed screening during a 6-month window. Patients completed measures in a timely manner (within 3 minutes) without disruption to clinic flow, and they rated the process as easy, comfortable, and valuable. Depression scores varied across disease type. Patients rated lower global health relative to a previously assessed validation cohort. Depression and global health related significantly to certain medical outcomes. Fifteen percent of patients screened positive on the PHQ-9, of whom 50% confirmed attending behavioral health appointments within 6 months of screening. A standardized depression and global health assessment protocol implemented across pediatric subspecialties was feasible and effective. Universal behavioral health screening for adolescents and young adults living with chronic disease is necessary to meet programmatic needs in pediatric subspecialty clinics. Copyright © 2017 Society for Adolescent Health and Medicine

  17. Guidance Manual for Conducting Screening Level Ecological Risk Assessments at the INEL

    Energy Technology Data Exchange (ETDEWEB)

    R. L. VanHorn; N. L. Hampton; R. C. Morris

    1995-06-01

    This document presents reference material for conducting screening level ecological risk assessments (SLERAs)for the waste area groups (WAGs) at the Idaho National Engineering Laboratory. Included in this document are discussions of the objectives of and processes for conducting SLERAs. The Environmental Protection Agency ecological risk assessment framework is closely followed. Guidance for site characterization, stressor characterization, ecological effects, pathways of contaminant migration, the conceptual site model, assessment endpoints, measurement endpoints, analysis guidance, and risk characterization are included.

  18. Assessing Colorectal Cancer Screening Behaviors and Knowledge among At-Risk Hispanics in Southern New Mexico.

    Science.gov (United States)

    Sanchez, Janeth I; Palacios, Rebecca; Thompson, Beti; Martinez, Vanessa; O'Connell, Mary A

    2013-07-01

    Colorectal cancer (CRC) mortality rates in New Mexico (NM) continue to be higher than national rates. Hispanic CRC mortality rates in NM surpass those of overall Hispanics in the US. This study was designed to characterize and understand factors contributing to low CRC screening rates in this border region. A CRC Knowledge Assessment Survey (KAS) was administered in either English or Spanish to 247 individuals attending community events throughout southern NM. A subset of these individuals completed an online CRC risk assessment survey managed by the National Cancer Institute (NCI). Data analysis tested for significant differences in knowledge, physician-patient CRC interactions, CRC risk level perception, and screening rates across diverse ethnic and age groups. Both CRC knowledge and physician-patient CRC interactions were positively associated with participant screening history. Significant age and ethnic differences for CRC knowledge, physician-patient CRC interactions, and screening history in the NM border sample were also seen. Age-eligible Hispanics (50+) as well as those less than 50 years of age had lower CRC knowledge and were less likely to engage in physician-patient CRC interactions than non-Hispanic Whites (NHWs). The age-eligible Hispanics also reported lower CRC screening rates than their NHW counterparts. Low CRC knowledge and limited physician-patient CRC interactions appear to contribute to low screening rates in this NM population. Expanding education and outreach efforts for this border population are essential to promote early CRC detection and thereby decrease overall CRC mortality rates.

  19. The Drug Abuse Prevention and Control Act of 1970: Retrospective Assessments of Disparate Treatment and Consequential Impact.

    Science.gov (United States)

    Yamatani, Hide; Feit, Marvin; Mann, Aaron

    2017-01-01

    Although the basic paradigm of the U.S. federal drug policy targeting the supply and demand reduction has not changed since its enactment in 1970, there have been seriously undesirable disparate treatments and impacts among various population groups. Although U.S. Congress could not define what is discrimination, it did provide two major criteria for the assessment of discriminatory practices as follows: (a) disparate treatment-basing a key decision on association with any of the five prohibited individual's demographic classifications (race, color, religion, sex, or national origin); and (b) disparate impact-correlation between any of the five prohibited demographic classifications and the key outcomes. In reference to those criteria, this article describes evidence-based indicators of national failure of the Comprehensive Drug Abuse Prevention and Control Act.

  20. Screening method to assess the risk of explosive spalling on fire exposed concrete

    DEFF Research Database (Denmark)

    Sørensen, Lars Schiøtt

    2003-01-01

    At the Technical University of Denmark (BYG.DTU)a new test set-up is under development to screen various concretes to assess their risk of explosive spalling. The test exposes a standard cylinder to compressive ring stresses together with rapid heating of the cylinder end.......At the Technical University of Denmark (BYG.DTU)a new test set-up is under development to screen various concretes to assess their risk of explosive spalling. The test exposes a standard cylinder to compressive ring stresses together with rapid heating of the cylinder end....

  1. Expanded newborn screening in Puerto Rico and the US Virgin Islands: education and barriers assessment.

    Science.gov (United States)

    Morales, Ana; Wierenga, Andrea; Cuthbert, Carla; Sacharow, Stephanie; Jayakar, Parul; Velazquez, Darcy; Loring, Jessica; Barbouth, Deborah

    2009-03-01

    The implementation of the expanded newborn screening panel of 29 disorders recommended by the American College of Medical Genetics in Puerto Rico and United States Virgin Islands is still in development or in early stages. Efforts in the territories are complicated by educational and resource barriers that generate a wide gap between the islands and the US mainland. To meet immediate educational needs, we conducted in-services for local newborn screening professionals. The efficacy of the educational intervention was measured by pre and posttest scores and a seminar evaluation. An assessment was obtained to document local newborn screening needs and barriers, with focus on human resources, intervention, language, social issues, education, and communication. Statistical significance was found (P value Puerto Rico and United States Virgin Islands face different challenges in their implementation of expanded newborn screening. The data obtained in the present study serves as foundation for the development of public policy and long-term educational programs.

  2. Screening model for assessing doses from radiological accidents

    International Nuclear Information System (INIS)

    Sjoreen, A.L.; Athey, G.F.; Sakenas, C.A.; McKenna, T.J.

    1988-01-01

    A new dose assessment model, called RASCAL, has been written for the US Nuclear Regulatory Commission (NRC) for use during response to emergencies. RASCAL is designed to provide rough estimates of the health effects from a radiological accident in progress and only limited information is available. RASCAL will be used by the NRC personnel who report to the site of a nuclear accident to conduct an independent evaluation of dose projections. It was written to correct the technical and operational problems in NRC's previous model and to be more appropriate to the personal computers presently in use by the NRC. The model has been constructed to be easy to modify, with separate modules for estimation of the quantity of radioactivity released, its transport through the atmosphere, and the resulting radiologic dose to man. RASCAL results can be displayed in graphical or ASCII form. 4 refs

  3. Assessing screening criteria for the radiocarbon dating of bone mineral

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Ricardo, E-mail: ldv1452@gmail.com [Leibniz Labor for Isotopic and Radiometric Dating, Max-Eyth-Str. 11-13, 24118 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany); Huels, Matthias [Leibniz Labor for Isotopic and Radiometric Dating, Max-Eyth-Str. 11-13, 24118 Kiel (Germany); Nadeau, Marie-Josee; Grootes, Pieter M. [Leibniz Labor for Isotopic and Radiometric Dating, Max-Eyth-Str. 11-13, 24118 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany); Garbe-Schoenberg, C.-Dieter [Institute of Geosciences, Marine Climate Research and ICPMS Lab, Kiel University, Ludewig-Meyn-Str. 10, D-24118 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany); Hollund, Hege I. [Institute for Geo- and Bioarchaeology, The VU University, De Boelelaan 1085, 1081 HV Amsterdam (Netherlands); Lotnyk, Andriy [Faculty of Engineering, Institute for Material Science, Synthesis and Real Structure, Kiel University, Kaiserstr. 2, D-24143 Kiel (Germany); Leibniz Institute of Surface Modification (IOM), Permoserstr. 15, D-04318 Leipzig (Germany); Kienle, Lorenz [Faculty of Engineering, Institute for Material Science, Synthesis and Real Structure, Kiel University, Kaiserstr. 2, D-24143 Kiel (Germany); Graduate School Human Development in Landscapes, Christian Albrecht University, Kiel (Germany)

    2013-01-15

    Radiocarbon dating of bone mineral (carbonate in the apatite lattice) has been the target of sporadic research for the last 40 years. Results obtained by different decontamination protocols have, however, failed to provide a consistent agreement with reference ages. In particular, quality criteria to assess bone mineral radiocarbon dating reliability are still lacking. Systematic research was undertaken to identify optimal preservation criteria for bone mineral in archeological bones. Six human long bones, originating from a single site, were radiocarbon-dated both for collagen and apatite, with the level of agreement between the dates providing an indication of exogenous carbon contamination. Several techniques (Histology, FTIR, TEM, LA-ICP-MS) were employed to determine the preservation status of each sample. Research results highlight the importance of a micro-scale approach in establishing bone preservation, in particular the use of trace element concentration profiles demonstrated its potential use as a viable sample selection criterion for bone carbonate radiocarbon dating.

  4. A systematic review of alcohol screening and assessment measures for young people: a study protocol.

    Science.gov (United States)

    Toner, Paul; Böhnke, Jan R; McCambridge, Jim

    2017-06-06

    Alcohol consumption creates a significant public health burden, and young people who drink alcohol place themselves at risk of harm. Expert guidance and reviews have highlighted the pressing need for reliable and valid, age-appropriate alcohol screening and assessment measures for young people. The proposed systematic review will evaluate existing alcohol screening and assessment measures for young people aged 24 and under. Six electronic databases will be searched for published and grey literature. In addition, reverse and forward citation searching and consultation with experts will be performed. Three sets of search terms will be combined, including alcohol use/problems, young people and validation studies. The titles and abstracts of reports from the searches will be screened, and potentially relevant full-text reports will be retrieved and independently assessed for inclusion by two reviewers based on prespecified criteria. Discrete validation studies within included reports will then be assessed for eligibility. There will be an a priori basic quality threshold for predictive validity, internal and test-retest for studies to warrant full data extraction. Studies above the quality threshold will be assessed for quality using the modified consensus-based standards for the selection of health measurement instruments checklist and a quality assessment tool for diagnostic accuracy studies. This review will highlight the best performing measures both for screening and assessment based on their psychometric properties and the quality of the validation studies supporting their use. Providing clear guidance on which existing measures perform best to screen and assess alcohol use and problems in young people will inform policy, practice and decision-making, and clarify the need for further research. International Prospective Register of Systematic Reviews, CRD42016053330. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

  5. Predicting cannabis abuse screening test (CAST) scores: a recursive partitioning analysis using survey data from Czech Republic, Italy, the Netherlands and Sweden.

    Science.gov (United States)

    Blankers, Matthijs; Frijns, Tom; Belackova, Vendula; Rossi, Carla; Svensson, Bengt; Trautmann, Franz; van Laar, Margriet

    2014-01-01

    Cannabis is Europe's most commonly used illicit drug. Some users do not develop dependence or other problems, whereas others do. Many factors are associated with the occurrence of cannabis-related disorders. This makes it difficult to identify key risk factors and markers to profile at-risk cannabis users using traditional hypothesis-driven approaches. Therefore, the use of a data-mining technique called binary recursive partitioning is demonstrated in this study by creating a classification tree to profile at-risk users. 59 variables on cannabis use and drug market experiences were extracted from an internet-based survey dataset collected in four European countries (Czech Republic, Italy, Netherlands and Sweden), n = 2617. These 59 potential predictors of problematic cannabis use were used to partition individual respondents into subgroups with low and high risk of having a cannabis use disorder, based on their responses on the Cannabis Abuse Screening Test. Both a generic model for the four countries combined and four country-specific models were constructed. Of the 59 variables included in the first analysis step, only three variables were required to construct a generic partitioning model to classify high risk cannabis users with 65-73% accuracy. Based on the generic model for the four countries combined, the highest risk for cannabis use disorder is seen in participants reporting a cannabis use on more than 200 days in the last 12 months. In comparison to the generic model, the country-specific models led to modest, non-significant improvements in classification accuracy, with an exception for Italy (p = 0.01). Using recursive partitioning, it is feasible to construct classification trees based on only a few variables with acceptable performance to classify cannabis users into groups with low or high risk of meeting criteria for cannabis use disorder. The number of cannabis use days in the last 12 months is the most relevant variable. The identified

  6. Predicting cannabis abuse screening test (CAST scores: a recursive partitioning analysis using survey data from Czech Republic, Italy, the Netherlands and Sweden.

    Directory of Open Access Journals (Sweden)

    Matthijs Blankers

    Full Text Available Cannabis is Europe's most commonly used illicit drug. Some users do not develop dependence or other problems, whereas others do. Many factors are associated with the occurrence of cannabis-related disorders. This makes it difficult to identify key risk factors and markers to profile at-risk cannabis users using traditional hypothesis-driven approaches. Therefore, the use of a data-mining technique called binary recursive partitioning is demonstrated in this study by creating a classification tree to profile at-risk users.59 variables on cannabis use and drug market experiences were extracted from an internet-based survey dataset collected in four European countries (Czech Republic, Italy, Netherlands and Sweden, n = 2617. These 59 potential predictors of problematic cannabis use were used to partition individual respondents into subgroups with low and high risk of having a cannabis use disorder, based on their responses on the Cannabis Abuse Screening Test. Both a generic model for the four countries combined and four country-specific models were constructed.Of the 59 variables included in the first analysis step, only three variables were required to construct a generic partitioning model to classify high risk cannabis users with 65-73% accuracy. Based on the generic model for the four countries combined, the highest risk for cannabis use disorder is seen in participants reporting a cannabis use on more than 200 days in the last 12 months. In comparison to the generic model, the country-specific models led to modest, non-significant improvements in classification accuracy, with an exception for Italy (p = 0.01.Using recursive partitioning, it is feasible to construct classification trees based on only a few variables with acceptable performance to classify cannabis users into groups with low or high risk of meeting criteria for cannabis use disorder. The number of cannabis use days in the last 12 months is the most relevant variable

  7. Driving simulators for occupational therapy screening, assessment, and intervention.

    Science.gov (United States)

    Classen, Sherrilene; Brooks, Johnell

    2014-04-01

    Simulation technology provides safe, objective, and repeatable performance measures pertaining to operational (e.g., avoiding a collision) or tactical (e.g., lane maintenance) driver behaviors. Many occupational therapy researchers and others are using driving simulators to test a variety of applications across diverse populations. A growing body of literature provides support for associations between simulated driving and actual on-road driving. One limitation of simulator technology is the occurrence of simulator sickness, but management strategies exist to curtail or mitigate its onset. Based on the literature review and a consensus process, five consensus statements are presented to support the use of driving simulation technology among occupational therapy practitioners. The evidence suggests that by using driving simulators occupational therapy practitioners may detect underlying impairments in driving performance, identify driving errors in at-risk drivers; differentiate between driving performance of impaired and healthy controls groups; show driving errors with absolute and relative validity compared to on-road studies; and mitigate the onset of simulator sickness. Much progress has been made among occupational therapy researchers and practitioners in the use of driving simulation technology; however, empirical support is needed to further justify the use of driving simulators in clinical practice settings as a valid, reliable, clinical useful, and cost effective tool for driving assessment and intervention.

  8. Screening test for assessment of ultimate biodegradability: linear alkylbenzene sulfonates.

    Science.gov (United States)

    Gledhill, W E

    1975-01-01

    A relatively simple shake-flask system for determining CO2 evolution was developed to assess the ultimate biodegradability by soil and sewage micro-organisms of chemicals which enter the environment. Linear alkylbenzene sulfonates (LAS) were used as model compounds to evaluate the method and were found to undergo substantial biodegradation in this dilute system. At the 30 mg/liter test concentration, higher-molecular-weight LAS compounds were biodegraded at a slower rate and to a lesser extent than lower-molecular-weight LAS, an effect which was eliminated or greatly reduced upon incremental addition of the LAS to the test medium during the first week of incubation. LA35S was used to demonstrate rapid LAS desulfonation, and 14CO2 evolution studies with (14C) benzene ring-labeled LAS indicated concomitant biodegradation of the entire LAS molecule as well as the LAS aromatic component. The test can be employed to examine numerous compounds at the same time and is readily adapted to studies of the effect of variation in temperature and oxygen concentration on biodegradation. PMID:1211937

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

    Science.gov (United States)

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

    2006-01-01

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

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

    Science.gov (United States)

    Tolliver, Bryan K; Anton, Raymond F

    2015-06-01

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

  11. An instrumental variables approach to assess the effect of class size reduction on student screen time.

    Science.gov (United States)

    Cohen, Alison K

    2018-03-01

    An emerging area of research considers links between characteristics of the school setting and health. The existing small evidence base assessing the association between class size and health is inconclusive. This quasi-experimental study uses an instrumental variables approach based on North Carolina's elementary class size reduction policy to assess the relationship between class size and student screen time. Specifically, data are from public school students in North Carolina, USA, who were in 3rd grade any time between fall 2005 and spring 2011. There was no association between class size and screen time (measured as recreational television and/or electronic device use), after accounting for grade size and school size, year fixed effects, and clustering at the school and district level. These findings suggest that, in statewide policy implementation settings, there may not be any immediate spillover benefits of class size reduction policies on student screen time. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Quantitative assessment of smoking-induced emphysema progression in longitudinal CT screening for lung cancer

    Science.gov (United States)

    Suzuki, H.; Mizuguchi, R.; Matsuhiro, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.; Moriyama, N.

    2015-03-01

    Computed tomography has been used for assessing structural abnormalities associated with emphysema. It is important to develop a robust CT based imaging biomarker that would allow quantification of emphysema progression in early stage. This paper presents effect of smoking on emphysema progression using annual changes of low attenuation volume (LAV) by each lung lobe acquired from low-dose CT images in longitudinal screening for lung cancer. The percentage of LAV (LAV%) was measured after applying CT value threshold method and small noise reduction. Progression of emphysema was assessed by statistical analysis of the annual changes represented by linear regression of LAV%. This method was applied to 215 participants in lung cancer CT screening for five years (18 nonsmokers, 85 past smokers, and 112 current smokers). The results showed that LAV% is useful to classify current smokers with rapid progression of emphysema (0.2%/year, pemphysema in CT screening for lung cancer.

  13. An Improved On-line Contingency Screening for Power System Transient Stability Assessment

    DEFF Research Database (Denmark)

    Weckesser, Johannes Tilman Gabriel; Jóhannsson, Hjörtur; Glavic, Mevludin

    2017-01-01

    This paper presents a contingency screening method and a framework for its on-line implementation. The proposed method carries out contingency screening and on-line stability assessment with respect to first-swing transient stability. For that purpose, it utilizes the single machine equivalent...... method and aims at improving the prior developed contingency screening approaches. In order to determine vulnerability of the system with respect to a particular contingency, only one time-domain simulation needs to be performed. An early stop criteria is proposed so that in a majority of the cases...... the simulation can be terminated after a few hundred milliseconds of simulated system response. The method's outcome is an assessment of the system's stability and a classification of each considered contingency. The contingencies are categorized by exploiting parameters of an equivalent one machine infinite bus...

  14. Breast cancer screening among women younger than age 50: a current assessment of the issues.

    Science.gov (United States)

    Smith, R A

    2000-01-01

    In the hope of resolving underlying policy questions related to the value of breast cancer screening with mammography for women younger than 50 years of age, the National Institutes of Health and the National Cancer Institute in 1997 jointly sponsored a consensus conference on the subject. While the panel concluded that the data were insufficient to endorse mammography for this age group apart from individual choice, the conclusion was not the "consensus" sought by many of those with strong opinions on both sides of this issue, and the debate raged on. Prior to the 1997 conference, and since, meta-analyses of trial data and assessments of service screening programs have indicated that breast cancer screening with mammography for women between 40 and 49 meets recommended levels of performance compared with performance in women 50 years and older, especially if programs achieve high quality and screen at 12-to-18 month intervals. Because the detectable preclinical phase is shorter in younger women who develop breast cancer compared with that in women 50 years of age or older, a key component of any screening program for those younger than 50 is an appropriate screening interval. Many of the screening programs that had historically been developed for women in their forties--and whose disappointing results contributed to the confusion and controversy about the efficacy of mammography in younger women--had a 24-month screening interval, which was not found to be of significant benefit for early detection of breast cancer in this age group. While a new emphasis of this controversy has focused on the balance of benefits and harms in women ages 40 to 49, women of all ages need to be fully informed about the benefits and limitations of breast cancer screening--more specifically, what to expect at the time of screening, and what to expect from screening. There are differences in the performance and effectiveness of mammography in different age groups of women aged 40 and

  15. Self-report Assessment of Severe Periodontitis: Periodontal Screening Score Development.

    Science.gov (United States)

    Carra, Maria Clotilde; Gueguen, Alice; Thomas, Frédérique; Pannier, Bruno; Caligiuri, Giuseppina; Steg, Philippe Gabriel; Zins, Marie; Bouchard, Philippe

    2018-04-03

    To derive from a validated questionnaire a periodontal screening score, intended as an user-friendly tool to identify individuals at risk of periodontitis in epidemiological studies. A French 12-item self-reported questionnaire was developed by translating English questions previously used for periodontitis screening and surveillance. After a cognitive evaluation, the questionnaire was validated in a sample of 232 individuals (mean age: 46.1±12.6 years) receiving full-mouth periodontal examination, including probing pocket depth and clinical attachment level recordings. Case definition was based on the American Academy of Periodontology/Centers for Disease Control and Prevention criteria. Logistic regression analyses and C-statistics were used to assess the validity and accuracy of the questionnaire and to develop the periodontal screening score. The sample was constituted of 109 individuals with severe periodontitis, who were compared with 123 individuals with no/moderate periodontitis. The questionnaire had moderate-to-high accuracy in identifying severe cases; the periodontal screening score (calculated on 5 self-report items, age, and smoking) showed a sensitivity of 78.9% and a specificity of 74.8%, with an area under the receiver operating characteristics curve of 0.821. The periodontal screening score represents a valuable and accurate tool to screen for severe periodontitis at the population level. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. Postoperative delirium in patients with history of alcohol abuse.

    Science.gov (United States)

    Sousa, G; Pinho, C; Santos, A; Abelha, F J

    2017-04-01

    Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI). Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD. Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Bioassays for Evaluating Water Quality: Screening for total bioactivity to assess water safety

    Science.gov (United States)

    Bioassays are a potential solution for assessing complex samples since they screen for total bioactivity for a given pathway or mode of action (MOA), such as estrogen receptor activation, in the samples. Overall, they can account for the three challenges listed above, and can sim...

  18. The Athlete Sleep Screening Questionnaire: a new tool for assessing and managing sleep in elite athletes.

    Science.gov (United States)

    Samuels, Charles; James, Lois; Lawson, Doug; Meeuwisse, Willem

    2016-04-01

    The purpose of this study was to develop a subjective, self-report, sleep-screening questionnaire for elite athletes. This paper describes the development of the Athlete Sleep Screening Questionnaire (ASSQ). A convenience sample of 60 elite athletes was randomly distributed into two groups; 30 athletes completed a survey composed of current psychometric tools, and 30 athletes completed a revised survey and a sleep specialist structured clinical interview. An item analysis was performed on the revised survey with comparison to clinical decisions regarding appropriate intervention based on a sleep specialist assessment. A comparison of existing sleep-screening tools with determination of clinical need from a sleep specialist showed low consistency, indicating that current sleep-screening tools are unsuitable for assessing athlete sleep. A new 15-item tool was developed (ASSQ) by selecting items from existing tools that more closely associated with the sleep specialist's reviews. Based on test-retest percentage agreement and the κ-statistic, we found good internal consistency and reliability of the ASSQ. To date, 349 athletes have been screened, and 46 (13.2%) identified as requiring follow-up consultation with a sleep specialist. Results from the follow-up consultations demonstrated that those athletes identified by the ASSQ as abnormal sleepers have required intervention. The research developed a new athlete-specific sleep-screening questionnaire. Our findings suggest that existing sleep-screening tools are unsuitable for assessing sleep in elite athletes. The ASSQ appears to be more accurate in assessing athlete sleep (based on comparison with expert clinical assessment). The ASSQ can be deployed online and provides clinical cut-off scores associated with specific clinical interventions to guide management of athletes' sleep disturbance. The next phase of the research is to conduct a series of studies comparing results from the ASSQ to blinded clinical reviews and

  19. Outcomes of unconventional utilization of BI-RADS category 3 assessment at opportunistic screening.

    Science.gov (United States)

    Altas, Hilal; Tureli, Derya; Cengic, Ismet; Kucukkaya, Fikret; Aribal, Erkin; Kaya, Handan

    2016-11-01

    Background An important difficulty regarding the Breast Imaging Reporting and Data System (BI-RADS) category 3 assessment is the need for extensive diagnostic workup and an additional 6-month follow-up study. Purpose To evaluate the feasibility of the BI-RADS category 3 assessments at opportunistic screening. Material and Methods Mammography charts of 9062 screening patients in a major teaching hospital situated in an urban setting of a developing country were evaluated retrospectively (1997-2010). BI-RADS category 3 patients, called for a 6-month follow-up, which comprised a single-view spot or magnification mammogram. The length of follow-up period, compliance to periodic mammographic surveillance, cancer detection rate, and negative predictive values of category 3 assessments were calculated. Results Of the screened population, 9.2% were assigned BI-RADS category 3, and 31.2% of these cases were lost to follow-up. The mean follow-up period for 606 patients was 36.9 months. The negative predictive values for 6-month, 12-month, and final control studies were 90.9%, 87.5%, and 100%, respectively. Patient compliance for 6 months, 12 months, and any control evaluations beyond 12 months was low (50.0%, 29.8%, and 47.5%, respectively). Cancer detection rate was 0.8%. Conclusion Results of the study supports the feasibility of the BI-RADS category 3 assessments at opportunistic screening without any additional diagnostic workup. The practice of category 3 assessment following screening mammograms may be a more cost-effective method for developing countries with high recall rates and low resources in eliminating the maximum risk with minimum cost within the limits of available resources.

  20. Development of a Social Skills Assessment Screening Scale for Psychiatric Rehabilitation Settings: A Pilot Study.

    Science.gov (United States)

    Bhola, Poornima; Basavarajappa, Chethan; Guruprasad, Deepti; Hegde, Gayatri; Khanam, Fatema; Thirthalli, Jagadisha; Chaturvedi, Santosh K

    2016-01-01

    Deficits in social skills may present in a range of psychiatric disorders, particularly in the more serious and persistent conditions, and have an influence on functioning across various domains. This pilot study aimed at developing a brief measure, for structured evaluation and screening for social skills deficits, which can be easily integrated into routine clinical practice. The sample consisted of 380 inpatients and their accompanying caregivers, referred to Psychiatric Rehabilitation Services at a tertiary care government psychiatric hospital. The evaluation included an Inpatient intake Proforma and the 20-item Social Skills Assessment Screening Scale (SSASS). Disability was assessed using the Indian Disability Evaluation and Assessment Scale (IDEAS) for a subset of 94 inpatients. The analysis included means and standard deviations, frequency and percentages, Cronbach's alpha to assess internal consistency, t -tests to assess differences in social skills deficits between select subgroups, and correlation between SSASS and IDEAS scores. The results indicated the profile of social skills deficits assessed among the inpatients with varied psychiatric diagnoses. The "psychosis" group exhibited significantly higher deficits than the "mood disorder" group. Results indicated high internal consistency of the SSASS and adequate criterion validity demonstrated by correlations with select IDEAS domains. Modifications were made to the SSASS following the pilot study. The SSASS has potential value as a measure for screening and individualised intervention plans for social skills training in mental health and rehabilitation settings. The implications for future work on the psychometric properties and clinical applications are discussed.

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

    NARCIS (Netherlands)

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

    2016-01-01

    Child sexual abuse is associated with social anxiety, low self-esteem, and intimacy deficits. This, in combination with the core belief of a dangerous world, might suggest that child abusers are sexually attracted to submissiveness. The Implicit Association Test (IAT) was used to examine this

  2. Accuracy of quick and easy undernutrition screening tools--Short Nutritional Assessment Questionnaire, Malnutrition Universal Screening Tool, and modified Malnutrition Universal Screening Tool--in patients undergoing cardiac surgery

    NARCIS (Netherlands)

    van Venrooij, Lenny M. W.; van Leeuwen, Paul A. M.; Hopmans, Wendy; Borgmeijer-Hoelen, Mieke M. M. J.; de Vos, Rien; de Mol, Bas A. J. M.

    2011-01-01

    The objective of this study was to compare the quick-and-easy undernutrition screening tools, ie, Short Nutritional Assessment Questionnaire and Malnutrition Universal Screening Tool, in patients undergoing cardiac surgery with respect to their accuracy in detecting undernutrition measured by a

  3. Cardiac pre-competiton screening in Swiss athletes. Current situation in competitive athletes and short-time assessment of an exemplary local screening program.

