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Sample records for abuse subtle screening

  1. 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.)

  2. Screening Spouse Abusers for Child Abuse Potential.

    Science.gov (United States)

    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. Substance Abuse Screening

    Science.gov (United States)

    ... 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, ...

  4. Elder abuse telephone screen reliability and validity.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  8. The use of SBIRT in substance abuse screening.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  10. Validity of a screening tool for detecting subtle cognitive impairment in the middle-aged and elderly.

    Science.gov (United States)

    Bruce, Kathryn M; Robinson, Stephen R; Smith, Julian A; Yelland, Gregory W

    2014-01-01

    The present study tested 121 middle-aged and elderly community-dwelling individuals on the computer-based Subtle Cognitive Impairment Test (SCIT) and compared their performance with that on several neuropsychological tests. The SCIT had excellent internal consistency, as demonstrated by a high split-half reliability measure (0.88-0.93). Performance on the SCIT was unaffected by the confounding factors of sex, education level, and mood state. Many participants demonstrated impaired performance on one or more of the neuropsychological tests (Controlled Oral Word Association Task, Rey Auditory and Verbal Learning Task, Grooved Pegboard [GP], Complex Figures). Performance on SCIT subtests correlated significantly with performance on many of the neuropsychological subtests, and the best and worst performing quartiles on the SCIT subtest discriminated between good and poor performers on other subtests, collectively indicating concurrent validity of the SCIT. Principal components analysis indicated that SCIT performance does not cluster with performance on most of the other cognitive tests, and instead is associated with decision-making efficacy, and processing speed and efficiency. Thus, the SCIT is responsive to the processes that underpin multiple cognitive domains, rather than being specific for a single domain. Since the SCIT is quick and easy to administer, and is well tolerated by the elderly, it may have utility as a screening tool for detecting cognitive impairment in middle-aged and elderly populations.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Subtle Messages.

    Science.gov (United States)

    Tamplin de Poinsot, Nan

    1999-01-01

    Describes a self-portrait assignment inspired by the work of Frida Kahlo. Discusses Frida Kahlo's artwork and use of surrealist and symbolist views. States that each student had to incorporate personal symbolism in the portrait to convey a message about him or herself in a subtle manner. (CMK)

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

    Science.gov (United States)

    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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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.

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

    NARCIS (Netherlands)

    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

  20. 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

  1. 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.

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

    Science.gov (United States)

    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

  3. 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...

  4. 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.

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

    Science.gov (United States)

    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.

  6. 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

  7. 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.

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

    Science.gov (United States)

    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.

  9. 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

  10. 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.

  11. 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

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

    Directory of Open Access Journals (Sweden)

    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

  13. 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

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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 ...

  19. 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.

  20. 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 ...

  1. Mimumes for SUBTLE applications

    Science.gov (United States)

    Lakhtakia, Akhlesh

    2014-08-01

    Inspired by natural multifunctionality, mimumes are microfibrous multifunctional metamaterials. Their microfibrosity engenders multifunctionality. Poly(p-xylylene) polymers that are currently used in bulk non-fibrous forms for packaging and tribological applications in electronic and biomedical arenas are excellent initial candidates to fabricate mimumes. In microfibrous forms, these polymers are expected to display simultaneous ultrasonic, biomedical, terahertz, light, and energy (SUBTLE) functionalities, thereby furthering the paradigm of design for system performance.

  2. 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.

  3. 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.

  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. 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.

  9. 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…

  10. 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...

  11. 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.)

  12. 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.)

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

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

    Science.gov (United States)

    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.

  19. 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.

  20. 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 ...

  1. 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.

  2. 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.

  3. 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.

  4. Bioelectromagnetic and subtle energy medicine

    CERN Document Server

    Rosch, Paul J

    2014-01-01

    PREFACEPreface: Why and How This Book Was Assembled; Paul J. RoschA Tribute to W. Ross Adey: A Man for All Seasons; Paul J. RoschCHAPTERS REPRODUCED FROM THE FIRST EDITIONPreface from the First Edition; Paul J. RoschPotential Therapeutic Applications of Nonthermal Electromagnetic Fields: Ensemble Organization of Cells in Tissue as a Factor in Biological Field Sensing; W. Ross AdeyA Fundamental Basis for the Effects of EMFs in Biology and Medicine: The Interface between Matter and Function; Jacques BenvenisteSubtle Energies and Their Roles in Bioelectromagnetic Phenomena; William A. TillerElectromagnetism versus Bioelectromagnetism; William A. TillerMagneto-Metabolic Therapy for Advanced Malignancy and Cardiomyopathy; Demetrio Sodi Pallares and Paul J. RoschIs There an Electrical Circulatory System That Communicates Internally and Externally?; Paul J. Rosch and Björn E.W. NordenströmSUBTLE ENERGIES: THEORIES AND THERAPIESLife is Water Electric; Mae-Wan HoWhy Biological Water Differs from H2O and Acts Like a ...

  5. 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

  6. 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.

  7. 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.

  8. 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…

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Implicit Age Cues in Resumes: Subtle Effects on Hiring Discrimination

    OpenAIRE

    Derous, Eva; Decoster, Jeroen

    2017-01-01

    Anonymous resume screening, as assumed, does not dissuade age discriminatory effects. Building on job market signaling theory, this study investigated whether older applicants may benefit from concealing explicitly mentioned age signals on their resumes (date of birth) or whether more implicit/subtle age cues on resumes (older-sounding names/old-fashioned extracurricular activities) may lower older applicants’ hirability ratings. An experimental study among 610 HR professionals using a mixed ...

  14. 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.

  15. 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.

  16. 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,

  17. 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

  18. [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.

  19. 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.

  20. 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.

  1. 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 ...

  2. 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.

  3. Implicit Age Cues in Resumes: Subtle Effects on Hiring Discrimination

    Directory of Open Access Journals (Sweden)

    Eva Derous

    2017-08-01

    Full Text Available Anonymous resume screening, as assumed, does not dissuade age discriminatory effects. Building on job market signaling theory, this study investigated whether older applicants may benefit from concealing explicitly mentioned age signals on their resumes (date of birth or whether more implicit/subtle age cues on resumes (older-sounding names/old-fashioned extracurricular activities may lower older applicants’ hirability ratings. An experimental study among 610 HR professionals using a mixed factorial design showed hiring discrimination of older applicants based on implicit age cues in resumes. This effect was more pronounced for older raters. Concealing one’s date of birth led to overall lower ratings. Study findings add to the limited knowledge on the effects of implicit age cues on hiring discrimination in resume screening and the usefulness of anonymous resume screening in the context of age. Implications for research and practice are discussed.

  4. 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.

  5. 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.

  6. 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

  7. Screening for subtle chromosomal rearrangements in an Egyptian ...

    African Journals Online (AJOL)

    Full history taking, thorough clinical examination, IQ, visual, and audiological assessment, brain CT scan, plasma aminogram, pelvi-abdominal ultrasonography, echocardiography, and cytogenetic evaluation using routine conventional karyotyping, high resolution banding (HRB), and fluorescent in situ hybridization (FISH) ...

  8. Screening for subtle chromosomal rearrangements in an Egyptian ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    Visual and Auditory Responses and or audiometry), brain CT scan, plasma aminogram (to exclude aminoacidopathies), and pelvi-abdominal sonar and echocardiography for detection of any concomitant congenital malformations were carried out for all studied patients. Cytogenetic evaluation of enrolled cases included ...

  9. 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.

  10. 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...

  11. 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

  12. The subtle nature of financial random walks.

    Science.gov (United States)

    Bouchaud, Jean-Philippe

    2005-06-01

    We first review the most important "stylized facts" of financial time series, that turn out to be, to a large extent, universal. We then recall how the multifractal random walk of Bacry, Muzy, and Delour generalizes the standard model of financial price changes and accounts in an elegant way for many of their empirical properties. In a second part, we provide empirical evidence for a very subtle compensation mechanism that underlies the random nature of price changes. This compensation drives the market close to a critical point, that may explain the sensitivity of financial markets to small perturbations, and their propensity to enter bubbles and crashes. We argue that the resulting unpredictability of price changes is very far from the neoclassical view that markets are informationally efficient.

  13. The subtle nature of financial random walks

    Science.gov (United States)

    Bouchaud, Jean-Philippe

    2005-06-01

    We first review the most important "stylized facts" of financial time series, that turn out to be, to a large extent, universal. We then recall how the multifractal random walk of Bacry, Muzy, and Delour generalizes the standard model of financial price changes and accounts in an elegant way for many of their empirical properties. In a second part, we provide empirical evidence for a very subtle compensation mechanism that underlies the random nature of price changes. This compensation drives the market close to a critical point, that may explain the sensitivity of financial markets to small perturbations, and their propensity to enter bubbles and crashes. We argue that the resulting unpredictability of price changes is very far from the neoclassical view that markets are informationally efficient.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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…

  19. Judgments of subtle facial expressions of emotion.

    Science.gov (United States)

    Matsumoto, David; Hwang, Hyisung C

    2014-04-01

    Most studies on judgments of facial expressions of emotion have primarily utilized prototypical, high-intensity expressions. This paper examines judgments of subtle facial expressions of emotion, including not only low-intensity versions of full-face prototypes but also variants of those prototypes. A dynamic paradigm was used in which observers were shown a neutral expression followed by the target expression to judge, and then the neutral expression again, allowing for a simulation of the emergence of the expression from and then return to a baseline. We also examined how signal and intensity clarities of the expressions (explained more fully in the Introduction) were associated with judgment agreement levels. Low-intensity, full-face prototypical expressions of emotion were judged as the intended emotion at rates significantly greater than chance. A number of the proposed variants were also judged as the intended emotions. Both signal and intensity clarities were individually associated with agreement rates; when their interrelationships were taken into account, signal clarity independently predicted agreement rates but intensity clarity did not. The presence or absence of specific muscles appeared to be more important to agreement rates than their intensity levels, with the exception of the intensity of zygomatic major, which was positively correlated with agreement rates for judgments of joy.

  20. Arthroscopic Correlates of Subtle Syndesmotic Injury.

    Science.gov (United States)

    Guyton, Gregory P; DeFontes, Kenneth; Barr, Cameron R; Parks, Brent G; Camire, Lyn M

    2017-05-01

    Arthroscopic criteria for identifying syndesmotic disruption have been variable and subjective. We aimed to quantify syndesmotic disruption arthroscopically using a standardized measurement device. Ten cadaveric lower extremity specimens were tested in intact state and after serial sectioning of the syndesmotic structures (anterior inferior tibiofibular ligament [AiTFL], interosseous ligament [IOL], posterior inferior tibiofibular ligament [PiTFL], deltoid). Diagnostic ankle arthroscopy was performed after each sectioning. Manual external rotational stress was applied across the tibiofibular joint. Custom-manufactured spherical balls of increasing diameter mounted on the end of an arthroscopic probe were inserted into the tibiofibular space to determine the degree of diastasis of the tibiofibular joint under each condition. A ball 3 mm in diameter reliably indicated a high likelihood of combined disruption of the AiTFL and IOL. Disruption of the AiTFL alone could not be reliably distinguished from the intact state. Use of a spherical probe placed into the tibiofibular space during manual external rotation of the ankle provided an objective measure of syndesmotic instability. Passage of a 2.5-mm probe indicated some disruption of the syndesmosis, but the test had poor negative predictive value. Passage of a 3.0-mm spherical probe indicated very high likelihood of disruption of both the AiTFL and the IOL. The findings challenge the previously used but unsupported standard of a 2-mm diastasis of the tibiofibular articulation for diagnosis of subtle syndesmotic instability.

  1. 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...

  2. 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.

  3. 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.

  4. 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

    Directory of Open Access Journals (Sweden)

    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

  5. 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.

  6. 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, ...

  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. SUBTLE: Situation Understanding Bot through Language and Environment

    Science.gov (United States)

    2016-01-06

    2009) use a combinatorial categorial grammar (CCG) parser with a pre-specified map - ping between words or phrases and the matching branch- ing...agents communicating via rich language remain an open challenge. Toward this end, the central goal of the SUBTLE MURI project was to develop an...3451 Walnut Street , Suite P-221 Philadelphia, PA 19104 -6205 31-Aug-2014 ABSTRACT Final Report: SUBTLE: Situation Understanding Bot through Language

  9. 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

  10. 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 ...

  11. 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 ...

  12. Temporal subtraction technique for detection of subtle anomalies on temporally sequential bone-subtracted chest radiographs by energy subtraction

    International Nuclear Information System (INIS)

    Sanada, Shigeru; Kobayashi, Takeshi; Yoshida, Megumi; Takashima, Tsutomu; Matsui, Takeshi

    2000-01-01

    We developed a temporal subtraction technique for the detection of subtle anomalies on temporally sequential bone-subtracted chest radiographs (soft tissue images) by energy subtraction. To recognize the temporal changes in a current soft tissue image in comparison with those in a previous soft tissue image, we attempted to enhance the changes by a difference image processing technique. The lung markings were enhanced by the first derivative filter. The image registration for the lung markings on both images by the sequential similarity detection algorithm (SSDA) method was then employed. The soft tissue image provided by the energy subtraction technique was excellent in its detection of subtle abnormalities in the lung, and this method was able to detect subtle abnormalities such as infiltrates and nodules missed in screening. It was suggested that this temporal subtraction technique improves accuracy when radiologists diagnose soft tissue chest images by x-ray energy subtraction. (author)

  13. 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.

  14. 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.)

  15. Cranial MR imaging of abused children

    International Nuclear Information System (INIS)

    Zimmerman, R.D.; Heier, L.A.; Johnson, C.E.; Weingarten, K.; Kelly, A.B.; Deck, M.D.F.

    1987-01-01

    The diagnosis of intracranial sequelae of child abuse has important clinical and legal implications. CT findings are often subtle or nonspecific. Acutely, a small interhemispheric subdural hematoma (IHSDH) is seen, which may be difficult to distinguish from the falx. In chronic or recurrent abuse, ventricular dilatation and extracerebral fluid collections are encountered that may be difficult to distinguish from atrophy. Four abused children underwent MR imaging and, in each case, MR demonstrated the nature and extent of abnormalities with greater accuracy than CT. In acute abuse (two cases), the IHSDH was diagnosed with greater confidence than on CT, and convexity subdural collections were identified which could not be detected on CT. In chronic abuse (two cases) the subdural location of extracerebral collections and the extent of parenchymal damage was better appreciated on MR than CT

  16. 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

  17. 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

  18. Violence -- subtle and not so subtle -- understanding women's reproductive and sexual rights in Africa.

    Science.gov (United States)

    Toubia, N

    1995-01-01

    This article discusses violence in relation to women's reproductive and sexual rights in Africa. Two types of violent behaviors are defined. One type is defined as a straightforward, aggressive act of brutality inflicted on one person by another, which may range from battery to rape, and which may occur domestically or be inflicted by a stranger. The other type of violent behavior is the violation of rights or denial of rights, which often operates not only on personal, but also on societal or cultural levels. These definitions allow us to address the record of violence against women in a broad social and political context in which not only men but women and society as a whole act to perpetuate systems resulting in various forms of abuse. In Africa, the strong patriarchal tradition with the economic mode of more formal and systematic, less centralized commerce makes it virtually impossible for a woman to move, act, or think freely. The most damaging type of sexual violence against women centers on the lack of control that women are allowed over their fertility. Denial of reproductive rights, services and information acts as pervasive form of violence, with significant consequences. Women face both the threats of direct bodily violence from strangers and within their own homes; and the exposure to the risk of HIV infection and other sexually transmitted diseases, of unwanted and unplanned pregnancy, and of unsafe abortion due to the violation of women's basic human rights.

  19. Semiology of subtle motor phenomena in critically ill patients.

    Science.gov (United States)

    Florea, Bogdan; Beniczky, Simona Alexandra; Demény, Helga; Beniczky, Sándor

    2017-05-01

    to investigate the semiology of subtle motor phenomena in critically ill patients, with- versus without nonconvulsive status epilepticus (NCSE). 60 consecutive comatose patients, in whom subtle motor phenomena were observed in the intensive care unit (ICU), were analysed prospectively. The semiology of the subtle phenomena was described from video-recordings, blinded to all other data. For each patient, the type, location and occurrence-pattern/duration were described. EEGs recorded in the ICU were classified using the Salzburg criteria for NCSE. only 23% (14/60) of the patients had NCSE confirmed by EEG. None of the semiological features could distinguish between patients with NCSE and those without. In both groups, the following phenomena were most common: discrete myoclonic muscle twitching and discrete tonic muscle activation. Besides these, automatisms and eye deviation were observed in both groups. subtle motor phenomena in critically ill patients can raise the suspicion of NCSE. Nevertheless, EEG is needed to confirm the diagnosis, since none of the semiological features are specific. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  20. In defense of the subtle prejudice concept: A retort.

    NARCIS (Netherlands)

    Pettigrew, T.F.; Meertens, R.W.

    2001-01-01

    Responds to Coenders et al (see record 2001-06995-005) experiment replication and comments on the article by T. F. Pettigrew and R. W. Meertens' (see record 1995-28884-001) which investigated blatant and subtle intergroup prejudice. Coenders et al produced a different analysis of prejudice from the

  1. The psychology of electoral mobilization: a subtle priming experiment

    NARCIS (Netherlands)

    Nyhuis, Martin; Gosselt, Jordi Franciscus; Rosema, Martin

    2016-01-01

    In this paper we test the idea that citizens can be stimulated to vote in an election via subtle psychological processes, which have little or nothing to do with the act of voting as such. More specifically, we argue that presenting voters with stimuli that induce an active mood will increase their

  2. 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.

  3. 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 ...

  4. 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…

  5. 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 ...

  6. Radiographically Occult and Subtle Fractures: A Pictorial Review

    International Nuclear Information System (INIS)

    Jarraya, M.; Hayashi, D.; Roemer, F.W.; Crema, M.D.; Conlin, J.; Marra, M.D.; Guermazi, A.; Roemer, F.W.; Crema, M.D.; Diaz, L.; Conlin, J.; Jomaah, N.

    2013-01-01

    Radiographically occult and subtle fractures are a diagnostic challenge. They may be divided into (1) high energy trauma fracture, (2) fatigue fracture from cyclical and sustained mechanical stress, and (3) insufficiency fracture occurring in weakened bone (e.g., in osteoporosis and post radiotherapy). Independently of the cause, the initial radiographic examination can be negative either because the findings seem normal or are too subtle. Early detection of these fractures is crucial to explain the patients symptoms and prevent further complications. Advanced imaging tools such as computed tomography, magnetic resonance imaging, and scintigraphy are highly valuable in this context. Our aim is to raise the awareness of radiologists and clinicians in these cases by presenting illustrative cases and a discussion of the relevant literature.

  7. Subtle Motion Analysis and Spotting using the Riesz Pyramid

    OpenAIRE

    Arango, Carlos,; Alata, Olivier; Emonet, Rémi; Legrand, Anne-Claire; Konik, Hubert

    2018-01-01

    International audience; Analyzing and temporally spotting motions which are almost invisible to the human eye might reveal interesting information about the world. However, detecting these events is difficult due to their short duration and low intensities. Taking inspiration from video magnification techniques, we design a workflow for analyzing and temporally spotting subtle motions based on the Riesz pyramid. In addition, we propose a filtering and masking scheme that segments motions of i...

  8. 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…

  9. 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.

  10. 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. ...

  11. 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

  12. 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 ...

  13. 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…

  14. 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. ...

  15. Thoracolumbar fracture with listhesis - an uncommon manifestation of child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Levin, Terry L.; Blitman, Netta M. [Department of Radiology, Montefiore Medical Center, 111 E. 210th Street, Bronx, New York, NY 10467-2490 (United States); Berdon, Walter E. [Department of Radiology, Babies Hospital, New York Presbyterian Hospital, New York (United States); Cassell, Ian [Department of Radiology, Phoenix Children' s Hospital, Phoenix, AZ (United States)

    2003-05-01

    Thoracolumbar fracture with listhesis (FL) is an uncommon manifestation of child abuse (increasingly known as nonaccidental trauma), with only six prior reports in the literature. This article seeks to call attention to FL of the thoracolumbar spine in abused children and infants. We reviewed plain films, CT and MR images in seven new cases of FL of the thoracolumbar spine in abused children ages 6 months to 7 years, two of whom became paraplegic from their injuries. Findings varied from subtle listhesis of one vertebra on another to frank vertebral dislocation, most commonly at L1/2. Paravertebral calcification was present in all but one case. In two children, thoracolumbar FL was the only radiographic sign of abuse. Radiographic findings of FL of the thoracolumbar spine may be subtle and may be erroneously interpreted as due to a congenital or neoplastic cause. While other signs of child abuse should be sought, spinal injury may be the sole sign of abuse. Recognition of this entity is important to pursue the diagnosis of abuse. (orig.)

  16. Thoracolumbar fracture with listhesis - an uncommon manifestation of child abuse

    International Nuclear Information System (INIS)

    Levin, Terry L.; Blitman, Netta M.; Berdon, Walter E.; Cassell, Ian

    2003-01-01

    Thoracolumbar fracture with listhesis (FL) is an uncommon manifestation of child abuse (increasingly known as nonaccidental trauma), with only six prior reports in the literature. This article seeks to call attention to FL of the thoracolumbar spine in abused children and infants. We reviewed plain films, CT and MR images in seven new cases of FL of the thoracolumbar spine in abused children ages 6 months to 7 years, two of whom became paraplegic from their injuries. Findings varied from subtle listhesis of one vertebra on another to frank vertebral dislocation, most commonly at L1/2. Paravertebral calcification was present in all but one case. In two children, thoracolumbar FL was the only radiographic sign of abuse. Radiographic findings of FL of the thoracolumbar spine may be subtle and may be erroneously interpreted as due to a congenital or neoplastic cause. While other signs of child abuse should be sought, spinal injury may be the sole sign of abuse. Recognition of this entity is important to pursue the diagnosis of abuse. (orig.)

  17. Harnessing the Interaction Continuum for Subtle Assisted Living

    Directory of Open Access Journals (Sweden)

    Xavier Alamán

    2012-07-01

    Full Text Available People interact with each other in many levels of attention, intention and meaning. This Interaction Continuum is used daily to deal with different contexts, adapting the interaction to communication needs and available resources. Nevertheless, computer-supported interaction has mainly focused on the most direct, explicit and intrusive types of human to human Interaction such as phone calls, emails, or video conferences. This paper presents the results of exploring and exploiting the potentials of undemanding interaction mechanisms, paying special attention to subtle communication and background interaction. As we argue the benefits of this type of interaction for people with special needs, we present a theoretical framework to define it and propose a proof of concept based on Augmented Objects and a color codification mechanism. Finally, we evaluate and analyze the strengths and limitations of such approach with people with cognitive disabilities.

  18. Learning mnemonics: roles of aging and subtle cognitive impairment.

    Science.gov (United States)

    Yesavage, J A; Sheikh, J I; Friedman, L; Tanke, E

    1990-03-01

    Previously validated methods of memory training were used in conjunction with the Folstein Mini-Mental State Examination (MMSE) to explore the relationship between complexity of learned mnemonic, aging, and subtle cognitive impairment. Subjects were 218 community-dwelling elderly. Treatment included imagery mnemonics for remembering names and faces and lists. There was a significant interaction among age, type of learning task (face-name vs. list), and improvement when controlling for MMSE score. There was also a significant interaction among MMSE score, type of learning task, and improvement when controlling for age. Scores on the more complex list-learning mnemonic were more affected by age and MMSE scores than were scores on the face-name mnemonic. Implications of the findings for cognitive training of the old old and the impaired are discussed.

  19. Cranial imaging in child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Wilms, G. [Department of Radiology, University Hospitals, Leuven (Belgium); Casteels, I. [Department of Ophthalmology, University Hospitals, Leuven (Belgium)

    2002-04-01

    Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Opthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma. (orig.)

  20. Cranial imaging in child abuse

    International Nuclear Information System (INIS)

    Demaerel, P.; Wilms, G.; Casteels, I.

    2002-01-01

    Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Opthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma. (orig.)

  1. Comparing intergroup contact effects on blatant and subtle prejudice in adolescents: a multivariate multilevel model.

    Science.gov (United States)

    Herrero Olaizola, Juan; Rodríguez Díaz, Francisco Javier; Musitu Ochoa, Gonzalo

    2014-01-01

    The literature has rarely paid attention to the differential influence of intergroup contact on subtle and blatant prejudice. In this study, we hypothesized that the influence of intergroup contact on subtle prejudice will be smaller than its influence on blatant prejudice. This hypothesis was tested with data from a cross-sectional design on 1,655 school-aged native Spanish adolescents. Prejudice was measured with a shortened version of the Meertens and Pettigrew scale of blatant and subtle prejudice adapted to Spanish adolescent population. Results from multivariate multilevel analyses for correlated outcome variables supported the hypothesis. Students tended to score higher on the subtle prejudice scale; contact with the outgroup was statistically related both to levels of blatant and subtle prejudice; and, the negative relationship of contact with the outgroup and prejudice is greater for blatant prejudice as compared to subtle prejudice. Overall, results provide statistical evidence supporting the greater resistance to change of subtle forms of prejudice.

  2. 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.

  3. Modeling of subtle kinetic processes in plasma simulation

    International Nuclear Information System (INIS)

    Sydora, R.D.; Decyk, V.K.; Dawson, J.M.

    1988-01-01

    A new diagnostic method for plasma simulation models is presented which enables one to probe the subtle dielectric properties of the plasma medium. The procedure involves the removal of the background plasma response in order to isolate the effects of small perturbing influences which are externally added. We have found the technique accurately describes fundamental kinetic plasma behavior such as the shielding of individual test charges and currents. Wave emission studies and drag of test particles has been carried out in explicit particle algorithms as well as large time step implicit and gyrokinetic models. Accurate plasma behavior is produced and it is possible to investigate in detail, processes which can be compared with plasma kinetic theory. The technique of subtraction is not only limited to particle simulation models but also can be used in MHD or fluid models where resolution is difficult due to the intensity of the background response relative to the phenomena one is interested in measuring, such as a weakly grouwing instability or nonlinear mode coupling effect. (author)

  4. NA48 unravels one of nature's most subtle secrets

    CERN Multimedia

    2001-01-01

    NA48 has just announced its final results confirming direct CP-violation with great precision. This phenomenon helps us to understand the imbalance between matter and antimatter in the Universe. At a seminar at CERN on 10 May Guillaume Unal of the Laboratory's NA48 collaboration announced NA48's final result on one of nature's best-kept secrets. Direct CP-violation, as it is called, is a subtle effect that betrays nature's preference for matter over antimatter, the reason why we are here. In 1993, an earlier CERN experiment, NA31, and the E731 experiment at Fermi National Accelerator Laboratory (Fermilab) in the USA published the first precise results on direct CP-violation. The CERN result suggested that direct CP-violation was a real effect. The Fermilab result, while not excluding the effect, was also compatible with no direct CP-violation. More precise measurements were clearly needed, and ambitious new experiments at the two laboratories - NA48 and KTeV - soon rose to the challenge. Both have now measure...

  5. 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, ...

  6. Wind energy's subtle effect - habitat fragmentation

    Energy Technology Data Exchange (ETDEWEB)

    Pruett, Jay

    2011-07-01

    Full text: New wind energy production facilities are being built to accommodate demands for more, renewable, emission-free energy. This development is most often in windy, remote parts of the United States, so new transmission infrastructure capacity is also needed for shipment of energy from prairies, hilltops and shorelines to distant population centres. Well known environmental effects from wind energy development have included direct mortality to birds and bats. However, there is a more subtle effect also at play. 'Habitat fragmentation' is an impact caused by the siting and presence of infrastructure features on wildlife species. Instead of direct mortality, there is behavioural avoidance of such features because of activity, noise and even simply the presence of vertical structures that are different from the original nature of the habitat. This fragmentation threatens to make some of the last remaining habitat for declining species, especially grassland birds, unusable by them. Prairie grouse such as prairie chickens and sage grouse appear to be particularly susceptible to habitat fragmentation due to the presence of vertical structures. Other species such as the grasshopper sparrow have also been shown to avoid such features. It is believed that these species have evolved to avoid any vertical structure because it can serve as a perch for bird-eating raptors, including eagles, hawks, falcons and owls. Certain life cycle stages, such as nesting and chick rearing, appear to be most vulnerable to these fragmentation influences. Some of the research contributing to concern over habitat fragmentation, along with the mechanism of such fragmentation, will be presented. Solutions will also be offered for the siting of wind energy facilities and transmission lines to avoid this negative environmental impact. (Author)

  7. 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...

  8. 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.

  9. Counseling Abused Children.

    Science.gov (United States)

    McFadden, Emily Jean

    This guide on counseling abused children was written to help counselors meet the needs of children and adolescents and to provide ways of working with the child's family. Chapter 1 presents an overview of child maltreatment by identifying types of maltreatment (neglect, physical abuse, sexual abuse and exploitation, and emotional abuse or neglect)…

  10. Preventing Internal Computer Abuse

    Science.gov (United States)

    1986-12-01

    Substance Abuse . The use -)i illegal drugs or the abuse of prescribed drugs and/or alcohol must be proscribed from the workplace . Also, substance abuse ...resolving their own personal problems. Their problems include money, family, drug or alcohol addiction , gambling, or work-related difficulties perhaps...Moonlighting * Organizational Property * Nonuse/nondisclosure * Substance Abuse * Gambling Employee Assistance Program "Whistle

  11. Magnitude and patterns of child sexual abuse: A retrospective cross ...

    African Journals Online (AJOL)

    user

    the prevalence and describe the patterns of sexual abuse of male pediatric patients at Tikur Anbessa Specialized. Hospital in Addis ... Affairs, and child advocacy organizations should be called up on to work together and design mechanisms of checking the ..... Effects of Systematic Screening and Detection of. Child Abuse ...

  12. New Evidence of Construct Validity Problems for Pettigrew and Meertens' (1995) Blatant and Subtle Prejudice Scale.

    Science.gov (United States)

    Arancibia-Martini, Héctor; Ruiz, Miguel Á; Blanco, Amalio; Cárdenas, Manuel

    2016-04-01

    Given the current debate over the distinction between subtle and blatant prejudice, this study provides new evidence regarding problems with the construct validity of the Pettigrew and Meertens' Blatant and Subtle Prejudice Scale. To assess these issues, an existing data sample of 896 Chilean participants collected in 2010 was reanalyzed. The main analysis method used was a confirmatory factor analysis. The model that best represented the original theory (a model of two correlated second-order factors) had an improper solution due to the unidentified model. The scale has substantial psychometric problems, and it was not possible to distinguish between subtle and blatant prejudice. © The Author(s) 2016.

  13. 77 FR 75179 - National Institute on Drug Abuse; Notice of Closed Meetings

    Science.gov (United States)

    2012-12-19

    ... invasion of personal privacy. Name of Committee: National Institute on Drug Abuse Special Emphasis Panel... Extramural Affairs, National Institute on Drug Abuse, NIH, DHHS, 6001 Executive Blvd., Room 4229, MSC 9550... Drug Abuse Special Emphasis Panel; Profile Screening and Predictive Toxicology (8909). Date: February...

  14. Childhood Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Evrim Aktepe

    2009-08-01

    Full Text Available Sexual abuse is defined as use of child or adolescent by the adults for satisfying of sexual urges and needs with forcing, threatening or tricking. Sexual abuse can be in the form of sexual abuse without touch, sexual touch, interfemoral intercourse, sexual penetration, and sexual exploitation. The prevalence of sexual abuse is reported as 10-40%. It is seen in female four times more than in males. Abusers are frequently male, only 5-15% of them are female. The abuse by females is usually towards male child. Thirty-fifty percent of abuse cases among child and adolescent are outside the family including strangers or familiar person. Some features of abusers are introvert personality, pedophilic and antisocial personality. Most of the abusers have a history of sexual abuse or aggression during childhood. Sexual intercourse between two people who are not allowed to marry by law is called as incest. Family pattern of incest is defined globally as disorganized and dysfunctional. The most commonly reported familial pattern is rigid and patriarchal family pattern with a harsh father using force quite frequently. The clinical features and impacts of the sexual abuse on the child varies according to the relation between abusers and the child, form of abuse, duration of abuse, presence of physical assault, developmental phase, child age and psychological development before the abuse. Sexual abuse history may result in psychiatric disorders including anxiety, depression, substance dependence, suicide act, borderline personality disorder, posttraumatic stress disorder. Abuse negatively affects interpersonal relationships and self esteem of abused individuals. Several studies reported close association between risky sexual behaviors in adulthood and a history of of sexual abuse during childhood. Four traumatic dynamics including traumatic sexuality with abuse, feeling of betrayal, weakness, and stigmatization exist in childhood abuse. Trauma can cause

  15. Advances in Advertising Research (Vol. VI) : The Digital, the Classic, the Subtle, and the Alternative

    NARCIS (Netherlands)

    Verlegh, P.; Voorveld, H.; Eisend, M.

    2016-01-01

    This book provides insights into the inspiring and multifaceted field of advertising research, which is confronted with challenges regarding ad content and execution, media placement, as well as online and social media. Distinguishing between digital, classic, subtle, and alternative advertising

  16. 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.

  17. hMPV and RSV: subtle differences but comparable severity

    Directory of Open Access Journals (Sweden)

    Nour Akhras

    2010-08-01

    further understand hMPV-associated illness, compare clinical characteristics of hMPV and RSV and establish the utility of routine screening for hMPV.hMPV-associated illnesses were retrospectively identified and described among children with respiratory symptoms admitted to a tertiary care center in southeast Michigan during the 2006-2007 respiratory viral season. A convenience sample of 256 nasopharyngeal specimens was subjected to nucleic acid extraction and amplification to identify those specimens positive for hMPV.  Medical record review was undertaken to retrieve demographic and clinical data of patients with hMPV, comparing them to RSV-positive patients and patients evaluated for respiratory symptoms who were negative for hMPV and RSV.hMPV was the second most commonly identified virus after RSV.  hMPV-positive patients were older than RSV-positive patients.  Among hMPV-positive patients, pneumonia was diagnosed in 37.5%, bronchiolitis was diagnosed in 31.2%, peribronchial cuffing was present on chest radiographs of 37.5%, antibiotic treatment was used in 81.2% and admission to the ICU was seen in 37.5%.  Finally, hMPV-positive patients were more likely to have fever than RSV-positive patients or patients negative for hMPV and RSV. hMPV is a major pathogen associated with hospitalization of children and is associated with the same severity of illness as RSV but in a slightly older population.   Due to apparent prevalence and severity of illness, routine screening should be implemented.

  18. Preventing Abuse and Neglect

    Science.gov (United States)

    ... respect, and even their freedom. Guarding Against Child Sexual Abuse March 15, 2018 @ 9:58 AM | 9 Min ... Views You can help protect your children from sexual abuse by providing careful supervision, establishing open communication and ...

