Overview of harm reduction in prisons in seven European countries.

Science.gov (United States)

Sander, Gen; Scandurra, Alessio; Kamenska, Anhelita; MacNamara, Catherine; Kalpaki, Christina; Bessa, Cristina Fernandez; Laso, Gemma Nicolás; Parisi, Grazia; Varley, Lorraine; Wolny, Marcin; Moudatsou, Maria; Pontes, Nuno Henrique; Mannix-McNamara, Patricia; Libianchi, Sandro; Antypas, Tzanetos

2016-10-07

While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.

Harm reduction measures in prison (Methadone treatment and its effects on quality of life promotion

Directory of Open Access Journals (Sweden)

Iraj Esmaili

2009-02-01

Conclusion: In a look, it is obvious that the harm reduction measures which have been taken for prisoners under the coverage of Methadone treatment will be effective in improving their quality of life conditions.

Harm reduction - a historical view from the left.

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Friedman, S R.; Southwell, M; Bueno, R; Paone, D; Byrne, J; Crofts, N

2001-04-01

The harm reduction movement formed during a period in which social movements of the working class and the excluded were weak, neo-liberalism ideologically triumphant, and potential opposition movements were viewed as offering "tinkering" with the system rather than a total social alternative. This climate shaped and limited the perspectives, strategies, and tactics of harm reductionists almost everywhere. In many countries, this period was also marked by a "political economy of scapegoating" that often targeted drug users as the cause of social woes. This scapegoating took the form of "divide and rule" political initiatives by business and political leaderships to prevent social unrest in a long period of worldwide economic trends toward lowered profit rates and toward increasing income inequality. However, times have changed. Mass strikes and other labor struggles, opposition to the World Trade Organisation and other agencies of neo-liberalism, community-based protests against belt-tightening, and other forms of social unrest have been increasing in many countries. This opens up the possibility of new allies for the harm reduction movement, but also poses difficult problems for which we need to develop answers. On-the-ground experience in alliance formation needs to be combined with careful discussion of and research about what approaches work to convince other movements to work for and with harm reduction, and which approaches do not. Class differences within the harm reduction movement are likely to become more salient in terms of (a) creating internal tensions, (b) increasingly, opening up new ways in which working class harm reductionists can organize within their own communities and workplaces, and (c) producing different strategic orientations that will need to be discussed and debated. As a movement, we will need to find ways to accommodate and discuss differing perspectives, needs, and assessments of opportunities and threats without paralyzing harm

The development of peer educator-based harm reduction programmes in Northern Vietnam.

Science.gov (United States)

Walsh, Nick; Gibbie, Tania M; Higgs, Peter

2008-03-01

Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

Harm reduction psychotherapy: extending the reach of traditional substance use treatment.

Science.gov (United States)

Tatarsky, Andrew

2003-12-01

Harm reduction is a paradigm-shifting idea that has the potential to significantly improve the treatment of problem substance users. The essence of harm reduction is the recognition that treatment must start from the client's needs and personal goals and that all change that reduces the harms associated with substance use can be regarded as valuable. The paper presents harm reduction's rationale, principles, treatment implications, and application to psychotherapy. The author describes his model of Integrative Harm Reduction Psychotherapy, an approach that integrates a strategic skills-building focus with an exploration of the multiple meanings of substance use and the importance of the therapeutic alliance.

Harm reduction as a strategy for supporting people who self-harm on mental health wards: the views and experiences of practitioners.