    Science.gov (United States)

    Schmied, Christian; Notz, Sara; Cribari, Marco; Gähwiler, Roman; Keller, Dagmar I; Lüscher, Thomas F

    2012-05-31

    In Switzerland, screening concepts for the prevention of sports-associated sudden cardiac death are still insufficiently established in the large group of competitive athletes who are not integrated in an Olympic- or other high-level squad. The aim of the present study was to objectively determine the current situation in this particular group of athletes concerning cardiac pre-competition screening and define specific features of an "ideal" Swiss screening concept. Based on these data, the feasibility and validity was tested by the implementation of an exemplary local screening programme. A standardised questionnaire was completed by 1,047 competitive athletes of different ages and gender. The individual, sports-specific profile of an athlete and furthermore, the personal attitude towards and the vision of a "perfect" cardiac screening were assessed. Based on the results, an exemplary local screening programme for competitive athletes was implemented at the "Academic Sports Association Zurich" (ASVZ) in Zurich, Switzerland and evaluated 1 year after its introduction. Only 9% of the 1,047 interviewed competitive athletes (aged 13 to 64 years; median age 22 years, SD = 5.87) had previously undergone a cardiac screening. Only 47% of the interviewed competitive athletes expressed their interest to undergo a cardiac screening at all. Male and older athletes showed a significantly higher acceptance rate for the screening programme than women and younger athletes. All athletes accepted to bear the expenses for the baseline screening programme, adapted to international standards (minimal accepted fee of 60 Swiss Francs). Almost half of the athletes (49.2%) preferred easy accessibility to a sports cardiologist (max. distance of 10 kilometres). The exemplary local screening programme proved to be feasible and successful. However, only 30% of the 102 screened individuals were female and most of the athletes (80%) who made use of the screening had a specific concern or

  4. A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

    Science.gov (United States)

    Ghanouni, Alex; Renzi, Cristina; Waller, Jo

    2017-04-18

    There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p screening uptake may also increase subsequent engagement with information. Future research could investigate how to improve engagement at initial invitations. There may also be scope to reduce barriers to accessing non-English information and

  5. The final word on nutritional screening and assessment in older persons.

    Science.gov (United States)

    Cereda, Emanuele; Veronese, Nicola; Caccialanza, Riccardo

    2018-01-01

    To provide an updated perspective of how nutritional screening and assessment in older persons should be performed and reasonably implemented in the near future. Although nutritional screening and assessment should be fast and easy procedures, there is increasing evidence that more time should be dedicated to them. This is probably an answer to the claim to a medicine being more preventive than curative. Increasing interest is currently given to healthy aging and nutritional status is more likely to be addressed for its implications on functional status and disability. Important prognostic conditions, such as frailty, sarcopenia, and cachexia, which are closely linked to the nutritional domain, are at the top of the agenda. Therefore, body composition is a key issue and functional status is suggested as primary endpoint of nutrition trials. In this scenario, there is also a rationale for systematic assessment of inflammation, protein intake, and vitamin D status as potential contributing factors to reduced muscle mass and function. A 'second-generation' multidimensional nutritional screening and assessment including the evaluation of body composition, frailty, sarcopenia, and cachexia could be hypothesized. Nutritional assessment should be also completed by the systematic evaluation of inflammation, protein intake, and vitamin D status.

  6. Cross-cultural validity of standardized motor development screening and assessment tools: a systematic review.

    Science.gov (United States)

    Mendonça, Bianca; Sargent, Barbara; Fetters, Linda

    2016-12-01

    To investigate whether standardized motor development screening and assessment tools that are used to evaluate motor abilities of children aged 0 to 2 years are valid in cultures other than those in which the normative sample was established. This was a systematic review in which six databases were searched. Studies were selected based on inclusion/exclusion criteria and appraised for evidence level and quality. Study variables were extracted. Twenty-three studies representing six motor development screening and assessment tools in 16 cultural contexts met the inclusion criteria: Alberta Infant Motor Scale (n=7), Ages and Stages Questionnaire, 3rd edition (n=2), Bayley Scales of Infant and Toddler Development, 3rd edition (n=8), Denver Developmental Screening Test, 2nd edition (n=4), Harris Infant Neuromotor Test (n=1), and Peabody Developmental Motor Scales, 2nd edition (n=1). Thirteen studies found significant differences between the cultural context and normative sample. Two studies established reliability and/or validity of standardized motor development assessments in high-risk infants from different cultural contexts. Five studies established new population norms. Eight studies described the cross-cultural adaptation of a standardized motor development assessment. Standardized motor development assessments have limited validity in cultures other than that in which the normative sample was established. Their use can result in under- or over-referral for services. © 2016 Mac Keith Press.

  7. An assessment of gynecological cytology screening practices among health care providers nationwide.

    Science.gov (United States)

    Darwish-Yassine, May; Garvin, Ann D; Johnston, Carolyn M; Zoschnick, Lauren; Conners, Amy; Laing, Shannon; Wojcik, Christopher

    2015-05-01

    The Michigan Public Health Institute and the Michigan Cancer Consortium's Cervical Cancer Committee conducted a national survey of health care providers, thanks to funding from the Centers for Disease Control Cooperative Agreement 5U47CI000743-02. Papanicolaou test screening practices were examined, emphasizing the relationship between clinical and laboratory practices. This survey found differing screening practices among providers of women's health care. To collect information from family medicine practitioners, women's nurse practitioners, obstetricians and gynecologists, and certified nurse-midwives on Papanicolaou and human papillomavirus testing; to discuss how those practices align with current cytology screening and follow-up recommendations from professional organizations (US Preventive Services Task Force, American Cancer Society, American College of Obstetricians and Gynecologists, and American Society for Colposcopy, and Cervical Pathology); and ultimately, to make recommendations aimed at standardizing practice performance. This survey was conducted in part to examine clinicians' practices and their perceptions of laboratory performance, to evaluate items that are known to enhance quality of care, and to examine factors that may prohibit universal implementation of best standards of care. The survey used a self-administered questionnaire, distributed to 9366 clinicians, with 1601 (17.1%) completed surveys. This assessment shows a clear lack of consensus among practitioners in performing Papanicolaou testing. It demonstrates how differently patients are tested, based on the providers' screening practices, and demonstrates specific cervical cancer screening practice disparities between and among the 4 provider groups, both in Papanicolaou testing and in the use of human papillomavirus testing. A unified mandate for screening is needed to standardize screening practices.

  8. The SISAP: A New Screening Instrument for Identifying Potential Opioid Abusers in the Management of Chronic Nonmalignant Pain Within General Medical Practice

    Directory of Open Access Journals (Sweden)

    Robert B Coambs

    1996-01-01

    Full Text Available BACKGROUND: Many physicians are overly cautious about prescribing opioids for chronic pain because of fears of iatrogenic addiction. However, in patients with chronic pain, addiction to opioid analgesics is exceedingly rare when there is no prior history of alcohol or drug abuse.

  9. Health technology assessment of computer-assisted pap test screening in Italy.

    Science.gov (United States)

    Dalla Palma, Paolo; Moresco, Luca; Giorgi Rossi, Paolo

    2013-01-01

    To assess the introduction of computer-assisted Pap test screening in cervical cancer screening. Various scenarios are considered: conventional and liquid-based cytology (LBC) slides, fully automatic instrumentation (Becton Dickinson FocalPoint™ Slide Profiler and Hologic ThinPrep® Imaging System), and semiautomatic scanner (Hologic Integrated Imager I-Squared). A working group was formed that included researchers from the largest centers already using instrumentation. A questionnaire on laboratory management and on social/ethical issues and annual workload was proposed. Prices for the technology were obtained directly from the producers; costs were calculated from observed and literature data. The scope of the report and final draft were submitted to a consulting committee of stakeholders. The break-even point was found to be 49,000 cases/year, if conventional slides were used, while it was near the theoretical maximum capacity, 70,000 cases/year, with LBC slides. Efficiency increased with the volume of slides. Screening time decreased by two thirds for conventional slides and by less than half for LBC slides. Acceptance of the instrumentation by the users was good. Computer-assisted screening may increase productivity even if in most situations it will mean additional costs. Furthermore, primary screening with human papillomavirus tests will drastically reduce the need for Pap test reading. Copyright © 2013 S. Karger AG, Basel.

  10. Alcohol Abuse

    Science.gov (United States)

    ... Drinking to Excess U.S. National Library of Medicine, Alcoholism and Alcohol Abuse Last Updated: June 27, 2017 This article was contributed by: familydoctor.org editorial staff Categories: Family Health, Kids and Teens, Men, Seniors, WomenTags: alcohol, alcohol abuse, alcohol addiction ...

  11. Fetal Abuse.

    Science.gov (United States)

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  12. Psychometric Assessment of the Burgess-Partner Abuse Scale for Teens (B-PAST

    Directory of Open Access Journals (Sweden)

    Stephanie E. Burgess

    2005-01-01

    Full Text Available Propósito. Evaluar las propiedades psicométricas de la Escala para adolescentes “Burgués-Partner Abuse Scale” (B-PAST, examinando la consistencia interna y validándola. Métodos. A una muestra de 239 niñas adolescentes, entre 13 y 19 años, que formaron parte de la práctica privada y que aceptaron participar, se le aplicó dos medidas de violencia interpersonal, dos de bienestar psicoló- gico y un cuestionario demográfico. La validez fue valorada por 1 un factor de análisis de conducta exploratoria con una decisión a priori para retener dos factores, y 2 medición de la correlación diferencial de la violencia interpersonal y el bienestar psicosocial usando la correlación de Pearson. Con el fin de determinar la habilidad del instrumento para discriminar entre niñas que informaron abuso de sus compañeros y aquéllas que no lo informaron, se examinaron las diferencias de la media de los grupos (abusadas vs. no abusadas. Un ANOVA de una vía se utilizó para determinar las diferencias de la violencia interpersonal y el bienestar psicosocial. Se examinó la consistencia interna del B-PAST, estableciendo un criterio para el coeficiente alfa sobre .70. Resultados. El 70.9% de la variable se explicó por medio del B-PAST. El factor de análisis demostró una escala de 22 ítemes con dos subescalas diferentes. El B-PAST correlacionado con una medida de violencia interpersonal de los compañeros (r=.39 y dos medidas de bienestar psicosocial pobre, bajo nivel de esperanza y aumento de la depresión (r=-.42, r=.46. Las diferencias en los contrastes de la media mostraron que las niñas adolescentes que habían sido abusadas por un compañero reportaron cifras más altas de violencia interpersonal. El ANOVA de una vía mostró que las niñas tenían cifras más altas para violencia interpersonal y depresión y bajas para esperanza. La consistencia interna para la escala total final fue de .97 y .95 para abuso físico/sexual y .91 para las

  13. Assess the comparison of marital satisfaction between the abused and nonabused women

    Directory of Open Access Journals (Sweden)

    Mojdeh Banaei

    2016-11-01

    Full Text Available Given the high prevalence of domestic violence and its impact on the different aspects of women's lives, this study was conducted with the aim of determining the prevalence of domestic violence and its correlation with the marital satisfaction in women of Bandar Abbas in 2014.The present study was an analytical cross-sectional study based on the purposive and non-random sampling method which was carried out on 300 women referred to health centers in Bandar Abbas, Iran. The data of the study was collected by the questionnaires of demographic and obstetrics information, domestic violence, and Enrich marital satisfaction scale through interviews and was analyzed using SPSS version 22.The total amount of domestic violence was reported to be 54%. The psychological violence was the most prevalent one (45%. There was a significant negative correlation between the overall score of domestic violence and all forms of violence (physical, sexual& psychological and the marital satisfaction score (P<0.001.Psychological violence was the most frequent type of violence against women in Bandar Abbas and there was a significant correlation between the domestic violence and marital satisfaction. Therefore, screening is recommended for women to improve their health condition.

  14. Reliability of the Tuck Jump Injury Risk Screening Assessment in Elite Male Youth Soccer Players.

    Science.gov (United States)

    Read, Paul J; Oliver, Jon L; de Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S

    2016-06-01

    Read, PJ, Oliver, JL, de Ste Croix, MBA, Myer, GD, and Lloyd, RS. Reliability of the tuck jump injury risk screening assessment in elite male youth soccer players. J Strength Cond Res 30(6): 1510-1516, 2016-Altered neuromuscular control has been suggested as a mechanism for injury in soccer players. Ligamentous injuries most often occur during dynamic movements, such as decelerations from jump-landing maneuvers where high-risk movement patterns are present. The assessment of kinematic variables during jump-landing tasks as part of a preparticipation screen is useful in the identification of injury risk. An example of a field-based screening tool is the repeated tuck jump assessment. The purpose of this study was to analyze the within-subject variation of the tuck jump screening assessment in elite male youth soccer players. Twenty-five pre-peak height velocity (PHV) and 25 post-PHV elite male youth soccer players from the academy of a professional English soccer club completed the assessment. A test-retest design was used to explore the within-subject intersession reliability. Technique was graded retrospectively against the 10-point criteria set out in the screening protocol using two-dimensional video cameras. The typical error range reported for tuck jump total score (0.90-1.01 in pre-PHV and post-PHV players respectively) was considered acceptable. When each criteria was analyzed individually, kappa coefficient determined that knee valgus was the only criterion to reach substantial agreement across the two test sessions for both groups. The results of this study suggest that although tuck jump total score may be reliably assessed in elite male youth soccer players, caution should be applied in solely interpreting the composite score due to the high within-subject variation in a number of the individual criteria. Knee valgus may be reliably used to screen elite youth male soccer players for this plyometric technique error and for test-retest comparison.

  15. Method for screening prevention and control measures and technologies based on groundwater pollution intensity assessment

    Energy Technology Data Exchange (ETDEWEB)

    Li, Juan, E-mail: lijuan@craes.org.cn [College of Water Sciences, Beijing Normal University, Beijing 100875 (China); Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Yang, Yang [College of Environment, Beijing Normal University, Beijing 100875 (China); Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Huan, Huan; Li, Mingxiao [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Xi, Beidou, E-mail: xibd413@yeah.net [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Lanzhou Jiaotong University, Lanzhou 730070 (China); Lv, Ningqing [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Wu, Yi [Guizhou Academy of Environmental Science and Designing, Guizhou 550000 (China); Xie, Yiwen, E-mail: qin3201@126.com [School of Chemical and Environmental Engineering, Dongguan University of Technology, Dongguan, 523808 (China); Li, Xiang; Yang, Jinjin [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China)

    2016-05-01

    index-based methodology to assess the groundwater pollution intensity (GPI). • GPI assessment includes PSH assessment and GIV assessment. • Measures to prevent and control groundwater pollution based on GPI assessment. • An index-based methodology for prevention and control technologies (PCT) screening. • PCT screening based on GPI assessment results and TOPSIS method.

  16. Other Drugs of Abuse

    Science.gov (United States)

    ... People Abuse » Other Drugs of Abuse Other Drugs of Abuse Listen There are many other drugs of abuse, ... and Rehab Resources About the National Institute on Drug Abuse (NIDA) | About This Website Tools and Resources | Contact ...

  17. Self Concept of Adolescent Sexual Abuse Victims.

    Science.gov (United States)

    Orr, Donald P.; Downes, Maureen C.

    1985-01-01

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

  18. Validation of the Healthy Foot Screen: A Novel Assessment Tool for Common Clinical Abnormalities.

    Science.gov (United States)

    Persaud, Reneeka; Coutts, Patricia M; Brandon, Alisa; Verma, Luvneet; Elliott, James A; Sibbald, R Gary

    2018-04-01

    The purpose of this learning activity is to provide information about the Healthy Foot Screen, a new tool for assessment of common foot abnormalities. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After completing this continuing education activity, you should be able to:1. Recognize prevalence, causes, risk factors, signs, and types of common foot problems.2. Identify the results of this study about the new foot screening tool and its implications in primary care. Foot health is a key component of general health and well-being. Nevertheless, feet are often overlooked by healthcare providers and patients. Common foot problems include infections or inflammatory conditions, abnormal nail disorders (eg, onychomycosis), structural bony abnormalities, circulation disorders, and other conditions. The development of an easy-to-use, rapid, clinical tool to assess foot health can facilitate primary care provider recognition and treatment of common foot problems. This study ascertained interrater item reliability and validity from the preliminary version of one such tool called the Healthy Foot Screen.A total of 18 patients from a community dermatology clinic were individually screened by 11 interprofessional healthcare assessors using the preliminary tool. The assessors included a dermatologist/internist, family physicians, nurses, and podiatrists. The initial draft of the Healthy Foot Screen was created through an extensive literature review, complemented by the clinical judgment of the study team. Cronbach α was calculated for each item to determine interrater reliability. A minimum value of 0.6 was set for an item to be included in the final tool. Where applicable, scores for each item on the screen were calculated for right and left lower limbs and then averaged. Assessors were asked to complete a short survey.Interrater reliability scores for items on the

  19. Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool.

    Science.gov (United States)

    Renfro, Mindy Oxman; Fehrer, Steven

    2011-01-01

    Unintentional falls is an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. This article describes the content selection and development of a simple-to-administer, multifactorial, Fall Risk Assessment & Screening Tool (FRAST), designed specifically for use in primary care settings to identify those older adults with high fall risk. Fall Risk Assessment & Screening Tool incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. Fall Risk Assessment & Screening Tool has been developed to assess fall risk in the target population of older adults (older than 65 years) living and ambulating independently in the community. Many fall risk factors have been considered and 15 items selected for inclusion. Fall Risk Assessment & Screening Tool includes 4 previously validated measures to assess balance, depression, falls efficacy, and home safety. Reliability and validity studies of FRAST are under way. Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing primary care practitioners (PCPs) with a very simple screening tool is imperative. Fall Risk Assessment & Screening Tool was created to allow for safe, quick, and low-cost administration by minimally trained office staff with interpretation and

  20. Intimate partner violence: psychological and verbal abuse during pregnancy.

    Science.gov (United States)

    Debono, Christie; Borg Xuereb, Rita; Scerri, Josianne; Camilleri, Liberato

    2017-08-01

    To examine the association between sociodemographic, pregnancy-related variables and psychological and verbal intimate partner abuse, as well as to determine which of these variables are predictors of psychological and verbal intimate partner abuse during pregnancy. Intimate partner violence is a significant health issue, with severe implications to both mother and foetus. However, much of the research to date focuses on the outcomes of physical abuse. This article addresses the dearth in the literature by examining the association between sociodemographic, pregnancy-related variables and psychological and verbal intimate partner abuse during pregnancy. A survey research design was used. Three hundred postnatal women were recruited by convenience, nonproportional quota sampling technique. The WHO Violence Against Women Instrument was self-administered by participants. The association between categorical variables was assessed using Pearson's chi-square test, the strength of association using Cramer's V and the phi coefficient, and the identification of predictor variables for psychological and verbal abuse using logistic regression analysis. Four predictors were identified for psychological abuse, namely low education level in women, an unplanned pregnancy, experiencing two or more pregnancy-related health problems and living with an unemployed partner. However, unemployment in women, an unplanned pregnancy, fear of partner and a low education level of partner were identified as the predictors of verbal abuse. This study identified a number of variables that strongly predict psychological and verbal intimate partner abuse during pregnancy; however, it extends the available literature by identifying a low standard of education in males, unemployment and fear of the intimate partner as the significant predictors of psychological and verbal intimate partner abuse. Healthcare professionals should be aware of the predictors predisposing pregnant women to abuse. This

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

    Directory of Open Access Journals (Sweden)

    Warren Charlotte

    2013-01-01

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

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

    Science.gov (United States)

    Warren, Charlotte; Njuki, Rebecca; Abuya, Timothy; Ndwiga, Charity; Maingi, Grace; Serwanga, Jane; Mbehero, Faith; Muteti, Louisa; Njeru, Anne; Karanja, Joseph; Olenja, Joyce; Gitonga, Lucy; Rakuom, Chris; Bellows, Ben

    2013-01-24

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

  3. Accuracy of quick and easy undernutrition screening tools--Short Nutritional Assessment Questionnaire, Malnutrition Universal Screening Tool, and modified Malnutrition Universal Screening Tool--in patients undergoing cardiac surgery.

    Science.gov (United States)

    van Venrooij, Lenny M W; van Leeuwen, Paul A M; Hopmans, Wendy; Borgmeijer-Hoelen, Mieke M M J; de Vos, Rien; De Mol, Bas A J M

    2011-12-01

    The objective of this study was to compare the quick-and-easy undernutrition screening tools, ie, Short Nutritional Assessment Questionnaire and Malnutrition Universal Screening Tool, in patients undergoing cardiac surgery with respect to their accuracy in detecting undernutrition measured by a low-fat free mass index (FFMI; calculated as kg/m(2)), and secondly, to assess their association with postoperative adverse outcomes. Between February 2008 and December 2009, a single-center observational cohort study was performed (n=325). A low FFMI was set at ≤14.6 in women and ≤16.7 in men measured using bioelectrical impedance spectroscopy. To compare the accuracy of the Malnutrition Universal Screening Tool and Short Nutritional Assessment Questionnaire in detecting low FFMI sensitivity, specificity, and other accuracy test characteristics were calculated. The associations between the Malnutrition Universal Screening Tool and Short Nutritional Assessment Questionnaire and adverse outcomes were analyzed using logistic regression analyses with odds ratios and 95% confidence intervals (CI) presented. Sensitivity and receiver operator characteristic-based area under the curve to detect low FFMI were 59% and 19%, and 0.71 (95% CI: 0.60 to 0.82) and 0.56 (95% CI: 0.44 to 0.68) for the Malnutrition Universal Screening Tool and Short Nutritional Assessment Questionnaire, respectively. Accuracy of the Malnutrition Universal Screening Tool improved when age and sex were added to the nutritional screening process (sensitivity 74%, area under the curve: 0.72 [95% CI: 0.62 to 0.82]). This modified version of the Malnutrition Universal Screening Tool, but not the original Malnutrition Universal Screening Tool or Short Nutritional Assessment Questionnaire, was associated with prolonged intensive care unit and hospital stay (odds ratio: 2.1, 95% CI: 1.3 to 3.4; odds ratio: 1.6, 95% CI: 1.0 to 2.7). The accuracy to detect a low FFMI was considerably higher for the Malnutrition

  4. Impact of residential schooling and of child abuse on substance use problem in Indigenous Peoples.

    Science.gov (United States)

    Ross, Amélie; Dion, Jacinthe; Cantinotti, Michael; Collin-Vézina, Delphine; Paquette, Linda

    2015-12-01

    Residential schools were the institutions, in operation from the 19th century to the late 20th century, which Indigenous children in Canada were forced to attend. The literature shows that many young people who attended these institutions were victims of neglect and abuse. Negative psychological effects resulting from child abuse have been amply documented. However, very few studies on this subject have been carried out among Canada's Indigenous Peoples. The objective of this study is to evaluate, for an Indigenous population in Quebec (Canada), the impact of residential schooling as well as self-reported experiences of sexual and physical abuse during childhood on the development of alcohol and drug use problems in adulthood. A total of 358 Indigenous participants were interviewed (164 men [45.8%] and 194 women [54.2%]). Alcoholism was evaluated using the Michigan Alcoholism Screening Test (MAST). Drug abuse was assessed with the Drug Abuse Screening Test-20 (DAST). Child abuse and residential schooling were assessed with dichotomous questions (yes/no). Among the participants, 28.5% (n=102) had attended residential schools, 35.2% (n=121) reported having experienced sexual abuse, and 34.1% (n=117) reported having experienced physical abuse before adulthood. Results of the exact logistic regression analyses indicated that residential school attendance was linked to alcohol problems, while child abuse was related to drug use problems. The results of this study highlight the importance of considering the consequences of historical traumas related to residential schools to better understand the current situation of Indigenous Peoples in Canada. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Pattern of buprenorphine abuse among opioid abusers in Nepal

    OpenAIRE

    Aich, Tapas Kumar; Dhungana, Manoj; Khanal, Roshija

    2010-01-01

    Background: Although buprenorphine abusers are a common clinical entity, literature on them is rare in Nepal. Aim: To assess whether injectable opioid abusers are any different a subgroup vis-a-vis brown sugar abusers in relation to their demographic and clinical profiles. Materials and Methods: Seventy-six opioid abusers, who were admitted over a period of one year, in our de-addiction center, were included in the present study. They were divided into two groups based on the history of the p...

  6. Reliability Assessment of a Single-Shot System by Use of Screen Test Results

    Science.gov (United States)

    2018-02-01

    unlimited. NUWC Keyport #17-002. Reliability Assessment of a Single-Shot System by Use of Screen Test Results Abstract: Field reliability prediction...approach described here assumes that the defect density during testing takes the form of an exponential decay, although other mathematical functions can...be substituted for the exponential. In order to apply the decay rate function to a discrete pass/fail test scheme, the approach provides for

  7. A Brief Vestibular/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussions

    Science.gov (United States)

    Mucha, Anne; Collins, Michael W.; Elbin, R.J.; Furman, Joseph M.; Troutman-Enseki, Cara; DeWolf, Ryan M.; Marchetti, Greg; Kontos, Anthony P.

    2014-01-01

    Background Vestibular and ocular motor impairments and symptoms have been documented in patients with sport-related concussions. However, there is no current brief clinical screen to assess and monitor these issues. Purpose To describe and provide initial data for the internal consistency and validity of a brief clinical screening tool for vestibular and ocular motor impairments and symptoms after sport-related concussions. Study Design Cross-sectional study; Level of evidence, 2. Methods Sixty-four patients, aged 13.9 ± 2.5 years and seen approximately 5.5 ± 4.0 days after a sport-related concussion, and 78 controls were administered the Vestibular/Ocular Motor Screening (VOMS) assessment, which included 5 domains: (1) smooth pursuit, (2) horizontal and vertical saccades, (3) near point of convergence (NPC) distance, (4) horizontal vestibular ocular reflex (VOR), and (5) visual motion sensitivity (VMS). Participants were also administered the Post-Concussion Symptom Scale (PCSS). Results Sixty-one percent of patients reported symptom provocation after at least 1 VOMS item. All VOMS items were positively correlated to the PCSS total symptom score. The VOR (odds ratio [OR], 3.89; P concussed group. An NPC distance ≥5 cm and any VOMS item symptom score ≥2 resulted in an increase in the probability of correctly identifying concussed patients of 38% and 50%, respectively. Receiver operating characteristic curves supported a model including the VOR, VMS, NPC distance, and ln(age) that resulted in a high predicted probability (area under the curve = 0.89) for identifying concussed patients. Conclusion The VOMS demonstrated internal consistency as well as sensitivity in identifying patients with concussions. The current findings provide preliminary support for the utility of the VOMS as a brief vestibular/ocular motor screen after sport-related concussions. The VOMS may augment current assessment tools and may serve as a single component of a comprehensive approach

  8. Childhood abuse in adults in primary care: Empirical findings and clinical implications.

    Science.gov (United States)

    Porcerelli, John H; Jones, John R; Klamo, Rachel; Heeney, Rebecca

    2017-05-01

    In the healthcare setting, adult patients with histories of childhood abuse are of significant concern and are frequently encountered in the primary care setting. However, there is a dearth of studies investigating the relationships between psychopathology, overall health, healthcare utilization, physician ratings of patient difficulty, and childhood abuse. The present study examines these relationships in primary care patients with (N = 45) and without (N = 129) histories of childhood abuse (physical, sexual, and both). Findings revealed that adult patients with histories of childhood abuse generally scored significantly higher on measures of psychopathology, emergency room use, and doctor-patient relationship difficulty, and lower on a measure of mental and physician-rated physical health. In a multiple regression analysis, income and a history of childhood sexual abuse significantly predicted overall mental health. In a second multiple regression analysis, income, depression, somatization, borderline personality disorder, and difficult doctor-patient relationship ratings significantly predicted physician-rated physical health. Overall, these findings suggest that a history of childhood abuse is associated with a host of negative health outcomes. Findings also suggest that negative feelings about a patient may help physicians identify patients with histories of childhood abuse. It is especially important for physicians to routinely include an assessment of childhood abuse during the psychosocial portion of the medical interview or through screening instruments.

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

    Science.gov (United States)

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

    2011-01-01

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

  10. Screening-level risk assessment for styrene-acrylonitrile (SAN) trimer detected in soil and groundwater.

    Science.gov (United States)

    Kirman, C R; Gargas, M L; Collins, J J; Rowlands, J C

    2012-01-01

    A screening-level risk assessment was conducted for styrene-acrylonitrile (SAN) Trimer detected at the Reich Farm Superfund site in Toms River, NJ. Consistent with a screening-level approach, on-site and off-site exposure scenarios were evaluated using assumptions that are expected to overestimate actual exposures and hazards at the site. Environmental sampling data collected for soil and groundwater were used to estimate exposure point concentrations. Several exposure scenarios were evaluated to assess potential on-site and off-site exposures, using parameter values for exposures to soil (oral, inhalation of particulates, and dermal contact) and groundwater (oral, dermal contact) to reflect central tendency exposure (CTE) and reasonable maximum exposure (RME) conditions. Three reference dose (RfD) values were derived for SAN Trimer for short-term, subchronic, and chronic exposures, based upon its effects on the liver in exposed rats. Benchmark (BMD) methods were used to assess the relationship between exposure and response, and to characterize appropriate points of departure (POD) for each RfD. An uncertainty factor of 300 was applied to each POD to yield RfD values of 0.1, 0.04, and 0.03 mg/kg-d for short-term, subchronic, and chronic exposures, respectively. Because a chronic cancer bioassay for SAN Trimer in rats (NTP 2011a) does not provide evidence of carcinogenicity, a cancer risk assessment is not appropriate for this chemical. Potential health hazards to human health were assessed using a hazard index (HI) approach, which considers the ratio of exposure dose (i.e., average daily dose, mg/kg-d) to toxicity dose (RfD, mg/kg-d) for each scenario. All CTE and RME HI values are well below 1 (where the average daily dose is equivalent to the RfD), indicating that there is no concern for potential noncancer effects in exposed populations even under the conservative assumptions of this screening-level assessment.

  11. Analyzing slug tests in wells screened across the watertable: A field assessment

    Science.gov (United States)

    Stanford, K.L.; McElwee, C.D.