  19. Cough & Cold Medicine Abuse

    Science.gov (United States)

    ... Videos for Educators Search English Español Cough & Cold Medicine Abuse KidsHealth / For Teens / Cough & Cold Medicine Abuse ... resfriado Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  20. Prescription Drug Abuse

    Science.gov (United States)

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, ...

  1. Alcoholism and Alcohol Abuse

    Science.gov (United States)

    ... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... referrals. NIH: National Institute on Alcohol Abuse and Alcoholism

  2. Drug abuse first aid

    Science.gov (United States)

    ... use of these drugs is a form of drug abuse. Medicines that are for treating a health problem ... about local resources. Alternative Names Overdose from drugs; Drug abuse first aid References Myck MB. Hallucinogens and drugs ...

  3. Child Abuse - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Child Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Child Abuse - Multiple Languages To use the sharing features on ...

  4. Skin manifestations of child abuse

    OpenAIRE

    Ermertcan Aylin; Ertan Pelin

    2010-01-01

    Child abuse is a major public health problem all over the world. There are four major types of abuse: physical abuse, sexual abuse, emotional abuse and neglect. The most common manifestations of child abuse are cutaneous and their recognition; and differential diagnosis is of great importance. Clinicians, especially dermatologists, should be alert about the skin lesions of child abuse. In the diagnosis and management of child abuse, a multidisciplinary approach with ethical and legal procedur...

  5. Abuse of prescription drugs.

    OpenAIRE

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disable...

  6. Bruising characteristics discriminating physical child abuse from accidental trauma.

    Science.gov (United States)

    Pierce, Mary Clyde; Kaczor, Kim; Aldridge, Sara; O'Flynn, Justine; Lorenz, Douglas J

    2010-01-01

    Our objective was to conduct a pilot study to identify discriminating bruising characteristics and to model those findings into a decision tool for screening children at high risk for abuse. A case-control study of children 0 to 48 months of age who were admitted to a PICU because of trauma was performed. Case subjects (N = 42) were victims of physical abuse, and control subjects (N = 53) were children admitted because of accidental trauma during the same time period. Bruising characteristics (total number and body region) and patient age were compared for children with abusive versus accidental trauma. The development of a decision rule for predicting abusive trauma was accomplished with the fitting of a classification and regression tree through binary recursive partitioning. Ninety-five patients were studied. Seventy-one (33 of 42 patients in the abuse group and 38 of 53 in the accident group) were found to have bruising, and the characteristics were modeled. Characteristics predictive of abuse were bruising on the torso, ear, or neck for a child abuse. Discriminating differences exist in bruising characteristics for abusive versus accidental trauma. The body region- and age-based bruising clinical decision rule model functions as a clinically sensible screening tool to identify young children who require further evaluation for abuse.

  7. Woman abuse and pregnancy outcome among women in Khoram Abad, Islamic Republic of Iran.

    Science.gov (United States)

    Khodakarami, N; Naji, H; Dashti, M G; Yazdjerdi, M

    2009-01-01

    We carried out a descriptive analysis on the pregnancy outcome in 313 pregnant women abused, 160 non-abused). Abuse was statistically significantly correlated with mean weight gain during pregnancy, mean frequency of the prenatal care, prolonged labour (dystocia), premature rupture of membrane, low mean birth weight and mean gestational age at birth. Given the high likelihood that a woman will access health care services during her pregnancy, physicians providing prenatal care are in a strategic position to screen for partner abuse.

  8. Measuring abusive behaviors: is economic abuse a unique form of abuse?

    Science.gov (United States)

    Stylianou, Amanda Mathisen; Postmus, Judy L; McMahon, Sarah

    2013-11-01

    Recent attention has been given by researchers to exploring economic abuse strategies used by abusers. However, little research has been conducted to understanding how to conceptualize economic abuse in relation to other forms of abuse. This article examines the factor structure of abusive items from the Scale of Economic Abuse--12 and the Abusive Behavior Inventory through confirmatory factor analyses using data collected with 457 female survivors of abuse. The findings provide evidence for conceptualizing economic abuse as a unique form of abuse moderately correlated with psychological, physical, and sexual forms of abuse.

  9. Gently does it: Humans outperform a software classifier in recognizing subtle, nonstereotypical facial expressions.

    Science.gov (United States)

    Yitzhak, Neta; Giladi, Nir; Gurevich, Tanya; Messinger, Daniel S; Prince, Emily B; Martin, Katherine; Aviezer, Hillel

    2017-12-01

    According to dominant theories of affect, humans innately and universally express a set of emotions using specific configurations of prototypical facial activity. Accordingly, thousands of studies have tested emotion recognition using sets of highly intense and stereotypical facial expressions, yet their incidence in real life is virtually unknown. In fact, a commonplace experience is that emotions are expressed in subtle and nonprototypical forms. Such facial expressions are at the focus of the current study. In Experiment 1, we present the development and validation of a novel stimulus set consisting of dynamic and subtle emotional facial displays conveyed without constraining expressers to using prototypical configurations. Although these subtle expressions were more challenging to recognize than prototypical dynamic expressions, they were still well recognized by human raters, and perhaps most importantly, they were rated as more ecological and naturalistic than the prototypical expressions. In Experiment 2, we examined the characteristics of subtle versus prototypical expressions by subjecting them to a software classifier, which used prototypical basic emotion criteria. Although the software was highly successful at classifying prototypical expressions, it performed very poorly at classifying the subtle expressions. Further validation was obtained from human expert face coders: Subtle stimuli did not contain many of the key facial movements present in prototypical expressions. Together, these findings suggest that emotions may be successfully conveyed to human viewers using subtle nonprototypical expressions. Although classic prototypical facial expressions are well recognized, they appear less naturalistic and may not capture the richness of everyday emotional communication. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Identification and Evaluation of Physical Abuse in Children.

    Science.gov (United States)

    Hoehn, Erin F; Wilson, Paria M; Riney, Lauren C; Ngo, Vi; Bennett, Berkeley; Duma, Elena

    2018-03-01

    Child physical abuse affects hundreds of thousands of children annually and is an important cause of morbidity and mortality in children. Pediatric health care providers play a key role in the recognition and treatment of suspected child abuse. Abusive injuries are often missed, which may lead to dire consequences for the child. Standardized screening tools and treatment guidelines can enhance early recognition of child abuse. This article reviews key findings in a medical history and physical examination that should raise suspicion for abuse. We also review the recommended evaluation that should occur when child abuse is suspected, as well as indications for reporting to child protective services. [Pediatr Ann. 2018;47(3):e97-e101.]. Copyright 2018, SLACK Incorporated.

  11. The Influence of the Expression of Subtle and Blatant Sexual Prejudice on Personal Prejudice and Identification With the Expresser.

    Science.gov (United States)

    Krolikowski, Alex M; Rinella, Mark; Ratcliff, Jennifer J

    2016-01-01

    Although the negative consequences of subtle and blatant prejudice for the targets of prejudice are clear in the psychological literature, the impact of exposure to subtle and blatant prejudice on non-targets remains unclear. The current work examines how exposure to blatant and subtle sexual prejudice affects non-targets' personal endorsement of prejudice and their identification with the prejudice expresser. Results suggest that relative to exposure to blatant or neutral expressions of prejudice, exposure to subtle prejudice increased prejudice levels. Individuals were also more likely to distance from the prejudice expresser when exposed to blatant compared to subtle prejudice. The implications are discussed.

  12. Adolescent tramadol use and abuse in Egypt.

    Science.gov (United States)

    Bassiony, Medhat M; Salah El-Deen, Ghada M; Yousef, Usama; Raya, Yasser; Abdel-Ghani, Mohamed M; El-Gohari, Hayam; Atwa, Samar A

    2015-05-01

    Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has not been well studied in Egypt. The aim of this study was to estimate the prevalence and associated correlates of tramadol use and abuse among school students in Egypt. A total of 204 students, aged 13-18 years, from six schools in Zagazig, Egypt, were screened for tramadol use using The Drug Use Disorders Identification Test and a urine screen for tramadol. The prevalence of tramadol use was 8.8% among school students and the average age at onset of tramadol use was 16.5 ± 1.1. Some 83% of the users were using tramadol alone while the rest (17%) were using a combination of tramadol, alcohol, and cannabis. Two-thirds of these students started with tramadol as the first drug after the onset of tobacco smoking. Over one third of tramadol users had drug-related problems and 6% had dependence. There was a significant association between tramadol use and older age, male gender, and smoking. Drug-related problems were negatively correlated with age at onset of tramadol use. Tramadol use was common among adolescents and over one third of tramadol users had drug-related problems. Population-based longitudinal studies are needed to investigate tramadol use and the possible role of tramadol as a gateway drug in the development of substance abuse in Egypt.

  13. Subtle Alterations in Brain Anatomy May Change an Individual’s Personality in Chronic Pain

    Science.gov (United States)

    Gustin, Sylvia M.; McKay, Jamie G.; Petersen, Esben T.; Peck, Chris C.; Murray, Greg M.; Henderson, Luke A.

    2014-01-01

    It is well established that gross prefrontal cortex damage can affect an individual’s personality. It is also possible that subtle prefrontal cortex changes associated with conditions such as chronic pain, and not detectable until recent advances in human brain imaging, may also result in subtle changes in an individual’s personality. In an animal model of chronic neuropathic pain, subtle prefrontal cortex changes including altered basal dendritic length, resulted in altered decision making ability. Using multiple magnetic resonance imaging techniques, we found in humans, although gray matter volume and on-going activity were unaltered, chronic neuropathic pain was associated with reduced free and bound proton movement, indicators of subtle anatomical changes, in the medial prefrontal cortex, anterior cingulate cortex and mediodorsal thalamus. Furthermore, proton spectroscopy revealed an increase in neural integrity in the medial prefrontal cortex in neuropathic pain patients, the degree of which was significantly correlated to the personality temperament of novelty seeking. These data reveal that even subtle changes in prefrontal cortex anatomy may result in a significant change in an individual’s personality. PMID:25291361

  14. 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.

  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. Age-related differences in implicit learning of subtle third-order sequential structure.

    Science.gov (United States)

    Bennett, Ilana J; Howard, James H; Howard, Darlene V

    2007-03-01

    Age-related implicit learning deficits increase with sequence complexity, suggesting there might be limits to the level of structure that older adults can learn implicitly. To test for such limits, we had 12 younger and 12 older adults complete an alternating serial reaction time task containing subtle structure in which every third trial follows a repeating sequence and intervening trials are determined randomly. Results revealed significant age deficits in learning. However, both groups did learn the subtle regularity without explicit awareness, indicating that older adults remain sensitive to highly complex sequential regularities in their environment, albeit to a lesser degree than younger adults.

  17. A more subtle set of information in corporate annual reports for disadvantaged stakeholders

    Directory of Open Access Journals (Sweden)

    Christo Cronje

    2010-12-01

    Full Text Available The traditional corporate annual report consists of two types of disclosures, that is, mandatory and contextual disclosures. The research problem focuses on the issue whether full disclosure in corporate annual reports could entail mandatory and contextual disclosures as well as a more subtle set of information for disadvantaged stakeholders. To solve the research problem, use was mainly made of a literature review dealing with certain aspects of decision-useful financial reporting. The literature review was complemented by exploratory empirical research. It was found that full disclosure in corporate annual reports could consist of mandatory and contextual disclosures as well as a more subtle set of information for disadvantaged stakeholders.

  18. Unusual and subtle scintigraphic findings in the evaluation of the battered child

    International Nuclear Information System (INIS)

    Howard, J.L.; Barron, B.J.; Smith, G.G.

    1988-01-01

    Nuclear medicine imaging plays a key role in the evaluation of skeletal trauma. Recent findings in our department show that diagnoses other than skeletal trauma are often identified by means of subtle and unusual scintigraphic findings. The subject material will place strong emphasis on the less mentioned but often more important visceral and intracranial injury. Specific scintigraphic abnormalities to be demonstrated, with appropriate correlative radiographs, include (1) visceral and soft tissue (eg, duodenal hematoma, splenic laceration, renal contusion, hepatic hematoma, rhabdomyolysis and soft-tissue hematoma); (2) cranial (eg, intracranial bleeding, edema, and infarct, cephalohematoma, skull fracture, and widening of sutures; and (3) skeletal (various subtle abnormalities)

  19. 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.

  20. Cervical spinal cord injury in abused children.

    Science.gov (United States)

    Feldman, Kenneth W; Avellino, Anthony M; Sugar, Naomi F; Ellenbogen, Richard G

    2008-04-01

    Five infants and toddlers who sustained cervical spinal cord injury as the result of child abuse are described. Three cases are previously unreported. Diagnosis was complicated by coexistent brain injuries and their treatments, subtle and/or evolving paralysis, and central cord syndrome, in which arm function is diminished but leg function is preserved. Definitive spinal imaging by magnetic resonance imaging (MRI), computed tomography, and plain radiographs was delayed because of life support efforts. When completed, the MRI was most sensitive to cord injury. Evidence of associated bony spinal injury was often absent or unapparent until healing occurred; 4 children had spinal cord injury without (or with minimal) radiological abnormality. The 3 children presenting to our hospital with cord injury represent 1% of the estimated cases of inflicted head injury seen during a 23-year period.

  1. Gender-based abuse: the global epidemic

    Directory of Open Access Journals (Sweden)

    Heise Lori

    1994-01-01

    Full Text Available Gender Based violence-including rape, domestic violence, murder and sexual abuse-is a profund health problem for women across the globe. Although a significant cause of female morbidity and mortality, violence against women has only recently begun to be recognized as an issue for public health. This paper draws together existing data on the dimensions of violence against women worldwide and reviews available literature on the health consequences of abuse. It argues that the health sector has an important role to play in combatting violence against women through increased research, screening and referral of victims, and behavioral interventions. Any strategy to confrnt violence must address the root causes of abuse in addition to meeting the immediate needs of victims. This means challenging the social attitudes and beliefs that undergird men's violence and renegotiating the balance of power between women and men at all levels of society.

  2. Do general practitioners record alcohol abuse in the electronic medical records? : A comparison of survey and medical record data

    NARCIS (Netherlands)

    Abidi, L.; Oenema, A.; van den Akker, M.; van de Mheen, D.

    2018-01-01

    Objective: Primary care professionals are encouraged to screen patients for alcohol abuse. However, patients with alcohol abuse are often under-diagnosed as well as under-registered in medical records in general practices. This study aims to report on the registration rates of alcohol abuse

  3. Alternative drugs of abuse.

    Science.gov (United States)

    Sutter, M E; Chenoweth, J; Albertson, T E

    2014-02-01

    The incidence of drug abuse with alternative agents is increasing. The term "alternative drugs of abuse" is a catch-all term for abused chemicals that do not fit into one of the classic categories of drugs of abuse. The most common age group abusing these agents range from 17 to 25 years old and are often associated with group settings. Due to their diverse pharmacological nature, legislative efforts to classify these chemicals as a schedule I drug have lagged behind the development of new alternative agents. The potential reason for abuse of these agents is their hallucinogenic, dissociative, stimulant, anti-muscarinic, or sedative properties. Some of these drugs are easily obtainable such as Datura stramonium (Jimson Weed) or Lophophora williamsii (Peyote) because they are natural plants indigenous to certain regions. The diverse pharmacology and clinical effects of these agents are so broad that they do not produce a universal constellation of signs and symptoms. Detailed physical exams are essential for identifying clues leading one to suspect an alternative drug of abuse. Testing for the presence of these agents is often limited, and even when available, the results do not return in a timely fashion. Intoxications from these agents pose unique challenges for health care providers. Physician knowledge of the physiological effects of these alternative agents and the local patterns of drug of abuse are important for the accurate diagnosis and optimal care of poisoned patients. This review summarizes the current knowledge of alternative drugs of abuse and highlights their clinical presentations.

  4. Elder Abuse and Neglect

    Directory of Open Access Journals (Sweden)

    Muge Gulen

    2013-06-01

    Full Text Available Abuse and neglect are preventable societal problems that influence elderly individuals physically, spiritually and socially. Elder abuse is neglected for many years and is a growing problem all over the world. The aim of this article is to review the evaluation of elderly individuals who are exposed to abuse and neglect with systematic detailed history and physical examination and to describe individual, familial, and social measures that should be taken to prevent these abuses. [Archives Medical Review Journal 2013; 22(3.000: 393-407

  5. CERN result provides answer to one of nature's most subtle secrets

    CERN Multimedia

    CERN Press Office. Geneva

    1999-01-01

    At a seminar at CERN on 18 June Pascal Debu, spokesman of the Laboratory's NA48 experiment, announced its preliminary result, after analysis of 10% of the expected data, on one of nature's best-kept secrets. Direct CP-violation, as it is called, is a subtle effect that betrays nature's preference for matter over antimatter, the reason why we are here.

  6. Subtle lower esophageal sphincter relaxation abnormalities in patients with unexplained esophageal dysphagia

    NARCIS (Netherlands)

    Herregods, T. V. K.; van Hoeij, F. B.; Bredenoord, A. J.; Smout, A. J. P. M.

    2018-01-01

    Esophageal dysphagia is a relatively common symptom. We aimed to evaluate whether subtle, presently not acknowledged forms of dysfunction of the lower esophageal sphincter (LES) could explain dysphagia in a subset of patients with normal findings at high-resolution manometry (HRM) according to the

  7. Seeing Emotions: A Review of Micro and Subtle Emotion Expression Training

    Science.gov (United States)

    Poole, Ernest Andre

    2016-01-01

    In this review I explore and discuss the use of micro and subtle expression training in the social sciences. These trainings, offered commercially, are designed and endorsed by noted psychologist Paul Ekman, co-author of the Facial Action Coding System, a comprehensive system of measuring muscular movement in the face and its relationship to the…

  8. Subtle interaction between Ag and O2: A near ambient pressure UV ...

    Indian Academy of Sciences (India)

    Admin

    Subtle interaction between Ag and O2: A near ambient pressure UV photoelectron spectroscopy (NAP-UPS) investigations. MANOJ KUMAR GHOSALYA,a KASALA PRABHAKAR REDDY,a RUCHI JAIN,a KANAK. ROYa and CHINNAKONDA S GOPINATHa,b*. aCatalysis Division, National Chemical Laboratory, Dr. Homi ...

  9. Deaf Students' Knowledge of Subtle Lexical Properties of Transitive and Intransitive English Verbs

    Science.gov (United States)

    Berent, Gerald P.; Kelly, Ronald R.; Albertini, John A.; Toscano, Rose Marie

    2013-01-01

    Deaf Learners' Acquisition of fundamental lexical properties of high-frequency English verbs related to transitivity and intransitivity was examined, including the subtle distinction between unergative and unaccusative verbs. A 140-item sentence acceptability rating scale was used to assess this lexical knowledge in deaf college students at two…

  10. Validation of the Child Abuse Potential Inventory in Italy

    Directory of Open Access Journals (Sweden)

    Sarah Miragoli

    2015-07-01

    Full Text Available The aim of this study was to provide preliminary findings on the reliability and the validity of the Italian Child Abuse Potential (CAP Inventory, a screening tool that measures parents’ potential for child physical abuse. The CAP Inventory and measures on parenting stress (Parenting Stress Index–Short Form [PSI-SF] and parents’ perceptions of child adjustment (Child Behavior Checklist [CBCL] were administered in a nonclinical sample of Italian parents (N = 551 with a 2- to 6-year-old child. The Abuse scale showed adequate internal consistency (α = .87, with significantly negative correlations between socioeconomic status and educational level of the parents. Also, the Abuse scale scores were significantly predicted by high levels of parenting stress and by parental negative perceptions of the child’s behavior. Finally, using a cut score for the English version of the Abuse scale (where 95% of parents would be expected to be classified, 93.8% of Italian parents were classified as nonabusive by the Abuse scale. These results supported the cross-cultural generalizability of the Abuse scale. However, complementary studies with abusive samples are needed to verify the ability of the instrument to discriminate between abusive and nonabusive parents also in the Italian population.

  11. Sexual abuse of children as a form of power abuse and abuse of the ...

    African Journals Online (AJOL)

    Sexual abuse of children as a form of power abuse and abuse of the body. ... Abstract. This article investigates the relationship between sexual abuse, power and the body from a Catholic theological viewpoint. ... It discusses how the perception of the body has an impact on dealing with the body and potential sexual abuse.

  12. Elder abuse in assisted living.

    Science.gov (United States)

    Castle, Nicholas; Beach, Scott

    2013-03-01

    Assisted Living (AL) currently represents one of the most numerous institutional care settings for elders. Very little information exists on abuse in AL. Descriptive information on elder abuse reported by nurse aides working in AL is presented from a survey sent to nurse aides. The questionnaire had items addressing verbal, physical, psychological, caregiving, medication, material, and sexual abuse. The responses to the questions included in the verbal abuse, physical abuse, psychological abuse, caregiving abuse, medication abuse, and material exploitation abuse sections (28 questions) show that suspected abuse is not uncommon. We could not objectively verify the cases of abuse described in the survey, still, they give a first indication that staff abuse may occur in AL. This may be significant given the large number of ALs in the United States and may influence the health, quality of life, and safety of many residents.

  13. Child Abuse: The Hidden Bruises

    Science.gov (United States)

    ... 5; Updated November 2014 The statistics on physical child abuse are alarming. It is estimated hundreds of thousands ... Physical abuse is not the only kind of child abuse. Many children are also victims of neglect, or ...

  14. Cough and Cold Medicine Abuse

    Science.gov (United States)

    ... Twitter YouTube Flickr RSS Menu Home Drugs of Abuse Commonly Abused Drugs Charts Emerging Trends and Alerts ... the following language: Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health ...

  15. Animal models of substance abuse and addiction: implications for science, animal welfare, and society.

    Science.gov (United States)

    Lynch, Wendy J; Nicholson, Katherine L; Dance, Mario E; Morgan, Richard W; Foley, Patricia L

    2010-06-01

    Substance abuse and addiction are well recognized public health concerns, with 2 NIH institutes (the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism) specifically targeting this societal problem. As such, this is an important area of research for which animal experiments play a critical role. This overview presents the importance of substance abuse and addiction in society; reviews the development and refinement of animal models that address crucial areas of biology, pathophysiology, clinical treatments, and drug screening for abuse liability; and discusses some of the unique veterinary, husbandry, and IACUC challenges associated with these models.

  16. Protecting children from sexual abuse by health care providers.

    Science.gov (United States)

    2011-08-01

    Sexual abuse or exploitation of children is never acceptable. Such behavior by health care providers is particularly concerning because of the trust that children and their families place on adults in the health care profession. The American Academy of Pediatrics strongly endorses the social and moral prohibition against sexual abuse or exploitation of children by health care providers. The academy opposes any such sexual abuse or exploitation by providers, particularly by the academy's members. Health care providers should be trained to recognize and abide by appropriate provider-patient boundaries. Medical institutions should screen staff members for a history of child abuse issues, train them to respect and maintain appropriate boundaries, and establish policies and procedures to receive and investigate concerns about patient abuse. Each person has a responsibility to ensure the safety of children in health care settings and to scrupulously follow appropriate legal and ethical reporting and investigation procedures.

  17. Child Sexual Abuse

    Science.gov (United States)

    ... can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, and begin the process of overcoming the trauma. Such treatment can help reduce the risk that the child will develop serious problems ... you find Facts for Families © helpful and would like to make ...

  18. Opioid Abuse and Addiction

    Science.gov (United States)

    ... means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm. The risks of dependence and addiction are higher if you abuse the medicines. Abuse ...

  19. Battling Sexual Abuse

    Science.gov (United States)

    Dessoff, Alan

    2010-01-01

    From costly lawsuits on behalf of victims to negative media coverage, districts can face potentially devastating consequences as a result of sexual abuse of their students by district employees. This article offers a few tips on how to battle sexual abuse particularly in school districts. The author stresses that by adopting strong policies that…

  20. SNL Abuse Testing Manual.

    Energy Technology Data Exchange (ETDEWEB)

    Orendorff, Christopher [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lamb, Joshua [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Steele, Leigh Anna Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-07-01

    This report describes recommended abuse testing procedures for rechargeable energy storage systems (RESSs) for electric vehicles. This report serves as a revision to the FreedomCAR Electrical Energy Storage System Abuse Test Manual for Electric and Hybrid Electric Vehicle Applications (SAND2005-3123).

  1. Antitussives and substance abuse.

    Science.gov (United States)

    Burns, Jarrett M; Boyer, Edward W

    2013-01-01

    Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations.

  2. Recreational drugs of abuse.

    Science.gov (United States)

    Albertson, Timothy E

    2014-02-01

    The use of recreational drugs of abuse continues to expand without limitations to national boundaries, social status, race, or education. Beyond the prevalence of illicit drug use and dependence, their contribution to the global burden of disease and death are large and troubling. All medical providers should be aware of the evolving drugs of abuse and their medical and social consequences. In addition to heroin and stimulants such as cocaine and methamphetamine, new designer stimulants called "bath salts" and cannabinoids called "spice," along with the abuse of prescription drugs and volatile substances, are now widely recognized problems in many societies. The wide variety and continuingly expanding clinical manifestations of toxicity of recreational drugs of abuse is not widely appreciated by clinicians. This edition attempts to summarize six major classes of drugs of abuse and their clinical effects with special emphasis on their immunological and respiratory effects.

  3. Abuse of prescription drugs.

    Science.gov (United States)

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

  4. Abuse Potential of Pregabalin

    DEFF Research Database (Denmark)

    Schjerning, Ole; Rosenzweig, Mary; Pottegård, Anton

    2016-01-01

    BACKGROUND: Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last decade. Pregabalin is, in some cases, used for recreational purposes and it has incurred attention among drug abusers...... for causing euphoric and dissociative effects when taken in doses exceeding normal therapeutic dosages or used by alternative routes of administration, such as nasal insufflation or venous injection. The magnitude of the abuse potential and the mechanism behind it are not fully known. OBJECTIVE: The aim...... of this study was to present a systematic review of the data concerning the abuse potential of pregabalin. METHODS: We performed a systematic literature search and reviewed the preclinical, clinical and epidemiological data on the abuse potential of pregabalin. RESULTS: We included preclinical (n = 17...

  5. 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.

  6. Parents' perceptions about child abuse and their impact on physical and emotional child abuse: A study from primary health care centers in Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohammed N Al Dosari

    2017-01-01

    CONCLUSION: The causes of child abuse and neglect are complex. Though detecting child abuse may be difficult in primary care practice, many risk factors can be identified early. Parents' attitudes can be measured, and prevention initiatives, such as screening and counseling for parents of children at risk, can be developed and incorporated into primary care practice.

  7. Drug abuse: newly-emerging drugs and trends.

    Science.gov (United States)

    Davis, Gregory G

    2012-09-01

    Drug abusers have access to new, more potent compounds that evade existing laws by virtue of their novel chemical structures. These drugs are available for purchase at stores and over the internet. The drugs are not illegal because they are so new that laws have not yet been passed to ban them. These drugs are leading to emergency department visits for cardiovascular, neurologic, and psychiatric complications. Standard drug screens are not designed to detect these new substances. The internet provides access to drugs for substance abusers but also provides physicians speed of access to the habits of substance abusers.

  8. Detection of child abuse in emergency departments: a multi-centre study

    Science.gov (United States)

    Louwers, Eveline C F M; Korfage, Ida J; Affourtit, Marjo J; Scheewe, Dop J H; van de Merwe, Marjolijn H; Vooijs-Moulaert, Francoise A F S R; Woltering, Claire M C; Jongejan, Mieke H T M; Ruige, Madelon; Moll, Henriëtte A; De Koning, Harry J

    2011-01-01

    Objective This study examines the detection rates of suspected child abuse in the emergency departments of seven Dutch hospitals complying and not complying with screening guidelines for child abuse. Design Data on demographics, diagnosis and suspected child abuse were collected for all children aged ≤18 years who visited the emergency departments over a 6-month period. The completion of a checklist of warning signs of child abuse in at least 10% of the emergency department visits was considered to be compliance with screening guidelines. Results A total of 24 472 visits were analysed, 54% of which took place in an emergency department complying with screening guidelines. Child abuse was suspected in 52 children (0.2%). In 40 (77%) of these 52 cases, a checklist of warning signs had been completed compared with a completion rate of 19% in the total sample. In hospitals complying with screening guidelines for child abuse, the detection rate was higher (0.3%) than in those not complying (0.1%, pchild abuse in 0.2% of all children visiting the emergency department of seven Dutch hospitals. The numbers of suspected abuse cases detected were low, but an increase is likely if uniform screening guidelines are widely implemented. PMID:21278429

  9. Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) with substance abusers in outpatient and residential treatment.

    Science.gov (United States)

    Voluse, Andrew C; Gioia, Christopher J; Sobell, Linda Carter; Dum, Mariam; Sobell, Mark B; Simco, Edward R

    2012-01-01

    The psychometric properties of the Drug Use Disorders Identification Test (DUDIT), an 11-item self-report questionnaire developed to screen individuals for drug problems, are evaluated. The measure, developed in Sweden and evaluated there with individuals with severe drug problems, has not been evaluated with less severe substance abusers or with clinical populations in the United States. Participants included 35 drug abusers in an outpatient substance abuse treatment program, 79 drug abusers in a residential substance abuse treatment program, and 39 alcohol abusers from both treatment settings who did not report a drug abuse problem. The DUDIT was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r=.85) when compared with the Drug Abuse Screening Test (DAST-10), and to have a Cronbach's alpha of .94. In addition, a single component accounted for 64.91% of total variance, and the DUDIT had sensitivity and specificity scores of .90 and .85, respectively, when using the optimal cut-off score of 8. Additionally, the DUDIT showed good discriminant validity as it significantly differentiated drug from alcohol abusers. These findings support the DUDIT as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. Further research is warranted with additional clinical populations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Selective incivility: immigrant groups experience subtle workplace discrimination at different rates.

    Science.gov (United States)

    Krings, Franciska; Johnston, Claire; Binggeli, Steve; Maggiori, Christian

    2014-10-01

    Immigrants play an increasingly important role in local labor markets. Not only do they grow steadily in number but also in cultural, educational, and skill diversity, underlining the necessity to distinguish between immigrant groups when studying discrimination against immigrants. We examined immigrant employees' subtle discrimination experiences in a representative sample in Switzerland, controlling for dispositional influences. Results showed that mainly members of highly competitive immigrant groups, from immediate neighbor countries, experienced workplace incivility and that these incivility experiences were related to higher likelihoods of perceived discrimination at work. This research confirms recent accounts that successful but disliked groups are particularly likely to experience subtle interpersonal discrimination. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  11. Digital gastrointestinal imaging: Effect of pixel size of subtle mucosal abnormalities on observer performance

    International Nuclear Information System (INIS)

    Kastan, D.J.; Ackerman, L.V.; Feczko, P.J.

    1986-01-01

    Radiographs from double-contrast colon examinations demonstrating subtle mucosal changes of inflammatory bowel disease and radiographs showing normal colon were digitized (0.1-mm, 0.2-mm, 0.4-mm and 0.8-mm pixel sizes). Ten radiologists interpreted the laser-printed images. Receiver operating characteristic analysis was performed. The results indicated that (1) the sensitivity of radiography in detecting subtle mucosal abnormalities improved as resolution improved; (2) more experience readers performed remarkably well even at the poorer levels of resolution; (3) the resolution necessary for evaluating the colonic mucosa was less than expected; and (4) at low noise levels, conventional television fluoroscopy may have sufficient resolution for mucosal evaluation

  12. 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.

  13. Latin America’s Subtle Racism: Salient Managerial Implications For Non-Latin American Managers

    OpenAIRE

    Rutilio Martinez; Cris de la Torre

    2011-01-01

    Since the mid nineteen nineties most Latin American nations have implemented free market policies. The ensuing economic stability has attracted investment from non-Latin corporations, thereby causing the transfer of non-Latin executives to Latin nations. For many of these executives, their Latin assignments include an unexpected challenge: Dealing with Latin America’s subtle but pervasive racism. Such racism contributes to the mistreatment of labor and influences the promotion and hiring of e...

  14. Newborn Screening

    Science.gov (United States)

    ... Laboratory Sciences Office of Public Health Genomics Publications & Articles Newborn Screening Lab Bulletin Laboratory Partners Multimedia Tools Newborn Screening Program – Role of Laboratories Meet the Scientist Newborn Screening: Family Stories Newborn Screening: Public Health ...

  15. Subtle Raman signals from nano-diamond and β-SiC thin films

    International Nuclear Information System (INIS)

    Kuntumalla, Mohan Kumar; Ojha, Harish; Srikanth, Vadali Venkata Satya Siva

    2013-01-01

    Micro Raman scattering experiments are carried out in pursuit of subtle but discernable signals from nano-diamond and β-SiC thin films. The thin films are synthesized using microwave plasma assisted chemical vapor deposition technique. Raman scattering experiments in conjunction with scanning electron microscopy and x-ray diffraction were carried out to extract microstructure and phase information of the above mentioned thin films. Certain subtle Raman signals have been identified in this work. In the case of nanodiamond thin films, Raman bands at ∼ 485 and ∼ 1220 cm −1 are identified. These bands have been assigned to the nanodiamond present in nanodiamond thin films. In the case of nano β-SiC thin films, optical phonons are identified using surface enhanced Raman scattering. - Highlights: ► Subtle Raman signals from nano-diamond and β-silicon carbide related thin films. ► Raman bands at ∼ 485 and ∼ 1220 cm −1 from nanodiamond thin films are identified. ► Longitudinal optical phonon from nano β-silicon carbide thin films is identified

  16. Workplace abuse: finding solutions.

    Science.gov (United States)

    Christmas, Kate

    2007-01-01

    The atmosphere within the work setting speaks volumes about your culture, and is often a primary factor in recruitment and retention (or turnover) of staff. Workplace tension and abuse are significant contributing factors as to why nurses are exiting workplaces--and even leaving the profession. Abuse can take many forms from inappropriate interpersonal communication to sexual harassment and even violence. Administrators should adopt a zero tolerance policy towards abusive communication. Addressing peer behavior is essential, but positive behavior must also be authentically modeled from the CNO and other nursing leaders. Raising awareness and holding individuals accountable for their behavior can lead to a safer and more harmonious work environment.

  17. Opioid Abuse after TBI

    Science.gov (United States)

    2015-09-01

    Award Number: W81XWH-11-1-0373 TITLE: “Opioid Abuse after TBI” PRINCIPAL INVESTIGATOR: Candace L. Floyd, Ph.D., and Katherine L. Nicholson...30Jun2015 4. TITLE AND SUBTITLE “Opioid Abuse after TBI” 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0373 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...secondly tested the hypothesis that moderate TBI increases the susceptibility for opioid abuse as measured by an alteration in the rewarding properties of

  18. Child Abuse and Mandated Reporting

    Science.gov (United States)

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  19. [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.

  20. Drug Abuse - Multiple Languages

    Science.gov (United States)

    ... Substance Abuse or Dependence - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section Substance ...