Science.gov (United States)

James, Karen; Samuels, Isaac; Moran, Paul; Stewart, Duncan

2017-05-01

Harm reduction has had positive outcomes for people using sexual health and substance misuse services. Clinical guidance recommends these approaches may be appropriately adopted by mental health practitioners when managing some people who self-harm. There has, however, been very little research in this area. We explored practitioners' views of harm reduction as a strategy for supporting people who self-harm. The Self Harm Antipathy Scale (SHAS) was administered to a random sample of 395 mental health practitioners working on 31 wards in England, semi-structured interviews were then conducted with 18 survey respondents. Practitioners who had implemented the approach reported positive outcomes including a reduction in incidence and severity of self-harm and a perceived increase in empowerment of service users. Practitioners with no experience of using harm reduction were concerned that self-harm would increase in severity, and were unsure how to assess and manage risk in people under a harm reduction care plan. Some fundamentally disagreed with the principle of harm reduction for self-harm because it challenged their core beliefs about the morality of self-harm, or the ethical and potential legal ramifications of allowing individuals to harm themselves. This study was conducted solely with practitioners working on inpatient units. The majority of staff interviewed had no experience of harm reduction and so their concerns may not reflect challenges encountered by practitioners in clinical practice. Harm reduction is being used to support people who self-harm within inpatient psychiatry and some practitioners report potential benefits of this approach. However, this raises particularly complex practical, ethical and legal issues and further research is needed to assess the safety, acceptability and efficacy of the approach. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Harm reduction in U.S. tobacco control: Constructions in textual news media.

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Eversman, Michael H

2015-06-01

U.S. tobacco control has long emphasized abstinence, yet quitting smoking is hard and cessation rates low. Tobacco harm reduction alternatives espouse substituting cigarettes with safer nicotine and tobacco products. Policy shifts embracing tobacco harm reduction have increased media attention, yet it remains controversial. Discourse theory posits language as fluid, and socially constructed meaning as neither absolute nor neutral, elevating certain views over others while depicting "discursive struggle" between them. While an abstinence-based framework dominates tobacco policy, discourse theory suggests constructions of nicotine and tobacco use can change, for example by positioning tobacco harm reduction more favorably. Textual discourse analysis was used to explore constructions of tobacco harm reduction in 478 (308 original) U.S. textual news media articles spanning 1996-2014. Using keyword database sampling, retrieved articles were analyzed first as discrete recording units and then to identify emergent thematic content. Constructions of tobacco harm reduction shifted over this time, revealing tension among industry and policy interests through competing definitions of tobacco harm reduction, depictions of its underlying science, and accounts of regulatory matters including tobacco industry support for harm reduction and desired marketing and taxation legislation. Heightened salience surrounding tobacco harm reduction and electronic cigarettes suggests their greater acceptance in U.S. tobacco control. Various media depictions construct harm reduction as a temporary means to cessation, and conflict with other constructions of it that place no subjective value on continued "safer" tobacco/nicotine use. Constructions of science largely obscure claims of the veracity of tobacco harm reduction, with conflict surrounding appropriate public health benchmarks for tobacco policy and health risks of nicotine use. Taxation policies and e-cigarette pricing relative to

Research on the Ordered Mesoporous Silica for Tobacco Harm Reduction

Science.gov (United States)

Wang, Y.; Y Li, Z.; Ding, J. X.; Hu, Z. J.; Liu, Z.; Zhou, G.; Huang, T. H.

2017-12-01

For reducting tobacco harm, this paper prepared an ordered mesoporous silica by using triblock copolymer Pluronic P123 as template. The property of this material was characterized by the X-ray scattering spectrum(XRD), Transmission electron microscopy(TEM), Scanning electron microscopy (SEM) and Nitrogen adsorption/desorption. Then this ordered mesoporous silica was added into the cigarette filter in order to researching its effect of cigarette harm index. The result shows that the feature of SBA-15 was grain morphology, ordered arrangement, tubular porous 2-D hexagonal structure. The application of SBA-15 in cigarette filter can selectively reduce harmful components in cigarette smoke such as crotonaldehyde, hydrogen cyanide, benzo pyrene and tar. The synthesized SBA-15 could properly reduce cigarette harm index.

Harm reduction in the USA: the research perspective and an archive to David Purchase.