    2000-01-01

    The slug test is the most widely used technique for the in situ estimation of hydraulic conductivity in confined and unconfined formations. Currently, there are no generally accepted methods in the groundwater literature for the analysis of response data from slug tests performed in wells screened across the watertable. A field study was undertaken in an attempt to develop a set of practical guidelines for tests conducted in such wells. Three wells, screened within unconsolidated material exhibiting a range of hydraulic conductivities (.05-30.0 m/day), were installed to depths of up to 9 m (30 ft) in Kansas River alluvium that ranges in thickness from 15 m to 21 m (50 ft to 70 ft) near Lawrence, Kansas. Intensive well-development efforts removed any drilling debris that could interfere with well-formation hydraulics. Once the wells were developed properly, a series of slug tests was performed at each well. The tests were designed to assess the role of the unsaturated zone and the appropriateness of assuming a fixed hydraulic head upper boundary. The results of this investigation can be summarized as follows: (1) the sufficiency of well development should be based on repeat slug tests and not the clarity of pumped water; (2) the effective screen radius for best model analysis should be based on a mass balance and not nominal screen dimensions; (3) the watertable can be represented as a constant head boundary and flow in the unsaturated zone can be ignored in most situations; (4) conventional techniques for the analysis of slug-test data seem to be reasonable for slug tests conducted in wells screened across the watertable, when used with the appropriate effective screen radius and normalized head range; and (5) fluctuations in the watertable elevation through time can be exploited to obtain some insight into the nature of vertical variation in hydraulic conductivity at a well. The results of this investigation indicate that multiple slug tests should be performed at

  12. Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: effectiveness and economic assessment for the National Cervical Screening Program.

    Science.gov (United States)

    Lew, Jie-Bin; Simms, Kate T; Smith, Megan A; Hall, Michaela; Kang, Yoon-Jung; Xu, Xiang Ming; Caruana, Michael; Velentzis, Louiza Sofia; Bessell, Tracey; Saville, Marion; Hammond, Ian; Canfell, Karen

    2017-02-01

    Australia's National Cervical Screening Program currently recommends cytological screening every 2 years for women aged 18-69 years. Human papillomavirus (HPV) vaccination was implemented in 2007 with high population coverage, and falls in high-grade lesions in young women have been reported extensively. This decline prompted a major review of the National Cervical Screening Program and new clinical management guidelines, for which we undertook this analysis. We did effectiveness modelling and an economic assessment of potential new screening strategies, using a model of HPV transmission, vaccination, natural history, and cervical screening. First, we evaluated 132 screening strategies, including those based on cytology and primary HPV testing. Second, after a recommendation was made to adopt primary HPV screening with partial genotyping and direct referral to colposcopy of women positive for HPV16/18, we evaluated the final effect of HPV screening after incorporating new clinical guidelines for women positive for HPV. Both evaluations considered both unvaccinated and vaccinated cohorts. Strategies entailing HPV testing every 5 years and either partial genotyping for HPV16/18 or cytological co-testing were the most effective. One of the most effective and cost-effective strategies comprised primary HPV screening with referral of women positive for oncogenic HPV16/18 direct to colposcopy, with reflex cytological triage for women with other oncogenic types and direct referral for those in this group with high-grade cytological findings. After incorporating detailed clinical guidelines recommendations, this strategy is predicted to reduce cervical cancer incidence and mortality by 31% and 36%, respectively, in unvaccinated cohorts, and by 24% and 29%, respectively, in cohorts offered vaccination. Furthermore, this strategy is predicted to reduce costs by up to 19% for unvaccinated cohorts and 26% for cohorts offered vaccination, compared with the current programme

  13. Assessment of the Medmont C100 test for colour vision screening of male Saudi Arabians

    Directory of Open Access Journals (Sweden)

    Abdullah Z. Alotaibi

    2011-12-01

    Full Text Available Purpose: To assess the Medmont C100 test as a colour vision screening tool. Methods: One hundred and seventeen young male adults were screened with the Medmont C100, Ishihara plates, and the screening mode of the Oculus Anomaloscope tests. All subjects were tested under constant room illumination, namely that of a day light fluorescent lamp at 200 lux. Inclusion criteria were visual acuities (VA of 20/20 or better with or without correction and absence of known ocular pathologies.Aided and unaided visual acuities were measured with the Snellen VA chart. Results: Five out of the117 subjects, were found to have red-green colour vision deficiency (CVD with Ishihara and anomaloscope tests indicating a 4.7% CVD prevalence, while the Medmont C100 test yielded 33 cases of red-green deficiency indicating CVD prevalence of 28%.  With the Ishihara test, all five subjects were identified as deutans, while the anomaloscope revealed three as deutans and two as protans, and the Medmont C100 test identified all 33 cases as protans. Conclusion:  The Medmont C100 test yielded significantly higher prevalence of protan CVD compared with the Ishihara platesand Anomaloscope tests. These findings suggest that caution should be taken when using Medmont C100 test for colour vision screening as it tends togive more false positive results with bias for protans.  (S Afr Optom 2011 70(1 14-20

  14. Assessment of required resources for implementation of national breast cancer screening program in Serbia

    Directory of Open Access Journals (Sweden)

    Majstorović Nemanja

    2014-01-01

    Full Text Available Introduction. High values of standardized mortality and morbidity rates of standardized cancer mortality in Serbia, especially colorectal, cervical and breast cancer led to creation of national programs for their early detection and engagement of the international support for their implementation. Objective. Assessment of required resources (time, personnel, financial to implement the National program for screening of breast cancer in the Republic of Serbia. Methods. Three possible scenarios have been prepared (optimistic, realistic and pessimistic based on the expected coverage by screening of women aged 45 to 69 years, and time, personnel and financial feasibility estimates were made for a two-year screening cycle. Results. Time aspect of feasibility even under conditions of “relaxation” of the assumption on the number of working days during the year did not question feasibility of any of the scenarios. Personnel feasibility is only possible in the pessimistic scenario, while the financial feasibility only makes sense in optimistic scenario as the least unfavorable solution due to economies of scale. Conclusion. Establishment of the initial base of skilled radiologists and radiology technicians and the system for their continuous medical education as well as allocation of specific MoH budget line for screening program expenditures, along with donated mammographs and good organization and coordination, may provide unobstructed implementation of the National program for early detection of breast cancer in the Republic of Serbia.

  15. Association of Wage With Employee Participation in Health Assessments and Biometric Screening.

    Science.gov (United States)

    Sherman, Bruce W; Addy, Carol

    2018-02-01

    To understand differences in health risk assessment (HRA) and biometric screening participation rates among benefits-enrolled employees in association with wage category. Cross-sectional analysis of employee eligibility file and health benefits (wellness and claims) data. Data from self-insured employers participating in the RightOpt private exchange (Conduent HR Services) during 2014. Active employees from 4 companies continuously enrolled in health insurance for which wage data were available. Measures included HRA and biometric screening participation rates and wage status, with employee age, sex, employer, job tenure, household income, geographic location, and health benefits deductible as a percentage of total wages serving as covariates. Employees were separated into 5 groups based on wage status. Logistic regression analysis incorporated other measures as covariates to adjust for differences between groups, with HRA and biometric screening participation rates determined as binary outcomes. Participation rates for HRA and biometric screening were 90% and 87%, respectively, in the highest wage category, decreasing to 67% and 60%, respectively, among the lowest wage category. Employee wage status is associated with significant differences in HRA and biometric participation rates. Generalizing the results generated by modest participation in these offerings to entire populations may risk misinterpretation of results based on variable participation rates across wage categories.

  16. Effective dose assessment for participants in the National Lung Screening Trial undergoing posteroanterior chest radiographic examinations.

    Science.gov (United States)

    Kruger, Randell; Flynn, Michael J; Judy, Phillip F; Cagnon, Christopher H; Seibert, J Anthony

    2013-07-01

    The National Lung Screening Trial (NLST) is a multicenter randomized controlled trial comparing low-dose helical CT with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004, when 53,454 participants had been randomized at 33 screening sites. The objective of this study was to determine the effective radiation dose associated with individual chest radiographic screening examinations. A total of 73,733 chest radiographic examinations were performed with 92 chest imaging systems. The entrance skin air kerma (ESAK) of participants' chest radiographic examinations was estimated and used in this analysis. The effective dose per ESAK for each examination was determined with a Monte Carlo-based program. The examination effective dose was calculated as the product of the examination ESAK and the Monte Carlo estimate of the ratio of effective dose per ESAK. This study showed that the mean effective dose assessed from 66,157 postero-anterior chest examinations was 0.052 mSv. Additional findings were a median effective dose of 0.038 mSv, a 95th percentile value of 0.136 mSv, and a fifth percentile value of 0.013 mSv. The effective dose for participant NLST chest radiographic examinations was determined and is of specific interest in relation to that associated with the previously published NLST low-dose CT examinations conducted during the trial.

  17. Predicting a dissociative disorder from type of childhood maltreatment and abuser-abused relational tie.

    Science.gov (United States)

    Krüger, Christa; Fletcher, Lizelle

    2017-01-01

    We investigate the types of childhood maltreatment and abuser-abused relational ties that best predict a dissociative disorder (DD). Psychiatric inpatients (n = 116; mean age = 35; F:M = 1.28:1) completed measures of dissociation and trauma. Abuse type and abuser-abused relational ties were recorded in the Traumatic Experiences Questionnaire. Multidisciplinary team clinical diagnosis or administration of the SCID-D-R to high dissociators confirmed DD diagnoses. Logit models described the relationships between abuser-abused relational tie and the diagnostic grouping of patients, DD present (n = 16) or DD absent (n = 100). Fisher's exact tests measured the relative contribution of specific abuse types. There was a positive relationship between abuse frequency and the presence of DD. DD patients experienced more abuse than patients without DDs. Two combinations of abuse type and relational tie predicted a DD: childhood emotional neglect by biological parents/siblings and later emotional abuse by intimate partners. These findings support the early childhood etiology of DDs and subsequent maladaptive cycles of adult abuse. Enquiries about childhood maltreatment should include a history of emotional neglect by biological parents/siblings. Adult emotional abuse by intimate partners should assist in screening for DDs.

  18. Screening methodology for assessing potential health effects from municipal sludge incinerators

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, L.; Bruins, R.J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.

    1987-01-01

    This paper describes a risk assessment methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e., facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium.

  19. Screening methodology for assessing potential health effects from municipal sludge incinerators

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, L.; Bruins, R.J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.; Rubin, A.

    1987-04-01

    This paper describes a risk assessment of methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e. facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium. (Refs. 5).

  20. From assessment reactivity to aftercare for adolescent substance abuse: are we there yet?

    Science.gov (United States)

    Kaminer, Yifrah; Godley, Mark

    2010-07-01

    This article addresses less developed areas of clinical research that are of great importance for better understanding the therapeutic process along the continuum of care in youth with alcohol and other substance use disorders (AOSUD). These include the rationale, design, mechanisms of behavior change (MBCs), implementation, monitoring, and outcome-based modification of treatment continuum for youth with AOSUD. The specific objectives are: (1) present current knowledge pertaining to the pretreatment phase including the effect of baseline assessment on treatment outcome; (2) address potential MBCs in treatment; (3) discuss the importance of aftercare, also known as continued care, to prevent postintervention relapse; (4) consider how reconceptualization of therapeutic paradigms might advance the field, in particular treatment algorithm or adaptive treatment strategies addressing poor response to treatment. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  1. Inhalant Abuse

    Science.gov (United States)

    ... Paper) paint thinner cleaning fluids nail polish remover rubber cement gasoline. Teenagers are the most common abusers ... severe cases, it can cause sudden death. Inhalants block oxygen flow to your brain and other organs. ...

  2. Drug abuse

    International Nuclear Information System (INIS)

    Simon, T.R.; Seastrunk, J.W.; Malone, G.; Knesevich, M.A.; Hickey, D.C.

    1991-01-01

    This paper reports that this study used SPECT to examine patients who have abused drugs to determine whether SPECT could identify abnormalities and whether these findings have clinical importance. Fifteen patients with a history of substance abuse (eight with cocaine, six with amphetamine, and one with organic solvent) underwent SPECT performed with a triple-headed camera and Tc-99m HMPAO both early for blood flow and later for functional information. These images were then processed into a 3D videotaped display used in group therapy. All 15 patients had multiple areas of decreased tracer uptake peppered throughout the cortex but mainly affecting the parietal lobes, expect for the organic solvent abuser who had a large parietal defect. The videotapes were subjectively described by a therapist as an exceptional tool that countered patient denial of physical damage from substance abuse. Statistical studies of recidivism between groups is under way

  3. Abusive Relationships

    Science.gov (United States)

    ... a big part of moving from childhood into adolescence and adulthood. Unfortunately, some people may find themselves in a relationship that involves abuse or violence. It can be especially hard for guys to ...

  4. Bruising and Hemophilia: Accident or Child Abuse?

    Science.gov (United States)

    Johnson, Charles F.; Coury, Daniel L.

    1988-01-01

    Two case histories illustrate the difficulty in evaluating abuse/neglect in children with bleeding problems such as hemophilia. Discussed are guidelines for diagnosis and prevention of abuse, including: screening techniques, the need for protection from environmental trauma, parental stress, evaluation of parents' disciplinary methods, and the…

  5. Protein-observed (19)F-NMR for fragment screening, affinity quantification and druggability assessment.

    Science.gov (United States)

    Gee, Clifford T; Arntson, Keith E; Urick, Andrew K; Mishra, Neeraj K; Hawk, Laura M L; Wisniewski, Andrea J; Pomerantz, William C K

    2016-08-01

    NMR spectroscopy can be used to quantify the binding affinity between proteins and low-complexity molecules, termed 'fragments'; this versatile screening approach allows researchers to assess the druggability of new protein targets. Protein-observed (19)F-NMR (PrOF NMR) using (19)F-labeled amino acids generates relatively simple spectra that are able to provide dynamic structural information toward understanding protein folding and function. Changes in these spectra upon the addition of fragment molecules can be observed and quantified. This protocol describes the sequence-selective labeling of three proteins (the first bromodomains of Brd4 and BrdT, and the KIX domain of the CREB-binding protein) using commercially available fluorinated aromatic amino acids and fluorinated precursors as example applications of the method developed by our research group. Fragment-screening approaches are discussed, as well as Kd determination, ligand-efficiency calculations and druggability assessment, i.e., the ability to target these proteins using small-molecule ligands. Experiment times on the order of a few minutes and the simplicity of the NMR spectra obtained make this approach well-suited to the investigation of small- to medium-sized proteins, as well as the screening of multiple proteins in the same experiment.

  6. Terrestrial avoidance behaviour tests as screening tool to assess soil contamination

    Energy Technology Data Exchange (ETDEWEB)

    Loureiro, Susana [Department of Biology, University of Aveiro, 3810-193 Aveiro (Portugal)]. E-mail: sloureiro@bio.ua.pt; Soares, Amadeu M.V.M. [Department of Biology, University of Aveiro, 3810-193 Aveiro (Portugal); Nogueira, Antonio J.A. [Department of Biology, University of Aveiro, 3810-193 Aveiro (Portugal)

    2005-11-15

    To assess soil quality and risk assessment, bioassays can be useful tools to gauge the potential toxicity of contaminants focusing on their bioavailable fraction. A rapid and sublethal avoidance behaviour test was used as a screening tool with the earthworm Eisenia andrei and the isopod Porcellionides pruinosus, where organisms were exposed during 48 h to several chemicals (lindane, dimethoate and copper sulphate, for isopods and carbendazim, benomyl, dimethoate and copper sulphate for earthworms). Both species were also exposed to soils from an abandoned mine. For all bioassays a statistical approach was used to derive EC{sub 50} values. Isopods and earthworms were able to perceive the presence of toxic compounds and escaping from contaminated to clean soil. Furthermore the behaviour parameter was equally or more sensitive then other sublethal parameters (e.g. reproduction or growth), expressing the advantages of Avoidance Behaviour Tests as screening tools in ERA. - Avoidance Behaviour Tests with earthworms and isopods can be used as screening tools in the evaluation of soil contamination.

  7. Headspace screening: A novel approach for fast quality assessment of the essential oil from culinary sage.

    Science.gov (United States)

    Cvetkovikj, Ivana; Stefkov, Gjoshe; Acevska, Jelena; Karapandzova, Marija; Dimitrovska, Aneta; Kulevanova, Svetlana

    2016-07-01

    Quality assessment of essential oil (EO) from culinary sage (Salvia officinalis L., Lamiaceae) is limited by the long pharmacopoeial procedure. The aim of this study was to employ headspace (HS) sampling in the quality assessment of sage EO. Different populations (30) of culinary sage were assessed using GC/FID/MS analysis of the hydrodistilled EO (pharmacopoeial method) and HS sampling directly from leaves. Compound profiles from both procedures were evaluated according to ISO 9909 and GDC standards for sage EO quality, revealing compliance for only 10 populations. Factors to convert HS values, for the target ISO and GDC components, into theoretical EO values were calculated. Statistical analysis revealed a significant relationship between HS and EO values for seven target components. Consequently, HS sampling could be used as a complementary extraction technique for rapid screening in quality assessment of sage EOs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Assessment of automated disease detection in diabetic retinopathy screening using two-field photography.

    Directory of Open Access Journals (Sweden)

    Keith Goatman

    Full Text Available To assess the performance of automated disease detection in diabetic retinopathy screening using two field mydriatic photography.Images from 8,271 sequential patient screening episodes from a South London diabetic retinopathy screening service were processed by the Medalytix iGrading™ automated grading system. For each screening episode macular-centred and disc-centred images of both eyes were acquired and independently graded according to the English national grading scheme. Where discrepancies were found between the automated result and original manual grade, internal and external arbitration was used to determine the final study grades. Two versions of the software were used: one that detected microaneurysms alone, and one that detected blot haemorrhages and exudates in addition to microaneurysms. Results for each version were calculated once using both fields and once using the macula-centred field alone.Of the 8,271 episodes, 346 (4.2% were considered unassessable. Referable disease was detected in 587 episodes (7.1%. The sensitivity of the automated system for detecting unassessable images ranged from 97.4% to 99.1% depending on configuration. The sensitivity of the automated system for referable episodes ranged from 98.3% to 99.3%. All the episodes that included proliferative or pre-proliferative retinopathy were detected by the automated system regardless of configuration (192/192, 95% confidence interval 98.0% to 100%. If implemented as the first step in grading, the automated system would have reduced the manual grading effort by between 2,183 and 3,147 patient episodes (26.4% to 38.1%.Automated grading can safely reduce the workload of manual grading using two field, mydriatic photography in a routine screening service.

  9. Assessing Resident Performance in Screening Mammography: Development of a Quantitative Algorithm.

    Science.gov (United States)

    Lewis, Petra J; Rooney, Timothy B; Frazee, Tracy E; Poplack, Steven P

    2018-01-20

    This study aims to provide objective performance data and feedback, including examination volumes, recall rates, and concordance with faculty interpretations, for residents performing independent interpretation of screening mammography examinations. Residents (r) and faculty (f) interpret screening mammograms separately and identify non-callbacks (NCBs) and callbacks (CBs). Residents review all discordant results. The number of concordant interpretations (fCB-rCB and fNCB-rNCB) and discordant interpretations (fCB-rNCB and fNCB-rCB) are entered into a macro-driven spreadsheet. These macros weigh the data dependent on the perceived clinical impact of the resident's decision. Weighted outcomes are combined with volumes to generate a weighted mammography performance score. Rotation-specific goals are assigned for the weighted score, screening volumes, recall rate relative to faculty, and concordance rates. Residents receive one point for achieving each goal. Between July 2013 and May 2017, 18,747 mammography examinations were reviewed by 31 residents, in 71 resident rotations, over 246 resident weeks. Mean resident recall rate was 9.9% and significantly decreased with resident level (R), R2 = 11.3% vs R3 = 9.4%, R4 = 9.2%. Mean resident-faculty discordance rate was 10% and significantly decreased from R2 = 12% to R4 = 9.6%. Weighted performance scores ranged from 1.1 to 2.0 (mean 1.6, standard deviation 0.17), but did not change with rotation experience. Residents had a mean goal achievement score of 2.6 (standard deviation 0.47). This method provides residents with easily accessible case-by-case individualized screening outcome data over the longitudinal period of their residency, and provides an objective method of assessing resident screening mammography performance. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  10. The WERCAP Screen and the WERC Stress Screen: psychometrics of self-rated instruments for assessing bipolar and psychotic disorder risk and perceived stress burden.

    Science.gov (United States)

    Mamah, Daniel; Owoso, Akinkunle; Sheffield, Julia M; Bayer, Chelsea

    2014-10-01

    Identification of individuals in the prodromal phase of bipolar disorder and schizophrenia facilitates early intervention and promises an improved prognosis. There are no current assessment tools for clinical risk symptoms of bipolar disorder, and psychosis-risk assessment generally involves semi-structured interviews, which are time consuming and rater dependent. We present psychometric data on two novel quantitative questionnaires: the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen for assessing bipolar and psychotic disorder risk traits, and the accompanying WERC Stress Screen for assessing individual and total psychosocial stressor severities. Prevalence rates of the WERCAP Screen were evaluated among 171 community youth (aged 13-24 years); internal consistency was assessed and k-means cluster analysis was used to identify symptom groups. In 33 participants, test-retest reliability coefficients were assessed, and ROC curve analysis was used to determine the validity of the psychosis section of the WERCAP Screen (pWERCAP) against the Structured Interview of Psychosis-Risk Symptoms (SIPS). Correlations of the pWERCAP, the affectivity section of the WERCAP Screen (aWERCAP) and the WERC Stress Screen were examined to determine the relatedness of scores with cognition and clinical measures. Cluster analysis identified three groups of participants: a normative (47%), a psychosis-affectivity (18%) and an affectivity only (35%) group. Internal consistency of the aWERCAP and pWERCAP resulted in alphas of 0.87 and 0.92, and test-retest reliabilities resulted in intraclass correlation coefficients of 0.76 and 0.86 respectively. ROC curve analysis showed the optimal cut-point on the pWERCAP as a score of >30 (sensitivity: 0.89; specificity: 1.0). There was a significant negative correlation between aWERCAP scores and total cognition (R=-0.42), and between pWERCAP scores and sensorimotor processing speed. Total stress scores correlated

  11. Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Maltreatment.

    Science.gov (United States)

    Messman-Moore, Terri L.; Long, Patricia J.

    2000-01-01

    Assesses child sexual abuse (CSA) and adult sexual, physical, and psychological abuse with a sample of 633 college women. Survivors of CSA experienced more instances of physical abuse and psychological maltreatment than nonvictims. They were more likely to report unwanted sexual intercourse both by acquaintances due to force, and by acquaintances…

  12. Socioeconomic status as determinant for participation in mammography screening: assessing the difference between using women's own versus their partner's

    DEFF Research Database (Denmark)

    Kjellén, Malin; von Euler-Chelpin, My

    2010-01-01

    Earlier research has shown that participation in mammography screening tends to vary across socioeconomic levels. We assessed the difference between using the woman's own socioeconomic status (SES) and using that of her household or partner as determinant of participation in mammography screening....

  13. Assessment of the Knowledge and Attitudes of Saudi Mothers towards Newborn Screening

    Directory of Open Access Journals (Sweden)

    Ayman Al-Sulaiman

    2015-01-01

    Full Text Available Objective. To assess the attitude and knowledge of the Saudi mothers toward newborn screening (NBS program. Methods. A total of 425 Saudi women (only mothers who have at least one pregnancy participated in the study from different regions in Saudi Arabia and completed the structured questionnaire which sought their views on the NBS services. Results. A majority of the participating women (91.1% supported the NBS program and felt it was very important and useful. However, knowledge of NBS was found to be very limited and only 34.6% knew that NBS was a test to detect genetic disorders. A lack of communication and counseling to NBS clients by health authorities offering screening is implied. Conclusion. In general, there is a positive attitude towards the NBS program among Saudi women. However, they have several concerns to improve the availability of medication and formulas, genetic counseling, medical interventions, communication, education materials, and awareness.

  14. Types of abuse and risk factors associated with elder abuse.

    Science.gov (United States)

    Simone, Lacher; Wettstein, Albert; Senn, Oliver; Rosemann, Thomas; Hasler, Susann

    2016-01-01

    Detecting elder abuse is challenging because it is a taboo, and many cases remain unreported. This study aimed to identify types of elder abuse and to investigate its associated risk factors. Retrospective analyses of 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland, from January 1, 2008 to October 31, 2012. Characteristics of victims and perpetrators, types of abuse, and associated risk factors related to the victim or the perpetrator were assessed. Bi- and multivariate analysis were used to identify abuse and neglect determinants. A total of 150 cases reflected at least one form of elder abuse or neglect; 104 cases were categorised as abuse with at least one type of abuse (overall 135 mentions), 46 cases were categorised as neglect (active or passive). Psychological abuse was the most reported form (47%), followed by financial (35%), physical (30%) and anticonstitutional abuse (18%). In 81% of the 150 cases at least two risk factors existed. In 13% no associated risk factor could be identified. Compared with neglect, elders with abuse were less likely to be a nursing home resident than living at home (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.00-0.19). In addition, they were more likely to be cohabiting with their perpetrators (OR 18.01, 95% CI 4.43-73.19). For the majority of the reported elder abuse cases at least two associated risk factors could be identified. Knowledge about these red flags and a multifaceted strategy are needed to identify and prevent elder abuse.

  15. Pain and stress assessment after retinopathy of prematurity screening examination: Indirect ophthalmoscopy versus digital retinal imaging

    Directory of Open Access Journals (Sweden)

    Moral-Pumarega M

    2012-08-01

    Full Text Available Abstract Background Increasingly, neonatal clinics seek to minimize painful experiences and stress for premature infants. Fundoscopy performed with a binocular indirect ophthalmoscope is the reference examination technique for screening of retinopathy of prematurity (ROP, and it is associated with pain and stress. Wide-field digital retinal imaging is a recent technique that should be evaluated for minimizing infant pain and stress. Methods The purpose of the study was to assess and compare the impact of using a binocular indirect ophthalmoscope (BIO, or wide-field digital retinal imaging (WFDRI on pain and stress in infants undergoing ROP screening examination. This was a comparative evaluation study of two screening procedures. Ophthalmologic examinations (N = 70 were performed on 24 infants with both BIO and WFDRI. Pain assessments were performed with two specific neonatal scales (Crying, requires oxygen, increased vital signs, expression and sleeplessness, CRIES and, Premature infant pain profile, PIPP just prior to the examination, and 30 seconds, 1 hour, and 24 hours later after ending the examination. Results Changes over time were significantly different between BIO and WFDRI with both scales (PIPP score, p = .007, and CRIES score, p = .001. Median PIPP score (interquartile interval at baseline was 4 (3–5. At 30 seconds the score was 8 (6–9 for BIO and 6 (5–7 for WFDRI, respectively. The increase in PIPP score between baseline and 30 seconds was significantly lower with WFDRI (p = .006. The median increase in CRIES score from baseline to 30 seconds was 1 point lower for WFDRI than for BIO (p  Conclusions A transient short-term pain and stress response occurs with both BIO and WFDRI. Infants examined for screening of ROP with digital retinal imaging present less pain and stress at 30 seconds following completion of the exam when compared with binocular indirect ophthalmoscopy.

  16. Diet assessment and the screening for osteoporosis: a survey in a healthy menopause population.

    Science.gov (United States)

    Bianco, V; Filippi, F; Tassan-Simonat, P; Valente, I; D'Amico, C; Meroni, M

    2008-08-01

    The aim of this study was to investigate about diet assessment in the screening for osteoporosis. In 1,441 women (group A, mean age 53.5 years, mean time from menopause 3.92(+/-4.33)] the number of daily/weekly servings/cups of different foods has been collected. In 71 women (group B, mean age 59 years, mean time from menopause 6 years) diet was assessed through a detailed questionnaire. Demographic and clinical data and dietary habits were related to bone mineral density (BMD) values, using Student t-test and the chi2 test. Group A: borderline/reduced BMD 40%, the percentage increasing with age and the duration of menopause (Posteoporosis (Prelation with the number of eggs per week (Prelated to low calcium food intake in less than 50% of the women. Group B: borderline/reduced BMD 55%; BMD showed positive trends, not significant, with daily calcium intake, BMI, physical exercise. Estimated calcium intake less than 700 mg/day was found in 33% of the sample. Diet assessment is not useful in the screening for osteoporosis. In women with borderline or reduced BMD, diet assessment helps to detect those at low calcium intake who need calcium supplementation, alone or in combination with other treatments.

  17. A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style

    Directory of Open Access Journals (Sweden)

    Alex Ghanouni

    2017-04-01

    Full Text Available Abstract Background There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. Methods A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and ‘decision-making styles’ (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent. The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. Results After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009. Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively. Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008

  18. Abused nurses take no legal steps: a domestic violence study carried out in eastern Turkey.

    Science.gov (United States)

    Selek, Salih; Vural, Mehmet; Cakmak, Ilknur

    2012-12-01

    Our aim was to evaluate domestic violence among nurses in eastern Turkey. Ninety six (96) female nurses with an intimate partner were enrolled. Modified form of Abuse Assessment Screen Questionnaire was used. Twenty two (22.7%) of the participants reported domestic violence. None of them took legal steps. Most frequent domestic violence type was economic abuse (46%). Nurses, whose mothers were exposed to domestic violence, had significantly higher abuse rates. The abused group had also significantly higher smoking and miscarriage rates. Nurses need to be well informed for taking legal steps in case of domestic violence. Family history, smoking status and abortion rates may be further research focus for risk factors of domestic violence. Legal interventions should be optimized in order to encourage the victims to take legal steps.