  1. Sexual Abuse of Children.

    Science.gov (United States)

    Csapo, Marg

    1988-01-01

    Canadian reports and legislation are reviewed to highlight the school's role in prevention and reporting of suspicions of child sexual abuse. The vulnerability of handicapped children and child pornography are two areas of victimization emphasized. (Author/DB)

  2. Child Sexual Abuse

    Science.gov (United States)

    ... version, located in the "Professional" section of our website: Child Sexual Abuse . Date this content was last updated is at the bottom of the page. ... PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign ...

  3. Leaving an Abusive Relationship

    Science.gov (United States)

    ... agree on a secret location where they can pick you up. Keep an alternate cellphone nearby. Try ... 2017 by: Rape, Abuse & Incest National Network (RAINN) Staff Kathleen C. Basile, Ph.D., Lead Behavioral Scientist, ...

  4. Child abuse: underlying mechanisms

    OpenAIRE

    Martínez, Gladys S.

    2009-01-01

    Exposure to traumatic stress during childhood, in the form of abuse or neglect, is related to an increased vulnerability resulting in the development of several pathologies, this relation has been confi rmed by epidemiological studies; however, the neural mechanisms underlying such abnormalities are still unknown. Most of the research done has focused on the effects in the infant, and only recently it has begun to focus on the neurobiological changes in the abusive parents. In this article, I...

  5. The Child Abuse

    OpenAIRE

    Hossein abbasnezhadriyabi; Mozhganjalali

    2016-01-01

    While a large number of children are losing their lives due to poverty, malnutrition, contagious diseases and war, we are witnessing hundreds of children death by reason of misbehaving. Today, "child abuse" as a social-cultural phenomenon which shows crisis in a society, has a growing process in our country. The goal of this research was to investigate the base factors of child abuse that according to the results are consist as follows, poverty, unemployment, addiction, large families, single...

  6. Antitussives and substance abuse

    Directory of Open Access Journals (Sweden)

    Burns JM

    2013-11-01

    Full Text Available Jarrett M Burns, Edward W Boyer Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA Abstract: Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations. Keywords: dextromethorphan, purple drank, sizzurp, codeine/promethazine

  7. Vaccines for Drug Abuse

    OpenAIRE

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

    2011-01-01

    Current medications for drug abuse have had only limited success. Anti-addiction vaccines to elicit antibodies that block the pharmacological effects of drugs have great potential for treating drug abuse. We review the status for two vaccines that are undergoing clinical trials (cocaine and nicotine) and two that are still in pre-clinical development (methamphetamine and heroin). We also outline the challenges and ethical concerns for anti-addiction vaccine development and their use as future...

  8. Cannabis and Alcohol Abuse Among First Psychotic Episode Inpatients.

    Science.gov (United States)

    Katz, Gregory; Kunyvsky, Yehuda; Hornik-Lurie, Tzipi; Raskin, Sergey; Abramowitz, Moshe Z

    2016-01-01

    abuse of cannabis. Two-thirds of the "predominantly affective symptoms" subjects were positive for THC, whereas only a third of the "only psychosis" subjects screened positive for THC. The percentage of cannabis and alcohol abuse in the study population is much higher than one would expect to see in the general Israeli population (according to the Knesset Research Department 7.6-10.2% of the adult Israeli population abuse cannabis). Different patterns of cannabis abuse among "predominantly affective" and "psychotic only" patients may lend credence to the preferential use of a specific substance per diagnosis.

  9. Inflammasome in drug abuse.

    Science.gov (United States)

    Xu, Enquan; Liu, Jianuo; Wang, Xiaobei; Xiong, Huangui

    2017-01-01

    Drug abuse disorders refer to a set of related negative health implications associated with compulsive drug seeking and use. Because almost all addictive drugs act on the brain, many of them cause neurological impairments after long-term abuse. Neuropathological studies have revealed a widespread impairment of the cellular elements. As the key components to limit the damage of neural cells, CNS immune system is also found affected by these drugs, directly or indirectly. It has been shown that drugs of abuse alter neuroimmune gene expression and signaling. Growing studies on neuroimmune factors further demonstrate their indispensable role in drugs-induced neurotoxicity. As an important proinflammatory intracellular receptor, inflammasome is activated in many neurodegenerative diseases in response to a broad range of damage-associated molecular patterns (DAMPs) signals. In the cases of drug abuse, especially in those with comorbid of HIV infection and sustained pain, inflammasome activation significantly promotes the neuroinflammation-associated toxicities. To understand inflammasome in drug-associated neurotoxic activity, we reviewed the role played by inflammasome in drug abuse-induced microglial neurotoxicity and evaluated the potential of imflammasone as a therapeutic target for drug abuse disorders based on recent development of various selective small-molecular inflammasome inhibitors.

  10. Voxel-based 3D MRI analysis helps to detect subtle forms of subcortical band heterotopia.

    Science.gov (United States)

    Huppertz, Hans-Jürgen; Wellmer, Jörg; Staack, Anke Maren; Altenmüller, Dirk-Matthias; Urbach, Horst; Kröll, Judith

    2008-05-01

    To evaluate the potential diagnostic value of a novel magnetic resonance image (MRI) postprocessing technique in subtle forms of subcortical band heterotopia (SBH). The method was introduced to improve the visualization of blurred gray-white matter junctions associated with focal cortical dysplasia but was found to be applicable also to SBH. In the voxel-based MRI analysis presented here, T1-weighted MRI volume data sets are normalized and segmented using standard algorithms of SPM5. The distribution of gray and white matter is analyzed on a voxelwise basis and compared with a normal database of 150 controls. Based on this analysis, a three-dimensional feature map is created that highlights brain areas if their signal intensities fall within the range between normal gray and white matter and differ from the normal database in this respect. The method was applied to the MRI data of 378 patients with focal epilepsy in three different epilepsy centers. SBH was diagnosed in seven patients with five of them showing subtle forms of SBH that had gone unrecognized in conventional visual analysis of MRI and were only detected by MRI postprocessing. In contrast to distinct double cortex syndrome, these patients had partial double cortex with SBH mostly confined to posterior brain regions. The results of this study suggest that a considerable part of cases with SBH might remain unrecognized by conventional MRI. Voxel-based MRI analysis may help to identify subtle forms and appears to be a valuable additional diagnostic tool in the evaluation of patients with cryptogenic epilepsy.

  11. Effect of local background anatomical patterns on the detection of subtle lung nodules in chest radiographs

    Science.gov (United States)

    Samei, Ehsan; Flynn, Michael J.; Eyler, William R.; Peterson, Edward

    1998-04-01

    Anatomical noise in chest radiography, created by the projection of anatomical features in the thorax such as ribs and pulmonary vessels, greatly influences the detection of subtle lung nodules in chest radiographs. Detection may be hindered by 1) the 'global' statistical characteristics of the background in relation to the signal associated withthe nodule, and/or 2) the interference of the 'local' background pattern with the nodule signal. This investigation aimed at assessing the influence of the latter process in the detection of subtle lung nodules. Six 8 X 8 cm images were extracted from the lung regions o six digital chest radiographs of normal patients from our clinic. Simulated nodules emulating the radiographic characteristics of subtle tissue-equivalent lesions ranging in size from 3.2 to 6.4 mm were numerically superimposed on the images. For each of the six lung images, a set of thirty-one processed images were produced, six containing no nodule, and the remaining 25 containing single nodules of five different sizes placed at five different locations within 6 mm of the center. The variation in location allowed different local background patterns to overlay the nodules. An observer detection study was then performed using 14 experienced radiologists. The observer data were analyzed to determine the variation in detectability with nodule location for all five sizes of the nodules. The preliminary results indicate that the variation in detectability of a nodule due to the influence of its local background surroundings is equivalent to that caused by changing its CD product by a factor of 4.45.

  12. The challenges of detecting subtle population structure and its importance for the conservation of emperor penguins.

    Science.gov (United States)

    Younger, Jane L; Clucas, Gemma V; Kao, Damian; Rogers, Alex D; Gharbi, Karim; Hart, Tom; Miller, Karen J

    2017-08-01

    Understanding the boundaries of breeding populations is of great importance for conservation efforts and estimates of extinction risk for threatened species. However, determining these boundaries can be difficult when population structure is subtle. Emperor penguins are highly reliant on sea ice, and some populations may be in jeopardy as climate change alters sea-ice extent and quality. An understanding of emperor penguin population structure is therefore urgently needed. Two previous studies have differed in their conclusions, particularly whether the Ross Sea, a major stronghold for the species, is isolated or not. We assessed emperor penguin population structure using 4,596 genome-wide single nucleotide polymorphisms (SNPs), characterized in 110 individuals (10-16 per colony) from eight colonies around Antarctica. In contrast to a previous conclusion that emperor penguins are panmictic around the entire continent, we find that emperor penguins comprise at least four metapopulations, and that the Ross Sea is clearly a distinct metapopulation. Using larger sample sizes and a thorough assessment of the limitations of different analytical methods, we have shown that population structure within emperor penguins does exist and argue that its recognition is vital for the effective conservation of the species. We discuss the many difficulties that molecular ecologists and managers face in the detection and interpretation of subtle population structure using large SNP data sets, and argue that subtle structure should be taken into account when determining management strategies for threatened species, until accurate estimates of demographic connectivity among populations can be made. © 2017 John Wiley & Sons Ltd.

  13. Subtle paranodal injury slows impulse conduction in a mathematical model of myelinated axons.

    Directory of Open Access Journals (Sweden)

    Charles F Babbs

    Full Text Available This study explores in detail the functional consequences of subtle retraction and detachment of myelin around the nodes of Ranvier following mild-to-moderate crush or stretch mediated injury. An equivalent electrical circuit model for a series of equally spaced nodes of Ranvier was created incorporating extracellular and axonal resistances, paranodal resistances, nodal capacitances, time varying sodium and potassium currents, and realistic resting and threshold membrane potentials in a myelinated axon segment of 21 successive nodes. Differential equations describing membrane potentials at each nodal region were solved numerically. Subtle injury was simulated by increasing the width of exposed nodal membrane in nodes 8 through 20 of the model. Such injury diminishes action potential amplitude and slows conduction velocity from 19.1 m/sec in the normal region to 7.8 m/sec in the crushed region. Detachment of paranodal myelin, exposing juxtaparanodal potassium channels, decreases conduction velocity further to 6.6 m/sec, an effect that is partially reversible with potassium ion channel blockade. Conduction velocity decreases as node width increases or as paranodal resistance falls. The calculated changes in conduction velocity with subtle paranodal injury agree with experimental observations. Nodes of Ranvier are highly effective but somewhat fragile devices for increasing nerve conduction velocity and decreasing reaction time in vertebrate animals. Their fundamental design limitation is that even small mechanical retractions of myelin from very narrow nodes or slight loosening of paranodal myelin, which are difficult to notice at the light microscopic level of observation, can cause large changes in myelinated nerve conduction velocity.

  14. Screening for Intimate Partner Violence in Orthopedic Patients: A Comparison of Three Screening Tools

    Science.gov (United States)

    Sprague, Sheila; Madden, Kim; Dosanjh, Sonia; Petrisor, Brad; Schemitsch, Emil H.; Bhandari, Mohit

    2012-01-01

    Accurately identifying victims of intimate partner violence (IPV) can be a challenge for clinicians and clinical researchers. Multiple instruments have been developed and validated to identify IPV in patients presenting to health care practitioners, including the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS). The purpose…

  15. 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.

  16. Toxicological Analysis of Some Drugs of Abuse in Biological Samples

    Directory of Open Access Journals (Sweden)

    Anne Marie Ciobanu

    2015-10-01

    Full Text Available Consumption of drugs of abuse is a scourge of modern world. Abuse, drug addiction and their consequences are one of the major current problems of European society because of the significant repercussions in individual, family, social and economic level. In this context, toxicological analysis of the drugs of abuse in biological samples is a useful tool for: diagnosis of drug addiction, checking an auto-response, mandatory screening in some treatment programs, identification of a substance in the case of an overdose, determining compliance of the treatment. The present paper aims to address the needs of healthcare professionals involved in drugs addiction treatment through systematic presentation of information regarding their toxicological analysis. Basically, it is a tool that help you to select the suitable biological sample and the right collecting time, as well as the proper analysis technique, depending on the purpose of analysis, pharmacokinetic characteristics of the drugs of abuse, available equipment and staff expertise.

  17. Lesbian mommy blogging in Canada: documenting subtle homophobia in Canadian society and building community online.

    Science.gov (United States)

    Hunter, Andrea

    2015-01-01

    This article analyzes how lesbian mommy bloggers in Canada are using their blogs as forums for self-expression and a means to form community, as they record their unique experiences as queer parents. Further, it argues that lesbian mommy blogging is documenting a subtle form of homophobia that exists in Canada in terms of social acceptance. Although there is legal acceptance of queer families, society has not necessarily caught up with the law. These blogs show that lesbian parents in Canada still struggle with issues of equality, including difficulties being "out," invisibility, and having to advocate for the non-birth parent.

  18. Subtle traps in Cretaceous, Archuleta, Conejos, Mineral, and Rio Grande counties, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    Brown, W.T. Jr. (Coastal Oil and Gas Corp., Denver, CO (USA))

    1989-09-01

    Regional interpretation of the stratigraphy, faulting, fracturing, and hydrodynamics in Archuleta, Conejos, Mineral, and Rio Grande Counties in southern Colorado indicates that significant reserves of hydrocarbons could exist in subtle trapping situations within the Cretaceous sequences. The presence of Price-Gramps field (7 million bbl of oil ultimate recoverable), which produces primarily from the Dakota Formation, is presently anomalous in this area but is indicative of existing hydrocarbon potential. Hydrocarbon shows from drilled wells and outcrops suggest that significant quantities of hydrocarbons are present in this area, sourced both from the San Juan basin to the south and west, and from more local areas for fractured reservoirs.

  19. Emerging drugs of abuse.

    Science.gov (United States)

    Nelson, Michael E; Bryant, Sean M; Aks, Steven E

    2014-02-01

    Many new emerging drugs of abuse are marketed as legal highs despite being labeled "not for human consumption" to avoid regulation. The availability of these substances over the Internet and in "head shops" has lead to a multitude of emergency department visits with severe complications including deaths worldwide. Despite recent media attention, many of the newer drugs of abuse are still largely unknown by health care providers. Slight alterations of the basic chemical structure of substances create an entirely new drug no longer regulated by current laws and an ever-changing landscape of clinical effects. The purity of each substance with exact pharmacokinetic and toxicity profiles is largely unknown. Many of these substances can be grouped by the class of drug and includes synthetic cannabinoids, synthetic cathinones, phenethylamines, as well as piperazine derivatives. Resultant effects generally include psychoactive and sympathomimetic-like symptoms. Additionally, prescription medications, performance enhancing medications, and herbal supplements are also becoming more commonly abused. Most new drugs of abuse have no specific antidote and management largely involves symptom based goal directed supportive care with benzodiazepines as a useful adjunct. This paper will focus on the history, epidemiology, clinical effects, laboratory analysis, and management strategy for many of these emerging drugs of abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. 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

  1. 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 ...

  2. 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.

  3. A Chip Off the Old Block: Parents’ Subtle Ethnic Prejudice Predicts Children’s Implicit Prejudice

    Directory of Open Access Journals (Sweden)

    Sabine Pirchio

    2018-02-01

    Full Text Available The increasing flow of immigrants in many European countries and the growing presence of children from immigrant families in schools makes it relevant to study the development of prejudice in children. Parents play an important role in shaping children’s values and their attitudes toward members of other ethnic groups; an intergenerational transmission of prejudice has been found in a number of studies targeting adolescents. The present study aims to investigate the intergenerational transmission of ethnic prejudice in 3- to 9- year-old children and its relations to parenting styles. Parents’ blatant and subtle ethnic prejudice and parenting style are measured together with children’s explicit and implicit ethnic prejudice in pupils and parents of preschool and primary schools in the region of Rome, Italy (N = 318. Results show that parents’ subtle prejudice predicts children’s implicit prejudice regardless of the parenting style. Findings indicate that children might acquire prejudice by means of the parents’ implicit cognition and automatic behavior and educational actions. Implications for future studies and insights for possible applied interventions are discussed.

  4. Individual, population and community level effects of subtle anthropogenic contamination in estuarine meiobenthos

    Energy Technology Data Exchange (ETDEWEB)

    Rubal, Marcos [CIIMAR/CIMAR-LA - Centro Interdisciplinar de Investigacao Marinha e Ambiental, Universidade do Porto, Laboratorio de Ecotoxicologia, Rua dos Bragas 289, 4050-123 Porto (Portugal); Guilhermino, Lucia M. [CIIMAR/CIMAR-LA - Centro Interdisciplinar de Investigacao Marinha e Ambiental, Universidade do Porto, Laboratorio de Ecotoxicologia, Rua dos Bragas 289, 4050-123 Porto (Portugal); ICBAS - Instituto de Ciencias Biomedicas de Abel Salazar, Departamento de Estudos de Populacoes, Laboratorio de Ecotoxicologia, Universidade do Porto, Lg. Prof. Abel Salazar 2, 4099-003 Porto (Portugal); Medina, Matias H., E-mail: matias.medina@avs-chile.c [AVS Chile SA, Imperial 0655, Off. 3A, Puerto Varas (Chile); Centro i-mar, Universidad de Los Lagos, Camino Chinquihue km 6, Puerto Montt (Chile)

    2009-10-15

    The study presented here searched for the level of taxonomic resolution required to detect the effects of low-level chronic pollution on estuarine meiobenthic communities. Meiofauna from two sites, with special attention to harpacticoid copepods, was analysed at different taxonomic levels of aggregation using uni- and multivariate methods. Adaptation processes that could buffer biodiversity disruptions were also considered through the analysis of fitness-related and tolerance traits in the harpacticoid copepod Paronychocamptus nanus. Results showed that uni- and multivariate analyses could be inadequate when assessing subtle anthropogenic contamination. Instead, the assessment of inter-population differences in tolerance to the main source of stress rises as a required procedure if potential effects of this type of contamination are being investigated. Specifically, a 96 h acute toxicity test performed with populations from the affected site appears as a faster and reliable general tool to assess impacts of low-level chronic pollution in estuaries. - Tolerance of local populations as a reliable tool to assess impacts of subtle anthropogenic contamination in estuaries.

  5. Individual, population and community level effects of subtle anthropogenic contamination in estuarine meiobenthos

    International Nuclear Information System (INIS)

    Rubal, Marcos; Guilhermino, Lucia M.; Medina, Matias H.

    2009-01-01

    The study presented here searched for the level of taxonomic resolution required to detect the effects of low-level chronic pollution on estuarine meiobenthic communities. Meiofauna from two sites, with special attention to harpacticoid copepods, was analysed at different taxonomic levels of aggregation using uni- and multivariate methods. Adaptation processes that could buffer biodiversity disruptions were also considered through the analysis of fitness-related and tolerance traits in the harpacticoid copepod Paronychocamptus nanus. Results showed that uni- and multivariate analyses could be inadequate when assessing subtle anthropogenic contamination. Instead, the assessment of inter-population differences in tolerance to the main source of stress rises as a required procedure if potential effects of this type of contamination are being investigated. Specifically, a 96 h acute toxicity test performed with populations from the affected site appears as a faster and reliable general tool to assess impacts of low-level chronic pollution in estuaries. - Tolerance of local populations as a reliable tool to assess impacts of subtle anthropogenic contamination in estuaries.

  6. Subtle behavioral variation in wild chimpanzees, with special reference to Imanishi's concept of kaluchua.

    Science.gov (United States)

    Nakamura, Michio; Nishida, Toshisada

    2006-01-01

    Here we consider the concept of kaluchua (a word adopted from the English "culture") in group-living animals developed by Imanishi in the 1950s. He distinguished it from bunka (the Japanese equivalent to the English "culture") because he thought that bunka had strong connotations of noble and intellectual human-like activities. Although he did not rigidly define kaluchua, his original concept of kaluchua was much broader than bunka and represented non-hereditary, acquired behavior that was acknowledged socially. However, instead of social life, complex feeding skills have often formed the central topic in the current studies of animal culture. In order to provide evidence that more subtle behavioral variations exist among wild chimpanzee (Pan troglodytes) populations, we directly compared the behaviors of two well-habituated chimpanzee groups, at Bossou and Mahale. During a 2-month stay at Bossou, M.N. (the first author) saw several behavioral patterns that were absent or rare at Mahale. Two of them, "mutual genital touch" and "heel tap" were probably customary for mature females and for mature males, respectively. "Index to palm" and "sputter" are still open to question. These subtle patterns occurred more often than tool use during the study period, suggesting that rarity is not the main reason for their being ignored. Unlike tool use, some cultural behavioral patterns do not seem to require complex skills or intellectual processes, and sometimes it is hard to explain the existence of such behaviors only in terms of function.

  7. Adjustment to Subtle Time Constraints and Power Law Learning in Rapid Serial Visual Presentation.

    Science.gov (United States)

    Shin, Jacqueline C; Chang, Seah; Cho, Yang Seok

    2015-01-01

    We investigated whether attention could be modulated through the implicit learning of temporal information in a rapid serial visual presentation (RSVP) task. Participants identified two target letters among numeral distractors. The stimulus-onset asynchrony immediately following the first target (SOA1) varied at three levels (70, 98, and 126 ms) randomly between trials or fixed within blocks of trials. Practice over 3 consecutive days resulted in a continuous improvement in the identification rate for both targets and attenuation of the attentional blink (AB), a decrement in target (T2) identification when presented 200-400 ms after another target (T1). Blocked SOA1s led to a faster rate of improvement in RSVP performance and more target order reversals relative to random SOA1s, suggesting that the implicit learning of SOA1 positively affected performance. The results also reveal "power law" learning curves for individual target identification as well as the reduction in the AB decrement. These learning curves reflect the spontaneous emergence of skill through subtle attentional modulations rather than general attentional distribution. Together, the results indicate that implicit temporal learning could improve high level and rapid cognitive processing and highlights the sensitivity and adaptability of the attentional system to subtle constraints in stimulus timing.

  8. Self-adapted and tunable graphene strain sensors for detecting both subtle and large human motions.

    Science.gov (United States)

    Tao, Lu-Qi; Wang, Dan-Yang; Tian, He; Ju, Zhen-Yi; Liu, Ying; Pang, Yu; Chen, Yuan-Quan; Yang, Yi; Ren, Tian-Ling

    2017-06-22

    Conventional strain sensors rarely have both a high gauge factor and a large strain range simultaneously, so they can only be used in specific situations where only a high sensitivity or a large strain range is required. However, for detecting human motions that include both subtle and large motions, these strain sensors can't meet the diverse demands simultaneously. Here, we come up with laser patterned graphene strain sensors with self-adapted and tunable performance for the first time. A series of strain sensors with either an ultrahigh gauge factor or a preferable strain range can be fabricated simultaneously via one-step laser patterning, and are suitable for detecting all human motions. The strain sensors have a GF of up to 457 with a strain range of 35%, or have a strain range of up to 100% with a GF of 268. Most importantly, the performance of the strain sensors can be easily tuned by adjusting the patterns of the graphene, so that the sensors can meet diverse demands in both subtle and large motion situations. The graphene strain sensors show significant potential in applications such as wearable electronics, health monitoring and intelligent robots. Furthermore, the facile, fast and low-cost fabrication method will make them possible and practical to be used for commercial applications in the future.

  9. Increased Risk for Falling Associated with Subtle Cognitive Impairment: Secondary Analysis of a Randomized Clinical Trial

    Science.gov (United States)

    Gleason, Carey E.; Gangnon, Ronald E.; Fischer, Barbara L.; Mahoney, Jane E.

    2009-01-01

    Background/Aims Having dementia increases patients’ risk for accidental falls. However, it is unknown if having mild cognitive deficits also elevates a person's risk for falls. This study sought to clarify the relationship between subtle cognitive impairment, measured with a widely-used, clinic-based assessment, the Mini Mental State Exam (MMSE), and risk for falls. Methods In a secondary analysis of the Kenosha County Falls Prevention Study, a randomized controlled trial targeting older adults at risk for falls, we examined the association between baseline MMSE and prospective rate of falls over 12 months in 172 subjects randomized to control group. Results Using univariate analysis, the rate of falls increased with each unit decrease in MMSE score down to at least 22 (rate ratio 1.25, 95% confidence interval (CI) 1.09–1.45, p = 0.0026). Using stepwise multivariate regression, controlling for ability to perform activities of daily living, use of assistive device, current exercise, and arthritis, the association between MMSE score and falls rate persisted (rate ratio 1.20, 95% CI 1.03–1.40, p = 0.021). Conclusion Minimal decrements on the MMSE were associated with elevations in rate of falls, suggesting that subtle cognitive deficits reflected in MMSE scores above a cut-off consistent with a diagnosis of dementia, can influence risk for falls. PMID:19602883

  10. A Chip Off the Old Block: Parents’ Subtle Ethnic Prejudice Predicts Children’s Implicit Prejudice

    Science.gov (United States)

    Pirchio, Sabine; Passiatore, Ylenia; Panno, Angelo; Maricchiolo, Fridanna; Carrus, Giuseppe

    2018-01-01

    The increasing flow of immigrants in many European countries and the growing presence of children from immigrant families in schools makes it relevant to study the development of prejudice in children. Parents play an important role in shaping children’s values and their attitudes toward members of other ethnic groups; an intergenerational transmission of prejudice has been found in a number of studies targeting adolescents. The present study aims to investigate the intergenerational transmission of ethnic prejudice in 3- to 9- year-old children and its relations to parenting styles. Parents’ blatant and subtle ethnic prejudice and parenting style are measured together with children’s explicit and implicit ethnic prejudice in pupils and parents of preschool and primary schools in the region of Rome, Italy (N = 318). Results show that parents’ subtle prejudice predicts children’s implicit prejudice regardless of the parenting style. Findings indicate that children might acquire prejudice by means of the parents’ implicit cognition and automatic behavior and educational actions. Implications for future studies and insights for possible applied interventions are discussed. PMID:29479328

  11. Chronic time abuse.

    Science.gov (United States)

    Berglas, Steven

    2004-06-01

    Anyone who has ever managed people who abuse time--whether they are chronic procrastinators or individuals who work obsessively to meet deadlines weeks in advance--knows how disruptive they can be to a business's morale and operating efficiency. But lessons in time management will have no impact on these employees. That's because real time abuse results from psychological conflict that neither a workshop nor a manager's cajoling can cure. Indeed, the time abuser's quarrel isn't even with time but rather with a brittle self-esteem and an unconscious fear of being evaluated and found wanting. This article describes four types of time abusers typically encountered in the workplace: Perfectionists are almost physically afraid of receiving feedback. Their work has to be "perfect," so they can increase their likelihood of earning a positive evaluation or at least avoid getting a negative one. Preemptives try to be in control by handing in work far earlier than they need to, making themselves unpopular and unavailable in the process. People pleasers commit to far too much work because they find it impossible to say no. Procrastinators make constant (and often reasonable-sounding) excuses to mask a fear of being found inadequate in their jobs. Managing these four types of people can be challenging, since time abusers respond differently from most other employees to criticism and approval. Praising a procrastinator when he is on time, for instance, will only exacerbate the problem, because he will fear that your expectations are even higher than before. In fact, some time abusers, like the perfectionist, may need professional treatment. This article will give you insight into why they are the way they are--and what can be done to help them manage their problems.

  12. Vaccines against drug abuse.

    Science.gov (United States)

    Shen, X Y; Orson, F M; Kosten, T R

    2012-01-01

    The currently available medications for the treatment of drug abuse have had only limited success. Anti-addiction vaccines, aimed at eliciting antibodies that block the pharmacological effects of drugs, have great potential for treating drug abuse. We review the status of two vaccines that are undergoing clinical trials (for cocaine and nicotine addiction) and two that are still in preclinical development (for methamphetamine and heroin addiction). We also outline the challenges and ethical concerns associated with the development of anti-addiction vaccines and their use as future therapeutics.

  13. Child Abuse or Osteogenesis Imperfecta?

    Science.gov (United States)

    Child Abuse or Osteogenesis Imperfecta? A child is brought into the emergency room with a fractured leg. The ... welfare services to report a suspected case of child abuse. The child is taken away from the parents ...

  14. Substance abuse and child maltreatment.

    Science.gov (United States)

    Wells, Kathryn

    2009-04-01

    Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

  15. METHYLPHENIDATE (RITALIN) USE AND ABUSE

    African Journals Online (AJOL)

    A K Aucamp, Ciba (Pty) Ltd - person:aI communication, 1997). (See Table I.) .... literature documenting abuse and its inherent dangers. In other words, patients are not going to acknowledge willingly that they are abusing methylphenidate.

  16. National Center on Elder Abuse

    Science.gov (United States)

    ... Connect with Us Contact Us Newsroom FAQ Suspect Abuse? Get Help What We Do Research Synthesize and disseminate high quality research on elder abuse to encourage the translation of research into practice. ...

  17. Workplace Abuse: Problems And Consequences

    OpenAIRE

    Fred Ebeid; Tej Kaul; Kathleen Neumann; Hugh Shane

    2011-01-01

    Workplace abuse is a relatively recent phenomenon that affects millions of employee in all types of organizations and occupations. Most of the literature on workplace management deals with employment discrimination and due process. Workplace issues of emotional abuse inflicted on employees by supervisors or managers are seldom addressed. An organization becomes abusive when it permits or tolerates abusive employee treatment by supervisors or managers. In the news each day, the media regularly...

  18. Sex Differences in Drug Abuse

    OpenAIRE

    Becker, Jill B.; Hu, Ming

    2007-01-01

    Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstin...

  19. 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.

  20. Elder Abuse: Systematic Review and Implications for Practice.

    Science.gov (United States)

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

  1. Screening Teacher Education Candidates for Sexual Predators. [and] Can We Make Our Schools and Children Risk-Free? A Response to Berson, Berson, Karges-Bone, and Parker.

    Science.gov (United States)

    Berson, Ilene R.; Berson, Michael J.; Karges-Bone, Linda; Parker, Jonathon K.; Horns-Marsh, Virginia

    1999-01-01

    Presents current research on the incidence of child abuse by teachers and identifies the preconditions of abuse. Outlines the responsibilities of teacher-education programs in screening applicants. (SK)

  2. The Satanic Ritual Abuse Controversy.

    Science.gov (United States)

    Putnam, Frank W.

    1991-01-01

    The issues raised by Jonker and Jonker-Bakker and Young et al (EC 601 187-188) illustrate a major controversy dividing the child abuse community, the alleged existence of a conspiracy of satanic, ritual, sexual abuse of children. No evidence is found to support claims that large numbers of babies and children are being sacrificed or abused in…

  3. Childhood Sexual Abuse and Suicide

    Science.gov (United States)

    ... incidence of both forcible and non-forcible sexual abuse. 3 “Sexual abuse is associated with changes in the metabolism of ... Molnar, B., Berkman, L., & Buka, S. (2001). Psychopathology, childhood sexual abuse, and other childhood adversities: Relative links to subsequent ...

  4. Drug Abuse in Southeast Asia.

    Science.gov (United States)

    Scorzelli, James F.

    This report examines the incidence of drug abuse and the methods of treatment and prevention of drug abuse used in Southeast Asia. Countries studied include Malaysia, Singapore, Thailand, Indonesia, and the Philippines. Because of Malaysia's intensive effort to eliminate its drug abuse problem, emphasis is placed on this country's treatment and…

  5. Child Abuse Potential: How Persistent?

    Science.gov (United States)

    Haapasalo, Jaana; Aaltonen, Terhi

    1999-01-01

    Compares mothers whose children had been under supervision of Child Protective Services (CPS) with comparison mothers for child abuse potential using Millner's Child Abuse Potential Inventory. CPS mothers scored significantly higher than the comparison mothers, indicating their persistent elevated child abuse potential; there was no significant…

  6. 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,

  7. New drugs of abuse.

    Science.gov (United States)

    Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth

    2015-02-01

    Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases. © 2014 Pharmacotherapy Publications, Inc.

  8. Drug and Substance Abuse

    Science.gov (United States)

    ... Basic Facts & Information What does “Drug and Substance Abuse” mean? Most drugs and other chemical substances are helpful when used ... medications, and pain medications. Some older adults also abuse illegal drugs, including marijuana, cocaine, hallucinogens, and injected narcotics. Some ...

  9. sexually abused children

    African Journals Online (AJOL)

    sexually abused children are anxiety disorders, depression, increased aggression and disturbance in sexual behaviour and gender roles. An American study found significantly higher rates .... counterparts with post-admission disclosure, this difference was not ... sense of psychic loneliness and internal crisis which follows.

  10. Mania following ketamine abuse

    Directory of Open Access Journals (Sweden)

    Lu YY

    2016-01-01

    Full Text Available Yuan-Yuan Lu,1 Chieh-Hsin Lin,2,3 Hsien-Yuan Lane1,2,4 1Department of Psychiatry, China Medical University Hospital, 2Graduate Institute of Clinical Medical Science, China Medical University, Taichung, 3Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, 4Center for Drug Abuse and Addiction, China Medical University Hospital, Taichung, Taiwan Abstract: Ketamine, a noncompetitive antagonist of the N-methyl-d-aspartate (NMDA receptor, has multiple clinical uses. On the other hand, ketamine abuse or recreational use has been gaining increasing attention. Induction of mania and psychotic symptoms has been reported in a patient receiving IV ketamine therapy for reflex sympathetic dystrophy. We here report a 26 year-old man who abused ketamine by inhalation for 12 months and developed manic-like symptoms after ketamine use. This case suggests a possible relationship between manic symptoms and ketamine abuse. To the best of our knowledge, this may be the first report regarding mania after recreational use of ketamine. Keywords: ketamine, mania, antidepressant, bipolar

  11. Drug abuse in pregnancy

    Directory of Open Access Journals (Sweden)

    Tatiana dos Reis Nunes

    2014-12-01

    Full Text Available The authors report the case of a pregnant woman admitted to cocaine overdose and discuss maternal and fetal complications of cocaine abuse in pregnancy. Considering the increased frequency of users in the female population, the obstetric team should be able to make the patient's care and your baby.