Science.gov (United States)

Des Jarlais, Don C

2017-07-26

The history of harm reduction in the USA has led to the development of some of the most important methods for treating persons for drug use disorders, such as methadone and buprenorphine for opiate use disorder. However, there has been fierce political resistance to implementation and scale-up of harm reduction in the USA. This resistance is rooted in historical demonization of particular psychoactive drugs that were associated with stigmatized racial/ethnic groups.With the discovery of acquired immunodeficiency syndrome (AIDS) in 1981, harm reduction became important not only for treating substance use disorders, but for reducing transmission of blood-borne infection. However, within the context of the crack cocaine epidemic in the 1980s, it was very difficult to implement any programs that appeared to "condone" drug use.It was not until the late 1980s that syringe exchange programs began at the state and local level in the USA. With funding primarily from state and local governments and the support of the North American Syringe Exchange Network (NASEN), there are now approximately 200 programs for syringe exchange in the USA. Research has shown that these programs have been extremely effective in reducing human immunodeficiency virus (HIV) transmission among persons who inject drugs (PWID). The programs in the USA also offer many additional services for drug users, including condom distribution, referrals to substance abuse treatment, HIV, hepatitis C virus (HCV), hepatitis B virus (HBV) counseling and testing, overdose education and naloxone distribution to reverse for overdose.Currently, the USA is experiencing an opioid/heroin epidemic, with significant increases in overdose deaths among drug users. Much of this epidemic is occurring in suburban and rural of the country without harm reduction services. The current challenges for harm reduction and harm reduction research involve expansion of services to suburban and rural areas and implementation science on

Public health implications of smokeless tobacco use as a harm reduction strategy.

Science.gov (United States)

Savitz, David A; Meyer, Roger E; Tanzer, Jason M; Mirvish, Sidney S; Lewin, Freddi

2006-11-01

Harm reduction strategies involve promoting a product that has adverse health consequences as a substitute for one that has more severe adverse health consequences. Smokeless tobacco low in nitrosamine content offers potential benefits in reducing smoking prevalence rates. Possible harm arises from the potential for such products to serve as a gateway to more harmful tobacco products, public misinterpretation of "less harmful" as "safe," distraction from the public health goal of tobacco elimination, and ethical issues involved in advising those marketing these harmful products. We offer a research agenda to provide a stronger basis for evaluating the risks and benefits of smokeless tobacco as a means of reducing the adverse health effects of tobacco.

Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study

Science.gov (United States)

2014-01-01

Background The UK continues to experience a rise in the number of anabolic steroid-using clients attending harm reduction services such as needle and syringe programmes. Methods The present study uses interviews conducted with harm reduction service providers as well as illicit users of anabolic steroids from different areas of England and Wales to explore harm reduction for this group of drug users, focussing on needle distribution policies and harm reduction interventions developed specifically for this population of drug users. Results The article addresses the complexity of harm reduction service delivery, highlighting different models of needle distribution, such as peer-led distribution networks, as well as interventions available in steroid clinics, including liver function testing of anabolic steroid users. Aside from providing insights into the function of interventions available to steroid users, along with principles adopted by service providers, the study found significant tensions and dilemmas in policy implementation due to differing perspectives between service providers and service users relating to practices, risks and effective interventions. Conclusion The overarching finding of the study was the tremendous variability across harm reduction delivery sites in terms of available measures and mode of operation. Further research into the effectiveness of different policies directed towards people who use anabolic steroids is critical to the development of harm reduction. PMID:24986546

Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India

Science.gov (United States)

Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca

2013-01-01

Abstract Problem Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. Approach In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. Local setting In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. Relevant changes By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. Lessons learnt A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines. PMID:23599555

Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India.

Science.gov (United States)

Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca; Sgaier, Sema K

2013-04-01

Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines.

E-cigarette Regulation and Harm Reduction: The Case of Hong Kong.