  19. Qualitative vs. quantitative data: Controls on the accuracy of PID field screening in petroleum contamination assessment applications

    International Nuclear Information System (INIS)

    Luessen, M.J.; Allex, M.K.; Holzel, F.R.

    1995-01-01

    The use of photoionization detectors (PIDs) for field screening of soils for volatile organic contaminants has become a standard industry practice. PID screening data is generally utilized as a qualitative basis for selection of samples for laboratory analysis to quantify concentrations of specific contaminants of concern. Both qualitative field screening data and quantitative laboratory analytical data were reviewed for more than 100 hydrogeologic assessment sites in Ohio to evaluate controls on the effectiveness of field screening data. Assessment data evaluated was limited to sites at which the suspected contaminant source was a gasoline underground storage tanks system. In each case, a 10.0 eV (or greater) PID calibrated for benzene was used to screen soils which were analyzed for benzene, toluene, ethylbenzene and xylene (BTEX) by SW 846 method 8020. Controls on field screening which were evaluated for each site included (1) soil classification, (2) soil moisture, (3) weather conditions, (4) background levels, (5) equipment quality, (6) screening methodology, and (7) laboratory QA/QC. Statistical data analysis predictably indicated a general overestimate of total BTEX levels based on field screening (gasoline is approximately 25 weight percent BTEX). However, data locally indicated cases of both significant (i.e., more than an order of magnitude difference) over- and under-estimation of actual BTEX concentrations (i.e., quantitative laboratory data) by field screening data

  20. Screening Risk Assessment for Possible Radionuclides in the Amchitka Marine Environment

    Energy Technology Data Exchange (ETDEWEB)

    NNSA/NV

    2002-10-31

    As part of its environmental stewardship program the U.S. Department of Energy (DOE) is reevaluating three sites where underground nuclear tests were conducted in the deep subsurface of Amchitka Island, Alaska. The tests (i.e., Long Shot, Milrow, and Cannikin) were conducted in 1965, 1969, and 1971, respectively. Extensive investigations were conducted on these tests and their effect on the environment. Evaluations at the time of testing indicated limited release of radionuclides and absence of risk related to the testing; however, these are being reevaluated under the current DOE environmental stewardship program. A screening risk assessment of potential radionuclide release into the marine environment is an important part of this reevaluation. The risk assessment is one of three interrelated activities: a groundwater model and this screening risk assessment, both of which guide the decisions in the third activity, the site closure plan. Thus, the overall objective of the work is to understand, and subsequently manage, any risk to humans and the environment through a closure and long-term stewardship plan. The objective of this screening risk assessment is to predict whether possible releases of radionuclides at the ocean floor would represent potential risks to Native Alaskans by consumption of marine subsistence species. In addition, risks were predicted for consumers of commercial catches of marine organisms. These risks were calculated beginning with estimates of possible radionuclide release at the seafloor (from a groundwater modeling study), into the seawater, through possible uptake by marine organisms, and finally possible consumption by humans. The risk assessment model has 11 elements, progressing from potential release at the seafloor through water and food chains to human intake. Data for each of these elements were systematically found and synthesized from many sources, and represent the best available knowledge. Whenever precise data were lacking

  1. Community approaches to elder abuse.

    Science.gov (United States)

    Dyer, Carmel B; Heisler, Candace J; Hill, Carrie A; Kim, Lucia C

    2005-05-01

    Collaboration of professionals from diverse disciplines is required to address the multiple, complex issues and needs of community-dwelling elders who are abused or neglected. Reporting suspected elder abuse or neglect cases to Adult Protective Service (APS) agencies provides access to services that address the social, medical, and legal needs of elderly persons. A geriatric interdisciplinary team can provide a comprehensive medical, functional, and social assessment. Based on the findings from the assessment and in collaboration with the APS team, the intervention plan can be formulated. Some cases of elder abuse or neglect may require intervention from the criminal justice or the civil justice system for serious legal issues such as sexual assault, financial exploitation, or guardianship. Other resources, such as Area Agencies on Aging, local women's shelters, and The National Center for Elder Abuse, are available to help manage elder abuse and neglect cases in the community.

  2. Preclinical Abuse Potential Assessment of Flibanserin: Effects on Intracranial Self-Stimulation in Female and Male Rats.

    Science.gov (United States)

    Lazenka, Matthew F; Blough, Bruce E; Negus, S Stevens

    2016-03-01

    Flibanserin is a serotonin receptor subtype 1A agonist and 2A antagonist that has been approved by the Food and Drug Administration for treating female sexual interest and arousal disorder. Little is known about the abuse potential of flibanserin. To examine abuse-related effects of flibanserin in rats using an intracranial self-stimulation (ICSS) procedure previously used to evaluate the abuse potential of other drugs. Adult female and male Sprague-Dawley rats with electrodes implanted in the medial forebrain bundle were trained to press a lever for electrical brain stimulation under a "frequency-rate" ICSS procedure. In this procedure, increasing frequencies of brain stimulation maintain increasing rates of responding. Drugs of abuse typically increase (or "facilitate") ICSS rates and produce leftward and upward shifts in ICSS frequency-rate curves, whereas drugs that lack abuse potential typically do not alter or only decrease ICSS rates. Initial studies determined the potency and time course of effects on ICSS produced by acute flibanserin administration (1.0, 3.2 and 10.0 mg/kg). Subsequent studies determined the effects of flibanserin (3.2-18 mg/kg) before and after a regimen of repeated flibanserin administration (5.6 mg/kg/d for 5 days). Effects of the abused stimulant amphetamine (1.0 mg/kg) were examined as a positive control. Flibanserin effects on ICSS frequency-rate curves in female and male rats were examined and compared with the effects of amphetamine. Baseline ICSS frequency-rate curves were similar in female and male rats. Acute and repeated administrations of flibanserin produced only decreases in ICSS rates, and rate-decreasing effects of the highest flibanserin dose (10 mg/kg) were greater in female than in male rats. In contrast to flibanserin, amphetamine produced an abuse-related increase in ICSS rates that did not differ between female and male rats. These results suggest that flibanserin has low abuse potential. In addition, this study

  3. Infant crying and abuse

    NARCIS (Netherlands)

    Reijneveld, S.A.; Wal, M.F.V.D.; Brugman, E.; Sing, R.A.H.; Verloove-Vanhorick, S.P.

    2004-01-01

    Child abuse and neglect are important causes of child morbidity and death. We assessed potentially detrimental parental actions induced by infant crying in 3259 infants aged 1-6 months, in the Netherlands. In infants aged 6 months, 5·6% (95% CI 4·2-7·0) of parents reported having smothered, slapped,

  4. The Brief Early Childhood Screening Assessment: Preliminary Validity in Pediatric Primary Care.

    Science.gov (United States)

    Fallucco, Elise M; Wysocki, Tim; James, Lauren; Kozikowski, Chelsea; Williams, Andre; Gleason, Mary M

    Brief, well-validated instruments are needed to facilitate screening for early childhood behavioral and emotional problems (BEPs). The objectives of this study were to empirically reduce the length of the Early Childhood Screening Assessment (ECSA) and to assess the validity and reliability of this shorter tool. Using caregiver ECSA responses for 2467 children aged 36 to 60 months seen in primary care, individual ECSA items were ranked on a scale ranging from "absolutely retain" to "absolutely delete." Items were deleted sequentially beginning with "absolutely delete" and going up the item prioritization list, resulting in 35 shorter versions of the ECSA. A separate primary care sample (n = 69) of mothers of children aged 18 to 60 months was used to determine the sensitivity and specificity of each shorter ECSA version using psychiatric diagnosis on the Diagnostic Infant and Preschool Assessment as the gold standard. The version with the optimal balance of sensitivity, specificity, and length was selected as the Brief ECSA. Associations between Brief ECSA scores and other pertinent measures were evaluated to estimate reliability and validity. A 22-item measure reflected the best combination of brevity, sensitivity and specificity. A cutoff score of 9 or higher on the 22-item Brief ECSA demonstrated acceptable sensitivity (89%) and specificity (85%) for predicting a psychiatric diagnosis. Brief ECSA scores correlated significantly and in expected directions with scores on pertinent measures and with demographic variables. The results indicate that the Brief ECSA has sound psychometric properties for identifying young children with BEPs in primary care.

  5. Texas Renewable Energy Evaluation Software (TREES): A screening tool for economic assessment of renewable energy options

    International Nuclear Information System (INIS)

    Vliet, G.C.; Hunn, B.D.; Kapileshwari, R.

    1996-01-01

    Screening software has been developed to assess the economic feasibility of renewable energy alternatives for applications in Texas. The renewable options include solar water heating and PV and wind for electric power generation. A range of hot water applications, from swimming pool heating to process heat are permitted, and PV and wind energy may be considered for either stand-alone or grid-connected use. The user inputs data such as application type, location, size of load, system cost, competing fuel cost, and discount rate. For the solar water heating options the software outputs the optimum collector area, life cycle savings compared to a conventional system, and a cost effectiveness index to assess economic feasibility. For the PV and wind options the software outputs life cycle savings, the average unit cost of delivered electricity, and a cost effectiveness index to assess economic feasibility. The software is designed as a screening tool, rather than design tool, and is developed for use with a spreadsheet program

  6. The novel measuring method for screening and assessing chromium content in clothes and shoes materials

    Science.gov (United States)

    Salerno-Kochan, R.

    2017-10-01

    The aim of this paper is to propose the bioindicative measuring method for screening and assessing the safety of textile and leather materials in relation to chemical threats. This method is based on toxicological assay in which Tetrahymena pyriformis, unicellular organism belonging to protozoans, is used as a test organism. For the realization of the research goal the sensitivity threshold of test organisms to chromium(VI) solutions was identified. The changes in cell development of test organisms in chromium solutions were registered by colorimetric measurements in the presence of alamarBlue® cell viability reagent. Empirical data enabled to fit logistic curves on the base of which the level of chromium toxicity was estimated. In the second step, harmfulness of aqueous extracts obtained from textile and leather samples containing chromium in relation to test organisms was evaluated. The performed research confirmed the high efficiency of the proposed method in screening and assessing chromium content in clothes and shoes materials and showed possibilities of using it in safety assessment of products with regard to chemical risks.

  7. Readability, Suitability and Health Content Assessment of Cancer Screening Announcements in Municipal Newspapers in Japan.

    Science.gov (United States)

    Okuhara, Tsuyoshi; Ishikawa, Hirono; Okada, Hiroko; Kiuchi, Takahiro

    2015-01-01

    The objective of this study was to assess the readability, suitability, and health content of cancer screening information in municipal newspapers in Japan. Suitability Assessment of Materials (SAM) and the framework of Health Belief Model (HBM) were used for assessment of municipal newspapers that were published in central Tokyo (23 wards) from January to December 2013. The mean domain SAM scores of content, literacy demand, and layout/typography were considered superior. The SAM scores of interaction with readers, an indication of the models of desirable actions, and elaboration to enhance readers' self-efficacy were low. According to the HBM coding, messages of medical/clinical severity, of social severity, of social benefits, and of barriers of fear were scarce. The articles were generally well written and suitable. However, learning stimulation/motivation was scarce and the HBM constructs were not fully addressed. Articles can be improved to motivate readers to obtain cancer screening by increasing interaction with readers, introducing models of desirable actions and devices to raise readers' self-efficacy, and providing statements of perceived barriers of fear for pain and time constraints, perceived severity, and social benefits and losses.

  8. New screening approach for risk assessment of pesticides in ambient air

    Science.gov (United States)

    Yusà, Vicent; Coscollà, Clara; Millet, Maurice

    2014-10-01

    We present a novel screening approach for inhalation risk assessment of currently used pesticides (CUPs) in ambient air, based on the measurements of pesticide levels in the inhalable fraction of the particulate matter (PM10). Total concentrations in ambient air (gas + particle phases) were estimated using a theoretical model of distribution of semi-volatile organic compounds between the gas and the particulate phase based on the octanol-air partition (Koa) of each pesticide. The proposed approach was used in a pilot study conducted in a rural station in Valencia (Spain) from April through to October 2010. Twenty out of 82 analysed pesticides were detected in average concentrations ranging from 1.63 to 117.01 pg m-3. For adults, children and infants the estimated chronic inhalation risk, expressed as Hazard Quotient (HQ) was pesticides. Likewise, the cumulative exposure for detected organophosphorus, pyrethroids and carbamates pesticides, was estimated using as metrics the Hazard Index (HI), which was less than 1 for the three families of pesticides assessed. The cancer risk estimated for the detected pesticides classified as Likely or Possible carcinogens was less than 1.15E-7 for infants. In our opinion, the screening approach proposed could be used in the monitoring and risk assessment of pesticides in ambient air.

  9. Use of geriatric assessment and screening tools of frailty in elderly patients with prostate cancer. Review.

    Science.gov (United States)

    Molina-Garrido, Maria-José; Guillén-Ponce, Carmen

    2017-06-01

    The management of prostate cancer in the elderly is a major public health concern in most countries. Currently, most prostate cancers are diagnosed in elderly males. The elderly population is very heterogeneous. Thus, the current challenge is to identify better those individuals for whom specific screening tools and a Comprehensive Geriatric Assessment (CGA) would be beneficial. On the basis of the recommendations of the Prostate Cancer Working Group in the International Society of Geriatric Oncology, older patients with prostate cancer should be managed according to their individual health status and not by their age. CGA is the best tool for determining the health status of an older patient. In this article, we sought to assemble all available evidence on the models of CGA and the prevalence of geriatric conditions in older patients with prostate cancer. We also discuss the feasibility of the most used screening tools in elderly patients, that is, the Vulnerable Elders Survey-13 (VES-13) and G-8 as screening tools in this group of patients.

  10. SCREENING FOR POSTSTROKE COGNITIVE IMPAIRMENT VIA MINI MENTAL STATE EXAMINATION AND MONTREAL COGNITIVE ASSESSMENT SCALE

    Directory of Open Access Journals (Sweden)

    Mirena Valkova

    2012-10-01

    Full Text Available Objective: The aim of our study is to examine cognitive performance after mild stroke via Mini Mental State Examination (MMSE and Montreal cognitive assessment scale (MoCA and to compare the results.Material and methods: We examined 54 patients with mild stroke (aged 52 to 72 (mean 63.17, SD 5.96; 34 males and 20 females and 54 controls, adjusted by age, sex and education level. All subjects were tested via MMSE (Bulgarian version and MoCa (Bulgarian version. Data was collected in the single step model at the 90th day after stroke incident for patients and at the day of obtaining informed consent for controls. Results: Patients have poorer performance on both MMSE and MoCa than controls. MoCa has comparatively good discriminative validity and sensitivity.Conclusions: Although MMSE is one of the classical screening tools for cognitive impairment widely used in Bulgaria, other screening tools should not be ignored. On the basis of our results, MoCa is also a good screening instrument, especially for poststroke cognitive impairment.

  11. Screening tests for assessing the anaerobic biodegradation of pollutant chemicals in subsurface environments

    Science.gov (United States)

    Suflita, Joseph M.; Concannon, Frank

    1995-01-01

    Screening methods were developed to assess the susceptibility of ground water contaminants to anaerobic biodegradation. One method was an extrapolation of a procedure previously used to measure biodegradation activity in dilute sewage sludge. Aquifer solids and ground water with no additional nutritive media were incubated anaerobically in 160-ml serum bottles containing 250 mg·l−1 carbon of the substrate of interest. This method relied on the detection of gas pressure or methane production in substrateamended microcosms relative to background controls. Other screening procedures involved the consumption of stoichiometrically required amounts of sulfate or nitrate from the same type of incubations. Close agreement was obtained between the measured and calculated amounts of substrate bioconversion based on the measured biogas pressure in methanogenic microcosms. Storage of the microcosms for up to 6 months did not adversely influence the onset or rate of benzoic acid mineralization. The lower detection limits of the methanogenic assay were found to be a function of the size of the microcosm headspace, the mean oxidation state of the substrate carbon, and the method used to correct for background temperature fluctuations. Using these simple screening procedures, biodegradation information of regulatory interest could be generated, including, (i) the length of the adaptation period, (ii) the rate of substrate decay and (iii) the completeness of the bioconversion.

  12. Organised screening for cervical cancer in France: a cost-effectiveness assessment.

    Science.gov (United States)

    Barré, Stéphanie; Massetti, Marc; Leleu, Henri; De Bels, Frédéric

    2017-10-06

    According to the third cancer plan, organised screening (OS) of cervical cancer (CC) among women aged 25-65 years should be implemented in France in the forthcoming years. The most efficient way to implement OS in the French healthcare system is yet to be determined. A microsimulation model was developed adopting a collective 'all payers' perspective. A closed cohort of women eligible for CC screening and representative in terms of age and participation in individual screening (IndScr) by annual Papanicolaou (Pap) testing every 3 years was modelled on a lifetime horizon. Different OS strategies, additive to IndScr with a 61.9% participation rate based on mailed invitations to non-participant women to perform OS were assessed. Similar modalities were applied to OS and IndScr participants. Strategies implied different screening tests (Papanicolaou (Pap) test, human papillomavirus (HPV) test and p16/Ki67 double staining) and OS periodicity. Compared with IndScr only, all OS strategies were associated with decreased cancer incidence/mortality (from 14.2%/13.5% to 22.9%/25.8%). Most strategies generated extra costs ranging from €37.9 to €1607 per eligible woman. HPV testing every 10 and 5 years were cost saving. HPV tests every 10 and 5 years were the most efficient strategies, generating more survival at lower costs than Pap-based strategies. Compared to IndScr only, an HPV test every 10 years was cost saving. The most effective strategies were p16/Ki67 as primary or HPV positive confirmation tests, with respective incremental cost-effectiveness ratios of €6 541 250 and €101 391 per life year. Pap-based strategies generated intermediary results. OS strategies based on the HPV test appear highly efficient. However, our results rely on the assumption that women and practitioners comply with the recommended OS periodicities (3, 5, 10 years). Implementing these OS modalities will require major adaptations to the current CC screening organisation. Pap test

  13. Prior Substance Abuse and Related Treatment History Reported by Recent Victims of Sexual Assault

    Science.gov (United States)

    Resnick, Heidi S.; Walsh, Kate; Schumacher, Julie A.; Kilpatrick, Dean G.; Acierno, Ron

    2013-01-01

    To inform intervention approaches, the current study examined prevalence and comorbidity of recent use and history of abuse of alcohol, marijuana, and other illicit drugs as well as history of substance treatment among a sample of female victims of sexual assault seeking post-assault medical care. Demographic variables and prior history of assault were also examined to further identify factors relevant to treatment or prevention approaches. Participants were 255 women and adolescent girls seeking post sexual assault medical services who completed an initial follow-up assessment on average within 3 months post-assault. The majority (72.9%) reported recent substance use prior to assault, approximately 40% reported prior substance abuse history, and 12.2% reported prior substance treatment history. Prior history of assault was associated with recent drug use and history of drug abuse as well as substance treatment. Among those with prior histories of substance abuse and assault, assault preceded substance abuse onset in the majority of cases. Almost all those with prior treatment history reported recent drug or alcohol use. A portion of sexual assault survivors seen for acute medical services may benefit from facilitated referral for substance abuse treatment in addition to counseling at the time of screening. Assessment and intervention approaches should target alcohol, marijuana, and other illicit drug use and abuse. Substance use and associated impairment may serve as a rape tactic by perpetrators of assault. Substance use at the time of assault does not imply blame on the part of assault victims. Previous findings indicate that rape poses high risk of PTSD particularly among women with prior history of assault. Screening and intervention related to substance abuse should be done with recognition of the increased vulnerability it may pose with regard to assault and the high risk of PTSD within this population. PMID:23396174

  14. Validation of the Rowland universal dementia assessment scale for multicultural screening in Danish memory clinics

    DEFF Research Database (Denmark)

    Nielsen, T Rune; Andersen, Birgitte Bo; Gottrup, Hanne

    2013-01-01

    Background/Aims: The Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive screening test that was developed to detect dementia in multicultural populations. The RUDAS has not previously been validated in multicultural populations outside of Australia. The aim of this study...... was to evaluate the diagnostic accuracy of the RUDAS in a multicultural sample of patients referred to Danish memory clinics. Methods: Data were collected from 137 consecutive patients (34 with an immigrant background) in three Danish memory clinics. All patients were given the RUDAS as a supplement...

  15. An open framework for automated chemical hazard assessment based on GreenScreen for Safer Chemicals: A proof of concept.

    Science.gov (United States)

    Wehage, Kristopher; Chenhansa, Panan; Schoenung, Julie M

    2017-01-01

    GreenScreen® for Safer Chemicals is a framework for comparative chemical hazard assessment. It is the first transparent, open and publicly accessible framework of its kind, allowing manufacturers and governmental agencies to make informed decisions about the chemicals and substances used in consumer products and buildings. In the GreenScreen® benchmarking process, chemical hazards are assessed and classified based on 18 hazard endpoints from up to 30 different sources. The result is a simple numerical benchmark score and accompanying assessment report that allows users to flag chemicals of concern and identify safer alternatives. Although the screening process is straightforward, aggregating and sorting hazard data is tedious, time-consuming, and prone to human error. In light of these challenges, the present work demonstrates the usage of automation to cull chemical hazard data from publicly available internet resources, assign metadata, and perform a GreenScreen® hazard assessment using the GreenScreen® "List Translator." The automated technique, written as a module in the Python programming language, generates GreenScreen® List Translation data for over 3000 chemicals in approximately 30 s. Discussion of the potential benefits and limitations of automated techniques is provided. By embedding the library into a web-based graphical user interface, the extensibility of the library is demonstrated. The accompanying source code is made available to the hazard assessment community. Integr Environ Assess Manag 2017;13:167-176. © 2016 SETAC. © 2016 SETAC.

  16. Mental health of adolescents who abuse psychoactive substances in Enugu, Nigeria - A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Igwe Wilson C

    2010-08-01

    Full Text Available Abstract Background Association between psychiatric morbidity and substance abuse among adolescent has been reported. However prevalence and pattern of such dysfunctions are unknown in our environment. Aims To determine the prevalence of psychosocial dysfunction and depressive symptoms among adolescents who abuse substance and also note the influence of socio-demographic factors and type of substance on the pattern of dysfuction. Method A cross-sectional study was carried out among 900 adolescents selected from 29 secondary schools in Enugu metropolis. A multi-stage sampling procedure was used to select the students. The student drug use questionnaire was used to screen respondents for substance abuse. Those who were abusing substance and matched controls (non substance abusers were assessed for psychiatric symptoms using the 35-item Paediatric Symptom Checklist (PSC and the Zung Self-rating Depression Scale (SDS. Social classification was done using the parental educational attainment and occupation. Result A total of 290 students were current substance abusers. The substances most commonly abused were alcohol (31.6%, cola nitida (kola nut (20.7% and coffee (15.7%. Using the PSC scale, 70 (24.1% subjects compared to 29 (10.7% of the controls had scores in the morbidity range of ≥ 28 for psychosocial dysfuction. This was statistically significant (χ2 = 17.57 p = 0.001. Fifty-four subjects (18.6% had scores in the morbidity range of ≥ 50 for depressive symptoms using the Zung SDS compared to 21 (7.7% of controls. This was statistically significant (χ2 = 14.43, p = 0.001. Prevalence of dysfunction was not significantly related to age in both subjects and controls (χ2 = 4.62, p = 0.010, χ2 = 4.8, p = 0.10 respectively. Also using both scales, there was no significant relationship between psychosocial dysfunction and gender or social class in both subjects and control. The prevalence of dysfuction using both scales was significantly higher

  17. Child Sexual Abuse

    Science.gov (United States)

    ... children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual abuse. Most sexual abusers know the child they abuse. They may be family friends, neighbors or babysitters. ...

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

    Science.gov (United States)

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

    2012-01-01

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

  19. Physical symptoms in very young children assessed for sexual abuse: a mixed method analysis from the ASAC study

    NARCIS (Netherlands)

    Vrolijk-Bosschaart, Thekla F.; Brilleslijper-Kater, Sonja N.; Widdershoven, Guy A.; Teeuw, Arianne Rian H.; Verlinden, Eva; Voskes, Yolande; van Duin, Esther M.; Verhoeff, Arnoud P.; Benninga, Marc A.; Lindauer, Ramón J. L.

    2017-01-01

    So far, a recognizable pattern of clinical symptoms for child sexual abuse (CSA), especially in young male children, is lacking. To improve early recognition of CSA, we reviewed physical complaints, physical examination, and tests on sexually transmitted infections (STIs) in confirmed victims

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

    Science.gov (United States)

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

    2010-01-01

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

  1. Assessment of two complementary liquid chromatography coupled to high resolution mass spectrometry metabolomics strategies for the screening of anabolic steroid treatment in calves

    International Nuclear Information System (INIS)

    Dervilly-Pinel, Gaud; Weigel, Stefan; Lommen, Arjen; Chereau, Sylvain; Rambaud, Lauriane; Essers, Martien; Antignac, Jean-Philippe; Nielen, Michel W.F.; Le Bizec, Bruno

    2011-01-01

    Anabolic steroids are banned in food producing livestock in Europe. Efficient methods based on mass spectrometry detection have been developed to ensure the control of such veterinary drug residues. Nevertheless, the use of 'cocktails' composed of mixtures of low amounts of several substances as well as the synthesis of new compounds of unknown structure prevent efficient prevention. New analytical tools able to detect such abuse are today mandatory. In this context, metabolomics may represent new emerging strategies for investigating the global physiological effects associated to a family of substances and therefore, to suspect the administration of steroids. The purpose of the present study was to set up, assess and compare two complementary mass spectrometry-based metabolomic strategies as new tools to screen for steroid abuse in cattle and demonstrate the feasibility of such approaches. The protocols were developed in two European laboratories in charge of residues analysis in the field of food safety. Apart from sample preparation, the global process was different in both laboratories from LC-HRMS fingerprinting to multivariate data analysis through data processing and involved both LC-Orbitrap-XCMS and UPLC-ToF-MS-MetAlign strategies. The reproducibility of both sample preparation and MS measurements were assessed in order to guarantee that any differences in the acquired fingerprints were not caused by analytical variability but reflect metabolome modifications upon steroids administration. The protocols were then applied to urine samples collected on a large group of animals consisting of 12 control calves and 12 calves administrated with a mixture of 17β-estradiol 3-benzoate and 17β-nandrolone laureate esters according to a protocol reflecting likely illegal practices. The modifications in urine profiles as indicators of steroid administration have been evaluated in this context and proved the suitability of the approach for discriminating anabolic

  2. Assessment of two complementary liquid chromatography coupled to high resolution mass spectrometry metabolomics strategies for the screening of anabolic steroid treatment in calves

    Energy Technology Data Exchange (ETDEWEB)

    Dervilly-Pinel, Gaud, E-mail: laberca@oniris-nantes.fr [ONIRIS, Ecole nationale veterinaire, agroalimentaire et de l' alimentation Nantes-Atlantique, Laboratoire d' Etude des Residus et Contaminants dans les Aliments (LABERCA), Atlanpole - La Chantrerie, BP 40706, Nantes F-44307 (France); Weigel, Stefan; Lommen, Arjen [RIKILT - Institute of Food Safety, Wageningen UR, P.O. Box 230, 6700 AE Wageningen (Netherlands); Chereau, Sylvain; Rambaud, Lauriane [ONIRIS, Ecole nationale veterinaire, agroalimentaire et de l' alimentation Nantes-Atlantique, Laboratoire d' Etude des Residus et Contaminants dans les Aliments (LABERCA), Atlanpole - La Chantrerie, BP 40706, Nantes F-44307 (France); Essers, Martien [RIKILT - Institute of Food Safety, Wageningen UR, P.O. Box 230, 6700 AE Wageningen (Netherlands); Antignac, Jean-Philippe [ONIRIS, Ecole nationale veterinaire, agroalimentaire et de l' alimentation Nantes-Atlantique, Laboratoire d' Etude des Residus et Contaminants dans les Aliments (LABERCA), Atlanpole - La Chantrerie, BP 40706, Nantes F-44307 (France); Nielen, Michel W.F. [RIKILT - Institute of Food Safety, Wageningen UR, P.O. Box 230, 6700 AE Wageningen (Netherlands); Wageningen University, Laboratory of Organic Chemistry, Wageningen (Netherlands); Le Bizec, Bruno [ONIRIS, Ecole nationale veterinaire, agroalimentaire et de l' alimentation Nantes-Atlantique, Laboratoire d' Etude des Residus et Contaminants dans les Aliments (LABERCA), Atlanpole - La Chantrerie, BP 40706, Nantes F-44307 (France)

    2011-08-26

    Anabolic steroids are banned in food producing livestock in Europe. Efficient methods based on mass spectrometry detection have been developed to ensure the control of such veterinary drug residues. Nevertheless, the use of 'cocktails' composed of mixtures of low amounts of several substances as well as the synthesis of new compounds of unknown structure prevent efficient prevention. New analytical tools able to detect such abuse are today mandatory. In this context, metabolomics may represent new emerging strategies for investigating the global physiological effects associated to a family of substances and therefore, to suspect the administration of steroids. The purpose of the present study was to set up, assess and compare two complementary mass spectrometry-based metabolomic strategies as new tools to screen for steroid abuse in cattle and demonstrate the feasibility of such approaches. The protocols were developed in two European laboratories in charge of residues analysis in the field of food safety. Apart from sample preparation, the global process was different in both laboratories from LC-HRMS fingerprinting to multivariate data analysis through data processing and involved both LC-Orbitrap-XCMS and UPLC-ToF-MS-MetAlign strategies. The reproducibility of both sample preparation and MS measurements were assessed in order to guarantee that any differences in the acquired fingerprints were not caused by analytical variability but reflect metabolome modifications upon steroids administration. The protocols were then applied to urine samples collected on a large group of animals consisting of 12 control calves and 12 calves administrated with a mixture of 17{beta}-estradiol 3-benzoate and 17{beta}-nandrolone laureate esters according to a protocol reflecting likely illegal practices. The modifications in urine profiles as indicators of steroid administration have been evaluated in this context and proved the suitability of the approach for

  3. Relationship between drug discrimination and ratings of subjective effects: implications for assessing and understanding the abuse potential of D-amphetamine in humans.