  12. Drug abuse in athletes

    Directory of Open Access Journals (Sweden)

    Reardon CL

    2014-08-01

    Full Text Available Claudia L Reardon, Shane Creado Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Abstract: Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions. Keywords: doping, athletes, steroids, drug abuse, mental illness

  13. Derivation of a clinical prediction rule for pediatric abusive head trauma.

    Science.gov (United States)

    Hymel, Kent P; Willson, Douglas F; Boos, Stephen C; Pullin, Deborah A; Homa, Karen; Lorenz, Douglas J; Herman, Bruce E; Graf, Jeanine M; Isaac, Reena; Armijo-Garcia, Veronica; Narang, Sandeep K

    2013-02-01

    Abusive head trauma is a leading cause of traumatic death and disability during infancy and early childhood. Evidence-based screening tools for abusive head trauma do not exist. Our research objectives were 1) to measure the predictive relationships between abusive head trauma and isolated, discriminating, and reliable clinical variables and 2) to derive a reliable, sensitive, abusive head trauma clinical prediction rule that-if validated-can inform pediatric intensivists' early decisions to launch (or forego) an evaluation for abuse. Prospective, multicenter, cross-sectional, observational. Fourteen PICUs. Acutely head-injured children less than 3 years old admitted for intensive care. None. Applying a priori definitional criteria for abusive head trauma, we identified clinical variables that were discriminating and reliable, calculated likelihood ratios and post-test probabilities of abuse, and applied recursive partitioning to derive an abusive head trauma clinical prediction rule with maximum sensitivity-to help rule out abusive head trauma, if negative. Pretest probability (prevalence) of abusive head trauma in our study population was 0.45 (95 of 209). Post-test probabilities of abusive head trauma for isolated, discriminating, and reliable clinical variables ranged from 0.1 to 0.86. Some of these variables, when positive, shifted probability of abuse upward greatly but changed it little when negative. Other variables, when negative, largely excluded abusive head trauma but increased probability of abuse only slightly when positive. Some discriminating variables demonstrated poor inter-rater reliability. A cluster of five discriminating and reliable variables available at or near the time of hospital admission identified 97% of study patients meeting a priori definitional criteria for abusive head trauma. Negative predictive value was 91%. A more completeunderstanding of the specific predictive qualities of isolated, discriminating, and reliable variables

  14. Child sexual abuse

    International Nuclear Information System (INIS)

    Khalid, N.

    2001-01-01

    Background: Child sexual abuse with significant impact on victim's physical, mental and social health has now been recognized as existing on an appreciable scale worldwide. Diversity of opinions exist about the concept, types, prevalence and repercussions along with a paucity of systematic and scientific work in the developing world including Pakistan. Objective: This paper aims at reviewing the literature for clarification of concept, update of estimates and correlates, and to identify lines for future research. Data sources: The literature was search through BMJ-Medline for international data, supplemented by local data through CPSP-MEDLIP service. The search term child sexual abuse with associated sub-heads were used. No constraint of time period, publication type or source applied except english Language version Comparative findings: Wide variations identified in conceptual boundaries with consequent impact on prevalence estimates. Agreement found for its existence as an international problem with rates ranging from 7% - 36% for women and 3% - 29% for men. Female abused 1.5-3 times more than male with exponential high rates in age group 3-6 years and 8-11 years. In 2/3 cases the perpetrator identified belonged to nuclear or extended family. Significant association exists with early onset of psychiatric ailments like substance abuse, eating disorders, personality disorders, dissociative disorders and depression. Conclusion and Suggestion: The need for extensive research studies in immense in developing countries like Pakistan where environmental circumstances suggest its presence at rates higher than the identified elsewhere. In addition to facilitate awareness and perhaps to clarify the concept as well as the prevalence of child sexual abuse researchers need to select methodologies and instruments with international comparison in mind. (author)

  15. 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

  16. The subtle field of the meeting: meta-corporeality and the clinic

    Directory of Open Access Journals (Sweden)

    Helia Borges

    2015-06-01

    Full Text Available This article aims to discuss the context of the analytic setting, proposing a clinical approach that encourages reflection on a practice that takes into account the encounter between analyst and patient, from the subtle field triggered by complaints, by corporeality. This meeting, as meta-corporeality, would enable the hold of subjective dynamics that escape the represented field. The flow of forces, the intensive field in Freudian concepts such as, for example, the drive concept, was dropped by a psychoanalytic construction restricted to representation speech. It takes up here the tradition already consolidated since Freud, when approaching art and clinic, thinking the analytical doing and its theoretical production, seeking to expand its devices.

  17. Seeing emotions: a review of micro and subtle emotion expression training

    Science.gov (United States)

    Poole, Ernest Andre

    2016-09-01

    In this review I explore and discuss the use of micro and subtle expression training in the social sciences. These trainings, offered commercially, are designed and endorsed by noted psychologist Paul Ekman, co-author of the Facial Action Coding System, a comprehensive system of measuring muscular movement in the face and its relationship to the expression of emotions. The trainings build upon that seminal work and present them in a way for either the layperson or researcher to easily add to their personal toolbox for a variety of purposes. Outlined are my experiences across the training products, how they could be used in social science research, a brief comparison to automated systems, and possible next steps.

  18. The Subtle Balance between Lipolysis and Lipogenesis: A Critical Point in Metabolic Homeostasis

    Directory of Open Access Journals (Sweden)

    Chiara Saponaro

    2015-11-01

    Full Text Available Excessive accumulation of lipids can lead to lipotoxicity, cell dysfunction and alteration in metabolic pathways, both in adipose tissue and peripheral organs, like liver, heart, pancreas and muscle. This is now a recognized risk factor for the development of metabolic disorders, such as obesity, diabetes, fatty liver disease (NAFLD, cardiovascular diseases (CVD and hepatocellular carcinoma (HCC. The causes for lipotoxicity are not only a high fat diet but also excessive lipolysis, adipogenesis and adipose tissue insulin resistance. The aims of this review are to investigate the subtle balances that underlie lipolytic, lipogenic and oxidative pathways, to evaluate critical points and the complexities of these processes and to better understand which are the metabolic derangements resulting from their imbalance, such as type 2 diabetes and non alcoholic fatty liver disease.

  19. An incidental case of biliary fascioliasis with subtle clinical findings: US and MRCP findings

    International Nuclear Information System (INIS)

    Önder, Hakan; Ekici, Faysal; Adin, Emin; Kuday, Suzan; Gümüş, Hatice; Bilici, Aslan

    2013-01-01

    Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions

  20. Deaf students' knowledge of subtle lexical properties of transitive and intransitive English verbs.

    Science.gov (United States)

    Berent, Gerald P; Kelly, Ronald R; Albertini, John A; Toscano, Rose Marie

    2013-01-01

    Deaf learners' acquisition of fundamental lexical properties of high-frequency English verbs related to transitivity and intransitivity was examined, including the subtle distinction between unergative and unaccusative verbs. A 140-item sentence acceptability rating scale was used to assess this lexical knowledge in deaf college students at two English proficiency levels, plus a control group of hearing native English speakers. Hypotheses addressed the influence of relative derivational complexity and overall English proficiency on verb acquisition. Though the hearing group showed greater accuracy in sentence acceptability judgments and greater accuracy tied to overall English proficiency, the two deaf groups displayed fairly robust knowledge of targeted verbs' fundamental transitive and intransitive lexical properties. Nevertheless, verb acquisition remains a formidable challenge. Further research should assess deaf students' knowledge of these lexical properties in lower-frequency English verbs, including unaccusative verbs prevalent in STEM (science, technology, engineering, mathematics) and other academic discourse.

  1. The subtle signs of Wolfram (DIDMOAD) syndrome: not all juvenile diabetes is type 1 diabetes.

    Science.gov (United States)

    Boettcher, Claudia; Brosig, Burkhard; Zimmer, Klaus P; Wudy, Stefan A

    2011-01-01

    Wolfram syndrome (also known as DIDMOAD = diabetes insipidus, diabetes mellitus, optic atrophy, deafness) is an autosomal recessive disorder characterized by the association of childhood non-immune insulin-dependent diabetes mellitus (DM) with progressive bilateral optic atrophy. Additional symptoms including signs of severe neurodegeneration and psychiatric illness are likely to evolve over time resulting in premature death. We report on two siblings of Turkish origin from our diabetes clinic who were diagnosed with Wolfram syndrome after 6 years and 2 years duration of DM, respectively. Subtle symptoms such as attitude changes, growing reading difficulties in the history of children or adolescents with antibody negative and ketone negative DM should alert the treating physician and lead to re-evaluation of the diagnosis, keeping in mind that not all juvenile DM is type 1 DM.

  2. Probing the Subtle Structure Modifications of Thermoelectric Materials by Variable Temperature Total Scattering

    DEFF Research Database (Denmark)

    Reardon, Hazel; Iversen, Bo Brummerstedt; Blichfeld, Anders Bank

    in air. PDF measurements were performed on data collected from ex situ annealed BGG samples. This ex situ study (to be submitted), reveals that the seemingly subtle change in the clathrate structure and the emergence of a significant amorphous phase observed from PXRD data is likely to be the result...... of modifications in the cage configuration, but further data analysis is necessary to identify the specific features of the cages that are affected. Although the thermal stability of thermoelectric materials has been highlighted as a critical bottleneck in their commercialization, the aim of this work...... is to understand how we may stabilize TE materials through a thorough understanding of their high temperature structure reorientations and decomposition mechanisms....

  3. Sex differences in drug abuse.

    Science.gov (United States)

    Becker, Jill B; Hu, Ming

    2008-01-01

    Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstinence. In this review, sex differences in drug abuse are discussed for humans and in animal models. The possible neuroendocrine mechanisms mediating these sex differences are discussed.

  4. Forensic aspects of animal abusing

    Directory of Open Access Journals (Sweden)

    Aleksić Jelena

    2008-01-01

    Full Text Available Animal abuse is important social issue, which includes a wide range of behaviors of humans that are harmful to animals, starting from unintentional neglect to intentional cruelty. Types of animal abuse are different and they can include physical, sexual, emotional abuse or neglect. Training dogs for fights and dog fighting are considered to be neglection of animals. Forensic veterinarians are called for testifining more often now for presenting the evidence that can lead to making a case regarding animal abuse. This study will include an explanation of forensic vet's role and different types of animal abuse.

  5. Subtle changes in the flavour and texture of a drink enhance expectations of satiety

    Directory of Open Access Journals (Sweden)

    McCrickerd Keri

    2012-10-01

    Full Text Available Abstract Background The consumption of liquid calories has been implicated in the development of obesity and weight gain. Energy-containing drinks are often reported to have a weak satiety value: one explanation for this is that because of their fluid texture they are not expected to have much nutritional value. It is important to consider what features of these drinks can be manipulated to enhance their expected satiety value. Two studies investigated the perception of subtle changes in a drink’s viscosity, and the extent to which thick texture and creamy flavour contribute to the generation of satiety expectations. Participants in the first study rated the sensory characteristics of 16 fruit yogurt drinks of increasing viscosity. In study two, a new set of participants evaluated eight versions of the fruit yogurt drink, which varied in thick texture, creamy flavour and energy content, for sensory and hedonic characteristics and satiety expectations. Results In study one, participants were able to perceive small changes in drink viscosity that were strongly related to the actual viscosity of the drinks. In study two, the thick versions of the drink were expected to be more filling and have a greater expected satiety value, independent of the drink’s actual energy content. A creamy flavour enhanced the extent to which the drink was expected to be filling, but did not affect its expected satiety. Conclusions These results indicate that subtle manipulations of texture and creamy flavour can increase expectations that a fruit yogurt drink will be filling and suppress hunger, irrespective of the drink’s energy content. A thicker texture enhanced expectations of satiety to a greater extent than a creamier flavour, and may be one way to improve the anticipated satiating value of energy-containing beverages.

  6. Recognizing subtle near-occlusion in carotid stenosis patients: a computed tomography angiographic study

    Energy Technology Data Exchange (ETDEWEB)

    Koskinen, Suvi Maaria [University of Helsinki, Clinicum, Department of Neurosciences (Finland); University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, Helsinki (Finland); Silvennoinen, Heli; Valanne, Leena [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, Helsinki (Finland); Ijaes, Petra; Nuotio, Krista; Lindsberg, Perttu J. [University of Helsinki and Helsinki University Hospital, Neurology, Clinical Neurosciences, Helsinki (Finland); University of Helsinki, Molecular Neurology, Research Programs Unit, Helsinki (Finland); Soinne, Lauri [University of Helsinki and Helsinki University Hospital, Neurology, Clinical Neurosciences, Helsinki (Finland)

    2017-04-15

    Near-occlusion of the internal carotid artery (ICA) is a significant luminal diameter (LD) reduction beyond a tight atherosclerotic carotid stenosis (CS). Recognition of even subtle near-occlusions is essential to prevent underestimation of the stenosis degree. Our goal was to investigate the prevalence of near-occlusion among CS patients using a single standard criterion to facilitate its recognition, even when distal ICA LD reduction is not visually evident in computed tomography angiography (CTA). We analysed carotid artery CTAs of 467 patients with moderate-to-severe CS scheduled for endarterectomy. We performed measurements of the bilateral distal ICA LDs from thin axial source images and utilized a 1.0 mm intra-individual side-to-side distal ICA LD difference to distinguish near-occlusions, based on a previous study, aware of the vagaries of measurement. For analysis stratification, we excluded cases with significant carotid pathology affecting LD measurements. We discovered 126 near-occlusions fulfilling our criterion of ipsilateral near-occlusion: the mean LD side-to-side difference (mm) with 95% confidence interval being 1.8 (1.6, 1.9) and a standard deviation of 0.8 mm. Among the 233 cases not meeting our near-occlusion criterion, we found 140 moderate (50-69%) and 93 severe (70-99%) ipsilateral stenoses. The utilization of 1.0 mm cut-off value for the intra-individual distal ICA LD side-to-side difference to distinguish atherosclerotic ICA near-occlusion leads to a relatively high incidence of near-occlusion. In CTA, recently suggested to be used for near-occlusion diagnosis, a discriminatory 1.0 mm cut-off value could function as a pragmatic tool to enhance the detection of even subtle near-occlusions. (orig.)

  7. Childhood Abuse and Current Health Problems among Older Adults: The Mediating Role of Self-Efficacy.

    Science.gov (United States)

    Sachs-Ericsson, Natalie; Medley, Amanda N; Kendall-Tackett, Kathleen; Taylor, John

    2011-04-01

    OBJECTIVES: Child abuse has negative consequences on health functioning and the self-concept. Prior studies have garnered support for these relationships in younger adults; yet few studies have looked at the effects of abuse on health in older adults and the psychosocial variables, specifically self-efficacy, that may influence the abuse-health relationship. METHODS: Data obtained from the Physical Health and Disability Study were used to explore the impact of child abuse on current medical problems among older adults who were screened on physical disability status (N=1396, Mean age = 67, SD = 10.2). The study was conducted in South Florida and employed a multiethnic sample that is representative of the general population in this area. RESULTS: Child abuse was associated with the number of current medical problems and disability. Child abuse was also related to lower self-efficacy, and self-efficacy explained the relationship between abuse and the number of health problems. CONCLUSIONS: There are far reaching effects of child abuse on older adults' health and self-concept. Health care providers and gerontologists need to be aware that child abuse is a life-long risk factor for increased disability and specific health problems, especially among the elderly. Future research should examine treatments designed to increase self-efficacy, especially among those who experienced child abuse, and observe any positive effects on health functioning.

  8. 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

    would enable the identification of pregnant women who are susceptible to psychological and verbal intimate partner abuse, thus enabling the provision of adequate support. There is also a need to introduce routine screening for psychological and verbal intimate partner abuse during the antenatal period, following extensive training to all professionals concerned. © 2016 John Wiley & Sons Ltd.

  9. Parents' perceptions about child abuse and their impact on physical and emotional child abuse: A study from primary health care centers in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Al Dosari, Mohammed N; Ferwana, Mazen; Abdulmajeed, Imad; Aldossari, Khaled K; Al-Zahrani, Jamaan M

    2017-01-01

    To determine perceptions of parents about child abuse, and their impact on physical and emotional child abuse. Two hundred parents attending three primary health care centers (PHCCs) in Riyadh serving National Guard employes and their families, were requested to participate in this survey. Data was collected by self administered questionnaire. Five main risk factors areas/domains were explored; three were parent related (personal factors, history of parents' childhood abuse, and parental attitude toward punishment), and two were family/community effects and factors specific to the child. SPSS was used for data entry and analysis. Descriptive analysis included computation of mean, median, mode, frequencies, and percentages; Chi-square test and t -test were used to test for statistical significance, and regression analysis performed to explore relationships between child abuse and various risk factors. Thirty-four percent of the parents reported a childhood history of physical abuse. Almost 18% of the parents used physical punishment. The risk factors associated significantly with child abuse were parents' history of physical abuse, young parent, witness to domestic violence, and poor self-control. Child-related factors included a child who is difficult to control or has attention deficit hyperactivity disorder (ADHD). Parents who did not own a house were more likely to use physical punishment. Abusive beliefs of parent as risk factors were: physical punishment as an effective educational tool for a noisy child; parents' assent to physical punishment for children; it is difficult to differentiate between physical punishment and child abuse; parents have the right to discipline their child as they deem necessary; and there is no need for a system for the prevention of child abuse. The causes of child abuse and neglect are complex. Though detecting child abuse may be difficult in primary care practice, many risk factors can be identified early. Parents' attitudes can

  10. Abuse Tolerance Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Orendorff, Christopher J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Nagasubramanian, Ganesan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Fenton, Kyle R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Allcorn, Eric [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-10-01

    As lithium-ion battery technologies mature, the size and energy of these systems continues to increase (> 50 kWh for EVs); making safety and reliability of these high energy systems increasingly important. While most material advances for lithium-ion chemistries are directed toward improving cell performance (capacity, energy, cycle life, etc.), there are a variety of materials advancements that can be made to improve lithium-ion battery safety. Issues including energetic thermal runaway, electrolyte decomposition and flammability, anode SEI stability, and cell-level abuse tolerance continue to be critical safety concerns. This report highlights work with our collaborators to develop advanced materials to improve lithium-ion battery safety and abuse tolerance and to perform cell-level characterization of new materials.

  11. Antitussives and substance abuse

    OpenAIRE

    Boyer, Edward; Burns,Jarrett

    2013-01-01

    Jarrett M Burns, Edward W Boyer Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA Abstract: Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly ...

  12. Differences in Addiction Severity between Social and Probable Pathological Gamblers among Substance Abusers in Treatment in Rio de Janeiro

    Science.gov (United States)

    Mathias, Ana Carolina R.; Vargens, Renata W.; Kessler, Felix H.; Cruz, Marcelo S.

    2009-01-01

    There is a strong association between pathological gambling and substance abuse. The objective of this study is to identify the differences between substance abusers with and without gambling problems. A cross sectional study was conducted interviewing with Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS), alcohol and drug…

  13. Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

    Science.gov (United States)

    Herman-Smith, Robert L.

    2013-01-01

    Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…

  14. State Child Care Licensing Laws in the Fifty States: A New Look in the Face of Child Abuse.

    Science.gov (United States)

    Bulkley, Josephine; Jackson, Jolie

    1989-01-01

    The article reviews state child care licensing legislation in light of reported child abuse and neglect in some such facilities. Recommended are licensing of all facilities of any size or religious affiliation, criminal record screening, at least annual inspections, unannounced inspections, and required notice to parents when abuse has been…

  15. Cross-cultural validation of the child abuse potential inventory in Belgium (Flanders) : Relations with demographic characteristics and parenting problems

    NARCIS (Netherlands)

    Grietens, Hans; De Haene, Lucia; Uyttebroek, Karolien

    This study examined the reliability and the validity of the Dutch CAP Inventory, a screening instrument that measures parents' potential for child physical abuse (Milner, The Child Abuse Potential Inventory: Manual (2nd ed.), Psytec, Webster, NC, 1986). The CAP Inventory and measures on parenting

  16. Child abuse in Bangladesh

    Directory of Open Access Journals (Sweden)

    Farzana Islam

    2015-01-01

    Full Text Available In Bangladesh, a large number of children are deprived of their basic human rights due to unacceptable health, nutrition, education as well as social conditions. In addition, children are exposed to severe forms of sexual, physical and mental abuses at home, in the work place, in institutions and other public places. The nature and extent of violence against children irrespective of age, sex and class has been increasing day by day. These include physical torture, rape, homicide and sometimes heinous attacks with acid. Children are also victims of child labor and trafficking, both of which are treated as the most severe form of child exploitation and child abuse in the world today. This review article is aimed to focus on the present situation of various forms of child abuses in our country. Data collection is based on secondary sources of information from Dhaka Medical College Hospital, One Stop Crisis Center (OCC,UNICEF, Ministry of Home Affairs, Ministry of Women and Children Affairs, several Dhaka based organizations and news paper clipping. Ibrahim Med. Coll. J. 2015; 9(1: 18-21

  17. Arousal and drug abuse.

    Science.gov (United States)

    Urbano, Francisco J; Bisagno, Verónica; Garcia-Rill, Edgar

    2017-08-30

    The reticular activating system (RAS) is not an amorphous region but distinct nuclei with specific membrane properties that dictate their firing during waking and sleep. The locus coeruleus and raphe nucleus fire during waking and slow wave sleep, with the pedunculopontine nucleus (PPN) firing during both waking and REM sleep, the states manifesting arousal-related EEG activity. Two important discoveries in the PPN in the last 10 years are, 1) that some PPN cells are electrically coupled, and 2) every PPN cell manifests high threshold calcium channels that allow them to oscillate at beta/gamma band frequencies. The role of arousal in drug abuse is considered here in terms of the effects of drugs of abuse on these two mechanisms. Drug abuse and the perception of withdrawal/relapse are mediated by neurobiological processes that occur only when we are awake, not when we are asleep. These relationships focus on the potential role of arousal, more specifically of RAS electrical coupling and gamma band activity, in the addictive process as well as the relapse to drug use. Copyright © 2017. Published by Elsevier B.V.

  18. Using electronic health record data for substance use Screening, Brief Intervention, and Referral to Treatment among adults with type 2 diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network study.

    Science.gov (United States)

    Wu, Li-Tzy; Brady, Kathleen T; Spratt, Susan E; Dunham, Ashley A; Heidenfelder, Brooke; Batch, Bryan C; Lindblad, Robert; VanVeldhuisen, Paul; Rusincovitch, Shelley A; Killeen, Therese K; Ghitza, Udi E

    2016-01-01

    The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes. Given the complexity of high-risk patients' medical problems and the cost of conducting randomized trials, a feasibility project is warranted to guide practical study designs. We describe the study design, which explores the feasibility of implementing substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus (T2DM) within a home-based primary care setting. Our study includes the development of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare data, and the use of a geographic health information system to understand the social context in patients' communities. Analysis will examine recruitment, proportion of patients receiving brief intervention and/or referrals, substance use, SUD treatment use, diabetes outcomes, and retention. By capitalizing on an existing T2DM project that uses home-based primary care, our study results will provide timely clinical information to inform the designs and implementation of future SBIRT studies among adults with multiple medical conditions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Using Electronic Health Records Data for Substance Use Screening, Brief Intervention, and Referral to Treatment among Adults with Type 2 Diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network Study

    Science.gov (United States)

    Wu, Li-Tzy; Brady, Kathleen T.; Spratt, Susan E.; Dunham, Ashley A.; Heidenfelder, Brooke; Batch, Bryan C.; Lindblad, Robert; VanVeldhuisen, Paul; Rusincovitch, Shelley A.; Killeen, Therese K.; Ghitza, Udi E.

    2015-01-01

    Background The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes. Given the complexity of high-risk patients' medical problems and the cost of conducting randomized trials, a feasibility project is warranted to guide practical study designs. Methods We describe the study design, which explores the feasibility of implementing substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus (T2DM) within a home-based primary care setting. Our study includes the development of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare data, and the use of a geographic health information system to understand the social context in patients' communities. Analysis will examine recruitment, proportion of patients receiving brief intervention and/or referrals, substance use, SUD treatment use, diabetes outcomes, and retention. Discussion By capitalizing on an existing T2DM project that uses home-based primary care, our study results will provide timely clinical information to inform the designs and implementation of future SBIRT studies among adults with multiple medical conditions. PMID:26563446

  20. Economic abuse between intimate partners in Australia: prevalence, health status, disability and financial stress.

    Science.gov (United States)

    Kutin, Jozica; Russell, Roslyn; Reid, Mike

    2017-06-01

    Economic abuse is a form of domestic violence that has a significant impact on the health and financial wellbeing of victims, but is understudied. This study determined the lifetime prevalence of economic abuse in Australia by age and gender, and the associated risk factors. The 2012 ABS Personal Safety Survey was used, involving a cross-sectional population survey of 17,050 randomly selected adults using face-to-face interviews. The survey-weighted prevalence of economic abuse was calculated and analysed by age and gender. Logistic regression was used to adjust odds ratios for possible confounding between variables. The lifetime prevalence of economic abuse in the whole sample was 11.5%. Women in all age groups were more likely to experience economic abuse (15.7%) compared to men (7.1%). Disability, health and financial stress status were significant markers of economic abuse. For women, financial stress and disability were important markers of economic abuse. However, prevalence rates were influenced by the measures used and victims' awareness of the abuse, which presents a challenge for screening and monitoring. Implications for public health: Social, health and financial services need to be aware of and screen for the warning signs of this largely hidden form of domestic violence. © 2017 The Authors.

  1. 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.

  2. Prevalence of childhood physical and sexual abuse in veterans with psychiatric diagnoses.

    Science.gov (United States)

    Koola, Maju Mathew; Qualls, Clifford; Kelly, Deanna L; Skelton, Kelly; Bradley, Bekh; Amar, Richard; Duncan, Erica J

    2013-04-01

    We examined the prevalence of childhood (≤ 18 years) physical and sexual abuse reported among patients admitted to the psychiatric inpatient service and the differential rates of this abuse associated with psychiatric diagnoses. This study consisted of a retrospective chart review of 603 patients admitted to a psychiatric ward during a period of 1 year at Atlanta Veterans Affairs Medical Center who had data on childhood physical and sexual abuse. The prevalence of reported childhood physical or sexual abuse in this inpatient clinical population was 19.4% (117/603). The prevalence of reported physical abuse was 22.6% (19/84) in the women and 12.0% (62/519) in the men (p = 0.008); the prevalence of sexual abuse was 33.3% (28/84) in the women and 7.7% (40/519) in the men (p abuse than did those without these disorders. More patients with posttraumatic stress disorder (PTSD) reported physical and sexual abuse than did those without these disorders. Stratifying by race, sex, and diagnoses, multivariate analyses showed that the women with PTSD had a greater likelihood to report physical abuse (p = 0.03) and sexual abuse histories (p = 0.008) than did the women without PTSD. The men with substance-induced mood disorder (p = 0.01) were more likely to report physical abuse compared with the men without substance-induced mood disorder. Screening for abuse in patients with depressive disorders and PTSD is warranted to tailor individualized treatments for these patients. More research is needed to better understand the potential implications of childhood abuse on psychiatric diagnoses.

  3. [Child abuse in Cameroon: evaluation of a training course on awareness, detection, and reporting of child abuse].

    Science.gov (United States)

    Menick, D Mbassa; Ngoh, F

    2005-01-01

    The twofold purpose of this study was to promote and facilitate awareness, detection and reporting of child abuse by improving the diagnostic ability of a group of pediatric care providers working in pediatric emergency rooms and to evaluate the impact of training on awareness, detection and reporting of child abuse. This study was conducted in three phases. In the first phase data were retrospectively collected for a three-month period prior to the study (May, June, and July 1996). In the second phase a training seminar about awareness, detection, and reporting of child abuse was organized from April 29 to 30, 1997 for pediatric care providers working in the pediatric emergency rooms of several facilities in Yaoundé, Cameroon. Trainees included pediatricians, general practitioners, nurses, and social workers. An oral presentation using 137-slides (visual diagnosis of physical abuse) from the American Academy of Paediatrics (1994) was used as a teaching aid. In the third phase the same data as in the first phase was prospectively collected on the same three-month period after the seminar (May, June and July 1997). As in the first phase data was collected by the same person from emergency room registers according to the WHO protocol (1994) (study of interpersonal physical abuse of children). During the first phase 39 cases of physical abuse were reported in a population 1269 consulting patients, i.e. 3.1% of the cohort. In the third phase prospective analysis of reporting following the training seminar showed that 161 cases of physical abuse were reported in a population of 1425 consulting patients, i.e., 11.3% of the cohort. The victim group (n=161) in the third phase was four-fold larger than the victim group in the first phase (n = 39). These findings suggest that the seminar achieved its main goals, i.e., to improve the diagnostic ability of the trainees and to increase detection and screening of physical abuse of children.

  4. Cancer Screening

    Directory of Open Access Journals (Sweden)

    Krishna Prasad

    2004-10-01

    Full Text Available Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  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. Tracer kinetic modelling for DCE-MRI quantification of subtle blood-brain barrier permeability.

    Science.gov (United States)

    Heye, Anna K; Thrippleton, Michael J; Armitage, Paul A; Valdés Hernández, Maria Del C; Makin, Stephen D; Glatz, Andreas; Sakka, Eleni; Wardlaw, Joanna M

    2016-01-15

    There is evidence that subtle breakdown of the blood-brain barrier (BBB) is a pathophysiological component of several diseases, including cerebral small vessel disease and some dementias. Dynamic contrast-enhanced MRI (DCE-MRI) combined with tracer kinetic modelling is widely used for assessing permeability and perfusion in brain tumours and body tissues where contrast agents readily accumulate in the extracellular space. However, in diseases where leakage is subtle, the optimal approach for measuring BBB integrity is likely to differ since the magnitude and rate of enhancement caused by leakage are extremely low; several methods have been reported in the literature, yielding a wide range of parameters even in healthy subjects. We hypothesised that the Patlak model is a suitable approach for measuring low-level BBB permeability with low temporal resolution and high spatial resolution and brain coverage, and that normal levels of scanner instability would influence permeability measurements. DCE-MRI was performed in a cohort of mild stroke patients (n=201) with a range of cerebral small vessel disease severity. We fitted these data to a set of nested tracer kinetic models, ranking their performance according to the Akaike information criterion. To assess the influence of scanner drift, we scanned 15 healthy volunteers that underwent a "sham" DCE-MRI procedure without administration of contrast agent. Numerical simulations were performed to investigate model validity and the effect of scanner drift. The Patlak model was found to be most appropriate for fitting low-permeability data, and the simulations showed vp and K(Trans) estimates to be reasonably robust to the model assumptions. However, signal drift (measured at approximately 0.1% per minute and comparable to literature reports in other settings) led to systematic errors in calculated tracer kinetic parameters, particularly at low permeabilities. Our findings justify the growing use of the Patlak model in low

  7. Psychological Consequences of Wife Abuse | Chovwen | African ...

    African Journals Online (AJOL)

    Results also showed that old abused women scored significantly lower on depression than young abused women, F(1,337)=P<.01. Likewise, high education abused women self-reported significantly higher on depression than low education abused women, t(2,337)= 5.44. On self-esteem, old abused women were ...

  8. Nurses' perceptions about child abuse

    OpenAIRE

    Ahmad Saifan; Intima A Alrimawi; Ibrahim Bashaireh

    2015-01-01

    Background: Despite the efforts to protect children around the world, child abuse and neglect remain serious and global problems. In Palestine, child abuse is hidden under the community culture, does not appear in the Ministry of Health official reports, and little is known about nurses’ perceptions towards this phenomenon. Objectives: To identify nurses’ perceptions about child abuse definition, whether they faced such cases during their work, and how they managed them. Methods: Data...

  9. Forensic aspects of animal abusing

    OpenAIRE

    Aleksić Jelena; Jović Slavoljub

    2008-01-01

    Animal abuse is important social issue, which includes a wide range of behaviors of humans that are harmful to animals, starting from unintentional neglect to intentional cruelty. Types of animal abuse are different and they can include physical, sexual, emotional abuse or neglect. Training dogs for fights and dog fighting are considered to be neglection of animals. Forensic veterinarians are called for testifining more often now for presenting the evidence that can lead to making a case rega...

  10. 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

  11. Golden ratio: A subtle regulator in our body and cardiovascular system?

    Science.gov (United States)

    Ozturk, Selcuk; Yalta, Kenan; Yetkin, Ertan

    2016-11-15

    Golden ratio, which is an irrational number and also named as the Greek letter Phi (φ), is defined as the ratio between two lines of unequal length, where the ratio of the lengths of the shorter to the longer is the same as the ratio between the lengths of the longer and the sum of the lengths. The so-called formula is a mathematical ratio and there exist a variety of examples in natural and man-made structures of great beauty. Moreover, golden ratio is expressed throughout the human body in some ways, including digits, uterus, teeth, and cardiovascular system. Although the association of Fibonacci series or golden ratio with systems and organs of human being has not been assessed in depth yet, the mainstream regulation of cardiovascular system seems to be associated with golden ratio. This raises the idea that there might have been a fine and subtle regulator in our body. In this article, we aimed to elaborate the relationship between the existence of golden ratio and the human body and to discuss the golden ratio and its association with cardiovascular system. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Offering variety: a subtle manipulation to promote healthy food choice throughout the day.

    Science.gov (United States)

    Burns, Rachel J; Rothman, Alexander J

    2015-05-01

    Providing a variety of food generally increases consumption and enjoyment. This effect is typically associated with unhealthy behavior (e.g., overindulgence at a buffet) and studied during a single meal. Two studies tested whether this effect can be leveraged in a subtle, simple manipulation to promote healthy food choices over the course of a day. In Studies 1 and 2, 188 and 187 participants, respectively, chose between a sweet and a piece of fruit in the afternoon. The fruit was either the same as or different from fruit that was selected in the morning; choice was not given in the morning. Study 1 tested this effect in the domain of expressed preferences and Study 2 examined actual choice. In both studies, a second piece of fruit was more likely to be selected in the afternoon if it was different from fruit that was selected in the morning. These results illustrate how a robust effect that is typically associated with unhealthy outcomes can be harnessed to promote healthy food choices and underscore the importance of conceptualizing eating as a series of interrelated behavioral decisions. This work has implications for applied settings, such as cafeterias, and is distinguished from other simple structural manipulations by its focus on sustaining healthy food choice over the course of the day. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  13. Do subjects with vasovagal syncope have subtle haemodynamic alterations during orthostatic stress?

    Science.gov (United States)

    Fucà, Giuseppe; Dinelli, Maurizio; Gianfranchi, Lorella; Bressan, Sabrina; Lamborghini, Catia; Alboni, Paolo

    2008-06-01

    There are conflicting reports on the presence of subtle haemodynamic alterations during orthostatic stress in subjects with vasovagal syncope (VVS). The aim of the present study was to investigate whether young/middle-aged subjects with VVS show abnormal responses to orthostatic stress. Four groups of subjects underwent tilt testing (TT) during the passive phase and, if negative, after nitroglycerin administration: Group I, 20 subjects with a history of syncope and positive passive TT; Group II, 23 subjects with a history of syncope and TT positive after nitroglycerin; Group III, 23 subjects with a history of syncope and negative TT; and Group IV, 20 normal control subjects. Heart rate, systolic, diastolic, and mean blood pressure, stroke volume, cardiac output, and total peripheral resistance were computed from pressure pulsations (Modelflow). The demographic data and the values of the haemodynamic variables in the supine position did not differ significantly among the four groups. The per cent changes in these variables did not differ significantly among the four groups after 2 and 5 min of TT and among Groups II, III, and IV, 2 min after nitroglycerin administration. Young/middle-aged subjects with VVS have a normal measured haemodynamic response to orthostatic stress; therefore, the vasovagal reflex is not secondary to an impairment of the primary vasoconstrictive mechanism.