Science.gov (United States)

Churk, Shue Sing

Harm reduction is an internationally recognized tobacco control strategy. E-cigarettes, being a less harmful alternative to smoking, have the potential to achieve harm reduction. Within this context, this article critiques Hong Kong’s legal regime governing e-cigarettes and the proposed prohibition of the product. It is argued that the current law is uncertain and inadequate. Although a reform of laws relating to e-cigarettes is needed, it is argued that banning the product altogether as a means to reducing the harm of tobacco use is unsupported by evidence.

Harm reduction as a strategy for supporting people who self-harm on mental health wards : the views and experiences of practitioners

OpenAIRE

James, Karen; Samuels, Isaac; Moran, Paul; Stewart, Duncan

2017-01-01

Background: Harm reduction has had positive outcomes for people using sexual health and substance misuse services. Clinical guidance recommends these approaches may be appropriately adopted by mental health practitioners when managing some people who self-harm. There has, however, been very little research in this area. Methods: We explored practitioners’ views of harm reduction as a strategy for supporting people who self-harm. The Self Harm Antipathy Scale (SHAS) was administered to a rando...

Virtue ethics as an alternative to deontological and consequential reasoning in the harm reduction debate.

Science.gov (United States)

Christie, Timothy; Groarke, Louis; Sweet, William

2008-02-01

There is strong evidence that harm reduction interventions such as Supervised Injection Sites and Needle Exchange Programs prevent many of the negative consequences of problematic substance use. Yet many governments, including the United States and Canada, still do not endorse these interventions, claiming that they do not get people off of drugs and send a mixed message. This paper will analyze objections to harm reduction in light of the ethical theories of John Stuart Mill, Immanuel Kant and Aristotle. The most important ethical issue in the abstinence vs. harm reduction debate is whether harm reduction - because it does not require individuals to either reduce their consumption of illicit substances or to abstain from illicit substance use - can be ethically justified. Harm reduction interventions are clearly justified on Utilitarian grounds because, based on the evidence, such policies would produce the greatest good for the greatest number. However, Kant would not think that the values guiding harm reduction are ethical because the justification of harm reduction interventions focuses exclusively on examining consequences. Virtue Ethics seeks to find the proper balance between harm reduction and abstinence. We claim that the virtue of compassion would provide a defense of harm reduction.

Quantifying the effects of promoting smokeless tobacco as a harm reduction strategy in the USA.

Science.gov (United States)

Mejia, Adrienne B; Ling, Pamela M; Glantz, Stanton A

2010-08-01

Snus (a form of smokeless tobacco) is less dangerous than cigarettes. Some health professionals argue that snus should be promoted as a component of a harm reduction strategy, while others oppose this approach. Major US tobacco companies (RJ Reynolds and Philip Morris) are marketing snus products as cigarette brand line extensions. The population effects of smokeless tobacco promotion will depend on the combined effects of changes in individual risk with population changes in tobacco use patterns. To quantitatively evaluate the health impact of smokeless tobacco promotion as part of a harm reduction strategy in the US. A Monte Carlo simulation of a decision tree model of tobacco initiation and use was used to estimate the health effects associated with five different patterns of increased smokeless tobacco use. With cigarette smoking having a health effect of 100, the base case scenario (based on current US prevalence rates) yields a total health effect of 24.2 (5% to 95% interval 21.7 to 26.5) and the aggressive smokeless promotion (less cigarette use and increased smokeless, health-concerned smokers switching to snus, smokers in smokefree environments switching to snus) was associated with a health effect of 30.4 (5% to 95% interval 25.9 to 35.2). The anticipated health effects for additional scenarios with lower rates of smokeless uptake also overlapped with the base case. Promoting smokeless tobacco as a safer alternative to cigarettes is unlikely to result in substantial health benefits at a population level.

Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality.

Science.gov (United States)

Tatarsky, Andrew; Kellogg, Scott

2010-02-01

Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence. This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies. A case is presented that illustrates the application of this approach with life-threatening substance use that was related to multiple trauma and suicidal depression. (c) 2010 Wiley Periodicals, Inc.

The politics of harm reduction in federal prisons.