    Science.gov (United States)

    Reynolds, Anna R; Bolin, B Levi; Stoops, William W; Rush, Craig R

    2013-09-01

    The discriminative and subjective effects of drugs in humans are related, but the full extent of this relationship remains to be determined. To further explore this relationship, a retrospective analysis was conducted on data from six studies completed in our laboratory that used identical procedures. The relationship between the discriminative and subjective effects of a range of doses of D-amphetamine (i.e. 2.5-15 mg) was examined using correlational analyses. Significant correlations with discrimination performance were observed on 15 of 20 items from the Drug-Effect Questionnaire across a range of qualities [e.g. Pay For (a positive effect indicative of abuse potential) and Active (a stimulant-like effect)], but the magnitude of these relationships was modest (reffects contribute to the discriminative effects of D-amphetamine and indicate that the former are a more practical means to assess the abuse potential of drugs. Although these procedures are fundamentally related in that they rely on the presence of an interoceptive drug state, they differ in the dimension(s) of the interoceptive effects that participants must quantify. The simultaneous use of drug discrimination and subjective effects may, therefore, reveal complimentary aspects of drug effects that underlie their potential for abuse.

  4. Quality of cervical cancer screening in Brazil: external assessment of the PMAQ

    Directory of Open Access Journals (Sweden)

    Mara Rejane Barroso Barcelos

    Full Text Available ABSTRACT OBJECTIVE To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening. METHODS This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context, demographic characteristics (user profile, and two domains related to the organization of basic services (work structure and process. The low quality of the screening was assessed from the lack of access, late examination, and lack of guidance. Crude and adjusted analyses by Poisson regression assessed the association between outcomes and independent variables. RESULTS The values of lack of access, late examination, and lack of guidance were 6.7%, 11.2%, and 19.2%, respectively. Problems of quality were lower according to the increase in Municipal Human Development Index and per capita household income, increasing with population size and municipal coverage of the Family Health Strategy. The Midwest region of the country presented the highest occurrences of low quality outcomes. Indigenous and yellow women had the highest prevalence of outcomes. Women with partner, who received the Bolsa Família Program, and who had paid work had less chances of having lack of access, late examination, and lack of guidance. The appropriate work process in health services decreased the likelihood of low quality in all indicators. CONCLUSIONS Investments in the work process of health teams, social cash transfer programs, and social conditions of the population are essential to improve the quality of the program of cervical cancer screening in Brazil.

  5. Screening for dietary fat intake of grade six children: self-assessment vs. maternal assessment.

    Science.gov (United States)

    Wenhold, Friede; MacIntyre, Una; Rheeder, Paul

    2014-10-01

    As part of justifiable nutrition promotion, this study aimed to determine internal consistency of a dietary fat screener and to compare self-assessment to maternal assessment of fat intake of grade six (about 12 years old) learners in a South African public primary school. The children completed in school a pictorial, quantitative food frequency-type screener consisting of 10 high-fat food categories; mothers individually completed a text version. Internal consistency was measured with item-total correlations, Cronbach's alpha and the split-half method. Child-mother comparison was based on kappa (κ) statistics, McNemar's tests, Wilcoxon signed-rank test and the Bland-Altman method. In total, 101 (93.5%) children and 78 (72.2%) mothers responded. The screener was internally consistent, regardless of data source and statistical technique. For portion sizes and frequency of intake, children consistently reported higher intake than mothers. This resulted in systematic error, also evidenced by a significant difference from zero for the difference between child's and mother's final test scores for the whole group, and for boys and girls separately (always P Children and mothers reported high fat intakes (93% and 75%, respectively). It was concluded that the dietary fat screener was internally consistent, yet children and mothers did not agree in their assessment. The high fat intakes reported by children and mothers warrant measurement refinement and implementation of primary prevention programmes. © 2012 John Wiley & Sons Ltd.

  6. Terrestrial Eco-Toxicological Tests as Screening Tool to Assess Soil Contamination in Krompachy Area

    Science.gov (United States)

    Ol'ga, Šestinová; Findoráková, Lenka; Hančuľák, Jozef; Fedorová, Erika; Tomislav, Špaldon

    2016-10-01

    In this study, we present screening tool of heavy metal inputs to agricultural and permanent grass vegetation of the soils in Krompachy. This study is devoted to Ecotoxicity tests, Terrestrial Plant Test (modification of OECD 208, Phytotoxkit microbiotest on Sinapis Alba) and chronic tests of Earthworm (Dendrobaena veneta, modification of OECD Guidelines for the testing of chemicals 317, Bioaccumulation in Terrestrial Oligochaetes) as practical and sensitive screening method for assessing the effects of heavy metals in Krompachy soils. The total Cu, Zn, As, Pb and Hg concentrations and eco-toxicological tests of soils from the Krompachy area were determined of 4 sampling sites in 2015. An influence of the sampling sites distance from the copper smeltery on the absolutely concentrations of metals were recorded for copper, lead, zinc, arsenic and mercury. The highest concentrations of these metals were detected on the sampling sites up to 3 km from the copper smeltery. The samples of soil were used to assess of phytotoxic effect. Total mortality was established at earthworms using chronic toxicity test after 7 exposure days. The results of our study confirmed that no mortality was observed in any of the study soils. Based on the phytotoxicity testing, phytotoxic effects of the metals contaminated soils from the samples 3KR (7-9) S.alba seeds was observed.

  7. Assessing the validity of a computer-generated cognitive screening instrument for patients with multiple sclerosis.

    Science.gov (United States)

    Lapshin, Helen; Lanctôt, Krista L; O'Connor, Paul; Feinstein, Anthony

    2013-12-01

    Neuropsychological testing requires considerable time, expense, and expertise to administer. These factors can limit patient access. Computerized cognitive testing has been proposed as an alternative. The objective of this paper is to validate a brief, simple-to-use computer-generated cognitive assessment screening battery for multiple sclerosis (MS) patients that has minimal motor involvement. A sample of 96 MS patients and 98 healthy controls completed a computer-generated battery that included the Stroop, Symbol Digit Modalities Test (C-SDMT), a two- and four-second visual analog of the Paced Auditory Serial Addition Test (PVSAT-2, PVSAT-4), and simple and choice reaction time tests. The Minimal Assessment of Cognitive Function in MS was used to define cognitive impairment in the MS sample. Each newly developed test successfully distinguished between cognitively impaired patients and healthy controls as well as cognitively intact patients. A combination of three computerized tests (C-SDMT, PVSAT-2, PVSAT-4) with a mean administration time of 10 minutes had a sensitivity of 82.5% and specificity of 87.5% in detecting cognitive impairment. Good test-retest reliability was obtained for each measure. Good sensitivity and specificity, brevity, ease of administration, and a limited motor component highlight the feasibility of introducing this computer-generated cognitive screening instrument in a busy MS clinic.

  8. Validity and reliability assessment of health belief scales for mammography screening in Greek asymptomatic women.

    Science.gov (United States)

    Anagnostopoulos, Fotios; Dimitrakaki, Christine; Niakas, Dimitris; Tountas, Yannis

    2013-08-01

    The purpose was to assess the validity and reliability of health belief model variables (perceived benefits, perceived barriers, and self-efficacy beliefs) that are often the target of mammography screening interventions. Based on Champion's health belief model scales, questionnaire data were obtained from a nationally representative sample of 408 Greek women, 40 years of age or older and with no personal history of cancer. Using confirmatory factor analysis, we found all items to load significantly on their respective factors. Standardized factor loadings ranged from 0.55 to 0.88. An analysis of localized areas of respecification of a three-factor model revealed that measurement error correlations between a few items existed. Known-groups and criterion-related validity was supported for all scales, while internal consistency reliability of the scales was satisfactory, with Cronbach's alpha ranging from 0.71 to 0.88. The Greek version of the scales measuring perceived benefits, perceived barriers, and self-efficacy beliefs is a reliable and valid tool when used to assess health beliefs for mammography screening among women. Implications for intervention strategies aimed at increasing the likelihood of mammography utilization are considered. Copyright © 2012 John Wiley & Sons, Ltd.

  9. Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome.

    Science.gov (United States)

    Klompenhouwer, Elisabeth G; Voogd, Adri C; den Heeten, Gerard J; Strobbe, Luc J A; Tjan-Heijnen, Vivianne C; Broeders, Mireille J M; Duijm, Lucien E M

    2015-10-01

    To determine the value of adding a third reader for arbitration of discrepant screening mammography assessments. We included a consecutive series of 84,927 digital screening mammograms, double read in a blinded or non-blinded fashion. Arbitration was retrospectively performed by a third screening radiologist. Two years' follow-up was performed. Discrepant readings comprised 57.2% (830/1452) and 29.1% (346/1188) of recalls at blinded and non-blinded double readings, respectively. At blinded double reading, arbitration would have decreased recall rate (3.4 to 2.2%, p arbitration would have decreased recall rate (2.8 to 2.3%, p Arbitration of discrepant screening mammography assessments is a good tool to improve recall rate and PPV, but is not desirable as it reduces the programme sensitivity at blinded double reading. • Blinded double reading results in higher programme sensitivity than non-blinded reading. • Discrepant readings occur more often at blinded compared to non-blinded reading. • Arbitration of discrepant readings reduces the recall rate and PPV. • Arbitration would reduce the programme sensitivity at blinded double reading.

  10. Psychophysiological assessment of stress and screening of health risk in peacekeeping operations.

    Science.gov (United States)

    Nikolova, Rouja; Aleksiev, Lyubomir; Vukov, Mircho

    2007-01-01

    Medical surveillance for military personnel participating in peacekeeping missions (PKMs) is required to define the effect of stress on health status. The aim of this study was to determine the effect of stress on the autonomic cardiovascular control and health risk of 72 Bulgarian peacekeepers participating in a PKM in Kosovo. The assessment of psychophysiological stress and determination of stress characteristics were implemented with analysis of heart rate variability and personal interviews. As a response to the cumulative exposure to the effect of stress on cognitive function, we observed reductions in parasympathetic function and baroreceptor modulation of heart rhythm. The alteration in cardiovascular control was registered as decreases in short-term variability and spectral powers of cardiointervals in the respiratory sinus arrhythmia and Traube-Hering-Mayer bands. The advantage of psychophysiological stress assessment and screening of health risk in PKMs is that results indicate the mechanisms of the effects of stress on cognitive function and health status.

  11. Use of a modified GreenScreen tool to conduct a screening-level comparative hazard assessment of conventional silver and two forms of nanosilver.

    Science.gov (United States)

    Sass, Jennifer; Heine, Lauren; Hwang, Nina

    2016-11-08

    Increased concern for potential health and environmental impacts of chemicals, including nanomaterials, in consumer products is driving demand for greater transparency regarding potential risks. Chemical hazard assessment is a powerful tool to inform product design, development and procurement and has been integrated into alternative assessment frameworks. The extent to which assessment methods originally designed for conventionally-sized materials can be used for nanomaterials, which have size-dependent physical and chemical properties, have not been well established. We contracted with a certified GreenScreen profiler to conduct three GreenScreen hazard assessments, for conventional silver and two forms of nanosilver. The contractor summarized publicly available literature, and used defined GreenScreen hazard criteria and expert judgment to assign and report hazard classification levels, along with indications of confidence in those assignments. Where data were not available, a data gap (DG) was assigned. Using the individual endpoint scores, an aggregated benchmark score (BM) was applied. Conventional silver and low-soluble nanosilver were assigned the highest possible hazard score and a silica-silver nanocomposite called AGS-20 could not be scored due to data gaps. AGS-20 is approved for use as antimicrobials by the US Environmental Protection Agency. An existing method for chemical hazard assessment and communication can be used - with minor adaptations- to compare hazards across conventional and nano forms of a substance. The differences in data gaps and in hazard profiles support the argument that each silver form should be considered unique and subjected to hazard assessment to inform regulatory decisions and decisions about product design and development. A critical limitation of hazard assessments for nanomaterials is the lack of nano-specific hazard data - where data are available, we demonstrate that existing hazard assessment systems can work. The work

  12. Sex/Gender Differences in Screening for Autism Spectrum Disorder: Implications for Evidence-Based Assessment.

    Science.gov (United States)

    Evans, Spencer C; Boan, Andrea D; Bradley, Catherine; Carpenter, Laura A

    2018-03-30

    Autism spectrum disorder (ASD) is diagnosed more often in boys than in girls; however, little is known about the nature of this sex/gender discrepancy or how it relates to diagnostic assessment practices. This study examined the performance of the Social Communication Questionnaire (SCQ) in screening for ASD among boys and girls. Data were drawn from the South Carolina Children's Educational Surveillance Study, a population-based study of ASD prevalence among children 8-10 years of age. Analyses were conducted using SCQ data from 3,520 children, with direct assessment data from 272 with elevated SCQ scores. A bifactor model based on the Diagnostic and Statistical Manual of Mental Disorders's (5th ed.) two ASD symptom domains fit the data well and performed slightly better for girls. In the general population sample, girls exhibited fewer social communication/interaction and restricted-repetitive behavior symptoms than boys. In the direct assessment sample, however, girls with ASD showed greater impairment in social communication/interaction than boys with ASD. Items pertaining to social communication/interaction problems at ages 4-5 were among the most diagnostically efficient overall and particularly for girls. Similarly, receiver operating characteristic analyses suggested that the SCQ performs adequately among boys and well among girls. Results support the use of the SCQ in screening for ASD but do not indicate sex/gender-specific cutoffs. Girls with ASD may exhibit pronounced intraindividual deficits in social communication/interaction compared to male peers with ASD and female peers without ASD. Although more research is needed, careful attention to social communication/interaction deficits around 4-5 years of age may be especially useful for assessing ASD in girls.

  13. State of the Science of Spirituality and Palliative Care Research Part II: Screening, Assessment, and Interventions.

    Science.gov (United States)

    Balboni, Tracy A; Fitchett, George; Handzo, George F; Johnson, Kimberly S; Koenig, Harold G; Pargament, Kenneth I; Puchalski, Christina M; Sinclair, Shane; Taylor, Elizabeth J; Steinhauser, Karen E

    2017-09-01

    The State of the Science in Spirituality and Palliative Care was convened to address the current landscape of research at the intersection of spirituality and palliative care and to identify critical next steps to advance this field of inquiry. Part II of the SOS-SPC report addresses the state of extant research and identifies critical research priorities pertaining to the following questions: 1) How do we assess spirituality? 2) How do we intervene on spirituality in palliative care? And 3) How do we train health professionals to address spirituality in palliative care? Findings from this report point to the need for screening and assessment tools that are rigorously developed, clinically relevant, and adapted to a diversity of clinical and cultural settings. Chaplaincy research is needed to form professional spiritual care provision in a variety of settings, and outcomes assessed to ascertain impact on key patient, family, and clinical staff outcomes. Intervention research requires rigorous conceptualization and assessments. Intervention development must be attentive to clinical feasibility, incorporate perspectives and needs of patients, families, and clinicians, and be targeted to diverse populations with spiritual needs. Finally, spiritual care competencies for various clinical care team members should be refined. Reflecting those competencies, training curricula and evaluation tools should be developed, and the impact of education on patient, family, and clinician outcomes should be systematically assessed. Published by Elsevier Inc.

  14. Prevalence and Correlates of Elder Abuse in São Paulo and Rio de Janeiro.

    Science.gov (United States)

    Blay, Sergio L; Laks, Jerson; Marinho, Valeska; Figueira, Ivan; Maia, Deborah; Coutinho, Evandro S F; Quintana, Ines M; Mello, Marcelo F; Bressan, Rodrigo A; Mari, Jair J; Andreoli, Sergio B

    2017-12-01

    To assess the prevalence of elder abuse and to investigate potential sociodemographic, health behavior, and medical correlates. Cross-sectional data were collected in face-to-face assessments. São Paulo and Rio de Janeiro, Brazil. Individuals aged 60 to 75. Information on elder abuse was obtained using the Brazil-adapted, nine-item Hwalek-Sengstock Elder Abuse Screening Test. Sampling design-adjusted descriptive statistics and logistic regression were used in analyses. The overall prevalence of abuse was 14.4% (n = 46/259, 95% confidence interval (CI) = 9.82-20.61) in São Paulo and 13.3% (n = 27/197, 95% CI = 8.76-19.74) in Rio de Janeiro. Unadjusted analyses indicated that poor education, low physical activity, unemployment, heart disease, and psychiatric problems were associated with abuse, but in adjusted analyses, self-reported elder abuse was significantly associated only with psychiatric problems (São Paulo: OR = 4.48, 95% CI = 1.75-11.45; Rio de Janeiro: OR = 21.61, 95% CI = 6.39-73.14). Elder abuse is prevalent in São Paulo and Rio de Janeiro, but whether concomitants of abuse are cause, effect, or both is unclear because this was a cross-sectional study. These findings highlight the importance of the problem, as well as the need to develop measures to increase awareness, facilitate prevention, and fight against abuse of elderly adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  15. [Health technology assessment report: Computer-assisted Pap test for cervical cancer screening].

    Science.gov (United States)

    Della Palma, Paolo; Moresco, Luca; Giorgi Rossi, Paolo

    2012-01-01

    -automated computer-assisted); to analyse the computer-assisted Pap test in the Italian context, through a survey of the centres using the technology, collecting data useful for the sensitivity analysis of the economic evaluation; to evaluate the acceptability of the technology in the screening services; to evaluate the organizational and financial impact of the computer-assisted Pap test in different scenarios; to illustrate the ideal organization to implement computer-assisted Pap test in terms of volume of activity, productivity, and human and technological resources. to produce this Report, the following process was adopted: application to the Ministry of health for a grant « Analysis of the impact of professional involvement in evidence generation for the HTA process »; within this project, the sub-project « Cost effectiveness evaluation of the computer-assisted Pap test in the Italian screening programmes » was financed; constitution of the Working Group, which included the project coordinator, the principal investigator, and the health economist; identification of the centres using the computer-assisted Pap test and which had published scientific reports on the subject; identification of the Consulting Committee (stakeholder), which included screening programmes managers, pathologists, economists, health policy-makers, citizen organizations, and manufacturers. Once the evaluation was concluded, a plenary meeting with Working Group and Consulting Committee was held. The working group drafted the final version of this Report, which took into account the comments received. the fully automated computer-assisted Pap test has an important financial and organizational impact on screening programmes. The assessment of this health technology reached the following conclusions: according to the survey results, after some distrust, cytologists accepted the use of the machine and appreciated the reduction in interpretation time and the reliability in identifying the fields of interest

  16. Development of a Child Abuse Checklist to Evaluate Prehospital Provider Performance.

    Science.gov (United States)

    Alphonso, Aimee; Auerbach, Marc; Bechtel, Kirsten; Bilodeau, Kyle; Gawel, Marcie; Koziel, Jeannette; Whitfill, Travis; Tiyyagura, Gunjan Kamdar

    2017-01-01

    To develop and provide validity evidence for a performance checklist to evaluate the child abuse screening behaviors of prehospital providers. Checklist Development: We developed the first iteration of the checklist after review of the relevant literature and on the basis of the authors' clinical experience. Next, a panel of six content experts participated in three rounds of Delphi review to reach consensus on the final checklist items. Checklist Validation: Twenty-eight emergency medical services (EMS) providers (16 EMT-Basics, 12 EMT-Paramedics) participated in a standardized simulated case of physical child abuse to an infant followed by one-on-one semi-structured qualitative interviews. Three reviewers scored the videotaped performance using the final checklist. Light's kappa and Cronbach's alpha were calculated to assess inter-rater reliability (IRR) and internal consistency, respectively. The correlation of successful child abuse screening with checklist task completion and with participant characteristics were compared using Pearson's chi squared test to gather evidence for construct validity. The Delphi review process resulted in a final checklist that included 24 items classified with trichotomous scoring (done, not done, or not applicable). The overall IRR of the three raters was 0.70 using Light's kappa, indicating substantial agreement. Internal consistency of the checklist was low, with an overall Cronbach's alpha of 0.61. Of 28 participants, only 14 (50%) successfully screened for child abuse in simulation. Participants who successfully screened for child abuse did not differ significantly from those who failed to screen in terms of training level, past experience with child abuse reporting, or self-reported confidence in detecting child abuse (all p > 0.30). Of all 24 tasks, only the task of exposing the infant significantly correlated with successful detection of child abuse (p child abuse checklist that demonstrated strong content validity and

  17. Drug abuse in hospitalized trauma patients in a university trauma care center: an explorative study

    Directory of Open Access Journals (Sweden)

    A.R. Soroush

    2006-08-01

    Full Text Available Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients. Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded. Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%. There was a history of smoking in 136 cases (38%. 58 cases (16.2% reported to abuse drugs (91.5% opium. The commonest route of administration was smoke inhalation (37.2%. Screening by Morphine Check test revealed 95 samples to be positive (26.5%. The preponderance of test-positive cases was among young people (of 20-30 years of age with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively. Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs

  18. Fast Gradient Elution Reversed-Phase HPLC with Diode-Array Detection as a High Throughput Screening Method for Drugs of Abuse

    Energy Technology Data Exchange (ETDEWEB)

    Peter W. Carr; K.M. Fuller; D.R. Stoll; L.D. Steinkraus; M.S. Pasha; Glenn G. Hardin

    2005-12-30

    A new approach has been developed by modifying a conventional gradient elution liquid chromatograph for the high throughput screening of biological samples to detect the presence of regulated intoxicants. The goal of this work was to improve the speed of a gradient elution screening method over current approaches by optimizing the operational parameters of both the column and the instrument without compromising the reproducibility of the retention times, which are the basis for the identification. Most importantly, the novel instrument configuration substantially reduces the time needed to re-equilibrate the column between gradient runs, thereby reducing the total time for each analysis. The total analysis time for each gradient elution run is only 2.8 minutes, including 0.3 minutes for column reequilibration between analyses. Retention times standard calibration solutes are reproducible to better than 0.002 minutes in consecutive runs. A corrected retention index was adopted to account for day-to-day and column-to-column variations in retention time. The discriminating power and mean list length were calculated for a library of 47 intoxicants and compared with previous work from other laboratories to evaluate fast gradient elution HPLC as a screening tool.

  19. The Breast Imaging Reporting and Data System (BI-RADS) in the Dutch breast cancer screening programme: its role as an assessment and stratification tool

    NARCIS (Netherlands)

    Timmers, J. M. H.; van Doorne-Nagtegaal, H. J.; Zonderland, H. M.; van Tinteren, H.; Visser, O.; Verbeek, A. L. M.; den Heeten, G. J.; Broeders, M. J. M.

    2012-01-01

    To assess the suitability of the Breast Imaging Reporting and Data System (BI-RADS) as a quality assessment tool in the Dutch breast cancer screening programme. The data of 93,793 screened women in the Amsterdam screening region (November 2005-July 2006) were reviewed. BI-RADS categories, work-up,

  20. The Breast Imaging Reporting and Data System (BI-RADS) in the Dutch breast cancer screening programme: its role as an assessment and stratification tool.

    NARCIS (Netherlands)

    Timmers, J.M.H.; Doorne-Nagtegaal, H.J. van; Zonderland, H.M.; Tinteren, H. van; Visser, O; Verbeek, A.L.M.; Heeten, G.J. den; Broeders, M.J.M.

    2012-01-01

    OBJECTIVES: To assess the suitability of the Breast Imaging Reporting and Data System (BI-RADS) as a quality assessment tool in the Dutch breast cancer screening programme. METHODS: The data of 93,793 screened women in the Amsterdam screening region (November 2005-July 2006) were reviewed. BI-RADS

  1. Measuring excessive pricing as an abuse of dominance – an assessment of the criteria used in the Harmony Gold/Mittal Steel complaint

    Directory of Open Access Journals (Sweden)

    Reena das Nair

    2012-10-01

    Full Text Available The Competition Tribunal recently found Mittal Steel SA guilty of abusing its super-dominant position by charging excessive prices to the detriment of consumers of flat carbon steel products. This article assesses the economic tests to be used for excessive pricing in light of the case and reviews the lessons that can be learned from the evidence required for the different tests. It discusses issues related to using profitability as a test and points out problems and pitfalls in profitability measures.

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

    Science.gov (United States)

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

    2012-01-01

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

  3. Systematic assessment of apraxia and functional predictions from the Birmingham Cognitive Screen.

    Science.gov (United States)

    Bickerton, Wai-Ling; Riddoch, M Jane; Samson, Dana; Balani, Alex Bahrami; Mistry, Bejal; Humphreys, Glyn W

    2012-05-01

    The validity and functional predictive values of the apraxia tests in the Birmingham Cognitive Screen (BCoS) were evaluated. BCoS was developed to identify patients with different forms of praxic deficit using procedures designed to be inclusive for patients with aphasia and/or spatial neglect. Observational studies were conducted from a university neuropsychological assessment centre and from acute and rehabilitation stroke care hospitals throughout an English region. Volunteers from referred patients with chronic acquired brain injuries, a consecutive hospital sample of patients within 3 months of stroke (n=635) and a population based healthy control sample (n=100) were recruited. The main outcome measures used were the Barthel Index, the Nottingham Extended Activities of Daily Living Scale as well as recovery from apraxia. There were high inter-rater reliabilities and correlations between the BCoS apraxia tasks and counterpart tests from the literature. The vast majority (88.3%) of the stroke survivors were able to complete the screen. Pantomime and gesture recognition tasks were more sensitive in differentiating between individuals with left hemisphere damage and right hemisphere damage whereas the Multistep Object Use test and the imitation task had higher functional correlates over and above effects of hemiplegia. Together, the initial scores of the four tasks enabled predictions with 75% accuracy, the recovery of apraxia and independence level at 9 months. As a model based assessment, BCoS offers a quick and valid way to detect apraxia and predict functional recovery. It enables early and informative assessment of most stroke patients for rehabilitation planning.

  4. Utility of BI-RADS Assessment Category 4 Subdivisions for Screening Breast MRI.

    Science.gov (United States)

    Strigel, Roberta M; Burnside, Elizabeth S; Elezaby, Mai; Fowler, Amy M; Kelcz, Frederick; Salkowski, Lonie R; DeMartini, Wendy B

    2017-06-01

    BI-RADS for mammography and ultrasound subdivides category 4 assessments by likelihood of malignancy into categories 4A (> 2% to ≤ 10%), 4B (> 10% to ≤ 50%), and 4C (> 50% to BI-RADS-specified rates of malignancy for mammography and ultrasound. All screening breast MRI examinations performed from July 1, 2010, through June 30, 2013, were included in this study. We identified in medical records prospectively assigned MRI BI-RADS categories, including category 4 subdivisions, which are used routinely in our practice. Benign versus malignant outcomes were determined by pathologic analysis, findings from 12 months or more clinical or imaging follow-up, or a combination of these methods. Distribution of BI-RADS categories and positive predictive value level 2 (PPV2; based on recommendation for tissue diagnosis) for categories 4 (including its subdivisions) and 5 were calculated. Of 860 screening breast MRI examinations performed for 566 women (mean age, 47 years), 82 with a BI-RADS category 4 assessment were identified. A total of 18 malignancies were found among 84 category 4 and 5 assessments, for an overall PPV2 of 21.4% (18/84). For category 4 subdivisions, PPV2s were as follows: for category 4A, 2.5% (1/40); for category 4B, 27.6% (8/29); for category 4C, 83.3% (5/6); and for category 4 (not otherwise specified), 28.6% (2/7). Category 4 subdivisions for MRI yielded malignancy rates within BI-RADS-specified ranges, supporting their use for benefits to patient care and more meaningful practice audits.

  5. Teaching child psychiatric assessment skills: Using pediatric mental health screening tools.

    Science.gov (United States)

    Hargrave, T M; Arthur, M E

    2015-01-01

    This article describes the workshop "Teaching Child Psychiatric Assessment Skills: Using Mental Health Screening Instruments," presented at the 35th Forum for Behavioral Sciences in Family Medicine on 20 September 2014. The goals of the presentation were (1) to teach family medicine behavioral health educators to use both general and problem-specific mental health screening tools (MHSTs) in their work with trainees to help satisfy the Accreditation Council for Graduate Medical Education (ACGME) mandate for behavioral and mental health experience during family medicine residency, (2) to reflect on how MHSTs might be integrated into the flow of family medicine teaching practices, and (3) to exemplify how evidence-based methods of adult education might be used in teaching such content. One general MHST, the Pediatric Symptom Checklist-17 and one problem-specific MHST for each of the four commonest pediatric mental health issues: for attention-deficit hyperactivity disorder, the Vanderbilt; for Anxiety, the Screen for Childhood Anxiety-Related Emotional Disorders; for Depression, the Patient Health Questionnaire-9 for teens; and for Aggression, the Retrospective-Modified Overt Aggression Scale, were practiced at least twice in the context of a clinical vignette. All of the selected MHSTs are free in the public domain and available for download from the website: www.CAPPCNY.org. Participants were asked to reflect on their own office practice characteristics and consider how MHSTs might be integrated into their systems of care. This workshop could be replicated by others wishing to teach the use of MHSTs in primary care settings or teaching programs. © The Author(s) 2015.