  14. See no evil: color blindness and perceptions of subtle racial discrimination in the workplace.

    Science.gov (United States)

    Offermann, Lynn R; Basford, Tessa E; Graebner, Raluca; Jaffer, Salman; De Graaf, Sumona Basu; Kaminsky, Samuel E

    2014-10-01

    Workplace discrimination has grown more ambiguous, with interracial interactions often perceived differently by different people. The present study adds to the literature by examining a key individual difference variable in the perception of discrimination at work, namely individual color-blind attitudes. We examined relationships between 3 dimensions of color-blind attitudes (Racial Privilege, Institutional Discrimination, and Blatant Racial Issues) and perceptions of racial microaggressions in the workplace as enacted by a White supervisor toward a Black employee (i.e., discriminatory actions ranging from subtle to overt). Findings showed that observer views on institutional discrimination fully mediated, and blatant racial issues partially mediated, the relationships between racial group membership and the perception of workplace microaggressions. Non-Hispanic Whites endorsed color blindness as institutional discrimination and blatant racial issues significantly more than members of racioethnic minority groups, and higher levels of color-blind worldviews were associated with lower likelihoods of perceiving microaggressions. Views on racial privilege did not differ significantly between members of different racial groups or affect microaggression perceptions. Implications for organizations concerned about promoting more inclusive workplaces are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  15. Overcoming the toxic influence of subtle messaging: Utah women who persist in STEM

    Science.gov (United States)

    Thackeray, Susan L.

    It is important to train more females to support the needs of a national and global economy workforce. The purpose of this thesis is to explore the proposition of the effect subtle messaging has on a Utah young woman's future career choice. The literature review will approach the science, technology, engineering, and math (STEM) subjects with historical, psychological, and cultural vantage points. An examination of three interconnected topics of research will include a history of women in the workforce and identified barriers to STEM education and careers to identify what types of messages are delivered to women as it relates to STEM and how it influences their career interest decisions. While there are historical barriers towards women in training for and entering STEM careers, no strong evidence is identified for sustained improvement. The changing concepts of social cognitive career theory can potentially provide a framework for constructivist assumptions regarding the topic of what can focus Utah young women learners to influence their own career development and surroundings to persist into STEM careers. Interpretative Phenomenology Analysis (IPA) provides increased understanding of the experiences of how Utah young women come to their decision and what role their environment contributes to that experience. Preliminary research outcomes demonstrate that the participants describe feelings of self-efficacy along with cultural expectations that do not align with their personal goals to enter into STEM education and careers.

  16. Second Harmonic Generation Reveals Subtle Fibrosis Differences in Adult and Pediatric Nonalcoholic Fatty Liver Disease.

    Science.gov (United States)

    Liu, Feng; Zhao, Jing-Min; Rao, Hui-Ying; Yu, Wei-Miao; Zhang, Wei; Theise, Neil D; Wee, Aileen; Wei, Lai

    2017-11-20

    Investigate subtle fibrosis similarities and differences in adult and pediatric nonalcoholic fatty liver disease (NAFLD) using second harmonic generation (SHG). SHG/two-photon excitation fluorescence imaging quantified 100 collagen parameters and determined qFibrosis values by using the nonalcoholic steatohepatitis (NASH) Clinical Research Network (CRN) scoring system in 62 adult and 36 pediatric NAFLD liver specimens. Six distinct parameters identified differences among the NASH CRN stages with high accuracy (area under the curve, 0835-0.982 vs 0.885-0.981, adult and pediatric). All portal region parameters showed similar changes across early stages 0, 1C, and 2, in both groups. Parameter values decreased in adults with progression from stage 1A/B to 2 in the central vein region. In children, aggregated collagen parameters decreased, but nearly all distributed collagen parameters increased from stage 1A/B to 2. SHG analysis accurately reproduces NASH CRN staging in NAFLD, as well as reveals differences and similarities between adult and pediatric collagen deposition not captured by currently available quantitative methods. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. Detecting the Subtle Shape Differences in Hemodynamic Responses at the Group Level

    Directory of Open Access Journals (Sweden)

    Gang eChen

    2015-10-01

    Full Text Available The nature of the hemodynamic response (HDR is still not fully understood due to the multifaceted processes involved. Aside from the overall amplitude, the response may vary across cognitive states, tasks, brain regions, and subjects with respect to characteristics such as rise and fall speed, peak duration, undershoot shape, and overall duration. Here we demonstrate that the fixed-shape or adjusted-shape methods may fail to detect some shape subtleties. In contrast, the estimated-shape method (ESM through multiple basis functions can provide the opportunity to identify some subtle shape differences and achieve higher statistical power at both individual and group levels. Previously, some dimension reduction approaches focused on the peak magnitude, or made inferences based on the area under the curve or interaction, which can lead to potential misidentifications. By adopting a generic framework of multivariate modeling (MVM, we showcase a hybrid approach that is validated by simulations and real data. Unlike the few analyses that were limited to main effect, two- or three-way interactions, we extend the approach to an inclusive platform that is more adaptable than the conventional GLM, achieving a practical equipoise among representation, false positive control, statistical power, and modeling flexibility.

  18. Ultrasound observations of subtle movements: a pilot study comparing foetuses of smoking and nonsmoking mothers.

    Science.gov (United States)

    Reissland, Nadja; Francis, Brian; Kumarendran, Kumar; Mason, James

    2015-06-01

    One way to assess foetal health of smokers is to ask mothers to count perceived movements, an unreliable method hiding differences in prenatal development. The aim of this pilot study was to assess subtle foetal movements in ultrasound scans and establish whether they differ in foetuses of mothers who smoked and nonsmoking mothers. This longitudinal pilot study recruited twenty mothers (16 nonsmoking; 4 smoking) scanned four times from 24 to 36 weeks gestation (80 ultrasound scans). Two types of fine-grained movements were coded offline and analysed using a Poisson log-linear mixed model. Foetuses of smoking mothers showed a significantly higher rate of mouth movements compared to foetuses of nonsmoking mothers (p = 0.02), after controlling for maternal stress and depression. As pregnancy progressed, these differences between the smoking and nonsmoking groups widened. Differences between the two groups in the rate of foetal facial self-touch remained constant as pregnancy progressed and were borderline significant (p = 0.07). Rates of foetal mouth movement and facial self-touch differ significantly between smokers and nonsmokers. A larger study is needed to confirm these results and to investigate specific effects, including the interaction of maternal stress and smoking. Additionally, the feasibility of this technique for clinical practice should be assessed. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  19. Displaying chest X-ray by beamer or monitor: comparison of diagnostic accuracy for subtle abnormalities.

    Science.gov (United States)

    Kuiper, L M; Thijs, A; Smulders, Y M

    2012-01-01

    The advent of beamer projection of radiological images raises the issue of whether such projection compromises diagnostic accuracy. The purpose of this study was to evaluate whether beamer projection of chest X-rays is inferior to monitor display. We selected 53 chest X-rays with subtle abnormalities and 15 normal X-rays. The images were independently judged by a senior radiologist and a senior pulmonologist with a state-of-art computer monitor. We used their unanimous or consensus judgment as the reference test. Subsequently, four observers (one senior pulmonologist, one senior radiologist and one resident from each speciality) judged these X-rays on a standard clinical computer monitor and with beamer projection. We compared the number of correct results for each method. Overall, the sensitivity and specificity did not differ between monitor and beamer projection. Separate analyses in senior and junior examiners suggested that senior examiners had a moderate loss of diagnostic accuracy (8% lower sensitivity, ppfinding illustrates the need for more extensive studies.

  20. Subtle lower esophageal sphincter relaxation abnormalities in patients with unexplained esophageal dysphagia.

    Science.gov (United States)

    Herregods, T V K; van Hoeij, F B; Bredenoord, A J; Smout, A J P M

    2018-02-01

    Esophageal dysphagia is a relatively common symptom. We aimed to evaluate whether subtle, presently not acknowledged forms of dysfunction of the lower esophageal sphincter (LES) could explain dysphagia in a subset of patients with normal findings at high-resolution manometry (HRM) according to the Chicago classification v3.0. We used HRM to compare LES relaxation characteristics in 97 patients with unexplained dysphagia with those in 44 healthy subjects. In addition, normative values for time to LES relaxation and completeness of LES relaxation were calculated. Patients with delayed or incomplete LES relaxation were compared with patients with normal relaxation. Dysphagia patients had a higher nadir LES pressure (P=.001) and a longer time to LES relaxation (P=.012) than healthy subjects. Based on the findings in healthy subjects, normal values of LES relaxation were defined as: ≥50% of swallows with normal LES relaxation time (relaxation (not reaching a value below 10 mm Hg). Dysphagia patients had significantly more often >50% swallows with delayed and/or incomplete LES relaxation than healthy controls (25% vs 4.5%; P=.004). Dysphagia patients with >50% delayed and/or incomplete LES relaxation had a significantly higher LES resting pressure (Prelaxation abnormalities, such as a delayed relaxation of the LES and/or incomplete LES relaxation, could be a cause of dysphagia in approximately one quarter of the patients with otherwise unexplained esophageal dysphagia. © 2017 John Wiley & Sons Ltd.

  1. Stratified Mucin-Producing Intraepithelial Lesion of the Cervix: Subtle Features Not to Be Missed.

    Science.gov (United States)

    Schwock, Joerg; Ko, Hyang Mi; Dubé, Valérie; Rouzbahman, Marjan; Cesari, Matthew; Ghorab, Zeina; Geddie, William R

    2016-01-01

    Stratified mucin-producing intraepithelial lesion (SMILE) is an uncommon premalignant lesion of the uterine cervix. A detailed examination of preinvasive SMILE cases including a comparison of the cytologic features with usual-type adenocarcinoma in situ (AIS) and human papillomavirus (HPV) genotyping was performed. Excisions and preceding Papanicolaou (Pap) tests were retrieved from the files of 2 tertiary care centers. Histologic review estimated the lesional SMILE proportion. Pap tests were reviewed and assessed for architectural, cellular and background features. Cobas® HPV test was performed. 13 cases were identified. Mean/median patient age was 35/33 years (range 23-51 years). Concurrent high-grade squamous intraepithelial lesion was found in 10/13 (77%) and AIS in 8/13 (62%) cases. In 6 cases, SMILE was dominant (≥50%) and represented in 5/6 corresponding Pap tests. Cytology interpretations differed more often in the SMILE-dominant group (p < 0.05). SMILE and AIS had overlapping features. Feathering and prominent nucleoli were absent in SMILE. HPV DNA was detected in all 12 cases tested. HPV 18 was most common (7/12). Excisions with positive/suspicious margins were reported in 5/6 SMILE-dominant versus 3/7 nondominant cases. SMILE is best considered as an AIS variant for cytologic, etiologic and management purposes. Cytologic features overlap with AIS, but are more subtle and easily missed. HPV testing may play a role in facilitating SMILE detection. © 2016 S. Karger AG, Basel.

  2. Incidental white-matter foci on MRI in ''healthy'' subjects: evidence of subtle cognitive dysfunction

    International Nuclear Information System (INIS)

    Baum, K.A.; Schulte, C.; Girke, W.; Reischies, F.M.; Felix, R.

    1996-01-01

    The clinical significance of incidental white-matter foci seen on MRI is controversial. Mainly using a computer-assisted neuropsychological test battery, we tested the hypothesis that there is a clinical correlate of these foci. We studied 41 individuals aged 45-65 years with no history of neurological or psychiatric disorder, in whom no indication of central nervous system abnormalities was found on standardised neurological examination. A computer-assisted neuropsychological test battery, with the advantage of precise measuring of both time and deviation (e. g. in position memory tests), and rating scales for emotional dysfunction were administered; selected soft neurological signs were assessed. In 16 subjects (39 %) MRI showed high-signal foci in the white matter on spin-echo sequences. White-matter foci not adjacent to the lateral ventricles were found to be related to performance on immediate visual memory/visuoperceptual skills, visuomotor tracking/psychomotor speed and, to a lesser degree, learning capacity and abstract and conceptual reasoning skills. Subtle cognitive dysfunction would appear to be a clinical correlate of punctate white-matter foci on MRI of otherwise ''healty'' individuals. (orig.). With 1 fig., 2 tabs

  3. Diagnostic imaging of child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Oguma, Eiji; Aihara, Toshinori [Saitama Children' s Medical Center, Iwatsuki (Japan)

    2002-04-01

    The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)

  4. Diagnostic imaging of child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, P.K.

    1987-01-01

    This book provides a description for all the known radiological alterations occurring in child abuse. This allows for precise interpretation of findings by radiologists. It also helps eliminate the confusion among both clinicians and non-medical personnel involved in the diagnosis, management, and legal issues related to child abuse. CONTENTS: Introduction; Skeletal trauma: general considerations; Extremity trauma; Bony thoracic trauma; Spinal trauma; Dating fractures; Visceral trauma; Head trauma; Miscellaneous forms of abuse and neglect; The postmortem examination; Differential diagnosis of child abuse; Legal considerations; Psychosocial considerations; Technical considerations and dosimetry.

  5. Incest and Child Sexual Abuse

    Science.gov (United States)

    Collins, James L.; Hamlin, Willie T.; Minor, Marie A.; Knasel, Ann Lowe

    1982-01-01

    Child sexual abuse was examined nationally and in the Washington, DC and Howard University Hospital area. In an attempt to describe this widespread problem, two case histories are presented which reflect some of the typical characteristics of child sexual abuse cases seen at Howard University Hospital. Pertinent literature is reviewed citing the prevalence rates and the personality and environmental factors which may contribute to the sexual abuse of children in this country. Finally, the role of the physician in identifying and treating the physical and emotional effects of child abuse are discussed. PMID:7120485

  6. Diagnostic imaging of child abuse

    International Nuclear Information System (INIS)

    Oguma, Eiji; Aihara, Toshinori

    2002-01-01

    The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)

  7. Diagnostic imaging of child abuse

    International Nuclear Information System (INIS)

    Kleinman, P.K.

    1987-01-01

    This book provides a description for all the known radiological alterations occurring in child abuse. This allows for precise interpretation of findings by radiologists. It also helps eliminate the confusion among both clinicians and non-medical personnel involved in the diagnosis, management, and legal issues related to child abuse. CONTENTS: Introduction; Skeletal trauma: general considerations; Extremity trauma; Bony thoracic trauma; Spinal trauma; Dating fractures; Visceral trauma; Head trauma; Miscellaneous forms of abuse and neglect; The postmortem examination; Differential diagnosis of child abuse; Legal considerations; Psychosocial considerations; Technical considerations and dosimetry

  8. Spouse Abuse, Child Abuse, and Substance Abuse Among Army Facilities: Co-Occurrence, Correlations and Service Delivery Issues

    National Research Council Canada - National Science Library

    Gibbs, Deborah A

    2006-01-01

    ...: spouse abuse child abuse and substance abuse. By supporting the development of improved responses to troubled families findings from this study can potentially reduce mortality and morbidity among military personal and their family members...

  9. 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.

  10. 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

  11. The Body in New Age from the Perspective of the Subtle Body: The Example of the Source Breathwork Community

    Directory of Open Access Journals (Sweden)

    Katre Koppel

    2013-10-01

    Full Text Available The article discusses the perception of the body among Source Breathwork practitioners. Source Process and Breathwork can be classified as a New Age healing practice that aims to heal the person as a whole. There is also a specific emphasis on healing birth trauma, which is understood as healing the fundamental experience of an individual’s life. The body in New Age can be described with the notion of the ‘subtle body’, a non-dualistic approach to the body that blurs the boundaries between ‘matter’ and ‘spirit’. Subtle bodies, the ‘places’ where healing occurs, are considered energetic, invisible and nebulous. The concept of the subtle body as a scholarly tool is applied in the analysis of fieldwork data collected between 2011 and 2013 in Estonia. In a Source community, the body is considered to be energetic and to include chakras. Members of the community claim that the functioning of the body and well-being in life bear upon negative and positive thoughts or decisions that are held in the subconscious and embedded at a cellular level in the body. Moreover, the breathwork practitioners believe that an individual already makes fundamental decisions about life in the womb or during birth. Since the perception of the body and birth are closely interrelated in the Source community, the meaning of birth is viewed from the perspective of the subtle body. 

  12. The Body in New Age from the Perspective of the Subtle Body: The Example of the Source Breathwork Community

    Directory of Open Access Journals (Sweden)

    Katre Koppel

    2013-05-01

    Full Text Available The article discusses the perception of the body among Source Breathwork practitioners. Source Process and Breathwork can be classified as a New Age healing practice that aims to heal the person as a whole. There is also a specific emphasis on healing birth trauma, which is understood as healing the fundamental experience of an individual’s life. The body in New Age can be described with the notion of the ‘subtle body’, a non-dualistic approach to the body that blurs the boundaries between ‘matter’ and ‘spirit’. Subtle bodies, the ‘places’ where healing occurs, are considered energetic, invisible and nebulous. The concept of the subtle body as a scholarly tool is applied in the analysis of fieldwork data collected between 2011 and 2013 in Estonia. In a Source community, the body is considered to be energetic and to include chakras. Members of the community claim that the functioning of the body and well-being in life bear upon negative and positive thoughts or decisions that are held in the subconscious and embedded at a cellular level in the body. Moreover, the breathwork practitioners believe that an individual already makes fundamental decisions about life in the womb or during birth. Since the perception of the body and birth are closely interrelated in the Source community, the meaning of birth is viewed from the perspective of the subtle body.

  13. Colon cancer screening

    Science.gov (United States)

    Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal ...

  14. [Workplace testing of drugs of abuse and psychotropic drugs].

    Science.gov (United States)

    Mura, P; Saussereau, E; Brunet, B; Goullé, J-P

    2012-05-01

    In France, workplace testing of drugs of abuse and psychotropic drugs is rarely performed; meanwhile it is a major public health problem. Furthermore, France is the European country that has been associated with the highest increase of the use of drugs of abuse, particularly cannabis. So workplace biological screening of drugs of abuse and of psychotropic drugs exposure is of major concern. New analytical techniques have been developed during the last years. The authors will consider analytical screening of drugs of abuse and particularly the comparison of analytical techniques applied to urine and saliva. The advantages and the disadvantages of these two matrices will be considered. Urinary and blood quantification will be reviewed, but also the interest of hair testing to explore chronic exposure. The research of psychotropic drugs in biological fluids is also a part of this paper. New analytical trends are promising and complete analysis of these substances will be soon routinely possible in blood using a single spot test. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Accumulating experience in a child abuse clinic

    African Journals Online (AJOL)

    type uncertain' and no abuse. Training of other health personnel in child abuse ... abused children, registered nurses, social workers and psychologists. The patients and accompanying adults, usually parents, are interviewed by the sQQial ...

  16. 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

  17. The subtle effects of sea water acidification on the amphipod Gammarus locusta

    Science.gov (United States)

    Hauton, C.; Tyrrell, T.; Williams, J.

    2009-08-01

    We report an investigation of the effects of increases in pCO2 on the survival, growth and molecular physiology of the neritic amphipod Gammarus locusta which has a cosmopolitan distribution in estuaries. Amphipods were reared from juvenile to mature adult in laboratory microcosms at three different levels of pH in nominal range 8.1-7.6. Growth rate was estimated from weekly measures of body length. At sexual maturity the amphipods were sacrificed and assayed for changes in the expression of genes coding for a heat shock protein (hsp70 gene) and the metabolic enzyme glyceraldehyde-3-phosphate dehydrogenase (gapdh gene). The data show that the growth and survival of this species is not significantly impacted by a decrease in sea water pH of up to 0.5 units. Quantitative real-time PCR analysis indicated that there was no significant effect of growth in acidified sea water on the sustained expression of the hsp70 gene. There was a consistent and significant increase in the expression of the gapdh gene at a pH of ~7.5 which, when combined with observations from other workers, suggests that metabolic changes may occur in response to acidification. It is concluded that sensitive assays of tissue physiology and molecular biology should be routinely employed in future studies of the impacts of sea water acidification as subtle effects on the physiology and metabolism of coastal marine species may be overlooked in conventional gross "end-point" studies of organism growth or mortality.

  18. A Practical ECG Criterion to Unmask Left Accessory AV Connections in Patients With Subtle Preexcitation.

    Science.gov (United States)

    Thompson, J Jenkins; Shah, Jignesh; Charnigo, Richard; Tackett, Andrea; Darrat, Yousef H; Bailey, Alison; Delisle, Brian; Kakavand, Bahram; DI Biase, Luigi; Natale, Andrea; Morales, Gustavo; Elayi, Claude S

    2015-05-20

    Accessory AV-connections capable of antegrade conduction need to be recognized because of the potential for life-threatening arrhythmias. However, the preexcited ECG pattern may be subtle, especially among left-sided AV-connections. We explored whether additional ECG criteria might help identify left-sided AV-connections. We analyzed 156 patients who underwent an electrophysiology study (EPS) and ablation for paroxysmal supraventricular tachycardias (PSVT). Patients were divided into 2 groups: those with left-sided AV-connections (Group 1) and all other PSVT (Group 2). Various ECG parameters were compared before and after ablation in both groups. The EPS identified left-sided AV-connections among 43 patients (Group 1) and excluded it among 113 (Group 2). Baseline ECG in Group 1 demonstrated obvious preexcitation among 24/43 patients (55.8%), the remaining 19/43 missing obvious preexcitation. R/S ratio > 0.5 in V1 was noted in 38/43 (88.4%) patients in Group 1 before ablation (median 1.00; IQR 0.58-2.20), including 16/19 (84.2%) patients lacking obvious left-sided AVconnections. Conversely, only 10/113 (8.8%) patients in Group 2 had R/S ratios in V1 ≥ 0.5 (0.20; 0.10-0.31), P AV-connections (sensitivity 93.0%). The negative predictive value of this combined criterion was 103/106 (97.2%). In symptomatic patients, combining the R/S ratio (≥ 0.5) in lead V1 with the classic preexcitation pattern on ECG markedly improved the sensitivity to diagnose left-sided AV-connections. This ratio may be particularly useful among patients lacking obvious preexcitation. © 2015 Wiley Periodicals, Inc.

  19. The subtle effects of sea water acidification on the amphipod Gammarus locusta

    Directory of Open Access Journals (Sweden)

    J. Williams

    2009-08-01

    Full Text Available We report an investigation of the effects of increases in pCO2 on the survival, growth and molecular physiology of the neritic amphipod Gammarus locusta which has a cosmopolitan distribution in estuaries. Amphipods were reared from juvenile to mature adult in laboratory microcosms at three different levels of pH in nominal range 8.1–7.6. Growth rate was estimated from weekly measures of body length. At sexual maturity the amphipods were sacrificed and assayed for changes in the expression of genes coding for a heat shock protein (hsp70 gene and the metabolic enzyme glyceraldehyde-3-phosphate dehydrogenase (gapdh gene. The data show that the growth and survival of this species is not significantly impacted by a decrease in sea water pH of up to 0.5 units. Quantitative real-time PCR analysis indicated that there was no significant effect of growth in acidified sea water on the sustained expression of the hsp70 gene. There was a consistent and significant increase in the expression of the gapdh gene at a pH of ~7.5 which, when combined with observations from other workers, suggests that metabolic changes may occur in response to acidification. It is concluded that sensitive assays of tissue physiology and molecular biology should be routinely employed in future studies of the impacts of sea water acidification as subtle effects on the physiology and metabolism of coastal marine species may be overlooked in conventional gross "end-point" studies of organism growth or mortality.

  20. Lysosomal exocytosis in response to subtle membrane damage following nanosecond pulse exposure

    Science.gov (United States)

    Dalzell, Danielle R.; Roth, Caleb C.; Bernhard, Joshua A.; Payne, Jason A.; Wilmink, Gerald J.; Ibey, Bennett L.

    2011-03-01

    The cellular response to subtle membrane damage following exposure to nanosecond electric pulses (nsEP) is not well understood. Recent work has shown that when cells are exposed to nsEP, ion permeable nanopores ( 2nm) created by longer micro and millisecond duration pulses. Macroscopic damage to a plasma membrane by a micropipette has been shown to cause internal vesicles (lysosomes) to undergo exocytosis to repair membrane damage, a calcium mediated process called lysosomal exocytosis. Formation of large pores in the plasma membrane by electrical pulses has been shown to elicit lysosomal exocytosis in a variety of cell types. Our research objective is to determine whether lysosomal exocytosis will occur in response to nanopores formed by exposure to nsEP. In this paper we used propidium iodide (PI) and Calcium Green-1 AM ester (CaGr) to differentiate between large and small pores formed in CHO-K1 cells following exposure to either 1 or 20, 600-ns duration electrical pulses at 16.2 kV/cm. This information was compared to changes in membrane organization observed by increases in FM1-43 fluorescence, both in the presence and absence of calcium ions in the outside buffer. In addition, we monitored the real time migration of lysosomes within the cell using Cellular Lights assay to tag LAMP-1, a lysosomal membrane protein. Both 1 and 20 pulses elicited a large influx of extracellular calcium, while little PI uptake was observed following a single pulse exposure. Statistically significant increases in FM1-43 fluorescence were seen in samples containing calcium suggesting that calcium-triggered membrane repair may be occurring. Lastly, density of lysosomes within cells, specifically around the nucleus, appeared to change rapidly upon nsEP stimulation suggesting lysosomal migration.

  1. Working on Memories of Abuse....

    Science.gov (United States)

    Horsman, Jenny

    1994-01-01

    Through working with a woman abused as a child, a teacher concluded that the violence of sexual, physical, and psychological abuse is common among many adults who read and write poorly. Their experiences should be acknowledged in literacy programs that encourage people to develop skills with which to tell their stories. (SK)

  2. Signs of Childhood Sexual Abuse

    Science.gov (United States)

    ... with a child (by an adult or another child) is sexual abuse. It causes physical and emotional pain. It has long-term effects ... a watchful eye on any form of childhood abuse. These physical and behavioral signs should raise concern: When your child tells you he or she has been touched ...

  3. Elder abuse in the Netherlands

    NARCIS (Netherlands)

    Inger Plaisier; Mirjam de Klerk

    2015-01-01

    Original title: Ouderenmishandeling in Nederland It is twenty years since the last study was carried out on the number of older persons in the Netherlands who are deliberate or accidental victims of abuse in the form of verbal, physical or sexual violence, financial abuse and/or neglect by

  4. Observations on Substance Abuse Theory.

    Science.gov (United States)

    Shaffer, Howard J.

    1986-01-01

    Applies a philosophy of science perspective to substance abuse theory to clarify these theories in general and peer cluster theory in particular. Examines the natural history of an illicit drug from a macroscopic level of analysis to illuminate some of the social-psychological factors that influence drug use and abuse patterns. (Author/KS)

  5. Preventing Child Abuse and Neglect

    Science.gov (United States)

    ... Federal and national organizations and State contacts that work to prevent child abuse. Promoting child & family well-being Information on ... awareness & creating supportive communities Tools for sharing a child abuse ... research on what works, information on the role of related professionals, and ...

  6. Drug Abuse in the Army.

    Science.gov (United States)

    The essay discusses the growth of drug abuse in the Army, actions that have been taken to control the problem, and planned or proposed actions to...and supervisory personnel of the Drug Abuse Control Division in the Office of the Deputy Chief of Staff for Personnel, Headquarters, Department of

  7. 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.

  8. ABUSE OF ANABOLIC ANDROGENIC STEROIDS

    Directory of Open Access Journals (Sweden)

    Abbas Yavari

    2009-09-01

    Full Text Available According to the International Olympic Committee, the abuse of anabolic androgenic steroids (AASS is found in over 50% of positive doping tests. AASS abuse is not restricted to the organized sports andwidespread use. It remains as an unsolved public-health problem.Lower black market price, easier access to AASS, bodybuilding clubs and internet advertising are factors of this increasingly misuse. There is not real data about the prevalence of AASS abuse in various populations or countries, because most of athletes or students, due to their prohibition or ethical aspects do not admit to AASS abuse. Often they are aware of the risks of their choice and yet, are eager to put themselves at risk without deeper consideration. The abusers use them to improve their physical fitness and appearance.Present article has been collected to elucidate the risks and adverse effects of AASS and explanation of mechanisms of these events.

  9. 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.

  10. Adolescent suicide risk screening in the emergency department.

    Science.gov (United States)

    King, Cheryl A; O'Mara, Roisin M; Hayward, Charles N; Cunningham, Rebecca M

    2009-11-01

    Many adolescents who die by suicide have never obtained mental health services. In response to this, the National Strategy for Suicide Prevention recommends screening for elevated suicide risk in emergency departments (EDs). This cross-sectional study was designed to examine 1) the concurrent validity and utility of an adolescent suicide risk screen for use in general medical EDs and 2) the prevalence of positive screens for adolescent males and females using two different sets of screening criteria. Participants were 298 adolescents seeking pediatric or psychiatric emergency services (50% male; 83% white, 16% black or African American, 5.4% Hispanic). The inclusion criterion was age 13 to 17 years. Exclusion criteria were severe cognitive impairment, no parent or legal guardian present to provide consent, or abnormal vital signs. Parent or guardian consent and adolescent assent were obtained for 61% of consecutively eligible adolescents. Elevated risk was defined as 1) Suicidal Ideation Questionnaire-Junior [SIQ-JR] score of > or =31 or suicide attempt in the past 3 months or 2) alcohol abuse plus depression (Alcohol Use Disorders Identification Test-3 [AUDIT-3] score of > or =3, Reynolds Adolescent Depression Scale-2 [RADS-2] score of > or =76). The Beck Hopelessness Scale (BHS) and Problem Oriented Screening Instrument for Teenagers (POSIT) were used to ascertain concurrent validity. Sixteen percent (n = 48) of adolescents screened positive for elevated suicide risk. Within this group, 98% reported severe suicide ideation or a recent suicide attempt (46% attempt and ideation, 10% attempt only, 42% ideation only) and 27% reported alcohol abuse and depression. Nineteen percent of adolescents who screened positive presented for nonpsychiatric reasons. One-third of adolescents with positive screens were not receiving any mental health or substance use treatment. Demonstrating concurrent validity, the BHS scores of adolescents with positive screens and the POSIT

  11. Learning Classification Models of Cognitive Conditions from Subtle Behaviors in the Digital Clock Drawing Test

    OpenAIRE

    Souillard-Mandar, William; Davis, Randall; Rudin, Cynthia; Au, Rhoda; Libon, David J.; Swenson, Rodney; Price, Catherine C.; Lamar, Melissa; Penney, Dana L.

    2015-01-01

    The Clock Drawing Test—a simple pencil and paper test—has been used for more than 50 years as a screening tool to differentiate normal individuals from those with cognitive impairment, and has proven useful in helping to diagnose cognitive dysfunction associated with neurological disorders such as Alzheimer’s disease, Parkinson’s disease, and other dementias and conditions. We have been administering the test using a digitizing ballpoint pen that reports its position with considerable spatial...

  12. Effects of mother-son incest and positive perceptions of sexual abuse experiences on the psychosocial adjustment of clinic-referred men.

    Science.gov (United States)

    Kelly, Robert J; Wood, Jeffrey J; Gonzalez, Lauren S; MacDonald, Virginia; Waterman, Jill

    2002-04-01

    The primary objective was to examine the long-term impact of mother-son incest and positive initial perceptions of sexual abuse experiences on adult male psychosocial functioning. Sixty-seven clinic-referred men with a history of sexual abuse participated. The participants completed self-report measures regarding their current psychosocial functioning and described the nature of their sexual and physical abuse experiences during childhood. Seventeen men reported mother-son incest, and these men endorsed more trauma symptoms than did other sexually abused men, even after controlling for a history of multiple perpetrators and physical abuse. Mother-son incest was likely to be subtle, involving behaviors that may be difficult to distinguish from normal caregiving (e.g., genital touching), despite the potentially serious long-term consequences. Twenty-seven men recalled positive or mixed initial perceptions of the abuse, including about half of the men who had been abused by their mothers. These men reported more adjustment problems than did men who recalled purely negative initial perceptions. Mother-son incest and positive initial perceptions of sexual abuse experiences both appear to be risk factors for more severe psychosocial adjustment problems among clinic-referred men.

  13. Fear of Falling Correlates with Subtle Neuromuscular Balance and Strength Deficits of Fragility Fracture Patients.

    Science.gov (United States)

    Wee, Corinne E; Ames, Tyler D; Le, Khoi M; Wang, Tiffany; Phieffer, Laura S; Quatman, Carmen E

    2016-10-01

    Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures. Forty-one subjects (20 fragility fracture patients, 21 controls without history of fragility fractures) over the age of 50 were recruited from three outpatient orthopaedic clinics. All subjects were administered a FES-I Fear of Falling Survey, a portion of an SF-36 survey, and tested using three different portable CATs: the Wii Balance Board, iPod Level Belt and Saehan Squeeze Hand Grip Dynamometer. There were several measured variables that showed a moderate correlation with Fear of Falling scores. Of note, correlations between FES-I scores and maximum hand grip strength for both the dominant hand (R= -0.302, p=0.069) and non-dominant hand (R= -0.309, p=0.059), as well as maximum anterior-posterior sway measured by the iPod Level Belt (R=0.320, p=0.056) were found to be marginally significant. In addition, the correlation between FES-I and average anterior-posterior sway was found to be significant (R=0.416, p=0.012). The Nintendo Wii and iPod Level Belt are relatively inexpensive, portable tools that can assess patients for subtle deficits during dynamic functional tasks. The results indicate that these tools can provide a more objective measure of a patient's limitations during daily activities such as walking by assigning them a numerical value and correlating this value to physical deficits that impact balance and coordination. In the future, CATs may also have a role in predicting outcomes and

  14. Stroke And Substance Abuse

    Directory of Open Access Journals (Sweden)

    A Chitsaz

    2017-02-01

    Full Text Available Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injectors are at risk of infections endocarditis, which carries risk for both ischemic and hemorrhagic stroke. Cerebral or subarachnoid hemorrhage usually occurs after rupture of a septic (mycotic aneurysm. Heroine users can are also at risk for hemorrhagic stroke secondary to liver failure with deranged clotting and to heroin nephropathy with uremia or malignant hypertension. In some heroin users the drug it self is directly causal due to vasculitis, hypersensitivity and immunologic changes. Embolization of foreign material to brain due to mixed of heroine with quinine can cause cerebral embolism. AMPHETAMINE AND other psychostimulants: In abuser of amphetamine hemorrhagic stroke can occur, oral, intravenous, nasal, and inhalational routes of administration have been reported. Most were chronic user, but in several patients, stroke followed a first exposure. Some of amphetamine induced intracranial hemorrhages are secondary to acute hypertension, some to cerebral vacuities, and some to a combination of two. Decongestants and diet pills: Phenylpropanolamine (PPA, an amphetamine – like drug, in decongestants and diet pills, induce acute hypertension, sever headache, psychiatric symptoms, seizures and hemorrhagic stroke. Ephedrine and pseudo ephedrine are present in decongestants and bronchodilators and induce headache, tachyarrhythmia, hypertensive emergency, and hemorrhagic and occlusive stroke. Ecstasy, 3,4 Methylenedioxymethamphetamin (MDMA with amphetamine like can

  15. Abusive Consumption Of Alcohol By Elderly

    Directory of Open Access Journals (Sweden)

    Cecília Danielle Bezerra Oliveira

    2017-04-01

    Full Text Available Objectives: To investigate the abusive consumption of alcohol in the elderly in the municipality of Santa Cruz - PB. METHODS: This is a cross-sectional, descriptive study, with quantitative approach with a sample of 170 elderly. To perform the study, three instruments were used: the Mini Mental State Examination (MMSE, a sociodemographic questionnaire and the Michigan Alcoholism Screening Test - Geriatric Version (MAST-G. The data were analyzed in the program Statistical Package for Social Sciences (SPSS - version 21. Results: 14.7% of the elderly were classified by the MAST-G score as elderly individuals presenting problems related to alcohol abuse, the majority of whom were male, single, with education above 05 years, who reside alone, and present some pathology and make use of medications. Conclusion: the research points out the need for multiprofessional work in health in Primary Care, in order to develop health actions that include the prevention of alcohol consumption and minimize the deleterious effects of consumption, in order to reduce the number of undesirable events arising from the use of that substance. Keywords: Primary health care; Alcohol; Old man.