Science.gov (United States)

Watson, Tara Marie

2014-09-01

We need to understand better the political barriers to prison-based harm reduction programs. In this paper, I examine the situation in the Correctional Service of Canada (CSC), a federal prison agency with a zero-tolerance drug policy and general opposition to prison needle and syringe programs (PNSPs) and safer tattooing initiatives. This study draws on 16 interviews with former CSC senior officials, former frontline staff, and external stakeholders; CSC policy and practice documents; and testimony from a House of Commons Standing Committee public study. Thematic coding and comparison of texts were used to examine emergent themes of interest. Four interrelated issues were central for understanding the political barriers: a narrower definition of harm reduction used in corrections, both in principle and practice; the Conservative government's tough-on-crime agenda; strong union opposition; and stakeholder perceptions that political constraints will likely persist, including the view that litigation may offer the only way to introduce PNSPs. The system is at an impasse and key questions remain about the importability of harm reduction services into federal prisons. Despite a highly challenging policy environment, moving forward will demand asking new, critical questions and devising more strategic ways of entering the political-operational dialogue that opposes evidence-based programs. Copyright © 2014 Elsevier B.V. All rights reserved.

Global Fund investments in harm reduction from 2002 to 2009

DEFF Research Database (Denmark)

Bridge, Jamie; Hunter, Benjamin M; Atun, Rifat

2012-01-01

Injecting drug use has been documented in 158 countries and is a major contributor to HIV epidemics. People who inject drugs have poor and inequitable access to HIV services. The Global Fund to Fight AIDS, Tuberculosis and Malaria is the leading multilateral donor for HIV programmes and encourage...... applicants to include harm reduction interventions in their proposals. This study is the first detailed analysis of Global Fund investments in harm reduction interventions....

Select barriers to harm-reduction services for IDUs in eastern Europe

DEFF Research Database (Denmark)

Curth, Nadja Kehler; Hansson, Liv Nanna; Storm, Frederikke

2009-01-01

In eastern Europe, the high prevalence rates of HIV and the hepatitis C virus (HCV) are concentrated among injecting drug users (IDUs). Harm reduction programmes such as needle and syringe programmes and opioid substitution therapy (OST) have been shown to be effective in preventing these infecti...

Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

Directory of Open Access Journals (Sweden)

Godshall William T

2006-12-01

Full Text Available Abstract According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in

Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK.

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Kimergård, Andreas; McVeigh, Jim

2014-06-04

The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how 'risk environments' produce harm. Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK. Body satisfaction was an important factor when deciding to start the use of anabolic steroids. Many users were unaware of the potential dangers of using drugs from the illicit market, whereas some had adopted a range of strategies to negotiate the hazards relating to the use of adulterated products, including self-experimentation to gauge the perceived efficacy and unwanted effects of these drugs. Viewpoints, first-hand anecdotes, norms and practices among groups of steroid users created boundaries of 'sensible' drug use, but also promoted practices that may increase the chance of harms occurring. Established users encouraged young users to go to harm reduction services but, at the same time, promoted risky injecting practices in the belief that this would enhance the efficacy of anabolic steroids. Current steroid-related viewpoints and practices contribute to the risk environment surrounding the use of these drugs and may undermine the goal of current public health strategies including harm reduction interventions. The level of harms among anabolic steroid users are determined by multiple and intertwining factors, in addition to the harms caused by the pharmacological action or injury and illness associated with incorrect injecting techniques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[The issue of harm reduction in Polish legislation concerning drug addiction. A comparative study].

Science.gov (United States)

Sobeyko, Justyna

2008-01-01

The aim of work is the assessment of legal permissibility for health and social harm reduction programmes resulting from drug use in the context of the polish legislation on narcotic drug use and drug addiction. The thesis outlines harm reduction programmes implemented worldwide, role of penal code in counteracting both narcotic drug supply and demand, attitude of United Nations and European Union to the drug problem including harm reduction programmes, solutions adopted in the selected European Union member states. The main part of the thesis presents the evolution of polish legislation regarding drug use and analysis of legal permissibility for harm reduction programmes in this context. The conclusion inferred is the statement that implementation of the harm reduction programmes requires a certain minimal depenalisation of the drug use by a legislator and the fact that restrictive legal system impedes programme realization. Thus the thesis postulates depenalisation of small drug quantities for personal use.