  6. Recall rate reduction with tomosynthesis during baseline screening examinations – an assessment from a prospective trial

    Science.gov (United States)

    Sumkin, Jules H.; Ganott, Marie A.; Chough, Denise M.; Catullo, Victor J.; Zuley, Margarita L.; Shinde, Dilip D.; Hakim, Christiane M.; Bandos, Andriy I.; Gur, David

    2015-01-01

    Rational and Objectives Assess results of a prospective, single site clinical study evaluating digital breast tomosynthesis (DBT) during baseline screening mammography. Materials and Methods Under an institutional review board approved HIPAA compliant protocol, consenting women between ages 34 and 56 scheduled for their initial/baseline screening mammogram underwent both Full Field Digital Mammography (FFDM) and DBT. The FFDM and the FFDM plus DBT images were interpreted independently in a reader by mode balanced approach by two of 14 participating radiologists. A woman was recalled for a diagnostic workup if either radiologist recommended a recall. We report overall recall rates and related diagnostic outcome from the 1080 participants. Proportion of recommended recalls (BIRADS 0) were compared using a generalized linear mixed model (SAS 9.3) with a significance level of p=0.0294. Results The fraction of women without breast cancer recommended for recall using FFDM alone and FFDM plus DBT were 412/1074 (38.4%) and 274/1074 (25.5%), respectively (p<0.001). Large inter-reader variability in terms of recall reduction was observed among the 14 readers; however, 11 out of 14 readers recalled fewer women using FFDM plus DBT (5 with p-values <0.015). Six cancers (4 DCIS and 2 IDC) were detected. One IDC was detected only on DBT and one DCIS cancer was detected only on FFDM, while the remaining cancers were detected on both modalities. Conclusion The use of FFDM plus DBT resulted in a significant decrease in recall rates during baseline screening mammography with no reduction in sensitivity. PMID:26391857

  7. Assessing Technologies for Information-Seeking on Prostate Cancer Screening by Low-Income Men

    Directory of Open Access Journals (Sweden)

    Susan W. McRoy

    2014-11-01

    Full Text Available Purpose: This paper presents a multipart investigation of the benefits and challenges in deploying automated question-answering as an alternative to web-based searching to provide information about prostate cancer screening for low-income men age 40 years and older. Methods: The study comprised: 1 a survey assessing current use of the Internet, mobile phones and texting; 2 a controlled observational study of both web-based searching and automated question-answering for information about prostate cancer; and 3 a formative field study in which subjects interacted with a health department nurse using text messages. Results: Survey results suggest the target population has greater access to, and familiarity with, cell phones and text messaging compared to the Internet and web-based searching. Participants were significantly more confident using a cell phone and preferred to get health information through text messaging. Participants in the controlled observational study accepted the text messaging system, with most indicating it answered their questions, was easy to use and was a favorable tool for information-seeking. The field study also demonstrated potential for automated question-answering and text messaging to help the target population access health information. Conclusions: A two-way text messaging system has great potential to promote health communication and health information distribution. Participant interest in this system was high and did not seem to be specific to prostate cancer screening, suggesting that information about other topics, such as high blood pressure screening, could be provided similarly. We believe more investigations should be focused on this area, especially on benefits for the low-income community.

  8. Technology assessment: observer study directly compares screen/film to CR mammography

    Science.gov (United States)

    Fletcher-Heath, Lynn; Richards, Anne; Ryan-Kron, Susan

    2007-03-01

    A new study supports and expands upon a previous reporting that computed radiography (CR) mammography offers as good, or better, image quality than state-of-the-art screen/film mammography. The suitability of CR mammography is explored through qualitative and quantitative study components: feature comparison and cancer detection rates of each modality. Images were collected from 150 normal and 50 biopsy-confirmed subjects representing a range of breast and pathology types. Comparison views were collected without releasing compression, using automatic exposure control on Kodak MIN-R films, followed by CR. Digital images were displayed as both softcopy (S/C) and hardcopy (H/C) for the feature comparison, and S/C for the cancer detection task. The qualitative assessment used preference scores from five board-certified radiologists obtained while viewing 100 screen/film-CR pairs from the cancer subjects for S/C and H/C CR output. Fifteen general image-quality features were rated, and up to 12 additional features were rated for each pair, based on the pathology present. Results demonstrate that CR is equivalent or preferred to conventional mammography for overall image quality (89% S/C, 95% H/C), image contrast (95% S/C, 98% H/C), sharpness (86% S/C, 93% H/C), and noise (94% S/C, 91% H/C). The quantitative objective was satisfied by asking 10 board-certified radiologists to provide a BI-RADS TM score and probability of malignancy per breast for each modality of the 200 cases. At least 28 days passed between observations of the same case. Average sensitivity and specificity was 0.89 and 0.82 for CR and 0.91 and 0.82 for screen/film, respectively.

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

    Science.gov (United States)

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

    2016-02-01

    Child sexual abuse (CSA) prevention programs often include a focus on increased reporting of suspected abuse, in addition to other prevention components such as helping trainees recognize suspected abusive situations. This study aimed to determine whether the Stewards of Children prevention program is associated with increased CSA reporting. Analyses examined whether rates of CSA allegations increased over time in three counties in South Carolina (SC) targeted with program dissemination efforts and whether CSA reporting trends differed between the three targeted counties and three comparison counties that did not experience substantial program dissemination. CSA allegation data were obtained by county and year for predissemination and postdissemination periods from the SC Department of Social Services. Results indicated that, for the targeted counties but not the nontargeted counties, estimated allegation rates increased significantly over time, corresponding with the onset of significant program dissemination efforts. Results also indicated significant between-groups differences in allegation trends for targeted versus nontargeted counties. These findings suggest that the Stewards prevention intervention may be associated with increased CSA allegations. However, results require replication with randomization of counties. Moreover, whether increased reporting is associated with decreased CSA incidence remains unknown. © The Author(s) 2015.

  10. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit

    2015-01-01

    and subsequent non-participation in breast cancer screening. Methods This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50–69 years) for the first organised breast cancer screening programme -3 years later in the Central......Objective Population-based cancer screening is offered in many countries to detect early stages of cancer and reduce mortality. Screening efficiency and equality is susceptible due to a group of non-participants. We investigated associations between self-assessed health, perceived stress...... health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR = 1.44, 95% CI: 1.22–1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores...

  11. Environmental screening tools for assessment of infrastructure plans based on biodiversity preservation and global warming (PEIT, Spain)

    International Nuclear Information System (INIS)

    Garcia-Montero, Luis G.; Lopez, Elena; Monzon, Andres; Otero Pastor, Isabel

    2010-01-01

    Most Strategic Environmental Assessment (SEA) research has been concerned with SEA as a procedure, and there have been relatively few developments and tests of analytical methodologies. The first stage of the SEA is the 'screening', which is the process whereby a decision is taken on whether or not SEA is required for a particular programme or plan. The effectiveness of screening and SEA procedures will depend on how well the assessment fits into the planning from the early stages of the decision-making process. However, it is difficult to prepare the environmental screening for an infrastructure plan involving a whole country. To be useful, such methodologies must be fast and simple. We have developed two screening tools which would make it possible to estimate promptly the overall impact an infrastructure plan might have on biodiversity and global warming for a whole country, in order to generate planning alternatives, and to determine whether or not SEA is required for a particular infrastructure plan.

  12. Malnutrition-Sarcopenia Syndrome: Is This the Future of Nutrition Screening and Assessment for Older Adults?

    Directory of Open Access Journals (Sweden)

    Maurits F. J. Vandewoude

    2012-01-01

    Full Text Available Malnutrition is common across varying patient populations, particularly older adults, and sarcopenia prevalence increases with advancing age. Both malnutrition and sarcopenia are associated with substantial adverse outcomes affecting both the patient and the healthcare system, including increased morbidity, mortality, rehospitalization rates, and healthcare costs. Healthcare practitioners may assess patients for either malnutrition or sarcopenia; however, many patients clinically present with both conditions, resulting in the syndrome, Malnutrition-Sarcopenia Syndrome, which is the clinical presentation of both malnutrition and accelerated age-associated loss of lean body mass, strength, and/or functionality. Clinicians are urged to screen, assess, and treat these conditions currently so as to adequately address the full spectrum of patients’ nutritional issues. By examining aspects of both conditions, clinicians can more fully assess their patients’ clinical and nutritional status and can tailor targeted therapies to meet their needs and improve outcomes. This proposed syndrome embodies the inherent association of malnutrition and sarcopenia, highlighting their combined impact on clinical outcomes. The objective of this review paper is to characterize Malnutrition-Sarcopenia Syndrome to advance clinical practice, by providing clinicians with the necessary background information to integrate nutritional assessment along with loss of muscle mass and functionality in their everyday clinical practice.

  13. The development and standardization of Self-assessment for Hearing Screening of the Elderly

    Directory of Open Access Journals (Sweden)

    Kim G

    2016-06-01

    Full Text Available Gibbeum Kim,1 Wondo Na,1 Gungu Kim,1 Woojae Han,2 Jinsook Kim2 1Department of Speech Pathology and Audiology, Hallym University Graduate School, Chuncheon, Republic of Korea; 2Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym Universtiy, Chuncheon, Republic of Korea Purpose: The present study aimed to develop and standardize a screening tool for elderly people who wish to check for themselves their level of hearing loss. Methods: The Self-assessment for Hearing Screening of the Elderly (SHSE consisted of 20 questions based on the characteristics of presbycusis using a five-point scale: seven questions covered general issues related to sensorineural hearing loss, seven covered hearing difficulty under distracting listening conditions, two covered hearing difficulty with fast-rated speech, and four covered the working memory function during communication. To standardize SHSE, 83 elderly participants took part in the study: 25 with normal hearing, and 22, 23, and 13 with mild, moderate, and moderate-to-severe sensorineural hearing loss, respectively, according to their hearing sensitivity. All were retested 3 weeks later using the same questionnaire to confirm its reliability. In addition, validity was assessed using various hearing tests such as a sentence test with background noise, a time-compressed speech test, and a digit span test. Results: SHSE and its subcategories showed good internal consistency. SHSE and its subcategories demonstrated high test–retest reliability. A high correlation was observed between the total scores and pure-tone thresholds, which indicated gradually increased SHSE scores of 42.24%, 55.27%, 66.61%, and 78.15% for normal hearing, mild, moderate, and moderate-to-severe groups, respectively. With regard to construct validity, SHSE showed a high negative correlation with speech perception scores in noise and a moderate negative

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

    Science.gov (United States)

    Mapp, Susan C.

    2006-01-01

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

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

    Science.gov (United States)

    Gullone, Eleonora; Robertson, Nerida

    2008-01-01

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

  16. Ethical, Legal, and Social Issues in Health Technology Assessment for Prenatal/Preconceptional and Newborn Screening: A Workshop Report

    OpenAIRE

    Potter, B.K.; Avard, D.; Entwistle, V.; Kennedy, C.; Chakraborty, P.; McGuire, M.; Wilson, B.J.

    2008-01-01

    Prenatal/preconceptional and newborn screening programs have been a focus of recent policy debates that have included attention to ethical, legal, and social issues (ELSIs). In parallel, there has been an ongoing discussion about whether and how ELSIs may be addressed in health technology assessment (HTA). We conducted a knowledge synthesis study to explore both guidance and current practice regarding the consideration of ELSIs in HTA for prenatal/preconceptional and newborn screening. As the...

  17. Benchmarking methods and data sets for ligand enrichment assessment in virtual screening.

    Science.gov (United States)

    Xia, Jie; Tilahun, Ermias Lemma; Reid, Terry-Elinor; Zhang, Liangren; Wang, Xiang Simon

    2015-01-01

    Retrospective small-scale virtual screening (VS) based on benchmarking data sets has been widely used to estimate ligand enrichments of VS approaches in the prospective (i.e. real-world) efforts. However, the intrinsic differences of benchmarking sets to the real screening chemical libraries can cause biased assessment. Herein, we summarize the history of benchmarking methods as well as data sets and highlight three main types of biases found in benchmarking sets, i.e. "analogue bias", "artificial enrichment" and "false negative". In addition, we introduce our recent algorithm to build maximum-unbiased benchmarking sets applicable to both ligand-based and structure-based VS approaches, and its implementations to three important human histone deacetylases (HDACs) isoforms, i.e. HDAC1, HDAC6 and HDAC8. The leave-one-out cross-validation (LOO CV) demonstrates that the benchmarking sets built by our algorithm are maximum-unbiased as measured by property matching, ROC curves and AUCs. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Non-animal photosafety screening for complex cosmetic ingredients with photochemical and photobiochemical assessment tools.

    Science.gov (United States)

    Nishida, Hayato; Hirota, Morihiko; Seto, Yoshiki; Suzuki, Gen; Kato, Masashi; Kitagaki, Masato; Sugiyama, Mariko; Kouzuki, Hirokazu; Onoue, Satomi

    2015-08-01

    Previously, a non-animal screening approach was proposed for evaluating photosafety of cosmetic ingredients by means of in vitro photochemical and photobiochemical assays; however, complex cosmetic ingredients, such as plant extracts and polymers, could not be evaluated because their molecular weight is often poorly defined and so their molar concentration cannot be calculated. The aim of the present investigation was to establish a photosafety screen for complex cosmetic ingredients by using appropriately modified in vitro photosafety assays. Twenty plant extracts were selected as model materials on the basis of photosafety information, and their phototoxic potentials were assessed by means of ultraviolet (UV)/visible light (VIS) spectral analysis, reactive oxygen species (ROS)/micellar ROS (mROS) assays, and 3T3 neutral red uptake phototoxicity testing (3T3 NRU PT). The maximum UV/VIS absorption value was employed as a judgment factor for evaluating photoexcitability of samples, and the value of 1.0 was adopted as a tentative criterion for photosafety identification. The ROS/mROS assays were conducted at 50 μg/mL, and no false negative prediction was obtained. Furthermore, the ROS/mROS assays at 50 μg/mL had a similar predictive capacity to the ROS/mROS assays in the previous study. A systematic tiered approach for simple and rapid non-animal photosafety evaluation of complex cosmetic ingredients can be constructed using these modified in vitro photochemical assays. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Improving work-up of the abnormal mammogram through organized assessment: results from the ontario breast screening program.

    Science.gov (United States)

    Quan, May Lynn; Shumak, Rene S; Majpruz, Vicky; Holloway, Claire M D; O'Malley, Frances P; Chiarelli, Anna M

    2012-03-01

    Women with an abnormal screening mammogram should ideally undergo an organized assessment to attain a timely diagnosis. This study evaluated outcomes of women undergoing work-up after abnormal mammogram through a formal breast assessment affiliate (BAA) program with explicit care pathways compared with usual care (UC) using developed quality indicators for screening mammography programs. Between January 1 and December 31, 2007, a total of 320,635 women underwent a screening mammogram through the Ontario Breast Screening Program (OBSP), of whom 25,543 had an abnormal result requiring further assessment. Established indicators assessing timeliness, appropriateness of follow-up, and biopsy rates were compared between women who were assessed through either a BAA or UC using χ(2) analysis. Work-up of the abnormal mammogram for patients screened through a BAA resulted in a greater proportion of women attaining a definitive diagnosis within the recommended time interval when a histologic diagnosis was required. In addition, use of other quality measures including specimen radiography for both core biopsies and surgical specimens and preoperative core needle biopsy was greater in BAA facilities. These findings support future efforts to increase the number of BAAs within the OBSP, because the pathways and reporting methods associated with them result in improvements in our ability to provide timely and appropriate care for women requiring work-up of an abnormal mammogram.

  20. Adderall abuse in Texas, 1998-2004.

    Science.gov (United States)

    Forrester, Mathias B

    2007-04-01

    Adderall is used in the treatment of attention deficit hyperactivity disorder (ADHD) in children and is subject to abuse. This study describes the patterns of Adderall abuse calls received by several poison control centers in Texas during 1998-2004. Drug abuse calls were assessed by call year and geographic location. Drug abuse calls were then compared to all other human exposure (nonabuse) calls with respect to various factors. Of all Adderall exposure calls, 12% involved abuse. The number of drug abuse calls received per year increased during the first part of 7-yr period but then declined. Male patients accounted for almost 60% of both drug abuse and nonabuse calls. Adolescent patients comprised 69% of drug abuse calls and children less than 13 yr old comprised 66% of nonabuse calls. Although the majority of both types of human exposures occurred at the patient's own residence, drug abuse calls were more likely than nonabuse calls to involve exposures at another residence (6% vs. 3%), school (22% vs. 5%) and public areas (2% vs. 0.4%). Drug abuse calls were less likely than nonabuse calls to be managed outside of a health care facility (18% vs. 51%) and to be classified as no adverse effect (23% vs. 48%). Adderall abusers are more likely to be adolescents. Adderall abuse as compared to other exposures is more likely to occur outside of the person's home and involve more serious medical outcomes.

  1. Assessment of abuse-related injuries: a comparative study of forensic physicians, emergency room physicians, emergency room nurses and medical students.

    Science.gov (United States)

    Reijnders, Udo J L; Giannakopoulos, Georgios F; de Bruin, Kim H

    2008-01-01

    A comparative study was made investigating whether emergency room physicians, emergency room nurses, forensic physicians, and interns are competent in describing, recognising and determining the possible cause of injuries. The injury assessment scores varied from good--adequate--fail and remained blank in various participant groups. Forensic physicians scored significantly better than emergency room staff and interns in the assessment of abuse-related injuries. There were almost no differences noted between emergency room physicians and emergency room nurses. For the functional group with more or less than 4 to 6 years of experience, no significant differences were noted for scoring good in all 5 cases. The fact that forensic physicians scored better than the emergency room staff is probably explained by the fact that almost all practicing forensic physicians have been officially qualified. Training in this field for all professionals involved in such assessment should be mandatory.

  2. Drug abuse among the students

    Directory of Open Access Journals (Sweden)

    Muhammad Zaman

    2015-01-01

    Full Text Available ABSTRACT:Drug abuse is the willful misuse of either licit or illicit drugs for the purpose of recreation, perceived necessity or convenience. Drug abuse is a more intense and often willful misuse of drugs often to the point of addiction. In the eastern world the incidence shows a decline or a static pattern but the number of drug addicts is still enormous.. The major drug of abuse are heroin and marijuana but designer drugs are shown to be on the increase. The aim of the study is to determine the ratio of the drug abuse in student. For this purpose we selected different institutions including “the university of Lahore”, “Forman Christian college”(private sector and Punjab university(Govt sector and conducted survey in 500 student. High proportion of students was found abusing drugs. From this study, we came across multiple factors which are the main cause of drug abuse in medical student including depression, anxiety, schizophrenia, as well as personality disorder like antisocial personality disorder. The most commonly abused drugs include stimulants, opioids, and benzodiazepines, antihistamines. Although survey have indicated high rate of illicit and prescription drugs misuse among college students, few have assessed the negative consequences, personel concerns, or interest in intervention for drugs use. Drug abuse although regarded as a personality disorder, may also be seen as worldwide epidemic with evolutionary genetic, physiology and environmental influences Controlling and affecting human behavior. Globally, the use has reached all time high. The study showed males are more drug abusers as compared to females. The drug abuse ratio in students of private sector is more as compared to Govt sector.

  3. The development and standardization of Self-assessment for Hearing Screening of the Elderly.

    Science.gov (United States)

    Kim, Gibbeum; Na, Wondo; Kim, Gungu; Han, Woojae; Kim, Jinsook

    2016-01-01

    The present study aimed to develop and standardize a screening tool for elderly people who wish to check for themselves their level of hearing loss. The Self-assessment for Hearing Screening of the Elderly (SHSE) consisted of 20 questions based on the characteristics of presbycusis using a five-point scale: seven questions covered general issues related to sensorineural hearing loss, seven covered hearing difficulty under distracting listening conditions, two covered hearing difficulty with fast-rated speech, and four covered the working memory function during communication. To standardize SHSE, 83 elderly participants took part in the study: 25 with normal hearing, and 22, 23, and 13 with mild, moderate, and moderate-to-severe sensorineural hearing loss, respectively, according to their hearing sensitivity. All were retested 3 weeks later using the same questionnaire to confirm its reliability. In addition, validity was assessed using various hearing tests such as a sentence test with background noise, a time-compressed speech test, and a digit span test. SHSE and its subcategories showed good internal consistency. SHSE and its subcategories demonstrated high test-retest reliability. A high correlation was observed between the total scores and pure-tone thresholds, which indicated gradually increased SHSE scores of 42.24%, 55.27%, 66.61%, and 78.15% for normal hearing, mild, moderate, and moderate-to-severe groups, respectively. With regard to construct validity, SHSE showed a high negative correlation with speech perception scores in noise and a moderate negative correlation with scores of time-compressed speech perception. However, there was no statistical correlation between digit span results and either the SHSE total or its subcategories. A confirmatory factor analysis supported three factors in SHSE. We found that the developed SHSE had valuable internal consistency, test-retest reliability, and convergent and construct validity. These results suggest that

  4. Assessment of inattention in the context of delirium screening: one size does not fit all!

    Science.gov (United States)

    Voyer, Philippe; Champoux, Nathalie; Desrosiers, Johanne; Landreville, Philippe; Monette, Johanne; Savoie, Maryse; Carmichael, Pierre-Hugues; Richard, Sylvie; Bédard, Annick

    2016-08-01

    Despite its high prevalence and deleterious consequences, delirium often goes undetected in older hospitalized patients and long-term care (LTC) residents. Inattention is a core symptom of this syndrome. The aim of this study was to explore the usefulness of ten simple and objective attention tests that would enable efficient delirium screening among this population. This was a secondary analysis (n = 191) of a validation study conducted in one acute care hospital (ACH) and one LTC facility among older adults with, or without, cognitive impairment. The attention test tasks (n = 10) were drawn from the Concentration subscale the Hierarchic Dementia Scale (HDS). Delirium was defined as meeting the criteria for DSM-5 delirium. The Confusion Assessment Method (CAM) was used to determine the presence of delirium symptoms. The Months of the Year Backward (MOTYB) test, which 57% of participants completed successfully, showed the best balance between sensitivity and specificity (82.6%; 95% CI [61.2-95.0], and 62.5%; 95% CI [54.7-69.8] respectively) for the entire group. Subgroup analyses revealed that no test had both sensitivity and specificity over 50% in participants with cognitive impairment indicated in their medical chart. Our results revealed that these tests varied greatly in performance and none can be earmarked to become a single-item screening tool for delirium among older patients and residents with, or without, cognitive impairment. The presence of premorbid cognitive impairment may necessitate more extensive assessments of delirium, especially when a change in general status or mental state is observed.

  5. Assessing Psychological Fitness in the Military - Development of an Effective and Economic Screening Instrument.

    Science.gov (United States)

    Wesemann, Ulrich; Willmund, Gerd D; Ungerer, Jörn; Kreim, Günter; Zimmermann, Peter L; Bühler, Antje; Stein, Michael; Kaiser, Jakob; Kowalski, Jens T

    2018-03-27

    There are a high number of soldiers with deployment-related and non-deployment-related mental health problems in the German Armed Forces (Bundeswehr): This has led to an increase in mental disorders and a decrease in quality of life. To tackle these problems and to strengthen resources among the Bundeswehr personnel, this study aims at developing a screening instrument for assessing the psychological fitness of soldiers on the basis of questionnaire scales. In this approach, psychological fitness describes a soldier's ability to integrate and enhance his/her mental and emotional capabilities using resources and trainable skills. Bundeswehr combat soldiers (N = 361) answered questionnaires about resilience (RS-11), sense of coherence (SOC-L9), quality of life (WHOQOL-BREF), mental disorders (PHQ-D) and post-traumatic growth (PTG). Additionally, they were interviewed by trained troop psychologists both before and after their deployment in Afghanistan from January to June 2014. The screening model is based on self-report data; the psychological fitness in the standardized interview serves as a validation standard. A linear logistic regression model was performed that includes the social relationship and the psychological scale from WHOQOL-BREF and the somatoform and the stress scale from PHQ. This model allows specialists a first assessment between participants who are psychologically fit before and after deployment and those who are less so. The chosen cutoff for sensitivity is between 70% and 79% and for specificity between 70% and 85%. This screening approach is still not applicable to large populations like that of the Bundeswehr, which currently has about 170,000 soldiers but it is limited to deployed combat troops. Classifying psychological fitness allows specialists to differentiate between people in need of special training or additional diagnostic measures and those in need of sustaining their fitness regularly at the earliest possible stage. A follow

  6. Quality Assessment of Colonoscopy Reporting: Results from a Statewide Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    Jun Li

    2010-01-01

    Full Text Available This paper aimed to assess quality of colonoscopy reports and determine if physicians in practice were already documenting recommended quality indicators, prior to the publication of a standardized Colonoscopy Reporting and Data System (CO-RADS in 2007. We examined 110 colonoscopy reports from 2005-2006 through Maryland Colorectal Cancer Screening Program. We evaluated 25 key data elements recommended by CO-RADS, including procedure indications, risk/comorbidity assessments, procedure technical descriptions, colonoscopy findings, specimen retrieval/pathology. Among 110 reports, 73% documented the bowel preparation quality and 82% documented specific cecal landmarks. For the 177 individual polyps identified, information on size and morphology was documented for 87% and 53%, respectively. Colonoscopy reporting varied considerately in the pre-CO-RADS period. The absence of key data elements may impact the ability to make recommendations for recall intervals. This paper provides baseline data to assess if CO-RADS has an impact on reporting and how best to improve the quality of reporting.

  7. A human reliability assessment screening method for the NRU upgrade project

    International Nuclear Information System (INIS)

    Bremner, F.M.; Alsop, C.J.

    1997-01-01

    The National Research Universal (NRU) reactor is a 130MW, low pressure, heavy water cooled and moderated research reactor. The reactor is used for research, both in support of Canada's CANDU development program, and for a wide variety of other research applications. In addition, NRU plays an important part in the production of medical isotopes, e.g., generating 80% of worldwide supplies of Molybdenum-99. NRU is owned and operated by Atomic Energy of Canada Ltd. (AECL), and is currently undergoing upgrading as part of AECL's continuing commitment to operate their facilities in a safe manner. As part of these upgrades both deterministic and probabilistic safety assessments are being carried out. It was recognized that the assignment of Human Error Probabilities (HEPs) is an important part of the Probabilistic Safety Assessment (PSA) studies, particularly for a facility whose design predates modern ergonomic practices, and which will undergo a series of backfitted modifications whilst continuing to operate. A simple Human Reliability Assessment (HRA) screening method, looking at both pre- and post-accident errors, was used in the initial safety studies. However, following review of this method within AECL and externally by the regulator, it was judged that benefits could be gained for future error reduction by including additional features, as later described in this document. The HRA development project consisted of several stages; needs analysis, literature review, development of method (including testing and evaluation), and implementation. This paper discusses each of these stages in further detail. (author)

  8. ACR Appropriateness Criteria®Suspected Physical Abuse-Child.

    Science.gov (United States)

    Wootton-Gorges, Sandra L; Soares, Bruno P; Alazraki, Adina L; Anupindi, Sudha A; Blount, Jeffrey P; Booth, Timothy N; Dempsey, Molly E; Falcone, Richard A; Hayes, Laura L; Kulkarni, Abhaya V; Partap, Sonia; Rigsby, Cynthia K; Ryan, Maura E; Safdar, Nabile M; Trout, Andrew T; Widmann, Roger F; Karmazyn, Boaz K; Palasis, Susan

    2017-05-01

    The youngest children, particularly in the first year of life, are the most vulnerable to physical abuse. Skeletal survey is the universal screening examination in children 24 months of age and younger. Fractures occur in over half of abused children. Rib fractures may be the only abnormality in about 30%. A repeat limited skeletal survey after 2 weeks can detect additional fractures and can provide fracture dating information. The type and extent of additional imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and social considerations. Unenhanced CT of the head is the initial study for suspected intracranial injury. Clinically occult abusive head trauma can occur, especially in young infants. Therefore, head CT should be performed in selected neurologically asymptomatic physical abuse patients. Contrast-enhanced CT of the abdomen/pelvis is utilized for suspected intra-abdominal or pelvic injury. Particular attention should be paid to discrepancies between the patterns of injury and the reported clinical history. Making the diagnosis of child abuse also requires differentiation from anatomical and developmental variants and possible underlying metabolic and genetic conditions. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert

  9. Drugs of abuse and Parkinson's disease.

    Science.gov (United States)

    Mursaleen, Leah R; Stamford, Jonathan A

    2016-01-04

    The term "drug of abuse" is highly contextual. What constitutes a drug of abuse for one population of patients does not for another. It is therefore important to examine the needs of the patient population to properly assess the status of drugs of abuse. The focus of this article is on the bidirectional relationship between patients and drug abuse. In this paper we will introduce the dopaminergic systems of the brain in Parkinson's and the influence of antiparkinsonian drugs upon them before discussing this synergy of condition and medication as fertile ground for drug abuse. We will then examine the relationship between drugs of abuse and Parkinson's, both beneficial and deleterious. In summary we will draw the different strands together and speculate on the future merit of current drugs of abuse as treatments for Parkinson's disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Parent education: an evaluation of STEP on abusive parents' perceptions and abuse potential.