  16. Child abuse, a case report

    Directory of Open Access Journals (Sweden)

    Andri M.T. Lubis

    2004-03-01

    Full Text Available Child abuse is a pervasive social and medical problem that remains a major cause of disability and death among children. The annual incidence of abuse is estimated to be 15 to 42 cases per 1,000 children and appears to be increasing. Fractures are the second most common presentation of physical abuse after skin lesions, and approximately one third of abused children will eventually be seen by an orthopedic surgeon. We report a 7-month-old boy who was suspected to be abused. Our diagnosis was based on findings of multiple fractures, delay in seeking medical treatment and discrepancy between the history of illness and the clinical findings. He sustained multiple fractures in variety of healing, namely fractures on left supracondylar humeri, left radius and ulna, right radius and ulna, both femora, right tibia, and left tibia and fibula. Radiological examination was an important modality in revealing the possibility of abuse on this child. He had received medical treatment, protection, consultation team for the parents and an underway police investigation. (Med J Indones 2004; 13: 59-65 Keywords: child, abuse

  17. Abuse-deterrent Opioid Formulations.

    Science.gov (United States)

    Litman, Ronald S; Pagán, Olivia H; Cicero, Theodore J

    2017-12-18

    Abuse-deterrent opioid formulations have been suggested as one way to decrease the abuse, addiction, and overdose of orally prescribed opioids. Ten oral opioid formulations have received abuse-deterrent labeling by the U.S. Food and Drug Administration (FDA). Their properties consist of physical and/or chemical means by which the pills resist manipulation and create a barrier to unintended administration, such as chewing, nasal snorting, smoking, and intravenous injection. In this review, we describe the mechanisms of abuse-deterrent technology, the types of premarketing studies required for FDA approval, the pharmacology of the currently approved abuse-deterrent opioid formulations, and the evidence for and against their influence on opioid abuse. We conclude that there is currently insufficient evidence to indicate that the availability of abuse-deterrent opioid formulations has altered the trajectory of opioid overdose and addiction; however, postmarketing studies are in their infancy, and novel deterrent formulations are continually being developed and submitted for marketing approval.

  18. 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.

  19. Non-Invasive Screening Techniques for Drugs of Abuse,

    Science.gov (United States)

    1982-08-01

    Method of detection in biological specimens: RIA, EMIT. PRESCRIPTION DRUGS Barbi turates Hypnotics. Often implicated as the causative or secondary... barbi - turate assay 2.43i by ROCHE and 0% by SYVA; (c) for the amphetamine assay 14.24% by ROCHE and 14.58% by SYVA. The ROCHE and SYVA amphe- tamine...the scientific evolution of causes and effect , and philosophically to the notion that concepts are predictions of facts to be found and consequences

  20. Improving the performance of computer-aided detection of subtle breast masses using an adaptive cueing method

    International Nuclear Information System (INIS)

    Wang Xingwei; Lederman, Dror; Zheng Bin; Li Lihua; Xu Weidong; Liu Wei

    2012-01-01

    Current computer-aided detection (CAD) schemes for detecting mammographic masses have several limitations including high correlation with radiologists’ detection and cueing most subtle masses only on one view. To increase CAD sensitivity in cueing more subtle masses that are likely missed and/or overlooked by radiologists without increasing false-positive rates, we investigated a new case-dependent cueing method by combining the original CAD-generated detection scores with a computed bilateral mammographic density asymmetry index. Using the new method, we adaptively raise the CAD-generated scores of the regions detected on ‘high-risk’ cases to cue more subtle mass regions and reduce the CAD scores of the regions detected on ‘low-risk’ cases to discard more false-positive regions. A testing dataset involving 78 positive and 338 negative cases was used to test this adaptive cueing method. Each positive case involves two sequential examinations in which the mass was detected in ‘current’ examination and missed in ‘prior’ examination but detected in a retrospective review by radiologists. Applying to this dataset, a pre-optimized CAD scheme yielded 75% case-based and 55% region-based sensitivity on ‘current’ examinations at a false-positive rate of 0.25 per image. CAD sensitivity was reduced to 42% (case based) and 27% (region based) on ‘prior’ examinations. Using the new cueing method, case-based and region-based sensitivity could maximally increase 9% and 33% on the ‘prior’ examinations, respectively. The percentages of the masses cued on two views also increased from 27% to 65%. The study demonstrated that using this adaptive cueing method enabled us to help CAD cue more subtle cancers without increasing the false-positive cueing rate. (paper)

  1. Ligament reconstruction with single bone tunnel technique for chronic symptomatic subtle injury of the Lisfranc joint in athletes.

    Science.gov (United States)

    Miyamoto, Wataru; Takao, Masato; Innami, Ken; Miki, Shinya; Matsushita, Takashi

    2015-08-01

    Only few procedures for Lisfranc ligaments reconstruction to treat subtle injury of the Lisfranc joint have been reported. We have developed a novel technique for Lisfranc ligaments reconstruction, which was applied to treat chronic symptomatic subtle injuries that had failed to respond to initial treatment or were misdiagnosed. This article describes the technique and its operative outcome in a small case series. Between April 2011 and October 2013, 5 (4 male and 1 female) athletes with a mean age of 19.4 (range 17-21) years were diagnosed with chronic subtle injury of the Lisfranc joint and underwent our novel reconstructive operation. In this technique, only a bone tunnel between the medial cuneiform and the second metatarsal bone is needed for near-anatomical reconstruction of the dorsal and interosseous ligaments. All patients were evaluated before and at 1 year after surgery using the American Orthopaedic Foot and Ankle Society (AOFAS) scale for the ankle-midfoot. In addition, the interval between surgery and return to athletic activity, defined as return to near pre-injury performance level, was investigated. Mean duration of postoperative follow-up was 18.8 (range 12-26) months. Mean AOFAS score improved significantly from 74.6 ± 2.5 (range 71-77) preoperatively to 96.0 ± 5.5 (range 90-100) at 1 year after the operation (p athletic activities and the interval between surgery and return to athletic activity was 16.8 ± 1.1 (range 15-18) weeks. There was no complication related to the operation. The results of this study suggest that our technique of Lisfranc ligaments reconstruction using autologous graft is effective for athletes with chronic subtle injury. Level IV, retrospective case series.

  2. Correlative micro-diffraction and differential phase contrast study of mean inner potential and subtle beam-specimen interaction

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Mingjian, E-mail: mingjian.wu@fau.de; Spiecker, Erdmann, E-mail: erdmann.spiecker@fau.de

    2017-05-15

    Highlights: • Correlative micro-diffraction and DPC-STEM as effective and intuitive method for probing nano-scale electric fields/electrostatic potentials. • Mean inner potential accurately measured by electron refraction from cleaved crystal wedge. • Suggested a pseudo-contactless mode for probing electrostatic potential differences by considering subtle displacements of Fresnel fringes. - Abstract: We present a correlative micro-diffraction and differential phase contrast (DPC) study within scanning transmission electron microscopy (STEM) on the determination of mean inner potential (MIP) and explain the origin of subtle beam-specimen interactions at the edge of wedge-shaped crystals using both experiment and simulation. Our measurement of MIP of Si and GaAs resulted in 12.48 ± 0.22 V and 14.15 ± 0.22 V, respectively, from directly evaluating beam refraction in micro-diffraction mode. DPC-STEM measurements gave very similar values. Fresnel fringes within the diffraction disk resulting from interaction of the highly coherent electron beam with the aperture are observed and a numerical simulation scheme is implemented to reproduce the effect of the specimen on the fringe pattern. Perfect agreement between experiment and simulation has been achieved in terms of subtle displacements of the fringes upon approaching the sample edge with the electron probe. The existence of the fringes has minor effect on the DPC-STEM signal, which is well below the noise level of our setup at practically reasonable acquisition times. We suggest the possibility to perform pseudo-contactless probing of weak potential differences in beam sensitive samples by evaluating the subtle displacements of Fresnel fringes quantitatively.

  3. Trauma complexity and child abuse

    DEFF Research Database (Denmark)

    Riber, Karin

    2017-01-01

    a “Trauma Coding Manual” developed for this study, trauma types were identified in interview transcripts. In both men and women with Iraqi and Palestinian-Lebanese backgrounds, high levels of trauma complexity and high rates of childhood maltreatment were found (63%, n = 27). A number of concepts...... and categories emerged in the domains childhood physical abuse (CPA), childhood emotional abuse (CEA), and neglect. Participants articulated wide personal impacts of child abuse in emotional, relational, and behavioral domains in their adult lives. These narratives contribute valuable clinical information...

  4. Meth abuse and oral health

    Directory of Open Access Journals (Sweden)

    Deviprasad Makonahally

    2015-01-01

    Full Text Available Methamphetamine abuse is spreading its roots in India due to its widespread appeal, ease of manufacture and low cost compared with other stimulant drugs. Methamphetamine-induced caries is a characteristic finding among methamphetamine abusers. Thus, it is important to understand the typical clinical manifestations inclusive of cervical and proximal caries, elicit proper case history and develop a comprehensive treatment plan to help patients in a complete rehabilitation. We present a series of cases of "meth" abuser for dental professionals to help ensure successful treatment and prevention of disease progression.

  5. Drug abuse among the students

    OpenAIRE

    Muhammad Zaman; Sobia Razzaq; Rabia Hassan; Junaid Qureshi; Hira Ijaz; Muhammad Hanif; Fazal Rahman Chughtai

    2015-01-01

    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...

  6. Dentistry and Child Abuse Diagnosis

    OpenAIRE

    Doria Martínez, Ana Milena; Instituto Nacional de Medicina Legal y Ciencias Forenses, Regional Noroccidente. Medellín, Colombia; Navarro Chong, Melissa Ivette; Instituto de Medicina Legal y Ciencias Forenses, Panamá.

    2016-01-01

    Abstract. Background: Child abuse was first described in 1868 by pathologist Ambrosio Tardieu, but it was until the last century when the role of the dentist became relevant to early diagnose this syndrome. Several studies have shown that close to 50 % of head and face trauma is caused by physical abuse of which lips are the most commonly injured site (54 %), followed by oral mucosa, teeth, gums, and tongue. Complications of certain oral pathologies may be related to abuse for negligence. Bit...

  7. Impact of Childhood Abuse on Physical and Mental Health Status and Health Care Utilization Among Female Veterans.

    Science.gov (United States)

    Mercado, Rowena C; Wiltsey-Stirman, Shannon; Iverson, Katherine M

    2015-10-01

    To determine whether childhood abuse predicts health symptoms and health care use among female veterans. Participants were 369 female patients at Veterans Affairs hospitals in New England who completed a mail survey. Multiple regression analyses were conducted to determine the differential impact of childhood physical abuse and childhood sexual abuse on health symptoms and health care use, while accounting for age, race, military branch, and military sexual trauma (MST). In our sample, 109 (29%) female veterans reported experiencing childhood abuse. After adjusting for age, race, military branch, childhood sexual abuse, and MST, childhood physical abuse was predictive of poorer physical health, and greater depressive and post-traumatic stress disorder symptoms. No significant association was found between childhood sexual abuse and poor physical or mental health status. After adjusting for other factors, childhood physical abuse was associated with more frequent use of medical health care. Childhood sexual abuse was not a predictor for health care use. Childhood physical abuse remains an important contributor to physical health and mental health, even after adjusting for the more proximate experience of MST. Screening for adverse childhood experiences may facilitate access to appropriate physical and mental health treatment among female veterans. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  8. Elder Abuse: The Status of Current Knowledge.

    Science.gov (United States)

    Pedrick-Cornell, Claire; Gelles, Richard J.

    1982-01-01

    Discusses problems of definition of elderly abuse. Examines data and research on the rates of elderly abuse and factors found related to elderly abuse. Critiques theories developed to explain the abuse of the elderly. Presents recommendations for research and practice. (RC)

  9. Self-Esteem and Attitudes toward Love in Abused and Non-Abused Women.

    Science.gov (United States)

    Chambliss, Catherine; And Others

    This study sought to identify personality differences in abused versus non-abused women. Abused women (N=25) were from several centers for abused women and non-abused women (N=39) were students in evening psychology classes. All subjects completed Rubin's Love Scale, the abbreviated Dominance and Romanticism Scale, Rosenberg's Self-Esteem Scale,…

  10. The Genesis of Pedophilia: Testing the "Abuse-to-Abuser" Hypothesis.

    Science.gov (United States)

    Fedoroff, J. Paul; Pinkus, Shari

    1996-01-01

    This study tested three versions of the "abuse-to-abuser" hypothesis by comparing men with personal histories of sexual abuse and men without sexual abuse histories. There was a statistically non-significant trend for assaulted offenders to be more likely as adults to commit genital assaults on children. Implications for the abuse-to-abuser…

  11. Screen dealing

    International Nuclear Information System (INIS)

    Barlow, J.W.

    1991-01-01

    The screen dealing system provides a facility whereby buyers and sellers of spot thermal coal can make bids and offers via the medium of the Reuters screen. A sale results when a market participant notifies his acceptance of a price to a central dealing desk. Use of the system is available to all genuine participants in the coal trade. This paper reports that it provides a focus for information and for the visible making of coal prices. For years screen trading has been used successfully to trade other commodities. At last coal is being traded electronically. It makes sense. It works. Users like it

  12. 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

  13. 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.

  14. Child neglect and emotional abuse

    Science.gov (United States)

    ... that may be emotionally abused. They may have: Problems in school Eating disorders, leading to weight loss or poor weight gain Emotional issues such as low self-esteem, depression, and anxiety Extreme behavior such as acting ...

  15. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  16. Airport Screening

    Science.gov (United States)

    ... travel continues, especially given the ongoing threat of terrorism. The technology used in screening people and their ... can be found on the Radiation Terms and Definitions page on the Health Physics Society website at ...

  17. Toxicology screen

    Science.gov (United States)

    ... the type and approximate amount of legal and illegal drugs a person has taken. How the Test is ... prescription medicines that have not been prescribed, and illegal drugs have not been detected. A blood toxicology screen ...

  18. Streptococcal screen

    Science.gov (United States)

    A streptococcal screen is a test to detect group A streptococcus. This bacteria is the most common cause of ... throat swab. The swab is tested to identify group A streptococcus. It takes about 7 minutes to get the ...

  19. BRIEF INTERVENTIONS IN SUBSTANCE ABUSE

    OpenAIRE

    Kumar, Suresh; Malhotra, Anil

    2000-01-01

    Brief interventions in substance abuse refer to a group of cost-effective and time efficient strategies that aim at reduction of substance use and/or harm related to substance use. They are grounded in the scientific principles of harm reduction stage of change, motivational interviewing and feasibility of community-level delivery. This review discusses the characteristics, elements, and techniques of brief interventions for abuse of alcohol, tobacco and other drugs. The available evidence fo...

  20. Drugs of abuse--opiates.

    OpenAIRE

    Ling, W; Wesson, D R

    1990-01-01

    Treating opiate-dependent patients can be difficult for many physicians because the patients' life-styles, values, and beliefs differ from those of the physicians. Primary care physicians, however, are often involved in the treatment of the medical complications of opiate abuse, and physicians must often manage a patient's opiate dependence until appropriate referral to a drug abuse treatment program can be arranged. Treatment is guided by an understanding of the patient's addictive disease, ...

  1. Trauma Symptoms in Abused Children

    Directory of Open Access Journals (Sweden)

    Parvaneh Mohammadkhani

    2003-07-01

    Full Text Available Objective: There are many traumatic events (including natural disasters, physical, psychological and sexual abuse that may befall children and there is clear evidence that such experiences can produce a plethora of negative psychological effects. Children’s exposure to such traumas has been associated with a wide variety of negative mental health outcomes, including anxiety and depression, post-traumatic stress and dissociation and anger and aggression. It seems that the impacts of traumatic events are significantly related to type and intensity of trauma. Materials & Method: Through a systematized clustral sampling 3042 male and female students from junior high school who were participated in a survey study for investigating point prevalence of child abuse, completed Trauma Symptoms Checklist for Children-Alternate Version (TSCC-A and Child Abuse Self-report Scale (CASRS. After recognition of abused children, they were compared based on trauma symptoms. TSCC-A is a self-report measure of post-traumatic distress and related psychological symptomatology in male and female children aged 8-16 years. It is useful in the evaluation of children who have experienced traumatic events, including physical and sexual assault, victimization by peers, major losses, the witnessing of violence done to others and natural disasters. TSCC-A makes no reference to sexual issues. CASRS is a self-report scale to assess child abuse and neglect with 38 items and four subscales (psychological abuse, neglect, physical and sexual abuse. Results: Considering the type of traumatic experiences, the results showed that abused children significantly received higher scores in scales and subscales of TSCC-A than nonabused group. They specially reported more symptoms (depression, anxiety, post-traumatic stress, anger and dissociation comparing normal children. Conclusion: It is concluded that the type and rate of traumatic event is related to intensity of symptomatology.

  2. Mental health of adolescents who abuse psychoactive substances in Enugu, Nigeria - A cross-sectional study

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    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

  3. Behavioural consequences of child abuse

    Science.gov (United States)

    Al Odhayani, Abdulaziz; Watson, William J.; Watson, Lindsay

    2013-01-01

    Abstract Objective To discuss the consequences of abuse on childhood behavioural development, to highlight some behavioural clues that might alert physicians to ongoing child abuse, and to explore the specific role of the family physician in this clinical situation. Sources of information A systematic search was used to review relevant research, clinical review articles, and child protection agency websites. Main message A child’s behaviour is an outward manifestation of inner stability and security. It is a lens through which the family physician can observe the development of the child throughout his or her life. All types of abuse are damaging to children—physically, emotionally, and psychologically—and can cause long-term difficulties with behaviour and mental health development. Family physicians need to be aware of and alert to the indicators of child abuse and neglect so that appropriate interventions can be provided to improve outcomes for those children. Conclusion Child abuse might cause disordered psychological development and behaviour problems. Family physicians have an important role in recognizing behaviour clues that suggest child abuse and in providing help to protect children. PMID:23946022

  4. 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.

  5. Abuse Potential of Pregabalin: A Systematic Review.

    Science.gov (United States)

    Schjerning, Ole; Rosenzweig, Mary; Pottegård, Anton; Damkier, Per; Nielsen, Jimmi

    2016-01-01

    Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last decade. Pregabalin is, in some cases, used for recreational purposes and it has incurred attention among drug abusers for causing euphoric and dissociative effects when taken in doses exceeding normal therapeutic dosages or used by alternative routes of administration, such as nasal insufflation or venous injection. The magnitude of the abuse potential and the mechanism behind it are not fully known. The aim of this study was to present a systematic review of the data concerning the abuse potential of pregabalin. We performed a systematic literature search and reviewed the preclinical, clinical and epidemiological data on the abuse potential of pregabalin. We included preclinical (n = 17), clinical (n = 19) and epidemiological (n = 13) studies addressing the abuse potential of pregabalin. We also reviewed case reports (n = 9) concerning abuse of pregabalin. The preclinical studies indicated that pregabalin possesses modulatory effects on the GABA and glutamate systems, leaving room for an abuse potential. Further, clinical studies reported euphoria as a frequent side effect in patients treated with pregabalin. The majority of case reports concerning abuse of pregabalin involved patients with a history of substance abuse and, similarly, epidemiological studies found evidence of abuse, especially among opiate abusers. Overall, the available literature suggests an important clinical abuse potential of pregabalin and prescribers should pay attention to signs of abuse, especially in patients with a history of substance abuse.

  6. CHILD ABUSE AND ITS IMPLICATIONS FOR THE EDUCATIONAL ...

    African Journals Online (AJOL)

    Dr Ike

    Gateway, 2008). Forms of Child Abuse. Child abuse can be broadly categorized into five perspectives namely physical abuse, emotional abuse, sexual abuse, neglect and child exploitation (child labour). Physical Abuse: Physical abuse may be seen as the inflicting of a non-accidental bodily injury on a child. The injury may ...

  7. Childhood abuse increases the risk of depressive and anxiety symptoms and history of suicidal behavior in Mexican pregnant women

    Directory of Open Access Journals (Sweden)

    Ma. Asunción Lara

    2015-09-01

    Full Text Available Objective:To explore the relationship between individual and co-occurring childhood sexual, physical, and verbal abuse, prenatal depressive (PDS and anxiety symptoms (PAS, and history of suicidal behavior (HSB among Mexican pregnant women at risk of depression.Methods:A sample of 357 women screened for PDS was interviewed using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q, the Beck Depression Inventory (BDI-II, the anxiety subscale of the Hopkins Symptoms Checklist (SCL-90, and specific questions on verbal abuse and HSB.Results:Logistic regression analyses showed that women who had experienced childhood sexual abuse (CSA were 2.60 times more likely to develop PDS, 2.58 times more likely to develop PAS, and 3.71 times more likely to have HSB. Childhood physical abuse (CPA increased the risk of PAS (odds ratio [OR] = 2.51 and HSB (OR = 2.62, while childhood verbal abuse (CVA increased PDS (OR = 1.92. Experiencing multiple abuses increased the risk of PDS (OR = 3.01, PAS (OR = 3.73, and HSB (OR = 13.73.Conclusions:Childhood sexual, physical, and verbal abuse, especially when they co-occur, have an impact on PDS and PAS and lifetime HSB. These findings suggest that pregnant women at risk for depression should also be screened for trauma as a risk factor for perinatal psychopathology.

  8. Fighting Child Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Pesanayi Gwirayi

    2013-01-01

    Full Text Available This study investigated secondary school pupils’ views on strategies that can be used to prevent child sexual abuse (CSA. A survey design was adopted as the operational framework for data gathering. Data were collected from three secondary schools, all in the Gweru district of Zimbabwe. The sample comprised 268 secondary pupils (50% female; M age = 15.42, SD = 1.376. Each participant was asked to write down three main strategies that can be used to fight CSA on a given questionnaire. The responses were then analyzed using the thematic content analysis technique. The study revealed that most pupils believed that CSA can be prevented through teaching them about it and also reporting to the police. Another significant finding was that pupils’ responses tended to vary with gender and level of education. Whereas female respondents suggested that CSA can be fought by avoiding strangers, saying no to sexual advances, and having reliable friends, their male counterparts suggested teaching the community about CSA, forming new clubs, and enacting life imprisonment for perpetrators, among other suggestions. In terms of level of education, Form 2 participants suggested avoiding strangers, staying home at night, whereas their Form 4 counterparts suggested lessons for Guidance and Counseling, saying no to sexual advances, and having reliable friends. These findings unequivocally demonstrate the need to vigorously engage secondary school pupils in activities aimed at fighting CSA to safeguard their inalienable human rights.

  9. Verbal learning and memory in alcohol abusers and polysubstance abusers with concurrent alcohol abuse.

    Science.gov (United States)

    Bondi, M W; Drake, A I; Grant, I

    1998-07-01

    To define the combined effects of drug and alcohol abuse on verbal learning and memory, 70 alcoholic and 80 polysubstance abuse (PSA) individuals with concurrent alcohol abuse were compared on a list learning task, the California Verbal Learning Test (CVLT). Despite demonstrating similar learning strategies, response styles, and error patterns, the PSA group nontheless exhibited significantly greater recall deficits than the alcoholic group on the CVLT. These deficits were particularly evident in those who were heaviest abusers of cocaine. PSA participants did not, however, evidence greater recognition memory deficits. This pattern of greater deficits on recall than on recognition memory, as well as poor consolidation, is consistent with the initiation-retrieval difficulties of patient groups with subcortical dysfunction. It is concluded that the combined use of alcohol and drugs, cocaine in particular, may compound memory difficulties beyond what is typically observed in alcoholic individuals.

  10. The Prevalence of Substance Abuse in Students of Hamadan University

    Directory of Open Access Journals (Sweden)

    Nahid Mohamadi

    2012-03-01

    Full Text Available Background: Substance abuse refers to a maladaptive pattern of use of a substance. The purpose of this study was to determine the prevalence of substance abuse in hostel boys in Hamadan medical university, 2008. Materials and Method: This research was a descriptive cross-sectional study. The method of sample was census report study and sample number was 430. The research objective data was gathered thorough questionnaire. Data processing and statistical analysis were performed using SPSS software, version 15.0.Results: Outcome showed that the majority of samples were 20 years old (21.9%, non married (92.8%, the number of family member were six members (21.9%, and they are the first children (85.4%.Also outcome showed that 27% of students did not consume any drug, and majority of light material drug abuse was narcotic (44.77%, cigarette (28.4%, alcohol (20.19% and heavy material was opium (5.25%, hashish (4.1%, ecstasy (1.64% and others (1.13%. Narcotic was in the first rank and cigarette was in the last. Conclusion: The screening of drug abuse and promoting primary prevention programs at the university were recommended

  11. A systematic review of abusive visceral injuries in childhood--their range and recognition.

    Science.gov (United States)

    Maguire, S A; Upadhyaya, M; Evans, A; Mann, M K; Haroon, M M; Tempest, V; Lumb, R C; Kemp, A M

    2013-07-01

    To define what abusive visceral injuries occur, including their clinical features and the value of screening tests for abdominal injury among abused children. We searched 12 databases, with snowballing techniques, for the period 1950-2011, with all identified studies undergoing two independent reviews by trained reviewers, drawn from pediatrics, radiology, pediatric surgery and pathology. Of 5802 studies identified, 188 were reviewed. We included studies of children aged 0-18, with confirmed abusive etiology, whose injury was defined by computed tomography, contrast studies or at surgery/post mortem. We excluded injuries due to sexual abuse, or those exclusively addressing management or outcome. Of 88 included studies (64 addressing abdominal injuries), only five were comparative. Every organ in the body has been injured, intra-thoracic injuries were commoner in those aged less than five years. Children with abusive abdominal injuries were younger (2.5-3.7 years vs. 7.6-10.3 years) than accidentally injured children. Duodenal injuries were commonly recorded in abused children, particularly involving the third or fourth part, and were not reported in accidentally injured children less than four years old. Liver and pancreatic injuries were frequently recorded, with potential pancreatic pseudocyst formation. Abdominal bruising was absent in up to 80% of those with abdominal injuries, and co-existent injuries included fractures, burns and head injury. Post mortem studies revealed that a number of the children had sustained previous, unrecognized, abdominal injuries. The mortality from abusive abdominal injuries was significantly higher than accidental injuries (53% vs. 21%). Only three studies addressed screening for abdominal injury among abused children, and were unsuitable for meta-analysis due to lack of standardized investigations, in particular those with 'negative' screening tests were not consistently investigated. Visceral injuries may affect any organ of the

  12. Psychologic aspects of sexual abuse in adolescence.

    Science.gov (United States)

    Jeffrey, T B; Jeffrey, L K

    1991-12-01

    This paper reviews psychologic aspects of sexual abuse in female adolescents. It documents that sexual abuse is widespread, occurring at an alarming rate at all socioeconomic levels of society. It is perpetrated principally by adult men in the victim's family. Often its effects are tragic. Adolescent female sexual abuse victims are at high risk for subsequent acting out behavior, sexual promiscuity, physical and sexual abuse, anxiety, depression, low self-esteem, alcohol and drug abuse or dependence, chronic sleep disturbance, dissociative disorders, eating disorders, emotional numbing, dissociation, guilt, shame, hyperalertness, suicidal ideation, and multiple associated psychiatric disorders. Although it may appear at a surface level that sexual abuse victims recover from such abuse, follow-up studies suggest that many remain disabled long after the abuse has ended. Health care professionals should be especially cognizant of the magnitude of the impact of sexual abuse on adolescent girls and recognize the need of these patients for psychologic and medical services.

  13. 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

  14. 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.

  15. How social myths about childhood, motherhood and medicine affect the detection of subtle developmental problems in young children.

    Science.gov (United States)

    Williams, Jane

    Focus by child health professionals on the well-being of young Australian children and their families has intensified in the past decade, with particular attention drawn to the importance of the early detection and intervention of developmental problems. While many children with developmental difficulties are detected in the preschool years, those with more subtle forms of developmental problems are often only noticed by their mothers, passing unnoticed by professionals until the children begin school and fail socially or academically. This study aimed to ascertain ways in which child health professionals may utilise the experience of mothers to improve early recognition and diagnosis of subtle developmental and behavioural problems in children. French philosopher, Roland Barthes (1973) proposed that myths play an important social role in defining underlying social values that affect how people interpret what others say or do. This paper explores how the social myths of childhood, motherhood and medicine impact upon the early detection of children with subtle developmental problems. In particular, it examines how social myths affect when and how mothers become concerned about their children's development, from whom they seek advice, and the responses which mothers receive in regard to their concerns. Mythical notions of the 'blameless child', 'boys will be boys' and 'children who look OK are OK', and the constituted myth of motherhood, are all shown to affect when mothers become concerned about their children's development. What mothers do about their concerns and the responses they receive from child health professionals are also influenced by these myths. The myth of medicine is also examined to determine how it affects communication between mothers and doctors, the roles and responsibilities of doctors, and the value placed on a mother's concerns by doctors.

  16. Comparison of medical-grade and calibrated consumer-grade displays for diagnosis of subtle bone fissures.

    Science.gov (United States)

    Pinto Dos Santos, Daniel; Welter, Jonas; Emrich, Tilman; Jungmann, Florian; Dappa, Evelyn; Mildenberger, Peter; Kloeckner, Roman

    2017-12-01

    To compare the diagnostic accuracy of medical-grade and calibrated consumer-grade digital displays for the detection of subtle bone fissures. Three experienced radiologists assessed 96 digital radiographs, 40 without and 56 with subtle bone fissures, for the presence or absence of fissures in various bones using one consumer-grade and two medical-grade displays calibrated according to the DICOM-Grayscale Standard Display Function. The reference standard was consensus reading. Subjective image quality was also assessed by the three readers. Statistical analysis was performed using receiver operating characteristic analysis and by calculating the sensitivity, specificity, and Youden's J for each combination of reader and display. Cohen's unweighted kappa was calculated to assess inter-rater agreement. Subjective image quality was compared using the Wilcoxon signed-rank test. No significant differences were found for the assessment of subjective image quality. Diagnostic performance was similar across all readers and displays, with Youden's J ranging from 0.443 to 0.661. The differences were influenced more by the reader than by the display used for the assessment. No significant differences were found between medical-grade and calibrated consumer-grade displays with regard to their diagnostic performance in assessing subtle bone fissures. Calibrated consumer-grade displays may be sufficient for most radiological examinations. • Diagnostic performance of calibrated consumer-grade displays is comparable to medical-grade displays. • There is no significant difference with regard to subjective image quality. • Use of calibrated consumer-grade displays could cut display costs by 60-80%.

  17. Acculturation, depression, self-esteem, and substance abuse among Hispanic men.

    Science.gov (United States)

    Vasquez, Elias Provencio; Gonzalez-Guarda, Rosa M; De Santis, Joseph P

    2011-01-01

    The demographics of the United States are rapidly changing as a result of immigration from Latin America. Predictions indicate that by the year 2050, one of every four persons in the United States will be of Hispanic ethnicity. If health disparities relating to substance abuse and related mental health conditions among Hispanics are not fully understood and addressed, these will continue to grow along with this population. The purpose of this pilot study was to describe the relationships among acculturation, depression, self-esteem, and substance abuse among a community sample of Hispanic men in South Florida (N = 164, 82 heterosexual men and 82 men who have sex with men). Standardized instruments measuring acculturation, depression, self-esteem, and substance abuse were administered in English or Spanish in a face-to-face interview format. Descriptive statistics and multiple logistic regression were used to illustrate participant characteristics and test relationships among the variables. Despite the fact that the majority of participants were more acculturated to the Hispanic culture than US culture, reported low levels of education and income, were depressed, and used substances, this group of men reported high levels of self-esteem. However, age and depression were the only predictors of substance abuse. Acculturation and self-esteem were not predictors of substance abuse. Clinicians need to be aware of the high rates of depression and substance abuse in this population and screen frequently for signs and symptoms of depression and substance abuse during health care encounters.

  18. Learning Classification Models of Cognitive Conditions from Subtle Behaviors in the Digital Clock Drawing Test.

    Science.gov (United States)

    Souillard-Mandar, William; Davis, Randall; Rudin, Cynthia; Au, Rhoda; Libon, David J; Swenson, Rodney; Price, Catherine C; Lamar, Melissa; Penney, Dana L

    2016-03-01

    The Clock Drawing Test - a simple pencil and paper test - has been used for more than 50 years as a screening tool to differentiate normal individuals from those with cognitive impairment, and has proven useful in helping to diagnose cognitive dysfunction associated with neurological disorders such as Alzheimer's disease, Parkinson's disease, and other dementias and conditions. We have been administering the test using a digitizing ballpoint pen that reports its position with considerable spatial and temporal precision, making available far more detailed data about the subject's performance. Using pen stroke data from these drawings categorized by our software, we designed and computed a large collection of features, then explored the tradeoffs in performance and interpretability in classifiers built using a number of different subsets of these features and a variety of different machine learning techniques. We used traditional machine learning methods to build prediction models that achieve high accuracy. We operationalized widely used manual scoring systems so that we could use them as benchmarks for our models. We worked with clinicians to define guidelines for model interpretability, and constructed sparse linear models and rule lists designed to be as easy to use as scoring systems currently used by clinicians, but more accurate. While our models will require additional testing for validation, they offer the possibility of substantial improvement in detecting cognitive impairment earlier than currently possible, a development with considerable potential impact in practice.

  19. Implementing Effective Substance Abuse Treatments in General Medical Settings: Mapping the Research Terrain.

    Science.gov (United States)

    Ducharme, Lori J; Chandler, Redonna K; Harris, Alex H S

    2016-01-01

    The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Veterans Health Administration (VHA) share an interest in promoting high quality, rigorous health services research to improve the availability and utilization of evidence-based treatment for substance use disorders (SUD). Recent and continuing changes in the healthcare policy and funding environments prioritize the integration of evidence-based substance abuse treatments into primary care and general medical settings. This area is a prime candidate for implementation research. Recent and ongoing implementation projects funded by these agencies are reviewed. Research in five areas is highlighted: screening and brief intervention for risky drinking; screening and brief intervention for tobacco use; uptake of FDA-approved addiction pharmacotherapies; safe opioid prescribing; and disease management. Gaps in the portfolios, and priorities for future research, are described. Published by Elsevier Inc.