Is harm reduction profitable? An analytical framework for corporate social responsibility based on an epidemic model of addictive consumption.

Science.gov (United States)

Massin, Sophie

2012-06-01

This article aims to help resolve the apparent paradox of producers of addictive goods who claim to be socially responsible while marketing a product clearly identified as harmful. It advances that reputation effects are crucial in this issue and that determining whether harm reduction practices are costly or profitable for the producers can help to assess the sincerity of their discourse. An analytical framework based on an epidemic model of addictive consumption that includes a deterrent effect of heavy use on initiation is developed. This framework enables us to establish a clear distinction between a simple responsible discourse and genuine harm reduction practices and, among harm reduction practices, between use reduction practices and micro harm reduction practices. Using simulations based on tobacco sales in France from 1950 to 2008, we explore the impact of three corresponding types of actions: communication on damage, restraining selling practices and development of safer products on total sales and on the social cost. We notably find that restraining selling practices toward light users, that is, preventing light users from escalating to heavy use, can be profitable for the producer, especially at early stages of the epidemic, but that such practices also contribute to increase the social cost. These results suggest that the existence of a deterrent effect of heavy use on the initiation of the consumption of an addictive good can shed new light on important issues, such as the motivations for corporate social responsibility and the definition of responsible actions in the particular case of harm reduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Harm reduction and women in the Canadian national prison system: policy or practice?

Science.gov (United States)

Rehman, Laurene; Gahagan, Jacqueline; DiCenso, Anne Marie; Dias, Giselle

2004-01-01

Applying the principles of harm reduction within the context of incarcerated populations raises a number of challenges. Although some access to harm reduction strategies has been promoted in general society, a divide between what is available and what is advocated continues to exist within the prison system. This paper explores the perceptions and lived experiences of a sample of nationally incarcerated women in Canada regarding their perceptions and experiences in accessing HIV and Hepatitis C prevention, care, treatment and support. In-depth interviews were conducted with 156 women in Canadian national prisons. Q.S.R. Nudist was used to assist with data management. A constant comparison method was used to derive categories, patterns, and themes. Emergent themes highlighted a gap between access to harm reduction in policy and in practice. Despite the implementation of some harm reduction techniques, women in Canadian prisons reported variable access to both education and methods of reducing HIV/HCV transmission. Concerns were also raised about pre-and post-test counseling for HIV/HCV testing. Best practices are suggested for implementing harm reduction strategies within prisons for women in Canada.

Monitoring quality and coverage of harm reduction services for people who use drugs

DEFF Research Database (Denmark)

Wiessing, Lucas; Ferri, Marica; Běláčková, Vendula

2017-01-01

indicators and to present a framework for extending them with additional indicators of coverage and quality of harm reduction services, for monitoring and evaluation at international, national or subnational levels. The ultimate aim is to improve these services in order to reduce health and social problems......BACKGROUND AND AIMS: Despite advances in our knowledge of effective services for people who use drugs over the last decades globally, coverage remains poor in most countries, while quality is often unknown. This paper aims to discuss the historical development of successful epidemiological...... before their scaling up and routine implementation, to evaluate their effectiveness in comparing service coverage and quality across countries. CONCLUSIONS: The establishment of an improved set of validated and internationally agreed upon best practice indicators for monitoring harm reduction service...

Minors, Moral Psychology, and the Harm Reduction Debate: The Case of Tobacco and Nicotine.

Science.gov (United States)

Kozlowski, Lynn T

2017-12-01

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

Alcohol harm reduction advertisements: a content analysis of topic, objective, emotional tone, execution and target audience.