    Science.gov (United States)

    Fennell, D C; Fishel, A H

    1998-01-01

    To examine the effects of a structured, time-limited parent training group on abusive or potentially abusive parents. A pretest-posttest control group design was used with consenting parents (N = 18) to examine the effects of Systematic Training for Effective Parenting (STEP) on abusive parents' perceptions of their children's behaviors and on the parents' potential to physically abuse. The Adlerian Parental Assessment of Child Behavior Scale and the Child Abuse Potential Inventory were used to measure treatment effects. After participating in STEP, abusive parents had significantly more positive perceptions of their children and were significantly less potentially abusive. Using volunteers, the project cost an average of $100 for each parent. The research lends empirical support to individual psychology and family systems theory. Future research is indicated using larger samples to examine lay vs. professional leadership of the groups, as well as comparisons of different parenting programs with abusive parents.

  11. The RT-18: a new screening tool to assess young adult risk-taking behavior

    Directory of Open Access Journals (Sweden)

    de Haan L

    2011-08-01

    Full Text Available Lydia de Haan1, Esther Kuipers1, Yvanca Kuerten1, Margriet van Laar2, Berend Olivier1, Joris Cornelis Verster11Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University; 2Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The NetherlandsAbstract: Risk-taking behavior is a major determinant of health and plays a central role in various diseases. Therefore, a brief questionnaire was developed to assess risk taking among young adults with known different levels of risk-taking behavior (social drinkers and recreational drug users. In Study 1, N = 522 university students completed the RT-18 risk taking questionnaire. N = 100 students were retested after 2 to 4 weeks and performed the Cambridge Gambling Task (CGT. Mean RT-18 score was 7.69 and Cronbach's alpha was 0.886. The test-retest reliability was r = 0.94. Significant correlation was found between the RT-18 score and CGT scores of risk taking, bet proportion, and risk adjustment. In Study 2, N = 7834 young adult social drinkers, and recreational drug users, mean RT-18 score was 9.34 and Cronbach's alpha was 0.80. Factor analysis showed that the RT-18 comprises two factors assessing level of risk-taking behavior and risk assessment. Men scored significantly higher than women on the RT-18. Recreational drug users had significantly higher scores when compared to social drinkers. In Study 3 of N = 1000 students, construct validity was confirmed by showing that the RT-18 outcome correlates significantly with scores on the Stimulating-Instrumental Risk Inventory. In conclusion, the RT-18 is a valid and reliable screening tool to differentiate levels of risk-taking behavior. This short scale is quick and practical to administer, imposing minimal demands on participants. The RT-18 is able to differentiate risk taking and risk assessment which can help target appropriate intervention strategies.Keywords: risk taking, impulsivity, sensation

  12. Mental Health Help Seeking Among Traumatized Individuals: A Systematic Review of Studies Assessing the Role of Substance Use and Abuse

    Science.gov (United States)

    van den Berk-Clark, Carissa; Patterson Silver Wolf, David

    2015-01-01

    Objective Prior research has suggested that competing neurobehavioral decision-making processes might affect health outcomes among traumatized populations. Regulatory imbalances to impulsive and executive decision systems are affected by high levels of stress, including stress resulting from traumatic events. Such regulatory imbalances have been associated with addictive behaviors. However, it is not well known whether addictive behavior increases or decreases the likelihood of utilization of behavioral health services among traumatized populations. The aim of this study is to systematically review mental health utilization studies targeting traumatized populations to determine the direction of association between substance use and behavioral health utilization. Method Databases of literature were searched in a systematic manner, and 37 relevant studies were recovered and analyzed. Findings Out of the 37 relevant studies that included addictive behaviors as a predictor of utilization, 16 showed a positive significant relationship and 6 showed a negative significant relationship. Studies showing a negative significant relationship used younger samples with more recent trauma exposure. Conclusions Studies have shown that for the most part, substance abuse increases the likelihood of utilization, except among younger populations with more recent trauma. Longitudinal studies that access how utilization evolves over time among traumatized populations and interacts with posttraumatic stress disorder (PTSD) and substance abuse severity are necessary to better understand how decision-making processes of traumatized individuals may increase the likelihood of chronic PTSD. PMID:26232295

  13. Development of an in vitro cytochrome P450 cocktail inhibition assay for assessing the inhibition risk of drugs of abuse.

    Science.gov (United States)

    Dinger, Julia; Meyer, Markus R; Maurer, Hans H

    2014-10-01

    Drugs of abuse are not tested for cytochrome P450 (CYP) inhibition potential before distribution. Therefore, a cocktail assay should be developed for testing the inhibition potential for all relevant CYPs. The following CYP test substrates and selective inhibitors were incubated in pooled human liver microsomes: phenacetin (alpha-naphthoflavone for CYP1A2), coumarin (tranylcypromine, CYP2A6), bupropion (sertraline, CYP2B6), amodiaquine (trimethoprim, CYP2C8), diclofenac (sulfaphenazole, CYP2C9), omeprazole (fluconazole, CYP2C19), dextromethorphan (quinidine, CYP2D6), chlorzoxazone (clomethiazole, CYP2E1), testosterone (verapamil, CYP3A). Samples were analyzed after protein precipitation using a Thermo Fisher Q-Exactive LC-high-resolution-MS/MS. The IC50 values were calculated by plotting the concentration of the formed metabolite, relative to the control sample, over the logarithm of the inhibitor concentration. They were determined either for single substrate or the cocktail incubation. Unfortunately, the cocktail assay had to be split because of interferences during incubation caused by substrates or metabolites, but the mixture of both incubates could be analyzed in one analytical run. The IC50 values determined in the single substrate or both cocktail incubations were comparable among themselves and with published data. In conclusion, the new inhibition cocktail assay was reproducible and applicable for testing the inhibition potential of drugs of abuse as exemplified for 2,5-dimethoxy-4-iodo-amfetamine (DOI). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Clinicians' assessments of bipolar disorder and substance abuse as predictors of suicidal behavior in acutely hospitalized psychiatric inpatients.

    Science.gov (United States)

    Comtois, Katherine Anne; Russo, Joan E; Roy-Byrne, Peter; Ries, Richard K

    2004-11-15

    Suicide is a major risk for those with bipolar disorder, a risk amplified by comorbid substance abuse in some, but not all, previous studies. To further explore the relationships of substance abuse, suicide, and bipolarity as they present in clinical practice, we analyzed standardized clinical data from a large acute psychiatric inpatient service. Standardized clinical evaluations of 7819 patients with diagnoses of bipolar depression (n=990), bipolar mania (n=948), unipolar depressive episode (n=3626), or schizophrenia-schizoaffective disorders (n=2255) were analyzed to evaluate the relationship between current substance-use problems, substance-induced symptoms, and a current suicide crisis, as well as lifetime suicide attempts, with logistic regressions adjusting for age, gender, and ethnicity. Across the combined groups, current substance-use problems were significantly associated with a lifetime suicide attempt (odds ratios [ORs] 1.6-2.5) and to a lesser degree to the admission suicide crisis (ORs 1-2.2). Among bipolar (depressed/manic) patients, but not other diagnostic groups, those with both current substance-use problems and substance-induced symptoms had even higher rates of a recent suicide crisis (ORs 1.5-3.1) and of a lifetime attempt (ORs 2.5-3.4). In bipolar patients, substance use disorder doubled and substance use disorder plus substance-induced symptoms tripled the suicidal risk. Implications for future research are discussed.

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

    Science.gov (United States)

    Khalily, Muhammad Tahir; Hallahan, Brian

    2011-01-01

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

  16. On the assessment of children in suspected child sexual abuse in light of Daubert and Frye: limitations of profiles and interviews as scientifically grounded evidence.

    Science.gov (United States)

    Bigelow, B J

    2000-05-01

    Practice with children and families entails the higher probability of encountering forensic issues of child sexual abuse (CSA) assessments for which relatively few psychologists, allied mental health and legal practitioners are sufficiently well equipped. The current paper reviews some of the key psycholegal issues bearing on the assessment of suspected CSA in the contexts of: (a) recent psycholegal precedence and common law rules of reliability and admissibility of CSA profile evidence; (b) the empirical problems with CSA syndromes; and (c) the problems with children's interviews as evidence, and suggestions for valid interviewing guidelines supporting free recall. These psycholegal issues are presented in terms of the Frye standard for expert testimony and the Federal Rules of Evidence, with recent American and Canadian case illustrations, such as Daubert v. Merrell Dow Pharmaceuticals, Hadden v. State of Florida (1997), Bighead v. The United States of America (1997), Diocese of Winona v. Interstate Fire & Cas. Co. (1994), and R. v. Simpson (1996).

  17. The Music Attentiveness Screening Assessment, Revised (MASA-R): A Study of Technical Adequacy.

    Science.gov (United States)

    Waldon, Eric G; Lesser, Alexander; Weeden, Lydia; Messick, Emily

    2016-01-01

    Evidence suggests that attention is an important consideration when designing procedural support interventions for children undergoing distressing medical procedures. As such, the extent to which children can attend to musical stimuli used during music-based procedural support interventions would seem important. The Music Attentiveness Screening Assessment (MASA) was designed to assess a child's ability to attend to musical stimuli, but further revisions were deemed necessary to improve administration, test-retest reliability, and interobserver agreement for the measure's items. This study investigated the technical adequacy of the Music Attentiveness Screening Assessment, Revised (MASA-R), with a non-clinical sample of children aged 4 to 9 years by examining (a) Construct validity using comparator instruments measuring auditory attention; (b) Test-retest reliability following a two-week delay; and (c) Interobserver agreement when administered by two independent examiners. This non-clinical sample included 69 children who were administered both items from MASA-R and two comparator instruments: the Auditory Attention subtest from the NEPSY-II (NII-AA) for children aged 5 to 9 years (n = 47); and the Auditory Attention subtest from the Woodcock-Johnson Tests of Cognitive Abilities, 3rd ed. (WJIII-AA), for children aged 4 years (n = 22). A significant proportion of score variance was shared by both MASA-R items and the comparator measures: R (2) = .16, F(2, 66) = 6.30, p = .003. MASA-R score estimates with regard to test-retest reliability (Item I, intra-class correlation [ICC] = .88; Item II, ICC = .91) and interobserver agreement (Item I, ICC = .99; Item II, ICC = .98) also fell into acceptable ranges. Estimates of MASA-R score construct validity, test-retest reliability, and interobserver agreement appear improved over its predecessor, MASA. While findings are promising, additional investigation of its use with a clinical sample is needed before it can be

  18. Screening level dose assessment of aquatic biota downstream of the Marcoule nuclear complex in southern France.

    Science.gov (United States)

    St-Pierre, S; Chambers, D B; Lowe, L M; Bontoux, J G

    1999-09-01

    Aquatic biota in the Rhone River downstream of the Marcoule nuclear complex in France are exposed to natural sources of radiation and to radioactivity released from the Marcoule complex. A simple conservative screening level model was used to estimate the range of concentrations in aquatic media (water, sediments, and aquatic organisms) of both artificial and natural radionuclides and the consequent absorbed (whole body) dose rates for aquatic organisms. Five categories of aquatic organisms were studied, namely, submerged aquatic plants (phanerogam), non-bottom-feeding fish, bottom-feeding fish, mollusca, and fish-eating birds. The analysis was based on the radionuclide concentrations reported in four consecutive annual radioecological monitoring reports published by French agencies with nuclear regulatory responsibilities. The results of this assessment were used to determine, qualitatively, the magnitude of any potential health impacts on each of the five categories of aquatic organisms studied. The range of dose rate estimates ranged over three orders of magnitude, with maximum dose rates estimated to be in the order of 1 to 10 microGy h(-1). These maximum dose rates are a factor 40 or more below the international guideline intended to ensure the protection of aquatic populations (about 400 microGy h(-1)), and a factor ten or more below the level which may trigger the need for a more detailed evaluation of potential ecological consequences to the exposed populations (about 100 microGy h(-1)). As a result, chronic levels of radioactivity, artificial and natural, measured in aquatic media downstream of Marcoule are unlikely to result in adverse health impacts on the categories and species of aquatic organisms studied. Thus, based on the screening level analysis discussed in this paper, a more detailed evaluation of the dose rates does not appear to be warranted.

  19. Navy Radon Assessment and Mitigation Program: Work/quality assurance project plan screening phase

    International Nuclear Information System (INIS)

    1991-03-01

    In 1987, the military services of the United States were tasked to take appropriate action to establish an indoor radon assessment and mitigation program. As a result, the Naval Facilities Engineering Command (NAVFACENGCOM) was assigned the responsibility of identifying potential hazards to personnel from exposure to naturally occurring radon gas and prioritizing corrective actions and to coordinating these actions with the major claimants. NAVRAMP is based upon current US Environmental Protection Agency (EPA) guidelines. The program has been separated into four phases. The screening phase will concentrate on evaluating radon levels, based on statistical samples, in those buildings that have been determined to be at most at risk to elevated levels of radon, such as base housing, schools, day-care centers, hospitals, brigs, Base Officer Quarters, and Base Enlisted Quarters. During the assessment phase, every building that contains personnel for over 4 h/day will be evaluated. Mitigation work will be accomplished by Navy or Navy-contracted personnel. HAZWRAP services during the mitigation phase will consist of determining the extent of reduction in radon levels after the mitigation effort. 7 refs., 11 figs

  20. Landscape Diversity as a Screening Tool to Assess Agroecosystems Sustainability; Preliminary Study in Central Italy

    Directory of Open Access Journals (Sweden)

    Francesco Visicchio

    2007-06-01

    Full Text Available Modernization of agricultural activities has strongly modified agricultural landscapes. Intensive agriculture, with the increased use of inorganic fertiliser and density of livestock, affects water quality discharging nutrients such as nitrogen and phosphorus in water bodies. Nutrients in rivers, subsequently, are excellent indicators to assess sustainability/ land-use intensity in agroecosystems. Landscape, however, is a dynamic system and is the product of interaction amongst the natural environment and human activities, including farming which is a main driving force. At present not much has been investigated on the predictive role of landscape on land-use intensity. Aim of this study is to determine if, in Italian agroecosystem, landscape complexity can be related to land-use intensity. Indexes of landscape complexity (i.e. edge density, number of patches, Shannon’s diversity index, Interspersion-Juxtaposition index derived by processing Corine Land Cover data (level IV, 1:25.000 of Lazio Region, were related with landuse intensity (values of compounds of nitrogen and phosphorus and other parameters found in rivers monitored in accordance to European Directives on Waste Water. Results demonstrate that some landscape indexes were related to some environment parameters. Consequently landscape complexity, with further investigation, could be an efficient screening tool, at large scale, to assess water quality and ultimately agroecosystems sustainability in the absence of monitoring stations.

  1. Cannabis use and abuse correlates in a homogenous South African schizophrenia population

    Directory of Open Access Journals (Sweden)

    Liezl Koen

    2009-03-01

    Full Text Available Objective. Worldwide, cannabis is the most widely used illicit substance, and it has been identified as a correlate in schizophrenia samples for poorer symptomatic and functional outcomes in many international studies. The object of this retrospective study was to identify the prevalence of cannabis use/abuse and the demographic and clinical correlates therefor in a large homogeneous South African schizophrenia population. Methods. As part of a large genetic study, 547 subjects with a diagnosis of schizophrenia were recruited. Demographic and clinical data were collected and each participant underwent a urinary drug screen. Use/abuse of cannabis was defined as using cannabis more than 21 times in a single year. Subjects with and without cannabis use/abuse were statistically compared. Results. Significant differences between the two groups were found in terms of gender, marital status, age of onset of schizophrenia, number of hospitalisations and relapses, alcohol abuse, smoking, the Scale for the Assessment of Positive Symptoms (SAPS scores for hallucinations, delusions, bizarre behaviour and formal thought disorder, and the Scale for the Assessment of Negative Symptoms (SANS score for avolition/apathy. Conclusion. The prevalence of cannabis use/abuse in this study was high, and our findings were comparable with those of previous international studies. Abuse/use started mainly in the teenage years, was more prevalent among males than females, and was associated with negative overall outcomes. There was also a positive correlation between cannabis and nicotine and alcohol use/abuse. Determination of cannabis abuse based solely on history was found to be reliable, and urine cannabis testing appeared to be of limited value in routine management of this group of schizophrenic patients.

  2. Electronic health records: essential tools in integrating substance abuse treatment with primary care

    Science.gov (United States)

    Tai, Betty; Wu, Li-Tzy; Clark, H Westley

    2012-01-01

    While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted. PMID:24474861

  3. Out with the old, in with the new: Assessing change in screen time when measurement changes over time

    Directory of Open Access Journals (Sweden)

    Katie E. Gunnell

    2018-03-01

    Full Text Available We examined if screen time can be assessed over time when the measurement protocol has changed to reflect advances in technology. Beginning in 2011, 929 youth (9–12 years at time one living in in New Brunswick (Canada self-reported the amount of time spent watching television (cycles 1–13, using computers (cycles 1–13, and playing video games (cycles 3–13. Using longitudinal invariance to test a shifting indicators model of screen time, we found that the relationships between the latent variable reflecting overall screen time and the indicators used to assess screen time were invariant across cycles (weak invariance. We also found that 31 out of 37 indicator intercepts were invariant, meaning that most indicators were answered similarly (i.e., on the same metric across cycles (partial strong invariance, and that 28 out of 37 indicator residuals were invariant indicating that similar sources of error were present over time (partial strict invariance. Overall, across all survey cycles, 76% of indicators were fully invariant. Whereas issues were noted when new examples of screen-based technology (e.g., iPads were added, having established partial invariance, we suggest it is still possible to assess change in screen time despite having changing indicators over time. Although it is not possible to draw definitive conclusions concerning other self-report measures of screen time, our findings may assist other researchers considering modifying self-report measures in longitudinal studies to reflect technological advancements and increase the precision of their results.

  4. Out with the old, in with the new: Assessing change in screen time when measurement changes over time.

    Science.gov (United States)

    Gunnell, Katie E; Brunet, Jennifer; Bélanger, Mathieu

    2018-03-01

    We examined if screen time can be assessed over time when the measurement protocol has changed to reflect advances in technology. Beginning in 2011, 929 youth (9-12 years at time one) living in in New Brunswick (Canada) self-reported the amount of time spent watching television (cycles 1-13), using computers (cycles 1-13), and playing video games (cycles 3-13). Using longitudinal invariance to test a shifting indicators model of screen time, we found that the relationships between the latent variable reflecting overall screen time and the indicators used to assess screen time were invariant across cycles (weak invariance). We also found that 31 out of 37 indicator intercepts were invariant, meaning that most indicators were answered similarly (i.e., on the same metric) across cycles (partial strong invariance), and that 28 out of 37 indicator residuals were invariant indicating that similar sources of error were present over time (partial strict invariance). Overall, across all survey cycles, 76% of indicators were fully invariant. Whereas issues were noted when new examples of screen-based technology (e.g., iPads) were added, having established partial invariance, we suggest it is still possible to assess change in screen time despite having changing indicators over time. Although it is not possible to draw definitive conclusions concerning other self-report measures of screen time, our findings may assist other researchers considering modifying self-report measures in longitudinal studies to reflect technological advancements and increase the precision of their results.

  5. NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

    Science.gov (United States)

    Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

    2015-06-01

    The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

  6. Prevent Child Abuse America

    Science.gov (United States)

    ... call the police . Crisis and support contacts For Child Abuse Reporting Numbers in your State please visit: Child ... suspected child abuse and neglect. Parent Resources Prevent Child Abuse America (800) CHILDREN A resource for tips, referrals, ...

  7. Predictive validity of the Washington State Juvenile Court Pre-Screen Assessment in the Netherlands: the development of a new scoring system

    NARCIS (Netherlands)

    van der Put, C.E.; Stams, G.J.J.M.; Deković, M.; van der Laan, P.H.

    2014-01-01

    This study examined the predictive validity of the Washington State Juvenile Pre-Screen Assessment (WSJCA pre-screen) in the Netherlands. Previous research conducted in the United States showed the predictive validity of the WSJCA pre-screen to be modest, as is the case with the predictive validity

  8. Predictive Validity of the Washington State Juvenile Court Pre-Screen Assessment in the Netherlands : The Development of a New Scoring System

    NARCIS (Netherlands)

    van der Put, Claudia E.; Stams, Geert Jan J. M.; Dekovic, Maja; van der Laan, Peter H.

    This study examined the predictive validity of the Washington State Juvenile Pre-Screen Assessment (WSJCA pre-screen) in the Netherlands. Previous research conducted in the United States showed the predictive validity of the WSJCA pre-screen to be modest, as is the case with the predictive validity

  9. Correlates of partner abuse in male same-sex relationships.

    Science.gov (United States)

    Bartholomew, Kim; Regan, Katherine V; Oram, Doug; White, Monica A

    2008-01-01

    We investigated correlates of partner abuse in male same-sex relationships in a randomly selected community sample (N = 186). We included factors associated with abuse in heterosexual relationships, as well as factors of relevance to gay relationships. We assessed perpetration and receipt of partner abuse to examine whether variables were associated independently with abuse perpetration and/or receipt. Correlates of same-sex partner abuse were largely parallel to established correlates of heterosexual abuse. Income, education, and attachment orientation were associated with bidirectional partner abuse, and family violence and substance use were uniquely associated with victimization. Further, there were factors unique to same-sex partner abuse; HIV status and public outness were associated with bidirectional partner abuse, and internalized homophobia was uniquely associated with abuse perpetration.

  10. Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims.

    Science.gov (United States)

    Hébert, Martine; Langevin, Rachel; Oussaïd, Essaïd

    2018-01-01

    Child sexual abuse is associated with a plethora of devastating repercussions. A significant number of sexually abused children are likely to experience other forms of maltreatment that can seriously affect their emotion regulation abilities and impede on their development. The aim of the study was to test emotion regulation and dissociation as mediators in the association between cumulative childhood trauma and internalized and externalized behavior problems in child victims of sexual abuse. Participants were 309 sexually abused children (203 girls and 106 boys; Mean age = 9.07) and their non-offending parent. Medical and clinical files were coded for cumulative childhood trauma. At initial evaluation (T1), parents completed measures assessing children's emotion regulation abilities and dissociation. At Time 2 (T2), parents completed a measure assessing children's behavior problems. Mediation analyses were conducted with emotion regulation and dissociation as sequential mediators using Mplus software. Findings revealed that cumulative childhood trauma affects both internalized and externalized behavior problems through three mediation paths: emotion regulation alone, dissociation alone, and through a path combining emotion regulation and dissociation. Both emotion regulation and dissociation were assessed at T1 and thus the temporal sequencing of mediators remains to be ascertained through a longitudinal design. All measures were completed by the parents. Clinicians should routinely screen for other childhood trauma in vulnerable clienteles. In order to tackle behavior problems, clinical interventions for sexually abused youth need to address emotion regulation competencies and dissociation. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Electrostatic Dust Cloth: A Passive Screening Method to Assess Occupational Exposure to Organic Dust in Bakeries

    Directory of Open Access Journals (Sweden)

    Carla Viegas

    2018-02-01

    Full Text Available Organic dust is widespread in the environment including occupational settings, such as bakeries. Recently, a new collection device—the electrostatic dust cloth (EDC—has been described for the assessment of occupational exposures. The aim of this study was to investigate the suitability of EDC for identifying the distribution patterns and exposure concentrations of particulate matter and microbial contaminants such as fungi and bacteria in bakeries. Twelve bakeries were selected, and dust was allowed to settle for 13 to 16 days on EDCs (a total of 33 samples. Particle counts and size distribution (0.3 µm, 0.5 µm, 1 µm, 2.5 µm, 5 µm and 10 µm were measured with direct-reading equipment. Higher EDC mass was significantly correlated (p values < 0.05 with higher fungal load on dichloran glycerol (DG18 and with particle size distribution in the 0.3 µm, 0.5 µm, 1.0 µm and 10.0 µm range. Fungal levels on malt extract agar (MEA ranged from 0 to 2886 CFU/m2 EDC in the warehouse setting, 0 to 500 CFU/m2 EDC in the production setting, and 0 to 3135 CFU/m2 EDC in the store. Penicillium sp. (42.56% was the most frequent fungi. Total bacterial load ranged from 0 to 18,859 CFU/m2 EDC in the warehouse, 0 to 71,656 CFU/m2 EDC in production, and 0 to 21,746 CFU/m2 EDC in the store. EDC assessment provided a longer-term integrated sample of organic dust, useful for identifying critical worksites in which particulate matter and bio-burden exposures are elevated. These findings suggest that EDC can be applied as a screening method for particulate matter-exposure assessment and as a complementary method to quantify exposures in occupational environments.

  12. A comparison of electronic and manual fracture risk assessment tools in screening elderly male US veterans at risk for osteoporosis.

    Science.gov (United States)

    Williams, S T; Lawrence, P T; Miller, K L; Crook, J L; LaFleur, J; Cannon, G W; Nelson, R E

    2017-11-01

    This study compares four screening tools in their ability to predict osteoporosis. We found that there was no significant difference between the tools. These results provide support for the use of automated screening tools which work in conjunction with the electronic medical record and help improve screening rates for osteoporosis. The purpose of this study is to compare the performance of four fracture risk assessment tools (FRATs) in identifying osteoporosis by bone mineral density (BMD) T-score: Veterans Affairs Fracture Absolute Risk Assessment Tool (VA-FARA), World Health Organization's Fracture Risk Assessment Tool (FRAX), electronic FRAX (e-FRAX), and Osteoporosis Self-Assessment Screening Tool (OST). We performed a cross-sectional analysis of all patients enrolled in the VA Salt Lake City bone health team (BHT) who had completed a DXA scan between February 1, 2012, and February 1, 2013. DXA scan results were obtained by chart abstraction. For calculation of FRAX, osteoporosis risk factors were obtained from a screening questionnaire completed prior to DXA. For VA-FARA and e-FRAX, risk factors were derived from the electronic medical record (EMR). Clinical risk scores were calculated and compared against the gold standard of DXA-based osteoporosis. Sensitivity, specificity, and predictive values were calculated. Receiver operator characteristic (ROC) curves were plotted, and areas under the curve (AUC) were compared. A cohort of 463 patients met eligibility criteria (mean age 80.4 years). One hundred twelve patients (24%) had osteoporosis as defined by DXA T-score ≤-2.5. Sensitivity, specificity, and predictive values were calculated. ROC statistics were compared and did not reach statistical significance difference between FRATs in identifying DXA-based osteoporosis. Our study suggests that all FRATs tested perform similarly in identifying osteoporosis among elderly, primarily Caucasian, male veterans. If these electronic screening methods perform

  13. Patients' Attitudes Toward Nonphysician Screening of Low Back and Low Back Related Leg Pain Complaints Referred for Surgical Assessment.

    Science.gov (United States)

    Rempel, Joshua; Busse, Jason W; Drew, Brian; Reddy, Kesava; Cenic, Aleksa; Kachur, Edward; Murty, Naresh; Candelaria, Henry; Moore, Ainsley E; Riva, John J

    2017-03-01

    A questionnaire survey. The aim of this study was to explore patient attitudes toward screening to assess suitability for low back surgery by nonphysician health care providers. Canadian spine surgeons have shown support for nonphysician screening to assess and triage patients with low back pain and low back related leg pain. However, patients' attitudes toward this proposed model are largely unknown. We administered a 19-item cross-sectional survey to adults with low back and/or low back related leg pain who were referred for elective surgical assessment at one of five spine surgeons' clinics in Hamilton, Ontario, Canada. The survey inquired about demographics, expectations regarding wait time for surgical consultation, as well as willingness to pay, travel, and be screened by nonphysician health care providers. Eighty low back patients completed our survey, for a response rate of 86.0% (80 of 93). Most respondents (72.5%; 58 of 80) expected to be seen by a surgeon within 3 months of referral, and 88.8% (71 of 80) indicated willingness to undergo screening with a nonphysician health care provider to establish whether they were potentially a surgical candidate. Half of respondents (40 of 80) were willing to travel >50 km for assessment by a nonphysician health care provider, and 46.2% were willing to pay out-of-pocket (25.6% were unsure). However, most respondents (70.0%; 56 of 80) would still want to see a surgeon if they were ruled out as a surgical candidate, and written comments from respondents revealed concern regarding agreement between surgeons' and nonphysicians' determination of surgical candidates. Patients referred for surgical consultation for low back or low back related leg pain are largely willing to accept screening by nonphysician health care providers. Future research should explore the concordance of screening results between surgeon and nonphysician health care providers. 3.

  14. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study.

    Science.gov (United States)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit; Vedsted, Peter

    2015-12-01

    Population-based cancer screening is offered in many countries to detect early stages of cancer and reduce mortality. Screening efficiency and equality is susceptible due to a group of non-participants. We investigated associations between self-assessed health, perceived stress and subsequent non-participation in breast cancer screening. This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50-69 years) for the first organised breast cancer screening programme -3 years later in the Central Denmark Region in 2008-2009. A U-shaped association was observed for physical health assessment as women with the highest (PR=1.28, 95% CI: 1.06-1.55), and the lowest (PR=1.41, 95% CI: 1.18-1.68) physical health scores were less likely to participate in the programme than women with physical health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR=1.44, 95% CI: 1.22-1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores (PR=1.27, 95% CI: 1.07-1.51) compared with women scoring in the middle range. Women with highest and lowest self-assessed physical health, with lowest mental health or highest perceived stress were significantly more likely not to participate in breast cancer screening 2-3 years later than women who reported average health. Interventions targeting these groups may promote equal participation in future breast cancer screening programmes. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Alexithymia in Egyptian Substance Abusers.