  20. Subtle differences in molecular recognition between modified glycopeptide antibiotics and bacterial receptor peptides identified by electrospray ionization mass spectrometry

    DEFF Research Database (Denmark)

    Jørgensen, Thomas J. D.; Staroske, T; Roepstorff, P

    1999-01-01

    showing that electrospray ionization mass spectrometry (ESI-MS) can be used in the rapid quantitative analysis of mixtures of vancomycin-group antibiotics and their bacterial cell-wall receptors allowing the identification of even subtle differences in binding constants. Differences in affinities...... are quantified for a mixture of vancomycin antibiotics (vancomycin, dechlorovancomycin and N-demethylvancomycin) and for a mixture of ristocetin A and its pseudoaglycone. Binding constants determined by ESI-MS were found to be in close agreement with those determined by more direct methods in aqueous solution....

  1. Subtle evolutionary changes in the distribution of N-glycosylation sequons in the HIV-I envelope glycoprotein 120

    DEFF Research Database (Denmark)

    Rao, R Shyama Prasad; Wollenweber, Bernd

    2010-01-01

    in the recent past, even slight changes in the distribution of sequons may potentially play crucial roles in protein interaction and viral infection. This study tracked the prevalence and distribution of NXS/T sequons in gp120 over a period of 29 years (from 1981 to 2009). The gp120 showed location specific...... domain. Related changes were also seen in the distribution probabilities of sequons in two domains. The results indicate that the gp120, chiefly in subtype B, is redistributing NXS/T sequons within the molecule with specific selection for NXS sequons. The subtle evolution of sequons in gp120 may have...

  2. Luminescent screens

    International Nuclear Information System (INIS)

    Lu, C.-I.

    1982-01-01

    Luminescent screens which are useful for such purposes as intensifying screens for radiographs are comprised of a support bearing a layer of finely divided particles of a phosphor dispersed in a cross-linked polymeric matrix formed by heat-curing of a coating composition comprising an unsaturated cross-linkable polymer, a polymerizable acrylic monomer, a thermoplastic polyurethane elastomer, and a heat-activatable polymerization initiator. The phosphor layer includes voids formed by evaporation of an evaporable component which is present in the coating composition from which such layer is formed. (author)

  3. 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

  4. Drug abuse in Prishtina region.

    Science.gov (United States)

    Gashi, Sanije; Ramadani, Naser; Berisha, Merita; Gashi, Musli; Zhjeqi, Valbona; Hoxha, Rina

    2009-01-01

    Currently the drug abuse has become one of the most serious problems in many countries. The drugs abuse is also widespread in less developed societies. This problem is present in Kosova too with the tendency of rising. The of this research was to show the number of drug abusers in Prishtina region, the type of drugs used, the way of drug administration, then survey of the age, sex, marital status, residence of the drug abusers including their social status (employment, profession and economical status). During the surveyed period the number of hospitalized drug abusers in Neuropsychiatry clinic was 39. 25.5% of them were hospitalized more than ones, with 367 stay days with average treatment period of 7.5 days. Average age of those hospitalized for the first time was 27.9 years of age. 64.1% of them were 25-34 years old. 97.4% of the hospitalized were male. 32 (82.1%) patient were from Prishtina, 5 from Ferizaj and 1 from F. Kosova and Kacanik. During the surveyed period there was no patient hospitalized from other cities of Prishtina Region (Besiana, Drenas, Kastriot, Lipjan, Shtime and Shterpc).

  5. 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

  6. Political Correctness, Social Work, and the Breakdown of the Child Abuse System.

    Science.gov (United States)

    Karger, Howard Jacob; Stoesz, David

    1995-01-01

    Examines the relationship between political correctness, social work, and breakdown of the child abuse system. Examines groups that stand to gain from perpetuating the myth of classlessness. Investigates high turnover rates among social workers, declassification of public welfare jobs, and problems in screening and provision of services to…

  7. Mothers' versus Fathers' Alcohol Abuse and Attachment in Adult Daughters of Alcoholics

    Science.gov (United States)

    Kelley, Michelle L.; Schroeder, Valarie M.; Cooke, Cathy G.; Gumienny, Leslie; Platter, Amanda Jeffrey; Fals-Stewart, William

    2010-01-01

    Gender of the alcohol-abusing parent was examined in relation to general and romantic attachment (as measured by the Experiences in Close Relationships-Revised and the Relationship Scales Questionnaire) in female adult children of alcoholics (ACOAs; as indicated by the Children of Alcoholics Screening Test) as compared to non-ACOAs. As compared to…

  8. 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

  9. Impact of Employee Assistance Programs on Substance Abusers and Workplace Safety

    Science.gov (United States)

    Elliott, Karen; Shelley, Kyna

    2005-01-01

    Businesses have dealt with substance abuse in different ways. Some organizations have established Employee Assistance Programs (EAPs) to address these problems. One large national company chose to fire employees with positive drug screens, offer them EAP services, and then consider them for rehire after treatment. A study of performance records…

  10. The differential diagnosis of ritual abuse allegations.

    Science.gov (United States)

    Bernet, W; Chang, D K

    1997-01-01

    Because psychiatrists do not have a consistent way to classify and define the forms of child abuse that may be mistaken for ritual abuse, the objective of this paper is to create a comprehensive differential diagnosis of allegations of ritual abuse. The authors reviewed 60 articles, chapters, and books that contained allegations of ritual abuse or behaviors that might be mistaken for ritual abuse, that were made by patients or caretakers. This paper clarifies the behaviors that represent or may be mistaken for ritual abuse: Cult-based ritual abuse, pseudoritualistic abuse, activities by organized satanic groups, repetitive psychopathological abuse, sexual abuse by pedophiles, child pornography portraying ritual abuse, distorted memory, false memory, false report due to a severe mental disorder, pseudologia phantastica, adolescent behavior simulating ritual abuse, epidemic hysteria, deliberate lying, and hoaxes. The differential diagnosis of allegations of ritual abuse is important in both clinical and forensic psychiatry. In some cases, it will not be possible to tell whether a particular allegation is factual or what the underlying mental processes are. It is important to separate the role of the mental health professional as therapist from the role as an expert witness in court.

  11. Hearing Screening

    Science.gov (United States)

    Johnson-Curiskis, Nanette

    2012-01-01

    Hearing levels are threatened by modern life--headsets for music, rock concerts, traffic noises, etc. It is crucial we know our hearing levels so that we can draw attention to potential problems. This exercise requires that students receive a hearing screening for their benefit as well as for making the connection of hearing to listening.

  12. Opportunistische screening...

    NARCIS (Netherlands)

    Postma, M.J.; Welte, R.; Van Den Hoek, J.A.R.; Van Doornum, G.J.J.; Coutinho, R.A.; Jager, J.C.

    1999-01-01

    Objective. To estimate the cost effectiveness of Chlamydia trachomatis (CT) screening of young women visiting general practitioners. Design. Economic model analysis. Methods. Data on the health care needs for CT complications were derived from various sources; costing was done using estimated cost

  13. Vision Screening

    Science.gov (United States)

    ... an efficient and cost-effective method to identify children with visual impairment or eye conditions that are likely to lead ... main goal of vision screening is to identify children who have or are at ... visual impairment unless treated in early childhood. Other problems that ...

  14. Brief interventions in substance abuse.

    Science.gov (United States)

    Kumar, S; Malhotra, A

    2000-04-01

    Brief interventions in substance abuse refer to a group of cost-effective and time efficient strategies that aim at reduction of substance use and/or harm related to substance use. They are grounded in the scientific principles of harm reduction stage of change, motivational interviewing and feasibility of community-level delivery. This review discusses the characteristics, elements, and techniques of brief interventions for abuse of alcohol, tobacco and other drugs. The available evidence for effectiveness of these strategies vis-a-vis no treatment or extended treatment is also reviewed, which clearly supports these interventions to be effective, especially for alcohol abuse but also for others It is argued that India presents a fertile ground for application of these strategies and that Indian research in this area should be a top priority.

  15. Alcohol abuse and postoperative morbidity

    DEFF Research Database (Denmark)

    Tønnesen, Hanne

    2003-01-01

    Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re......-operation. The personal and economic consequences are tremendous. The incidence of alcohol abusers undergoing surgery was 7% to 49%, according to gender and diagnosis. They have been identified by a self-reported alcohol intake, which implies the possibility of underestimation. Alcohol markers could be used for a more...

  16. Cancer morbidity in alcohol abusers

    DEFF Research Database (Denmark)

    Tønnesen, H; Møller, Henrik; Andersen, J R

    1994-01-01

    Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared...... colonic (RR = 1.0; 95% CI 0.8-1.3) or rectal cancer (RR = 1.0; CI 0.7-1.3) than expected. The risk of breast cancer in women was slightly increased (RR = 1.3; 95% CI 0.9-1.7), but not statistically significant. Thus, the associations between alcohol and cancer of the upper digestive and respiratory tract...... and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers....

  17. Prevalence and correlates of client-perpetrated abuse among female sex workers in two Mexico-U.S. border cities.

    Science.gov (United States)

    Ulibarri, Monica D; Strathdee, Steffanie A; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L

    2014-04-01

    History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence (IPV), psychological distress, and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs.

  18. Alcohol and substance abuse in solid-organ transplant recipients.

    Science.gov (United States)

    Parker, Richard; Armstrong, Matthew J; Corbett, Chris; Day, Edward J; Neuberger, James M

    2013-12-27

    This review focuses on alcohol and substance abuse in the context of solid-organ transplantation. Alcohol and substance abuse are common and may lead to a need for solid-organ transplantation and may also contribute to significant physical and psychologic problems that impact upon the recipient. Damaging levels of alcohol intake can occur in the absence of dependence. Alcohol or substance abuse after transplantation is associated with poor medication compliance and this may increase risk of graft loss. Intravenous drug use is associated with increased risk of infections (especially secondary to opportunistic organisms-bacterial, viral, protozoal, and others-and such infections may be more severe in the immunosuppressed), but there is only anecdotal evidence that such behavior has a worse outcome in transplant recipients. Whereas previous alcohol excess and drug use in kidney recipients are both associated with a small but statistically significantly increased risk of adverse outcomes (hazard ratio, 1.16-1.56), alcohol use within recommended guidelines after transplantation appears safe and possibly beneficial. Robust data are lacking for other organs, but those available suggest that heart transplantation is safe in individuals with a history of alcohol or substance abuse. Health specialists in drug or alcohol addiction should carefully screen all potential transplant candidates for these conditions, and where there is evidence of dependency or abuse, effective psychologic and physical treatment should be offered. Studies have shown that interventions such as psychologic intervention have improved alcohol behavior in the context of liver transplantation. Although there are no comparable studies with other solid-organ recipients, it is reasonable to expect transferable outcomes.

  19. Cardiovascular Complications of Acute Amphetamine Abuse; Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Elham Bazmi

    2017-03-01

    Full Text Available Objectives: This study aimed to evaluate cardiovascular complications among patients who abuse amphetamines. Methods: This cross-sectional study took place between April 2014 and April 2015 among 3,870 patients referred to the Toxicology Emergency Department of Baharlou Hospital, Tehran University of Medical Sciences, Tehran, Iran. Those with clinical signs of drug abuse and positive urine screening tests were included in the study, while cases of chronic abuse were excluded. Cardiac complications were evaluated via electrocardiography (ECG and transthoracic echocardiography. Results: A total of 230 patients (5.9% had a history of acute amphetamine abuse and positive urine tests. Of these, 32 patients (13.9% were <20 years old and 196 (85.2% were male. In total, 119 (51.7% used amphetamine and methamphetamine compounds while 111 (48.3% used amphetamines with morphine or benzodiazepines. The most common ECG finding was sinus tachycardia (43.0%, followed by sinus tachycardia plus a prolonged QT interval (34.3%. Mean creatine kinase-MB and troponin I levels were 35.9 ± 4.3 U/mL and 0.6 ± 0.2 ng/mL, respectively. A total of 60 patients (26.1% were admitted to the Intensive Care Unit. The majority (83.3% of these patients had normal echocardiography results. The mean aortic root diameter (ARD was 27.2 ± 2.8 mm. Abnormalities related to the ARD were found in 10 patients (16.7%, three of whom subsequently died. Conclusion: According to these findings, cardiac complications were common among Iranian patients who abuse amphetamines, although the majority of patients had normal echocardiography and ECG findings.

  20. 24 CFR 5.851 - What authority do I have to screen applicants and to evict tenants?

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false What authority do I have to screen... Federally Assisted Housing-Denying Admission and Terminating Tenancy for Criminal Activity or Alcohol Abuse General § 5.851 What authority do I have to screen applicants and to evict tenants? (a) Screening...

  1. Absence or interruption of the supra-acetabular line: a subtle plain film indicator of hip pathology

    International Nuclear Information System (INIS)

    Major, N.M.; Helms, C.A.

    1996-01-01

    Objective. To show that absence or interruption of the supraacetabular line is a subtle plain film indicator of pathology in the acetabulum. Design. Nineteen hips from 17 patients with known disease processes involving the acetabulum as demonstrated by subsequent magnetic resonance imaging, bone scan or plain film follow-up were evaluated with antero-posterior (AP) plain films of the pelvis. Three additional cases were diagnosed prospectively using interruption of the supra-acetabular line as the criterion for inclusion. Fifty AP plain films of the pelvis in patients without hip pain were examined prospectively to determine normal imaging criteria. Results and conclusions. The normal supra-acetabular line measures 2-3 mm in thickness superiorly and is a thin sclerotic line in the medial aspect. In all 22 hips (with pathology) in this series, the line was interrupted or absent. Loss or interruption of the supra-acetabular line may thus be a subtle pain film indicator of a disease process involving the acetabulum. This plain film sign has not previously been reported. (orig.). With 8 figs., 1 tab

  2. Characterization of subtle brain abnormalities in a mouse model of Hedgehog pathway antagonist-induced cleft lip and palate.

    Science.gov (United States)

    Lipinski, Robert J; Holloway, Hunter T; O'Leary-Moore, Shonagh K; Ament, Jacob J; Pecevich, Stephen J; Cofer, Gary P; Budin, Francois; Everson, Joshua L; Johnson, G Allan; Sulik, Kathleen K

    2014-01-01

    Subtle behavioral and cognitive deficits have been documented in patient cohorts with orofacial clefts (OFCs). Recent neuroimaging studies argue that these traits are associated with structural brain abnormalities but have been limited to adolescent and adult populations where brain plasticity during infancy and childhood may be a confounding factor. Here, we employed high resolution magnetic resonance microscopy to examine primary brain morphology in a mouse model of OFCs. Transient in utero exposure to the Hedgehog (Hh) signaling pathway antagonist cyclopamine resulted in a spectrum of facial dysmorphology, including unilateral and bilateral cleft lip and palate, cleft of the secondary palate only, and a non-cleft phenotype marked by midfacial hypoplasia. Relative to controls, cyclopamine-exposed fetuses exhibited volumetric differences in several brain regions, including hypoplasia of the pituitary gland and olfactory bulbs, hyperplasia of the forebrain septal region, and expansion of the third ventricle. However, in affected fetuses the corpus callosum was intact and normal division of the forebrain was observed. This argues that temporally-specific Hh signaling perturbation can result in typical appearing OFCs in the absence of holoprosencephaly--a condition classically associated with Hh pathway inhibition and frequently co-occurring with OFCs. Supporting the premise that some forms of OFCs co-occur with subtle brain malformations, these results provide a possible ontological basis for traits identified in clinical populations. They also argue in favor of future investigations into genetic and/or environmental modulation of the Hh pathway in the etiopathogenesis of orofacial clefting.

  3. Subtle alterations in cerebrovascular reactivity in mild cognitive impairment detected by graph theoretical analysis and not by the standard approach

    Directory of Open Access Journals (Sweden)

    Carlos A. Sánchez-Catasús

    2017-01-01

    Full Text Available There is growing support that cerebrovascular reactivity (CVR in response to a vasodilatory challenge, also defined as the cerebrovascular reserve, is reduced in Alzheimer's disease dementia. However, this is less clear in patients with mild cognitive impairment (MCI. The current standard analysis may not reflect subtle abnormalities in CVR. In this study, we aimed to investigate vasodilatory-induced changes in the topology of the cerebral blood flow correlation (CBFcorr network to study possible network-related CVR abnormalities in MCI. For this purpose, four CBFcorr networks were constructed: two using CBF SPECT data at baseline and under the vasodilatory challenge of acetazolamide (ACZ, obtained from a group of 26 MCI patients; and two equivalent networks from a group of 26 matched cognitively normal controls. The mean strength of association (SA and clustering coefficient (C were used to evaluate ACZ-induced changes on the topology of CBFcorr networks. We found that cognitively normal adults and MCI patients show different patterns of C and SA changes. The observed differences included the medial prefrontal cortices and inferior parietal lobe, which represent areas involved in MCI's cognitive dysfunction. In contrast, no substantial differences were detected by standard CVR analysis. These results suggest that graph theoretical analysis of ACZ-induced changes in the topology of the CBFcorr networks allows the identification of subtle network-related CVR alterations in MCI, which couldn't be detected by the standard approach.

  4. Subtle differences in CTL cytotoxicity determine susceptibility to hemophagocytic lymphohistiocytosis in mice and humans with Chediak-Higashi syndrome.

    Science.gov (United States)

    Jessen, Birthe; Maul-Pavicic, Andrea; Ufheil, Heike; Vraetz, Thomas; Enders, Anselm; Lehmberg, Kai; Längler, Alfred; Gross-Wieltsch, Ute; Bay, Ali; Kaya, Zuhre; Bryceson, Yenan T; Koscielniak, Ewa; Badawy, Sherif; Davies, Graham; Hufnagel, Markus; Schmitt-Graeff, Annette; Aichele, Peter; Zur Stadt, Udo; Schwarz, Klaus; Ehl, Stephan

    2011-10-27

    Perforin-mediated cytotoxicity is important for controlling viral infections, but also for limiting immune reactions. Failure of this cytotoxic pathway leads to hemophagocytic lymphohistiocytosis (HLH), a life-threatening disorder of uncontrolled T-cell and macrophage activation. We studied susceptibility to HLH in 2 mouse strains (souris and beige(J)) and a cohort of patients with partial defects in perforin secretion resulting from different mutations in the LYST gene. Although both strains lacked NK-cell cytotoxicity, only souris mice developed all clinical and histopathologic signs of HLH after infection with lymphocytic choriomeningitis virus. The 2 strains showed subtle differences in CTL cytotoxicity in vitro that had a large impact on virus control in vivo. Whereas beige(J) CTLs eliminated lymphocytic choriomeningitis virus infection, souris CTLs failed to control the virus, which was associated with the development of HLH. In LYST-mutant patients with Chediak-Higashi syndrome, CTL cytotoxicity was reduced in patients with early-onset HLH, whereas it was retained in patients who later or never developed HLH. Thus, the risk of HLH development is set by a threshold that is determined by subtle differences in CTL cytotoxicity. Differences in the cytotoxic capacity of CTLs may be predictive for the risk of Chediak-Higashi syndrome patients to develop HLH.

  5. The subtle body: an interoceptive map of central nervous system function and meditative mind-brain-body integration.

    Science.gov (United States)

    Loizzo, Joseph J

    2016-06-01

    Meditation research has begun to clarify the brain effects and mechanisms of contemplative practices while generating a range of typologies and explanatory models to guide further study. This comparative review explores a neglected area relevant to current research: the validity of a traditional central nervous system (CNS) model that coevolved with the practices most studied today and that provides the first comprehensive neural-based typology and mechanistic framework of contemplative practices. The subtle body model, popularly known as the chakra system from Indian yoga, was and is used as a map of CNS function in traditional Indian and Tibetan medicine, neuropsychiatry, and neuropsychology. The study presented here, based on the Nalanda tradition, shows that the subtle body model can be cross-referenced with modern CNS maps and challenges modern brain maps with its embodied network model of CNS function. It also challenges meditation research by: (1) presenting a more rigorous, neural-based typology of contemplative practices; (2) offering a more refined and complete network model of the mechanisms of contemplative practices; and (3) serving as an embodied, interoceptive neurofeedback aid that is more user friendly and complete than current teaching aids for clinical and practical applications of contemplative practice. © 2016 New York Academy of Sciences.

  6. Subtle effects of the water soluble fraction of oil spills on natural phytoplankton assemblages enclosed in mesocosms

    Science.gov (United States)

    González, J.; Fernández, E.; Figueiras, F. G.; Varela, M.

    2013-06-01

    Four mesocosm experiments were conducted to evaluate the effect of episodic oil spills on coastal marine phytoplankton assemblages. The experimental design was selected to simulate the Prestige oil spill, which occurred in Galician coastal waters (NW Iberia) in November 2002. The empirical results indicate that no significant direct effects of the water soluble fraction of oil (20-60 μg l-1 of chrysene equivalents) on phytoplankton biomass and production were observed immediately after oil additions. Despite this, subtle negative effects on primary production were detected using a modelling approach, being the impact lower on phytoplankton communities dominated by diatoms. Consistent with the reduced direct effect of oil additions on phytoplankton biomass and photosynthesis-related variables, no indirect trophic cascading effects, previously reported in microcosm experiments, were detected. This shows that the effect of punctual inputs of the water accommodated fraction of oil on natural phytoplankton communities was very subtle, undetectable on some occasions, and of much lower magnitude than the effects recorded in microcosm experiments. This suggests that the initial composition of the phytoplankton community determines the degree of response and that the experimental approach adopted could explain the different, and sometimes contradictory, reported responses of the planktonic community to the input of oil into the marine environment.

  7. 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…

  8. Moving beyond disrespect and abuse

    DEFF Research Database (Denmark)

    Sadler, Michelle; Mario, Santos; Ruiz Buron, Dolores

    2016-01-01

    During recent decades, a growing and preoccupying excess of medical interventions during childbirth, even in physiological and uncomplicated births, together with a concerning spread of abusive and disrespectful practices towards women during childbirth across the world, have been reported. Despite...... of obstetric violence, as it is being used in Latin American childbirth activism and legal documents, might prove to be a useful tool for addressing structural violence in maternity care such as high intervention rates, non-consented care, disrespect and other abusive practices...

  9. A case of drug abuse

    Directory of Open Access Journals (Sweden)

    Matteo Pacini

    2008-09-01

    Full Text Available Methadone maintenance is one of the well-known harm reduction strategies for public health intervention in heroin addiction. The significance of methadone treatment in preventing needle sharing, which in turn reduces the risk of HIV and HCV transmission among injectors, has been demonstrated. Methadone maintenance is also considered gathering site where heroin addicts can effectively acquire knowledge on harm reduction and drug rehabilitation. We report a case of a 34-years-old patient with a history of heroin abuse. Therapy with methadone was essential for an adequate management of the case. The article describe difficulties and complexities of heroin abuse management and the therapeutic role of methadone.

  10. Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence

    Directory of Open Access Journals (Sweden)

    Tommasello Anthony C

    2004-04-01

    Full Text Available Abstract Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use

  11. Violence between Couples: Profiling the Male Abuser.

    Science.gov (United States)

    Ponzetti,James J. Jr.; And Others

    1982-01-01

    Presents an integrative review of the literature on spousal violence as it relates to the abusive male. Suggests various issues that need to be addressed before effective intervention with abusive males can proceed. (Author)

  12. Drug and alcohol abuse: general physician's perspective.

    Science.gov (United States)

    Basu, Debasish; Singh, Jaspreet

    2005-02-01

    Epidemiology, definitions, concepts and various other relevant aspects including management of drug and alcohol abuse are reviewed. The role of general/primary care physicians has been highlited in the persepctive of substance-abuse disorders.

  13. 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)

  14. Abuse of rights in Community Law

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    2006-01-01

    The article analyses the case law of the ECJ on abuse of rights with the aim to determine the extent to which EU law allows Member States and others to take measures to prevent abuse of Community rights...

  15. Family Checkup: Positive Parenting Prevents Drug Abuse

    Science.gov (United States)

    ... Email Facebook Twitter Family Checkup: Positive Parenting Prevents Drug Abuse Could your kids be at risk for substance ... drugs. Research supported by the National Institute on Drug Abuse (NIDA) has shown the important role that parents ...

  16. Signs of Alcohol Abuse and Addiction

    Science.gov (United States)

    ... Abuse and Addiction Signs of Alcohol Abuse and Addiction Listen ©istock.com/ KatarzynaBialasiewicz People who drink too ... Ysbrand Cosijn Peter is recovering from an alcohol addiction. The addiction grew slowly over many years. Read ...

  17. Neural Correlates of Craving in Methamphetamine Abuse

    Directory of Open Access Journals (Sweden)

    Fanak Shahmohammadi

    2016-07-01

    Conclusion: This study presented a novel and noninvasive method based on neural correlates to discriminate healthy individuals from methamphetamine drug abusers. This method can be employed in treatment and monitoring of the methamphetamine abuse.

  18. Abused and Nonabused Women: MMPI Profile Differences.

    Science.gov (United States)

    Gellen, Murray I.; And Others

    1984-01-01

    Compared abused women (N=10) with nonabused women (N=10) by using the Minnesota Multiphasic Personality Inventory. Results showed that when compared to a matched group of nonabused women, a significantly greater proportion of abused women evidenced pathological conditions. (LLL)

  19. Neighborhood Crime Rates among Drug Abusing and Non-Drug Abusing Families.

    Science.gov (United States)

    Davis, Norris; And Others

    1996-01-01

    Examines the relationship between paternal drug abuse status and neighborhood crime rates. Although paternal drug abusing families resided in neighborhoods with higher crime rates than parental non-drug abusing families, when controlling for socioeconomic status, ethnicity, and domicile, drug abuse status was not associated with neighborhood crime…

  20. Hidden Abuse within the Home: Recognizing and Responding to Sibling Abuse

    Science.gov (United States)

    Stutey, Diane; Clemens, Elysia V.

    2015-01-01

    Sibling abuse is a serious phenomenon in our society that often goes unaddressed. Victims of sibling abuse experience psychological effects similar to those of child abuse (Caspi, 2012; Wiehe, 2002). The purpose of this article is to provide school counselors with a definition of sibling abuse and a five-step model to recognize and respond. A…

  1. Game Concept for Seual Child Abuse Anticipation

    OpenAIRE

    Fajar As'ari; Ridwan Sanjaya; Ridwan Sanjaya; Hendra Prasetya; Hendra Prasetya

    2017-01-01

    Sexual child abuse are direct or indirect action from people who is older than children are. People whose close and known by children 90% of them are being sexual child abuse offenders. Sexual child abuse preventive measure delivered through sexual education by media such as pictures, comic, and video. Create this media as a tool to guide parents to teach their children to keep them safe from child sexual abuse. Parents could choose video that provide animation with stories detailing and ...

  2. Substance abuse in borderline personality disorder.

    Science.gov (United States)

    Miller, F T; Abrams, T; Dulit, R; Fyer, M

    1993-01-01

    The impact of substance abuse on patients with borderline personality disorder was investigated. Substance abuse was common. Female patients preferred alcohol and sedatives. Male patients preferred stimulants. Substance abuse was associated with poor school performance, unemployment, and promiscuity. Depersonalization-derealization was common in nonsubstance using and alcohol-sedative using patients, but was rarely found in stimulant users. Substance abuse appears to be a devastating complication in the patient with borderline personality disorder.

  3. Barriers and Facilitators to Detecting Child Abuse and Neglect in General Emergency Departments.

    Science.gov (United States)

    Tiyyagura, Gunjan; Gawel, Marcie; Koziel, Jeannette R; Asnes, Andrea; Bechtel, Kirsten

    2015-11-01

    Child abuse and neglect is common in the United States, and victims often present to emergency departments (EDs) for care. Most US children who seek care in EDs are treated in general EDs without specialized pediatric services. We aim to explore general ED providers' experiences with screening and reporting of child abuse and neglect to identify barriers and facilitators to detection of child abuse and neglect in the ED setting. We conducted 29 semistructured interviews with medical providers at 3 general EDs, exploring experiences with child abuse and neglect. Consistent with grounded theory, researchers coded transcripts and then collectively refined codes and identified themes. Data collection and analysis continued until theoretical saturation was achieved. Barriers to recognizing child abuse and neglect included providers' desire to believe the caregiver, failure to recognize that a child's presentation could be due to child abuse and neglect, challenges innate to working in an ED such as lack of ongoing contact with a family and provider biases. Barriers to reporting child abuse and neglect included factors associated with the reporting process, lack of follow-up of reported cases, and negative consequences of reporting such as testifying in court. Reported facilitators included real-time case discussion with peers or supervisors and the belief that it was better for the patient to report in the setting of suspicion. Finally, providers requested case-based education and child abuse and neglect consultation for unclear cases. Our interviews identified several approaches to improving detection of child abuse and neglect by general ED providers. These included providing education through case review, improving follow-up by Child Protective Services agencies, and increasing real-time assistance with patient care decisions. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  4. Development of a comprehensive hospital-based elder abuse intervention: an initial systematic scoping review.

    Directory of Open Access Journals (Sweden)

    Janice Du Mont

    Full Text Available Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review.Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation.The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1 addressed a response (e.g., an intervention to elder abuse, 2 contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3 were available in English.The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics.649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser;physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of recommendations.To address the lack of evidence to

  5. 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.

  6. Prenatal exposure to substance of abuse: a worldwide problem.

    Science.gov (United States)

    Narkowicz, Sylwia; Płotka, Justyna; Polkowska, Żaneta; Biziuk, Marek; Namieśnik, Jacek

    2013-04-01

    Substance abuse during pregnancy is an important public health issue affecting the mother and the growing infant. Preterm labor, miscarriage, abruption and postpartum hemorrhage are obstetric complications which have been associated with women who are dependent on abused substances. Moreover, women are also at an increased risk of medical problems such as poor nutrition, anemia, urinary tract infections as well as sexually transmitted infections, hepatitis, HIV and problems related to infection. Intrauterine growth restriction, prematurity, stillbirth, neonatal abstinence syndrome, and Sudden Infant Death Syndrome represent only some of fetal effects. Later on, during childhood, it has been shown that in utero exposure to substances of abuse is associated with increased rates of respiratory infections, asthma, ear and sinus infections. Moreover, these children are more irritable, have difficulty focusing their attention, and have more behavioral problems. Therefore, the assessment of in utero exposure to abused substance is extremely necessary and is relevant for the care of the mother and the offspring. In this sense, several approaches are possible; however, recently the evaluation of in utero exposure to abused drugs has been achieved by testing biological specimens coming from fetus or newborn, pregnant or nursing mother, or from both the fetus and the mother. Maternal and neonatal biological materials reflect exposure in a specific time period and each of them has different advantages and disadvantages in terms of accuracy, time window of exposure and cost/benefit ratio. The methodology for identification and determination of abused substances in biological materials are of great importance. Consequently, sensitive and specific bioanalytical methods are necessary to accurately measure biomarkers. Different immunoassays methods are used as screening methods for drug testing in the above reported specimens, however, the results from immunoassays should be

  7. SEXUAL ABUSE IN ADOLESCENTS - DATA FROM A ...

    African Journals Online (AJOL)

    Logistic regression showed that the presence of suicidal symptoms and alcohol use are to some extent independently associated with sexual abuse. Conclusion. The problem of sexual abuse among South. African youth is confirrried by this study. The association between sexual abuse and depresSIon, suicidal symptoms.

  8. Concealment of Child Sexual Abuse in Sports

    Science.gov (United States)

    Hartill, Mike

    2013-01-01

    When the sexual abuse of children is revealed, it is often found that other nonabusing adults were aware of the abuse but failed to act. During the past twenty years or so, the concealment of child sexual abuse (CSA) within organizations has emerged as a key challenge for child protection work. Recent events at Pennsylvania State University (PSU)…

  9. What Is Child Abuse and Neglect?

    Science.gov (United States)

    US Department of Health and Human Services, 2006

    2006-01-01

    Each State provides its own definitions of child abuse and neglect based on minimum standards set by Federal law. This fact sheet provides the answers to the following questions: (1) How is child abuse and neglect defined in Federal law?; and (2) What are the major types of child abuse and neglect? Additional resources are listed. (Contains 2…

  10. Predicting Child Abuse Potential across Family Types.

    Science.gov (United States)

    Burrell, Brenda; And Others

    1994-01-01

    This study examined whether stress, family resources, and social support are correlates of the child abuse potential of mothers. Stress in family functioning appeared to be an important predictor of child abuse potential. Mothers of children with disabilities may be more inclined than other mothers to have elevated child abuse potential.…

  11. 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.

  12. CHILD SEXUAL ABUSE IN ZIMBABWE: PREVENTION ...

    African Journals Online (AJOL)

    Jacob Mugumbate

    The phenomenon of child sexual abuse (CSA) remains topical in. Zimbabwe. Statistics, literature and debate reflect not only increased scientific interest in child sexual abuse and its potential effects but also growing public concern about this form of child maltreatment. The sexual abuse of children crosses cultural and.

  13. Sexually abused girls and their Rorschach responses.

    Science.gov (United States)

    Friedrich, W N; Einbender, A J; McCarty, P

    1999-10-01

    Exner's scoring (1990) was used on the responses by 46 sexually abused girls (6 to 14 years old) and 46 nonsexually abused girls (6 to 14 years old). Subjects were matched for age, race, family income, and family constellation. Sexually abused children exhibited significantly more unusual content, e.g., sex and blood, in their protocols as well as more frequent coping deficits.

  14. Vision Screening

    Science.gov (United States)

    1993-01-01

    The Visi Screen OSS-C, marketed by Vision Research Corporation, incorporates image processing technology originally developed by Marshall Space Flight Center. Its advantage in eye screening is speed. Because it requires no response from a subject, it can be used to detect eye problems in very young children. An electronic flash from a 35 millimeter camera sends light into a child's eyes, which is reflected back to the camera lens. The photorefractor then analyzes the retinal reflexes generated and produces an image of the child's eyes, which enables a trained observer to identify any defects. The device is used by pediatricians, day care centers and civic organizations that concentrate on children with special needs.

  15. Perioperative management in the patient with substance abuse.

    Science.gov (United States)

    Moran, Sharon; Isa, Jason; Steinemann, Susan

    2015-04-01

    Drug and alcohol use is a pervasive problem in the general population and in those requiring anesthesia for an operation. History and screening can help delineate those who may be acutely intoxicated or chronic drug and alcohol users. Both acute intoxication and chronic abuse of these substances present challenges for anesthetic management during and after an operation. The clinician should be aware of problems that may be encountered during any part of anesthesia or postoperative care. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Legal Aspects of Drug Abuse.

    Science.gov (United States)

    Sloat, Robert S.

    Discussed from a teacher's perspective are the legal and cultural ramifications of drug abuse. The importance of teachers' examining their own values concerning drug use is emphasized. Also reviewed are the history of drug use and of narcotics legislation. Recommendations concerning legislative reform are discussed. (CL)

  17. Adolescent Substance Abuse and Suicide

    Science.gov (United States)

    Dhawan, Anju; Balhara, Yatan Pal Singh; Natasha, M. Phil.