    Science.gov (United States)

    El Rasheed, Amany Haroun

    2001-03-01

    Alexithymia is thought of as a trait that predisposes to drug abuse. Moreover, it is suggested to be related to type of the substance abused, with the worst-case scenario including a worse prognosis as well as tendency to relapse or even not to seek treatment at all. To address this important subject in Egyptian patients, a sample of 200 Egyptian substance abusers was randomly selected from inpatients in the Institute of Psychiatry, Ain Shams University, Egypt. The study also included 200 group-matched controls. DSM-IV criteria were used for assessment of substance use disorders, and toxicologic urine analysis was used to confirm the substances of abuse. Toronto Alexithymia Scale (TAS)-Arabic version was used for assessment of alexithymia. It was found that alexithymia was significantly more prevalent in the substance use disorders group as compared to healthy controls. It was also found that among the substance use disorders group, alexithymics reported more polysubstance abuse, more opiate use (other than heroin IV), lower numbers of hospitalizations, lower numbers of reported relapses, and a lower tendency to relapse as a result of internal cues compared to patients without alexithymia. Statistically significant associations were also found between alexithymia and more benzodiazepine abuse and nonpersistence in treatment. The results suggest that alexithymia should be targeted in a treatment setting for substance use disorders.

  16. Prospective Assessment of Virtual Screening Heuristics Derived Using a Novel Fusion Score.

    Science.gov (United States)

    Pertusi, Dante A; O'Donnell, Gregory; Homsher, Michelle F; Solly, Kelli; Patel, Amita; Stahler, Shannon L; Riley, Daniel; Finley, Michael F; Finger, Eleftheria N; Adam, Gregory C; Meng, Juncai; Bell, David J; Zuck, Paul D; Hudak, Edward M; Weber, Michael J; Nothstein, Jennifer E; Locco, Louis; Quinn, Carissa; Amoss, Adam; Squadroni, Brian; Hartnett, Michelle; Heo, Mee Ra; White, Tara; May, S Alex; Boots, Evelyn; Roberts, Kenneth; Cocchiarella, Patrick; Wolicki, Alex; Kreamer, Anthony; Kutchukian, Peter S; Wassermann, Anne Mai; Uebele, Victor N; Glick, Meir; Rusinko, Andrew; Culberson, J Christopher

    2017-09-01

    High-throughput screening (HTS) is a widespread method in early drug discovery for identifying promising chemical matter that modulates a target or phenotype of interest. Because HTS campaigns involve screening millions of compounds, it is often desirable to initiate screening with a subset of the full collection. Subsequently, virtual screening methods prioritize likely active compounds in the remaining collection in an iterative process. With this approach, orthogonal virtual screening methods are often applied, necessitating the prioritization of hits from different approaches. Here, we introduce a novel method of fusing these prioritizations and benchmark it prospectively on 17 screening campaigns using virtual screening methods in three descriptor spaces. We found that the fusion approach retrieves 15% to 65% more active chemical series than any single machine-learning method and that appropriately weighting contributions of similarity and machine-learning scoring techniques can increase enrichment by 1% to 19%. We also use fusion scoring to evaluate the tradeoff between screening more chemical matter initially in lieu of replicate samples to prevent false-positives and find that the former option leads to the retrieval of more active chemical series. These results represent guidelines that can increase the rate of identification of promising active compounds in future iterative screens.

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

    Science.gov (United States)

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

    2015-02-01

    Preclinical models are needed to inform regulation of tobacco products by the Food and Drug Administration (FDA). Typically, animal models of tobacco addiction involve exposure to nicotine alone or nicotine combined with isolated tobacco constituents (e.g. minor alkaloids). The goal of this study was to develop a model using extracts derived from tobacco products that contain a range of tobacco constituents to more closely model product exposure in humans. This study compared the addiction-related effects of nicotine alone and nicotine dose-equivalent concentrations of aqueous smokeless tobacco extracts on intracranial self-stimulation (ICSS) in rats. Extracts were prepared from Kodiak Wintergreen, a conventional product, or Camel Snus, a potential "modified risk tobacco product". Binding affinities of nicotine alone and extracts at various nicotinic acetylcholine receptor (nAChR) subtypes were also compared. Kodiak and Camel Snus extracts contained levels of minor alkaloids within the range of those shown to enhance nicotine's behavioral effects when studied in isolation. Nonetheless, acute injection of both extracts produced reinforcement-enhancing (ICSS threshold-decreasing) effects similar to those of nicotine alone at low to moderate nicotine doses, as well as similar reinforcement-attenuating/aversive (ICSS threshold-increasing) effects at high nicotine doses. Extracts and nicotine alone also had similar binding affinity at all nAChRs studied. Relative nicotine content is the primary pharmacological determinant of the abuse liability of Kodiak and Camel Snus as measured using ICSS. These models may be useful to compare the relative abuse liability of other tobacco products and to model FDA-mandated changes in product performance standards. Copyright © 2015. Published by Elsevier Ireland Ltd.

  18. Which part of a short, global risk assessment, the Risk Instrument for Screening in the Community, predicts adverse healthcare outcomes?

    LENUS (Irish Health Repository)

    O’Caoimh, Rónán

    2015-01-01

    The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults’ one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC (\

  19. Validation of the MASK-rhinitis visual analogue scale on smartphone screens to assess allergic rhinitis control

    NARCIS (Netherlands)

    Caimmi, D.; Baiz, N.; Tanno, L. K.; Demoly, P.; Arnavielhe, S.; Murray, R.; Bedbrook, A.; Bergmann, K. C.; de Vries, G.; Fokkens, W. J.; Fonseca, J.; Haahtela, T.; Keil, T.; Kuna, P.; Mullol, J.; Papadopoulos, N.; Passalacqua, G.; Samolinski, B.; Tomazic, P. V.; Valiulis, A.; van Eerd, M.; Wickman, M.; Annesi-Maesano, I.; Bousquet, J.; Agache, I.; Angles, R.; Anto, J. M.; Asayag, E.; Bacci, E.; Bachert, C.; Baroni, I.; Barreto, B. A.; Bedolla-Barajas, M.; Bertorello, L.; Bewick, M.; Bieber, T.; Birov, S.; Bindslev-Jensen, C.; Blua, A.; Bochenska Marciniak, M.; Bogus-Buczynska, I.; Bosnic-Ancevich, S.; Bosse, I.; Bourret, R.; Bucca, C.; Buonaiuto, R.; Caiazza, D.; Caillot, D.; Caimmi, D. P.; Camargos, P.; Canfora, G.; Cardona, V.; Carriazo, A. M.; Cartier, C.; Castellano, G.; Chavannes, N. H.; Ciaravolo, M. M.; Cingi, C.; Ciceran, A.; Colas, L.; Colgan, E.; Coll, J.; Conforti, D.; Correira de Sousa, J.; Cortés-Grimaldo, R. M.; Corti, F.; Costa, E.; Courbis, A. L.; Cruz, A.; Custovic, A.; Dario, C.; da Silva, M.; Dauvilliers, Y.; de Blay, F.; Dedeu, T.; de Feo, G.; de Martino, B.; Di Capua, S.; Di Carluccio, N.; Dray, G.; Dubakiene, R.; Eller, E.; Emuzyte, R.; Espinoza-Contreras, J. M.; Estrada-Cardona, A.; Farrell, J.; Ferrero, J.; Fontaine, J. F.; Forti, S.; Gálvez-Romero, J. L.; Garcia Cruz, M. H.; García-Cobas, C. I.; Gemicioğlu, B.; Gerth van Wijck, R.; Guidacci, M.; Gómez-Vera, J.; Guldemond, N. A.; Gutter, Z.; Hajjam, J.; Hellings, P.; Hernández-Velázquez, L.; Illario, M.; Ivancevich, J. C.; Jares, E.; Joos, G.; Just, J.; Kalayci, O.; Kalyoncu, A. F.; Karjalainen, J.; Khaltaev, N.; Klimek, L.; Kull, I.; Kuna, T. P.; Kvedariene, V.; Kolek, V.; Krzych-Fałta, E.; Kupczyk, M.; Lacwik, P.; Larenas-Linnemann, D.; Laune, D.; Lauri, D.; Lavrut, J.; Lessa, M.; Levato, G.; Lewis, L.; Lieten, I.; Lipiec, A.; Louis, R.; Luna-Pech, J. A.; Magnan, A.; Malva, J.; Maspero, J. F.; Mayora, O.; Medina-Ávalos, M. A.; Melen, E.; Menditto, E.; Millot-Keurinck, J.; Moda, G.; Morais-Almeida, M.; Mösges, R.; Mota-Pinto, A.; Muraro, A.; Noguès, M.; Nalin, M.; Napoli, L.; Neffen, H.; O'Hehir, R.; Olivé Elias, M.; Onorato, G.; Palkonen, S.; Pépin, J. L.; Pereira, A. M.; Persico, M.; Pfaar, O.; Pozzi, A. C.; Prokopakis, E. P.; Raciborski, F.; Rizzo, J. A.; Robalo-Cordeiro, C.; Rodríguez-González, M.; Rolla, G.; Roller-Wirnsberger, R. E.; Romano, A.; Romano, M.; Salimäki, J.; Serpa, F. S.; Shamai, S.; Sierra, M.; Sova, M.; Sorlini, M.; Stellato, C.; Stelmach, R.; Strandberg, T.; Stroetman, V.; Stukas, R.; Szylling, A.; Tibaldi, V.; Todo-Bom, A.; Toppila-Salmi, S.; Tomazic, P.; Trama, U.; Triggiani, M.; Valero, A.; Valovirta, E.; Vasankari, T.; Vatrella, A.; Ventura, M. T.; Verissimo, M. T.; Viart, F.; Williams, S.; Wagenmann, M.; Wanscher, C.; Westman, M.; Young, I.; Yorgancioglu, A.; Zernotti, E.; Zurbierber, T.; Zurkuhlen, A.; de Oliviera, B.; Senn, A.

    2017-01-01

    Background: Visual Analogue Scale (VAS) is a validated tool to assess control in allergic rhinitis patients. Objective: The aim of this study was to validate the use of VAS in the MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) app (Allergy Diary) on smartphones screens to

  20. Assessment of the usefulness of telemammography for the second reading in screening mammography

    International Nuclear Information System (INIS)

    Okuda, Itsuko; Nakajima, Yasuo; Okazaki, Hiroko; Shimamoto, Hiroshi; Okamoto, Kyoko; Kanemaki, Yoshihide; Irimoto, Masahiro

    2010-01-01

    We assessed the usefulness of telemammography by soft-copy diagnosis. A wide area network for teleradiology was set up incorporating seven institutions located in two prefectures. A total of 1053 subjects were enrolled. The first reading was performed using hard-copy images at the institution where mammography was undertaken. The second reading using hard-copy images was then performed. These images were transferred to our institution, where a second reading based on soft-copy images was performed. The result of soft-copy diagnosis were then compared with those of the hard-copy diagnosis. The diagnosis concordance rate, which was higher than category 3, was evaluated. Category 1 or 2 accounted for 956 cases at the stage of the second hard-copy diagnosis, of which category 1 or 2 accounted for 930 cases analyzed in the second soft-copy diagnosis. A category higher than 3 accounted for 97 cases at the second hard-copy diagnosis, of which a category higher than 3 accounted for 75 cases at the stage of the second soft-copy diagnosis. The κ-value for the diagnosis concordance rate was 0.751. The diagnostic concordance between hard-copy diagnosis and soft-copy diagnosis was good. Diagnostic accuracy showed no significant difference between the two. We conclude that soft-copy diagnosis by telemammography is useful, and that its application is desirable for screening mammography. (author)

  1. Miniaturized screening of polymers for amorphous drug stabilization (SPADS): rapid assessment of solid dispersion systems.

    Science.gov (United States)

    Wyttenbach, Nicole; Janas, Christine; Siam, Monira; Lauer, Matthias Eckhard; Jacob, Laurence; Scheubel, Emmanuel; Page, Susanne

    2013-08-01

    Development of a novel, rapid, miniaturized approach to identify amorphous solid dispersions with maximum supersaturation and solid state stability. Three different miniaturized assays are combined in a 2-step decision process to assess the supersaturation potential and drug-polymer miscibility and stability of amorphous compositions. Step 1: SPADS dissolution assay. Drug dissolution is determined in 96-well plates to detect systems that generate and maintain supersaturation. Promising combinations graduate to step 2. Step 2: SPADS interaction and SPADS imaging assays. FTIR microspectroscopy is used to study intermolecular interactions. Atomic force microscopy is applied to analyze molecular homogeneity and stability. Based on the screening results, selected drug-polymer combinations were also prepared by spray-drying and characterized by classical dissolution tests and a 6-month physical stability study. From the 7 different polymers and 4 drug loads tested, EUDRAGIT E PO at a drug load of 20% performed best for the model drug CETP(2). The classical dissolution and stability tests confirmed the results from the miniaturized assays. The results demonstrate that the SPADS approach is a useful de-risking tool allowing the rapid, rational, time- and cost-effective identification of polymers and drug loads with appropriate dual function in supersaturation performance and amorphous drug stabilization. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Towards remote assessment and screening of acute abdominal pain using only a smartphone with native accelerometers.

    Science.gov (United States)

    Myers, David R; Weiss, Alexander; Rollins, Margo R; Lam, Wilbur A

    2017-10-06

    Smartphone-based telehealth holds the promise of shifting healthcare from the clinic to the home, but the inability for clinicians to conduct remote palpation, or touching, a key component of the physical exam, remains a major limitation. This is exemplified in the assessment of acute abdominal pain, in which a physician's palpation determines if a patient's pain is life-threatening requiring emergency intervention/surgery or due to some less-urgent cause. In a step towards virtual physical examinations, we developed and report for the first time a "touch-capable" mHealth technology that enables a patient's own hands to serve as remote surrogates for the physician's in the screening of acute abdominal pain. Leveraging only a smartphone with its native accelerometers, our system guides a patient through an exact probing motion that precisely matches the palpation motion set by the physician. An integrated feedback algorithm, with 95% sensitivity and specificity, enabled 81% of tested patients to match a physician abdominal palpation curve with <20% error after 6 attempts. Overall, this work addresses a key issue in telehealth that will vastly improve its capabilities and adoption worldwide.

  3. Tentative criteria for assessing workers exposure to toluene by urinary toluene screening.

    Science.gov (United States)

    Asakawa, Fumiyuki; Hirao, Tomohiro; Suna, Shigeru; Kureha, Akinori; Jitsunari, Fumihiko

    2006-04-01

    This study assessed screening thresholds for determining workers exposure to toluene (Tol) by urinary Tol (Tol-U) and proposed applicable criteria for on-site settings. Participants' urine samples (n = 21) were collected at the end of the workday during the latter half of a week and the Tol-U concentration was assayed. Simultaneously, each worker's exposure dose to Tol in the breathing zone during work, Tol-TWA (time-weighted average), was measured. Tentative criteria were proposed. Level I, less than Tol-U 38 microg/l, has the least chance of exceeding Tol-OEL 50 ppm (occupational exposure limit for Tol recommended by the Japan Society for Occupational Health), probability 95% <. Level II, Tol-U 38-60 microg/l, has a low possibility of exceeding Tol-OEL. Level III, Tol-U 60-110 microg/l, has a high possibility of exceeding Tol-OEL. Level IV, more than Tol-U 110 microg/l, clearly exceeds Tol-OEL, probability 95% <.

  4. Screening for psychosocial risk at pediatric cancer diagnosis: the psychosocial assessment tool.

    Science.gov (United States)

    Kazak, Anne E; Barakat, Lamia P; Ditaranto, Susan; Biros, Daniel; Hwang, Wei-Ting; Beele, David; Kersun, Leslie; Alderfer, Melissa A; Mougianis, Ifigenia; Hocking, Matthew C; Reilly, Anne

    2011-05-01

    To investigate the feasibility of integrating an evidence-based screening tool of psychosocial risk in pediatric cancer care at diagnosis. Parents of children newly diagnosed with cancer received either the Psychosocial Assessment Tool (PAT; n=52) or psychosocial care as usual (n=47; PAU), based on their date of diagnosis and an alternating monthly schedule. Time to completion of the PAT, time to communication of PAT results to clinical care teams, distribution of PAT risk scores, and identification of psychosocial risks in the medical record were examined. Of families receiving the PAT, 88% completed it within 48 hours. PAT was scored and results communicated within 48 hours in 98% of cases. Most families (72%) were classified as Universal risk based on the underlying Pediatric Psychosocial Preventative Health Model, 24% were classified as Targeted risk, and 4% scored in the Clinical range. Significantly more psychosocial risks were recorded in the medical record during PAT intervals than during PAU. An evidence-based psychosocial screener is feasible in pediatric oncology care and is associated with documentation of psychosocial risks in the medical record. Although the majority of families report low levels of psychosocial risk, about one-quarter report problems.

  5. Individualised risk assessment for diabetic retinopathy and optimisation of screening intervals: a scientific approach to reducing healthcare costs.

    Science.gov (United States)

    Lund, S H; Aspelund, T; Kirby, P; Russell, G; Einarsson, S; Palsson, O; Stefánsson, E

    2016-05-01

    To validate a mathematical algorithm that calculates risk of diabetic retinopathy progression in a diabetic population with UK staging (R0-3; M1) of diabetic retinopathy. To establish the utility of the algorithm to reduce screening frequency in this cohort, while maintaining safety standards. The cohort of 9690 diabetic individuals in England, followed for 2 years. The algorithms calculated individual risk for development of preproliferative retinopathy (R2), active proliferative retinopathy (R3A) and diabetic maculopathy (M1) based on clinical data. Screening intervals were determined such that the increase in risk of developing certain stages of retinopathy between screenings was the same for all patients and identical to mean risk in fixed annual screening. Receiver operating characteristic curves were drawn and area under the curve calculated to estimate the prediction capability. The algorithm predicts the occurrence of the given diabetic retinopathy stages with area under the curve =80% for patients with type II diabetes (CI 0.78 to 0.81). Of the cohort 64% is at less than 5% risk of progression to R2, R3A or M1 within 2 years. By applying a 2 year ceiling to the screening interval, patients with type II diabetes are screened on average every 20 months, which is a 40% reduction in frequency compared with annual screening. The algorithm reliably identifies patients at high risk of developing advanced stages of diabetic retinopathy, including preproliferative R2, active proliferative R3A and maculopathy M1. Majority of patients have less than 5% risk of progression between stages within a year and a small high-risk group is identified. Screening visit frequency and presumably costs in a diabetic retinopathy screening system can be reduced by 40% by using a 2 year ceiling. Individualised risk assessment with 2 year ceiling on screening intervals may be a pragmatic next step in diabetic retinopathy screening in UK, in that safety is maximised and cost

  6. Construct validity and reliability of the Music Attentiveness Screening Assessment (MASA).

    Science.gov (United States)

    Waldon, Eric G; Broadhurst, Emily

    2014-01-01

    Music as alternate engagement (MAE) can be used effectively to distract children during painful or anxiety-provoking medical procedures. For such interventions to be successful, it would seem important to assess the degree to which a child can attend to musical stimuli. The purposes of this study were as follows: (a) To establish construct validity by determining the extent to which the Music Attentiveness Screening Assessment (MASA) measures auditory attention; and (b) to gather evidence regarding MASA test-retest and inter-observer reliability. The Auditory Attention (AA) subtest from the NEPSY-II (NEPSY, Second Edition) and the two items from MASA were administered to a nonclinical sample of children (N = 50) aged 5 to 9 years. There was a statistically significant proportion of AA score variance shared with MASA (both items), R (2) = .21, F(2, 47) = 6.34, p = .004. Test-retest reliability on the first MASA item was moderately high (Pearson r = .84) while on the second item it was lower (r = .63). Similarly, interobserver agreement was high for Item I (intraclass correlation coefficient [ICC] = .95) and lower for Item II (ICC = .71). Evidence suggests that MASA measures, at least in part, auditory attention. Despite this finding, a large proportion of unexplained variance remains. Furthermore, reliability estimates (test-retest and interobserver agreement) differ between both items. These findings are discussed with particular attention paid to the ways in which MASA should be revised and further study conducted. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Printed and tablet e-paper newspaper from an environmental perspective - A screening life cycle assessment

    International Nuclear Information System (INIS)

    Moberg, Asa; Johansson, Martin; Finnveden, Goeran; Jonsson, Alex

    2010-01-01

    Viable alternatives to conventional newspapers, such as electronic papers, e-papers or e-readers, are intended to have many of the qualities of paper, such as reading using reflective light, high resolution, 180 deg. viewing angle. It has been suggested that the environmental impact of e-paper can be lower than for printed and internet-based newspapers. However, in order to find the facts of the matter, a thorough life cycle perspective covering raw material acquisition, production, use and disposal should preferably be used to study the environmental performance of the different products. A screening life cycle assessment was performed to describe the potential environmental impacts of two product systems; printed on paper and tablet e-paper newspapers. Results show that the most significant phase of the life cycle for both product systems was the production of substrate or platform. Accordingly, key aspects that may affect the resulting environmental performance of newspaper product systems were for the printed newspaper number of readers per copy and number of pages per issue and for the tablet e-paper newspaper lifetime and multi-use of the device. The printed newspaper in general had a higher energy use, higher emissions of gases contributing to climate change and several other impact categories than the tablet e-paper newspaper. It was concluded that tablet e-paper has the potential to decrease the environmental impact of newspaper consumption. However, further studies regarding the environmental impact of production and waste management of electronic devices and internet use, as well as more comprehensive assessment of toxicological impacts are needed. As the data on the electronic devices becomes more comprehensive this may prove to be a major limitation of electronic newspaper systems. Developers are suggested to strive towards minimisation of toxic and rare substances in production.

  8. Population Based Screening for Prostate Cancer: assessment of diagnostic tools and cancers detected

    NARCIS (Netherlands)

    J.B.W. Rietbergen (John)

    1998-01-01

    textabstractOver the past decade, considerable debate has occurred over the question whether or not to screen asymptomatic men for prostate cancer. It is unknown whether early detection and treatment of the disease will decrease the disease specific mortality. On theoretical grounds screening may

  9. Risk assessment of cattle handling on pasture using work environment screening tool.

    Science.gov (United States)

    Geng, Qiuqing; Field, William E; Salomon, Eva

    2015-01-01

    Working with beef cattle in an open area or while on pasture has been shown to expose workers to a high risk of work-related injury. Prior research on this problem has been conducted using mail surveys, interviews, self-reporting of work practices and injury experiences, and summaries of published injury data, including media reports. Prior research on injury prevention has largely focused on worker education in a specific cultural or geographical setting. A pilot study was conducted to test the cross-cultural usability of the Working Environment Screening Tool in Agriculture (WEST-AG), a modification of the WEST, developed for Swedish industrial applications, to assess risk factors associated with farmers working with cattle being raised largely on pasture as compared with cattle raised in confined feeding operations. Swedish and English language versions of WEST-AG were developed and pilot-tested on a convenient sample of eight Swedish and eight Indiana farms that raise beef cattle primarily on pasture. On-site observations were conducted independently by Swedish and US agricultural safety professionals and documented using photography and a 15-risk-of-injury component on an 11-degree linear scale. Comparisons were made between independent observations documented from the Swedish and Indiana application of the WEST, including collective assessment of photographic record, and the results reported. Key findings included (a) a higher level of observed risks on Indiana farms studied as compared with their Swedish counterparts; (b) high levels of worker exposure to cattle, especially mature breeding bulls, on both sets of farms; (c) a higher frequency of self-reported farm-related injuries than anticipated on both Swedish and Indiana farms; (d) substantially different economic, social, cultural, and regulatory forces that influence small-operation Swedish and Indiana beef producers' decisions regarding adoption of safer work practices, including use of new and safer

  10. Alcohol abuse, sexual risk behaviors, and sexually transmitted infections in women in Moshi urban district, northern Tanzania.

    Science.gov (United States)

    Ghebremichael, Musie; Paintsil, Elijah; Larsen, Ulla

    2009-02-01

    To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexually transmitted infections (STIs). Two thousand and nineteen women aged 20 to 44 were randomly selected in a 2-stage sampling from the Moshi urban district of northern Tanzania. Participant's demographic and socio-economic characteristics, alcohol use, sexual behaviors, and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas, and mycoplasma genitalium infections. Adjusted analyses showed that a history of physical (OR = 2.05; 95% CI: 1.06-3.98) and sexual violence (OR = 1.63; 95% CI: 1.05-2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR = 1.66; 95% CI: 1.01-2.73). Women who abused alcohol were more likely to report STIs symptoms (OR = 1.61; 95% CI: 1.08-2.40). Women who had multiple sexual partners were more likely to have an STI (OR = 2.41; 95% CI: 1.46-4.00) compared to women with 1 sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR = 0.86; 95% CI: 0.55-1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners. The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs.

  11. Abusing ethics

    DEFF Research Database (Denmark)

    Olivares Bøgeskov, Benjamin Miguel

    This paper presents the result from our research on how nurse managers use and occasionally misuse inconclusive ethical arguments to engage their personnel in current reforms. The Danish health care system has undergone a series of reforms inspired by New Public Management theories, which have......, paying special attention to the way in which ethical arguments are used in relation to engagement. Our research shows that ethical arguments are extremely common, and they are used either to elicit engagement, or to demand engagement considering the result of a duty. However, most interestingly...... it was possible for us to find recurrence of fallacious arguments of different kinds. Based on these findings, I will argue that the use of fallacious arguments in order to generate engagement is in reality an abusive use of ethics, which raises important questions. I argue that depending on the degree...

  12. A History of Abuse and Operative Delivery

    DEFF Research Database (Denmark)

    Schei, Berit; Lukasse, Mirjam; Ryding, Elsa Lena

    2014-01-01

    OBJECTIVE: The main aim of this study was to assess whether a history of abuse, reported during pregnancy, was associated with an operative delivery. Secondly, we assessed if the association varied according to the type of abuse and if the reported abuse had been experienced as a child or an adult....... DESIGN: The Bidens study, a cohort study in six European countries (Belgium, Iceland, Denmark, Estonia, Norway, and Sweden) recruited 6724 pregnant women attending routine antenatal care. History of abuse was assessed through questionnaire and linked to obstetric information from hospital records...... and multinomial regression analysis were used to assess the associations. RESULTS: Among 3308 primiparous women, sexual abuse as an adult (≥ 18 years) increased the risk of an elective CS, Adjusted Odds Ratio 2.12 (1.28-3.49), and the likelihood for a non-obstetrically indicated CS, OR 3.74 (1.24-11.24). Women...

  13. Evaluating wait times from screening to breast cancer diagnosis among women undergoing organised assessment vs usual care.

    Science.gov (United States)

    Chiarelli, Anna M; Muradali, Derek; Blackmore, Kristina M; Smith, Courtney R; Mirea, Lucia; Majpruz, Vicky; O'Malley, Frances P; Quan, May Lynn; Holloway, Claire Mb

    2017-05-09

    Timely coordinated diagnostic assessment following an abnormal screening mammogram reduces patient anxiety and may optimise breast cancer prognosis. Since 1998, the Ontario Breast Screening Program (OBSP) has offered organised assessment through Breast Assessment Centres (BACs). For OBSP women seen at a BAC, an abnormal mammogram is followed by coordinated referrals through the use of navigators for further imaging, biopsy, and surgical consultation as indicated. For OBSP women seen through usual care (UC), further diagnostic imaging is arranged directly from the screening centre and/or through their physician; results must be communicated to the physician who is then responsible for arranging any necessary biopsy and/or surgical consultation. This study aims to evaluate factors associated with diagnostic wait times for women undergoing assessment through BAC and UC. Of the 2 147 257 women aged 50-69 years screened in the OBSP between 1 January 2002 and 31 December 2009, 155 866 (7.3%) had an abnormal mammogram. A retrospective design identified two concurrent cohorts of women diagnosed with screen-detected breast cancer at a BAC (n=4217; 47%) and UC (n=4827; 53%). Multivariable logistic regression analyses examined associations between wait times and assessment and prognostic characteristics by pathway. A two-sided 5% significance level was used. Screened women with breast cancer were two times more likely to be diagnosed within 7 weeks when assessed through a BAC vs UC (OR=1.91, 95% CI=1.73-2.10). In addition, compared with UC, women assessed through a BAC were significantly more likely to have their first assessment procedure within 3 weeks of their abnormal mammogram (OR=1.25, 95% CI=1.12-1.39), ⩽3 assessment procedures (OR=1.54, 95% CI=1.41-1.69), ⩽2 assessment visits (OR=1.86, 95% CI=1.70-2.05), and ⩾2 procedures per visit (OR=1.41, 95% CI=1.28-1.55). Women diagnosed through a BAC were also more likely than those in UC to have imaging (OR=1.99, 95

  14. Readability, suitability, and health content assessment of web-based patient education materials on colorectal cancer screening.

    Science.gov (United States)

    Tian, Chenlu; Champlin, Sara; Mackert, Michael; Lazard, Allison; Agrawal, Deepak

    2014-08-01

    Colorectal cancer (CRC) screening rates in the Unites States are still below target level. Web-based patient education materials are used by patients and providers to provide supplemental information on CRC screening. Low literacy levels and patient perceptions are significant barri