    2007-01-01

    Adolescent substance abuse is a major public health concern. It is associated with an increased incidence of various psychiatric disorders like depressive disorders, anxiety disorders, attention deficit hyperactivity disorder, and conduct disorders and the relationship between mental and behavioral disorders and the substance use problems seems…

  18. child sexual abuse in zimbabwe

    African Journals Online (AJOL)

    J MUGUMBATE

    beings on the other hand, are irrational. Thus, in light of the above incidences of child sexual abuse, what is being put to question is the rationality / irrationality perceptions which distinguish human beings from non –human beings. Questions which beg answers in view of. African Journal of Social Work, 4(1), June 2014. 29 ...

  19. Crime, Abuse, and Hacker Ethics.

    Science.gov (United States)

    Johnson, Deborah G.

    1994-01-01

    Discusses computer ethics and the use of computer networks. Topics addressed include computer hackers; software piracy; computer viruses and worms; intentional and unintentional abuse; intellectual property rights versus freedom of thought; the role of information in a democratic society; individual privacy; legislation; social attitudes; and the…

  20. Childhood history of abuse and child abuse potential: the role of parent's gender and timing of childhood abuse.

    Science.gov (United States)

    Romero-Martínez, A; Figueiredo, B; Moya-Albiol, L

    2014-03-01

    It has been suggested that being physically abused leads to someone becoming a perpetrator of abuse which could be associated to parents' gender, timing of the physical abuse and specific socio-demographic variables. This study aims to investigate the role the parents' gender, timing of childhood abuse and socio-demographic variables on the relationship between parents' history of childhood physical abuse and current risk for children. The sample consisted of 920 parents (414 fathers, 506 mothers) from the Portuguese National Representative Study of Psychosocial Context of Child Abuse and Neglect who completed the Childhood History Questionnaire and the Child Abuse Potential Inventory. The results showed that fathers had lower current potential risk of becoming physical abuse perpetrators with their children than mothers although they did not differed in their physical victimization history. Moreover, the risk was higher in parents (both genders) with continuous history of victimization than in parents without victimization. Prediction models showed that for fathers and mothers separately similar socio-demographic variables (family income, number of children at home, employment status and marital status) predicted the potential risk of becoming physical abuses perpetrators. Nevertheless, the timing of victimization was different for fathers (before 13 years old) and mothers (after 13 years old). Then our study targets specific variables (timing of physical abuse, parents' gender and specific socio-demographic variables), which may enable professionals to select groups of parents at greater need of participating in abuse prevention programs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Prenatal Genetic Screening Tests

    Science.gov (United States)

    ... FAQs Prenatal Genetic Screening Tests Page Navigation ▼ ACOG Pregnancy Book Prenatal Genetic Screening Tests Patient Education FAQs Prenatal Genetic Screening Tests Patient Education Pamphlets - ...

  2. Long-term health outcomes of childhood sexual abuse and peer sexual contact among an urban sample of behaviourally bisexual Latino men.

    Science.gov (United States)

    Mattera, Brian; Levine, Ethan C; Martinez, Omar; Muñoz-Laboy, Miguel; Hausmann-Stabile, Carolina; Bauermeister, José; Fernandez, M Isa; Operario, Don; Rodriguez-Diaz, Carlos

    2017-09-20

    While previous research indicates high rates of childhood sexual abuse among Latino men who have sex with men, few studies have examined the long-term health outcomes of childhood sexual abuse specifically among behaviourally bisexual Latino men. In a sample of 148 behaviourally bisexual Latino men in New York City, we examined associations between childhood sexual abuse and multiple dimensions of adult health: sexual risk behaviours; sexually transmitted infections incidence; polydrug use; depressive symptoms; and perceived stress. We compared outcomes between those with histories of childhood sexual abuse, those reporting peer sexual contact prior to age 13 and those with no sexual contact prior to age 13. Over one-fifth (22.3%) reported a history of childhood sexual abuse, which was significantly associated with engaging in receptive condomless anal intercourse (aOR = 3.59, p childhood sexual abuse screening and culturally appropriate treatment and care into practice.

  3. Against the Odds: The Impact of Woman Abuse on Maternal Response to Disclosure of Child Sexual Abuse

    Science.gov (United States)

    Alaggia, Ramona; Turton, Jennifer V.

    2005-01-01

    Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways,…

  4. AOD Screening Tools for College Students. Prevention Update

    Science.gov (United States)

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the goal of screening in student health or other college settings is to reduce alcohol-related harm. NIAAA points out that identifying those students at greatest risk for alcohol problems is the first step in prevention. Colleges and universities have used a number of…

  5. Comprehensive training in suspected child abuse and neglect for dental students: a hybrid curriculum.

    Science.gov (United States)

    Ivanoff, Chris S; Hottel, Timothy L

    2013-06-01

    Child abuse and neglect are tragic realities of American society. However, most U.S. dental schools do not provide students with adequate training to deal with the problem. This article proposes expanding the predoctoral dental curriculum with a problem-based learning model that can effectively stimulate critical thinking skills to assist graduates in screening and reporting suspected child abuse and neglect throughout their careers. The unique multicultural environment of dental school offers students an unprecedented opportunity to develop awareness about child abuse and domestic violence, while increased vigilance can potentially save innocent young lives. Educating students about proper protocol when they suspect child abuse or neglect is imperative, particularly for dental schools involving students in community sealant and other preventive programs in public schools. By expanding their curriculum to include recognition and intervention, dental schools can help break the cycle of violence and transform attitudes towards taking decisive action. Clinical curricula that have moved to private practice preceptor models are well suited to screen for child abuse. The goal is to motivate dental schools to deal with this critical issue, develop reporting protocols and procedures for appropriate response, and provide their students with consummate training.

  6. [Abuse, dependence and intoxication of substances].

    Science.gov (United States)

    Wada, Kiyoshi

    2015-09-01

    As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.

  7. Clerical Child Abuse – The Irish Experience

    Directory of Open Access Journals (Sweden)

    Yvonne Murphy

    2013-12-01

    Full Text Available Ireland has been overwhelmed in the past two decades by what the Catholic Church itself has called ‘a tsunami’ of revelations of clerical child abuse – physical as well as sexual – of the meticulous concealment of abuse and abusers and of a long-established, and almost universal policy of protecting the assets and reputation of the Church, in preference to exposing the abusers.Between 2006 and 2009 Judge Yvonne Murphy chaired a Commission of Inquiry into the child sex abuse scandal in the Catholic Archdiocese of Dublin.

  8. Post-Traumatic Stress Disorder (PTSD) in Sexually Abused Children and Educational Status in Kenya: A Longitudinal Study.

    Science.gov (United States)

    Mutavi, Teresia; Mathai, Muthoni; Obondo, Anne

    2017-01-01

    Children who experience sexual abuse often meet the criteria of Post-Traumatic Stress Disorder and other psychiatric disorders. This article examines Post-Traumatic Stress Disorder and their educational status among children who have been sexually abused and its effects on the children's educational status. The study was carried out between June 2015 and July 2016. The study adopted a longitudinal study design. The study was conducted at Kenyatta National Teaching and Referral Hospital and Nairobi Women's Hospitals in Kenya. The children who had experienced sexual abuse and their parents/legal guardians were followed up for a period of one year after every four months interval. One hundred and ninety one children who had experienced sexual abuse and their parents/legal guardians were invited to participate in the study. Findings indicate that the children continued to experience PTSD one year after the sexual abuse incidence. PTSD was associated with the length of time taken to receive medical attention (pChildren with partial PTSD who had experienced sexual abuse were 2 times more likely to perform above average than children with full PTSD, OR=2.1 [95% CI of OR 1.2-3.8], p=0.01. Children who experience sexual abuse have negative mental health outcomes. These outcomes have detrimental effects to the normal development of children and educational status. There is need to screen for PTSD and offer psychosocial support and follow up to children who have been sexual abuse.

  9. Does a history of bullying and abuse predict lower urinary tract symptoms, chronic pain, and sexual dysfunction?

    Science.gov (United States)

    Nault, Tori; Gupta, Priyanka; Ehlert, Michael; Dove-Medows, Emily; Seltzer, Marlene; Carrico, Donna J; Gilleran, Jason; Bartley, Jamie; Peters, Kenneth M; Sirls, Larry

    2016-11-01

    To investigate associations of bullying and abuse with pelvic floor symptoms, urogenital pain, and sexual health characteristics of women presenting to a multidisciplinary women's urology center. Retrospective review of a prospective database. Patients completed questions about bullying, abuse, sexual health and validated questionnaires including the Pelvic Floor Dysfunction Inventory (PFDI-20), Overactive Bladder Questionnaire (OAB-q), and visual analog scale (VAS 0-10) for genitourinary pain. Statistical analyses included Chi-squared and t tests, which compared victims of bullying and/or abuse to non-victims. Three hundred and eighty patients were reviewed. Three hundred and thirty-eight had data on bullying and abuse history. Out of 380, 94 (24.7 %) reported that they were victims of bullying. Out of 380, 104 (27.4 %) reported that they were victims of abuse. Women with a history of bullying and abuse had increased overall pain scores compared to those without a history of either. Women with a history of abuse and bullying had increased PFDI-20, POPDI, and UDI-6 scores compared to women who were not bullied or abused. There was no difference in being sexually active or in sexual satisfaction between the groups. Patients with a history of abuse and bullying had the greatest percentage of dyspareunia (p = 0.009). Women with a history of bullying, abuse, or both predict increased pelvic floor distress, urological symptoms, increased urogenital pain, and increased dyspareunia. Clinicians should screen for exposure to bullying or abuse in order to provide comprehensive resources to address these psychosocial issues.

  10. Knowledge, Attitude and Practice of Community Health Workers Regarding Child Abuse in Tabriz Health Centers in 2015-2016

    Directory of Open Access Journals (Sweden)

    Mohammad Hasan Sahebihagh

    2017-07-01

    Full Text Available Background: Child abuse is a widespread social phenomenon with serious life-time consequences. Since parents bring their children to healthcare centers for growth screening and vaccinations, Community Health Workers play an important role in identifying and reporting child abuse cases. Thus, the current study aimed to investigate knowledge, attitude and performance of Community Health Workers regarding child abuse in Tabriz. Methods: This is a descriptive (cross-sectional study; census method was used for sampling. Study population consists of 265 people, employed at units of family health and vaccination in Tabriz healthcare centers in 2015-2016. A questionnaire was used to collect the data. Data analysis was carried out using SPSS, version 23 through descriptive (mean and standard deviation and analytical (Two Independent Samples T-test and analysis of variance statistics. Results: Findings indicate that 58.5 percent of Community Health Workers had good knowledge about causes of child abuse and 45 percent had good knowledge of the signs, symptoms and complications of child abuse. Their total knowledge was good (57%. The mean score of awareness (knowledge was significant according to the variable of training participation (P=0.04. The participants had a favorable attitude toward dealing with child abuse (91.3 %; the mean score of attitude was significant according to the educational field (P<0.001 and their performance in dealing with child abuse was moderate and lower (94.3 %. Conclusion: Community Health Workers had good knowledge regarding child abuse, favorable attitude toward dealing with child abuse, and poor performance in dealing with child abuse. This may be due to fear of side issues to deal with child abuse, or lack of clear legal guidelines regarding this.

  11. Knowledge, Attitude and Practice of Community Health Workers Regarding Child Abuse in Tabriz Health Centers in 2015-2016.

    Science.gov (United States)

    Sahebihagh, Mohammad Hasan; Hosseini, Seyedeh Zahra; Hosseinzadeh, Mina; Shamshirgaran, Seyed Morteza

    2017-07-01

    Child abuse is a widespread social phenomenon with serious life-time consequences. Since parents bring their children to healthcare centers for growth screening and vaccinations, Community Health Workers play an important role in identifying and reporting child abuse cases. Thus, the current study aimed to investigate knowledge, attitude and performance of Community Health Workers regarding child abuse in Tabriz. This is a descriptive (cross-sectional) study; census method was used for sampling. Study population consists of 265 people, employed at units of family health and vaccination in Tabriz healthcare centers in 2015-2016. A questionnaire was used to collect the data. Data analysis was carried out using SPSS, version 23 through descriptive (mean and standard deviation) and analytical (Two Independent Samples T-test and analysis of variance) statistics. Findings indicate that 58.5 percent of Community Health Workers had good knowledge about causes of child abuse and 45 percent had good knowledge of the signs, symptoms and complications of child abuse. Their total knowledge was good (57%). The mean score of awareness (knowledge) was significant according to the variable of training participation (P=0.04). The participants had a favorable attitude toward dealing with child abuse (91.3 %); the mean score of attitude was significant according to the educational field (P<0.001) and their performance in dealing with child abuse was moderate and lower (94.3 %). Community Health Workers had good knowledge regarding child abuse, favorable attitude toward dealing with child abuse, and poor performance in dealing with child abuse. This may be due to fear of side issues to deal with child abuse, or lack of clear legal guidelines regarding this.

  12. Evaluation of a two-question screening tool in the detection of ...

    African Journals Online (AJOL)

    A Saimen

    determine the operating characteristics of a two-question screening tool for intimate partner violence (Women Abuse Screening. Tool–short); and (2) to estimate .... episodes of emotional, physical and sexual violence. A Likert- type scale ..... there is discordancy in the couple's level of education.29 A curvilinear relationship ...

  13. Incidence of childhood abuse among women with psychiatric disorders compared with healthy women: Data from a tertiary care centre in India.

    Science.gov (United States)

    Jangam, Kavita; Muralidharan, Kesavan; Tansa, K A; Aravind Raj, E; Bhowmick, Paramita

    2015-12-01

    Childhood abuse has been recognized as a precursor and a maintaining factor for adult psychopathology. There are very few studies that have investigated the incidence of childhood abuse in adult women with psychiatric disorders. Hence, this current investigation is an attempt to study and compare the incidence of childhood abuse (physical, emotional and sexual) among women seeking treatment for psychiatric disorders to healthy women. Using consecutive sampling, women seeking treatment for psychiatric disorders (N=609) and a group of age-education matched healthy women (N=100) were recruited for the study from a tertiary mental health-care hospital in India. The participants were screened for childhood abuse using the ISPCAN Child Abuse Screening Tool - Retrospective (ICAST)-R (I-CAST R, International Society for the Prevention of Child Abuse and Neglect (ISPCAN) and The United Nations Children's Fund (UNICEF), 2009). Emotional abuse was significantly more common among women with psychiatric disorders compared with healthy women (ppsychiatric disorders compared with healthy women (p=0.07). There was no statistically significant difference between the two groups on physical and sexual abuse (all p>0.13). There was no statistically significant difference in all three types of abuse across disorder categories, though the report was more among women with severe mental disorders. Women with psychiatric disorders reported more emotional and overall abuse compared with healthy women. Sexual and physical abuse was similar in both groups. It is likely that more emotional abuse predisposes these women to psychiatric disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Child Abuse: Abused all the way but determined not to abuse ...

    African Journals Online (AJOL)

    The case of a 14-year old girl who was abused right from infancy through childhood, pregnancy labour and immediate post-partum period, and management of both the child mother and her baby is presented. Information was obtained both retrospectively and prospectively. Tender loving care to the child mother and her ...

  15. sexual abuse of children as a form of power abuse and abuse of the ...

    African Journals Online (AJOL)

    sexual abuse of children happens not only in the church or in pastoral relationships, but also within families where ..... Feminist theology opposes the dualistic thinking of the body and soul and the objectification of the ... of the Christian tradition can generate a positive view of the body (Dillen. 2007:159). Such reflections of a ...

  16. Diagnosing subtle palatal anomalies: Validation of video-analysis and assessment protocol for diagnosing occult submucous cleft palate.

    Science.gov (United States)

    Rourke, Ryan; Weinberg, Seth M; Marazita, Mary L; Jabbour, Noel

    2017-09-01

    Submucous cleft palate (SMCP) classically involves bifid uvula, zona pellucida, and notched hard palate. However, patients may present with more subtle anatomic abnormalities. The ability to detect these abnormalities is important for surgeons managing velopharyngeal dysfunction (VPD) or considering adenoidectomy. Validate an assessment protocol for diagnosis of occult submucous cleft palate (OSMCP) and identify physical examination features present in patients with OSMCP in the relaxed and activated palate positions. Study participants included patients referred to a pediatric VPD clinic with concern for hypernasality or SMCP. Using an appropriately encrypted iPod touch, transoral video was obtained for each patient with the palate in the relaxed and activated positions. The videos were reviewed by two otolaryngologists in normal speed and slow-motion, as needed, and a questionnaire was completed by each reviewer pertaining to the anatomy and function of the palate. 47 patients, with an average age of 4.6 years, were included in the study over a one-year period. Four videos were unusable due to incomplete view of the palate. The most common palatal abnormality noted was OSMCP, diagnosed by each reviewer in 26/43 and 30/43 patients respectively. Using the assessment protocol, agreement on palatal diagnosis was 83.7% (kappa = 0.68), indicating substantial agreement, with the most prevalent anatomic features being vaulted palate elevation (96%) and visible notching of hard palate (75%). The diagnosis of subtle palatal anomalies is difficult and can be subjective. Using the proposed video-analysis method and assessment protocol may improve reliability of diagnosis of OSMCP. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. 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.

  18. Abuse in hospital-based birth settings?

    Science.gov (United States)

    Hodges, Susan

    2009-01-01

    Are laboring and birthing women treated abusively in the hospital? Although seldom recognized as abuse or violence against women, bullying and medical treatments under false pretenses, even in a hospital, constitute abuse and a basic human rights issue that needs attention. Naming the problem is a first step. The power of medical authority, the lack of accountability in the hospital hierarchical system, policies and protocols, and expectations of compliancy all make an environment ripe for abuse and present obstacles for both women and staff to recognize or stop abuse. Learning to recognize abuse and take effective action, and understanding the legal requirements for "informed consent" can help, but ending abuse will require systemic change.

  19. Client Abuse to Public Welfare Workers

    DEFF Research Database (Denmark)

    Strøbæk, Pernille Solveig; Korczynski, Marek

    2016-01-01

    We analyse a case study of workers’ experience of client abuse in a Danish public welfare organisation. We make an original contribution by putting forward two different theoretical expectations of the case. One expectation is that the case follows a pattern of customer abuse processes in a social...... market economy – in which workers are accorded power and resources, in which workers tend to frame the abuse as the outcome of a co-citizen caught in system failure and in which workers demonstrate some resilience to abuse. Another expectation is that New Public Management reforms push the case to follow...... patterns of customer abuse associated with a liberal market economy – in which the customer is treated as sovereign against the relatively powerless worker, and in which workers bear heavy emotional costs of abuse. Our findings show a greater match to the social processes of abuse within a social market...

  20. Forensic odontology, part 5. Child abuse issues.

    Science.gov (United States)

    Hinchliffe, J

    2011-05-14

    Child abuse, child maltreatment, non-accidental injury and child homicide: all terms that are hard to believe exist in the 21st civilised century, but non-accidental injury of children is a major problem, crossing all socioeconomic, ethnic and educational groups, and is happening all over the world. Available statistics on child abuse and deaths related to abuse are frightening, and as many cases are not reported, actual numbers are likely to be much higher. This paper aims to increase understanding of child abuse issues and encourage the dental team to be alert to the possibility of abuse, recognise the physical injuries and make referrals to the appropriate agency if necessary. In child abuse cases physical injuries to the head and facial area are common while other types of abuse are less visible but are damaging to a vulnerable child in other ways. Keeping children safe is a shared responsibility and a top priority for all of us.

  1. 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

  2. Non-opioid anesthetic drug abuse among anesthesia care providers: a narrative review.

    Science.gov (United States)

    Zuleta-Alarcón, Alix; Coffman, John C; Soghomonyan, Suren; Papadimos, Thomas J; Bergese, Sergio D; Moran, Kenneth R

    2017-02-01

    The objective of this narrative review is to provide an overview of the problem of non-opioid anesthetic drug abuse among anesthesia care providers (ACPs) and to describe current approaches to screening, therapy, and rehabilitation of ACPs suffering from non-opioid anesthetic drug abuse. We first performed a search of all literature available on PubMed prior to April 11, 2016. The search was limited to articles published in Spanish and English, and the following key words were used: anesthesiology, anesthesia personnel, AND substance-related disorders. We also searched Ovid MEDLINE ® databases from 1946-April 11, 2016 using the following search terms: anesthesiology OR anesthesia, OR nurse anesthetist OR anesthesia care provider OR perioperative nursing AND substance-related disorders. Despite an increased awareness of drug abuse among ACPs and improvements in preventive measures, the problem of non-opioid anesthetic drug abuse remains significant. While opioids are the most commonly abused anesthesia medications among ACPs, the abuse of non-opioid anesthetics is a significant cause of morbidity, mortality, and professional demise. Early detection, effective therapy, and long-term follow-up help ACPs cope more effectively with the problem and, when possible, resume their professional activities. There is insufficient evidence to determine the ability of ACPs to return safely to anesthesia practice after rehabilitation, though awareness of the issue and ongoing treatment are necessary to minimize patient risk from potentially related clinical errors.

  3. Water screen

    Energy Technology Data Exchange (ETDEWEB)

    Kutepov, A.I.; Fedotov, I.N.; Prokopov, O.I.

    1981-01-01

    The invention refers to ventilation and can be used for repair-fitting operations in a blasting-dangerous gas condition, for example, during elimination of gas-oil gushers, repair of gas-oil pipelines, equipment etc. In order to improve safety of labor, the nozzle adapters of the water collector are oriented towards each other. The collector is installed on a support with the possibility of rotating and vertical movement. The proposed screen excludes the possibility of blasting-dangerous concentrations of gases and guarantees extinguishing of the impact spark during operation of the tool.

  4. Personality characteristics of men who physically abuse women.

    Science.gov (United States)

    Else, L T; Wonderlich, S A; Beatty, W W; Christie, D W; Staton, R D

    1993-01-01

    Studies have suggested that personality disorders may be common among men who habitually commit domestic violence. The study reported here attempted to characterize personality traits and psychological and cognitive characteristics of men who batter women in order to distinguish them from nonbattering men. A group of 21 batterers were compared with a group of nonbatterers using the Minnesota Multiphasic Personality Inventory and its personality disorder scales (MMPIPDS) and the Hostility and Direction of Hostility Questionnaire. Comparability of the two groups was assessed on several demographic variables and on scores on the Revised Michigan Alcoholism Screening Test, three cognitive measures, and three measures of affective disturbance. Batterers scored higher on only the borderline and antisocial MMPIPDS and on the acting-out hostility and self-criticism scales of the hostility questionnaire. Problem-solving skills for both of the groups were considerably poorer than published norms. No significant differences were found between the groups in age, race, education, socioeconomic status, alcohol abuse, performance on cognitive measures, depression scale scores, or overall scores on the MMPI. As children, batterers were more likely to have experienced physical or emotional abuse. Men who commit domestic violence may be found among a larger pool of men with poor problem-solving skills, but in addition they appear to have borderline-antisocial personality traits, certain types of hostility, and histories of abuse as children that may predispose them to become violent with their female companions.

  5. Mental Health Screening Center

    Science.gov (United States)

    ... Important security updates for DBSAlliance.org. Read more... Mental Health Screening Center These online screening tools are not ... you have any concerns, see your doctor or mental health professional. Depression Screening for Adult Depression Screening for ...

  6. RBC Antibody Screen

    Science.gov (United States)

    ... C Cystic Fibrosis (CF) Gene Mutations Testing Cytomegalovirus (CMV) Tests D-dimer Dengue Fever Testing Des-gamma- ... Index of Screening Recommendations Not Listed? Not Listed? Newborn Screening Screening Tests for Infants Screening Tests for ...

  7. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  8. Childhood abuse, adult interpersonal abuse, and depression in individuals with extreme obesity.

    Science.gov (United States)

    Salwen, Jessica K; Hymowitz, Genna F; Vivian, Dina; O'Leary, K Daniel

    2014-03-01

    This study sought to examine (a) a mediational model of childhood abuse, adult interpersonal abuse, and depressive symptoms and (b) the impact of weight-related teasing on rates and correlates of childhood abuse. Charts of 187 extremely obese individuals seeking psychological clearance for bariatric (weight-loss) surgery were retrospectively examined. Among the participants, 61% reported a history of childhood abuse, 30.5% reported adult interpersonal abuse, and 15% reported clinically significant depressive symptoms. Initially, the relationship between childhood abuse and current depressive symptoms was significant (pdepressive symptoms were significant (pdepression), and higher than those in community samples and other medical populations. The relationship between child abuse and depressive symptomatology may be partially explained by the presence of adult interpersonal abuse; additionally, the relationship between childhood and adult interpersonal abuse was stronger for those who did not endure weight-related teasing than for those who did. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Opportunities for Exploring and Reducing Prescription Drug Abuse Through Social Media.

    Science.gov (United States)

    Scott, Kevin R; Nelson, Lewis; Meisel, Zachary; Perrone, Jeanmarie

    2015-01-01

    The rising toll of opioid overdoses in the past decade has been declared a prescription drug epidemic by the Centers for Disease Control. In that same period, Internet platforms, such as Facebook and Twitter, have grown exponentially, being used primarily by a population similar to new initiates of substance abuse. Researchers have utilized social media to gain insights into use patterns and prevailing attitudes about various substances. Social media has potential to enhance screening, prevention, and treatment of addiction. With future funding, they should be leveraged to advance understanding of prescription drug use and improve treatment and prevention of abuse.

  10. Domestic violence screening practices of obstetrician-gynecologists.

    Science.gov (United States)

    Horan, D L; Chapin, J; Klein, L; Schmidt, L A; Schulkin, J

    1998-11-01

    To ascertain the current knowledge base and screening practices of obstetrician-gynecologists in the area of domestic violence. We mailed a survey to 189 ACOG Fellows who are members of the Collaborative Ambulatory Research Network. Questionnaires were also mailed to a random sample of 1250 nonmember Fellows. Obstetrician-gynecologists are aware of the nature of domestic violence and are familiar with common symptomatology that may be associated with domestic violence. For pregnant patients, 39% of respondents routinely screen at the first prenatal visit; 27% of respondents routinely screen nonpregnant patients at the initial visit. Screening is most likely to occur when the obstetrician-gynecologist suspects a patient is being abused, both during pregnancy (68%) and when the patient is not pregnant (72%). Only 30% of obstetrician-gynecologists received training on domestic violence during medical school; 37% received such instruction during residency training. The majority (67%) have received continuing education on the subject. Years since training and personal experiences with intimate-partner violence were associated with increased screening practices. Routine screening of all women for domestic violence has been recommended by ACOG for more than a decade. The majority of obstetrician-gynecologists screen both pregnant and nonpregnant patients when they suspect abuse. However, with universal screening, more female victims of violence can be identified and can receive needed services.

  11. Pyrethroid as a Substance of Abuse

    Directory of Open Access Journals (Sweden)

    Pravesh Sharma

    2014-01-01

    Full Text Available This is a case of a 22-year-old Hispanic male with a history of bipolar disorder and methamphetamine dependence who was admitted after presenting with suicidal ideations by slashing his throat with a machete. The patient had been smoking and inhaling “processed” pyrethroid for about eight weeks as an inexpensive methamphetamine substitute. He reported experiencing a “rush” similar to methamphetamine after using pyrethroid from liquid insecticide that had been heated (electrocuted or sprayed on hot metal sheets until it crystallized. The patient presented with no significant physical markings or findings but claimed to have his suicidal ideations precipitated by concerns of ill effects of pyrethroid on his health. He also had positive urine drug screen for methamphetamine, which he admitted to using on the day of admission. We conclude that it is important for physicians to maintain a high level of suspicion for alternate and uncommon substances of abuse as well as risks for suicidal tendencies in these patients.

  12. More Than Political Ideology: Subtle Racial Prejudice as a Predictor of Opposition to Universal Health Care Among U.S. Citizens

    Directory of Open Access Journals (Sweden)

    Megan Johnson Shen

    2016-08-01

    Full Text Available Political rhetoric surrounding Universal Health Care in the United States typically deals only with differences in political ideology. Research on symbolic racism, however, indicates that subtle racial prejudice may also predict attitudes toward policies like universal health care that are assumed to benefit racial minorities. This subtle racial prejudice hypothesis was supported across three studies conducted in the U.S. A measure of attitudes toward universal health care was found to be a reliable, single-dimension measure associated with political ideology (Pilot Study. Subtle racial prejudice (as measured by the Modern Racism Scale predicted opposition to universal health care, even when statistically controlling for political ideology and attitudes toward the poor (Study 1. Moreover, reading about a Black individual (compared to a White individual receiving universal health care benefits reduced support for universal health care, even when statistically controlling for political ideology and right-wing authoritarianism (Study 2. Being a person who takes advantage of the system (e.g., free rides was a significant predictor of universal health care attitudes while race was not (Study 3. This work demonstrates that subtle racial prejudice plays a critical role in predicting universal health care attitudes among U.S. citizens, reflecting a long-standing history of associations between subtle racial prejudice and opposition to governmental assistance programs in the U.S.

  13. Substance Abuse in Aging Population

    Directory of Open Access Journals (Sweden)

    Alireza Jazayeri

    2006-10-01

    Full Text Available substance abuse' specially opiates and prescribed drugs are spreading among the older adults. Most of the time it begins as an attempt to medicate chronic pains, medical conditions and loneliness. In other instances, it simply is the continuation of a problem that begun in young adulthood. But scholars and specialists in both fields of Addiction and Gerontology, rather neglected this fast growing problem, to the extent that we almost have no data on the epidemiology, prevention and treatment modalities among the substance abusing old adults in Iran. This paper reflects the necessity of designing age specific programs to identify and treat this group. Besides, some of the most effictive methods of treatment in other countries are reviewed.

  14. Update on abusive head trauma.

    Science.gov (United States)

    Shaahinfar, Ashkon; Whitelaw, Kevin D; Mansour, Karim M

    2015-06-01

    This article provides an update on abusive head trauma (AHT), focusing on new developments most salient to the emergency medicine clinician, including epidemiology, clinical recognition, diagnostic work-up, management of neurologic injury, and public health implications. The recent literature has focused on honing the clinician's ability to recognize AHT and its immediate sequelae, to more accurately distinguish between abusive and accidental head injuries by patterns of neuroimaging and retinal hemorrhages, and to appreciate the long-term impacts. Specifically, both a clinical prediction rule and biomarker show promise, and new research advocates for the early identification of subclinical seizures as well as cervical spine injuries. The emergency medicine provider must be able to recognize and manage children who may have AHT and to appreciate when the diagnostic findings warrant consultation with a child protection team. These authors summarize the recent and notable advances in our understanding of AHT.

  15. Preventing Child Sexual Abuse Early

    Directory of Open Access Journals (Sweden)

    Wenjing Zhang

    2015-02-01

    Full Text Available This study is aimed to examine preschool teachers’ knowledge of, attitudes about, and training related to child sexual abuse (CSA prevention in Beijing, China. Two hundred and forty-five preschool teachers were administered the 16-item questionnaire that contained questions on CSA prevention knowledge, attitudes, and teacher training. Results showed that Chinese preschool teachers had limited knowledge on CSA prevention (M = 4.86, SD = 2.12. Less than 5% of the teachers ever attended CSA prevention training programs. Preschool teachers’ training on CSA prevention was the significant factor for their knowledge and attitudes. To help protect children against sexual abuse, there is an urgent need to develop appropriate prevention training programs for preschool teachers in China.

  16. 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.

  17. Use and Abuse of Authority

    OpenAIRE

    Bartling, Björn; Fehr, Ernst; Schmidt, Klaus M.

    2012-01-01

    Employment contracts give a principal the authority to decide flexibly which task his agent should execute. However, there is a tradeoff, first pointed out by Simon (1951), between flexibility and employer moral hazard. An employment contract allows the principal to adjust the task quickly to the realization of the state of the world, but he may also abuse this flexibility to exploit the agent. We capture this tradeoff in an experimental design and show that principals exhibit a strong prefer...

  18. Trace Amines and Cocaine Abuse

    OpenAIRE

    Li, Jun-Xu

    2014-01-01

    Cocaine addiction remains a clinical challenge with no effective pharmacotherapy available. Trace amine associated receptor (TAAR) 1 represents a promising drug target for the modulation of dopaminergic system and stimulant abuse. This Viewpoint discusses the emerging data which strongly suggest that TAAR 1 functions as a molecular “brake” that controls the addiction-related effects of cocaine and could be a novel drug target for the development of efficacious pharmacothe...

  19. History of childhood abuse in Portuguese parents.

    Science.gov (United States)

    Figueiredo, Bárbara; Bifulco, Antonia; Paiva, Carla; Maia, Angela; Fernandes, Eugénia; Matos, Raquel

    2004-06-01

    The study examines the self-reported prevalence of childhood physical and sexual abuse in a large sample of Portuguese parents. Nearly 1,000 parents (506 mothers and 426 fathers) were selected through public primary schools from the Northern area of Portugal. All completed the Portuguese version of the Childhood History Questionnaire (CHQ) [Journal of Family Violence 5 (1990) 15]. Results show that the prevalence of abuse was 73%, but more severe physical abuse involving sequelae/injury was reported by 9.5%. Most physical abuses began prior to age 13, with half continuing after age 13. No gender differences were found for rates of physical abuse. However, among the milder physical abuse without sequelae/injury, those women who experienced "whipping" or "slapping/kicking" were more likely to do so from their mothers than fathers. Among men who were "slapped/kicked" this was more likely to be from their fathers. Low rates of sexual abuse were found at 2.6% with no gender or age differences. Lack of a supportive adult in childhood related to the more severe abuses, but only in adolescence. Portuguese rates of abuse were consistently lower than those reported in USA and Spanish studies using the CHQ. This is the first retrospective, self-report study of childhood abuse in a large sample of Portuguese parents and, even with a participation rate of 69%, shows lower rates than in US and Spanish samples.

  20. The abuse of nuclear power

    International Nuclear Information System (INIS)

    Hill, J.

    1976-01-01

    This paper reproduces an address by Sir John Hill, Chairman of the United Kingdom Atomic Energy Authority, at a conference in London organised by the Financial Times in July 1976. Actions that, in the author's view, could be regarded as constituting abuse of nuclear power are first summarised, and the various aspects of the use and abuse of nuclear power are discussed. The author considers that achieving the maximum degree of acceptance of the Non-Proliferation Treaty is the most important political objective in nuclear power, but considers that nuclear terrorism would be abortive and that, so far as the UK is concerned, the present precautions are adequate and will remain so. It is considered that much abuse of nuclear power arises from the prevalence of its critics, particularly with reference to Pu hazards, the health of nuclear employees, and possible damage to the health of the public. The Pu problem is considered to be far more emotive than rational. The possibility of lung cancer and leukaemia is discussed. It is concluded that atomic energy is one of the best of industries in which to work, both from the health and interest points of view. (U.K.)