Science.gov (United States)

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

2017-04-11

Public health mass media campaigns may contribute to reducing the health and social burden attributed to alcohol consumption, but little is known about which advertising characteristics have been used, or have been effective, in alcohol harm reduction campaigns to date. As a first step towards encouraging further research to identify the impact of various advertising characteristics, this study aimed to systematically identify and examine the content of alcohol harm reduction advertisements (ads). Ads were identified through an exhaustive internet search of Google, YouTube, Vimeo, and relevant government and health agency websites. Eligible ads were: English language, produced between 2006 and 2014, not primarily focused on drink-driving or alcohol in pregnancy, and not alcohol industry funded. Systematic content analysis of all ads was performed; each ad was double-coded. In total, 110 individual ads from 72 different alcohol harm reduction campaigns were identified, with the main source countries being Australia (40%) and the United Kingdom (26%). The dominant topic for 52% of ads was short-term harms, while 10% addressed long-term harms, 18% addressed underage drinking, 17% communicated a how-to-change message, and 3% advocated for policy change. The behavioural objective of most ads was to motivate audiences to reduce their alcohol consumption (38%) or to behave responsibly and/or not get drunk when drinking (33%). Only 10% of all ads mentioned low-risk drinking guidelines. Eighty-seven percent of ads used a dramatisation execution style and 74% had a negative emotional tone. Ninety percent of ads contained messages or content that appeared to target adults, and 36% specifically targeted young adults. Some message attributes have been employed more frequently than others, suggesting several promising avenues for future audience or population-based research to compare the relative effectiveness of different characteristics of alcohol harm reduction ads. Given

Alcohol harm reduction advertisements: a content analysis of topic, objective, emotional tone, execution and target audience

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Kimberley Dunstone

2017-04-01

Full Text Available Abstract Background Public health mass media campaigns may contribute to reducing the health and social burden attributed to alcohol consumption, but little is known about which advertising characteristics have been used, or have been effective, in alcohol harm reduction campaigns to date. As a first step towards encouraging further research to identify the impact of various advertising characteristics, this study aimed to systematically identify and examine the content of alcohol harm reduction advertisements (ads. Method Ads were identified through an exhaustive internet search of Google, YouTube, Vimeo, and relevant government and health agency websites. Eligible ads were: English language, produced between 2006 and 2014, not primarily focused on drink-driving or alcohol in pregnancy, and not alcohol industry funded. Systematic content analysis of all ads was performed; each ad was double-coded. Results In total, 110 individual ads from 72 different alcohol harm reduction campaigns were identified, with the main source countries being Australia (40% and the United Kingdom (26%. The dominant topic for 52% of ads was short-term harms, while 10% addressed long-term harms, 18% addressed underage drinking, 17% communicated a how-to-change message, and 3% advocated for policy change. The behavioural objective of most ads was to motivate audiences to reduce their alcohol consumption (38% or to behave responsibly and/or not get drunk when drinking (33%. Only 10% of all ads mentioned low-risk drinking guidelines. Eighty-seven percent of ads used a dramatisation execution style and 74% had a negative emotional tone. Ninety percent of ads contained messages or content that appeared to target adults, and 36% specifically targeted young adults. Conclusions Some message attributes have been employed more frequently than others, suggesting several promising avenues for future audience or population-based research to compare the relative effectiveness of

[Harm reduction policies in Brazil: contributions of a North American program].

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Inglez-Dias, Aline; Ribeiro, José Mendes; Bastos, Francisco I; Page, Kimberly

2014-01-01

Given the rapid spread of the HIV epidemic and the need to control its transmission among intravenous drug users (IDU), harm reduction strategies have been incorporated in many countries, including Brazil. Considering these aspects and taking into account the emergence of drugs as a core concern on the government's agenda, especially crack cocaine, this article presents some of the contributions acquired from observing and recording the practices of an American model of research and care for IDUs, namely the UFO (You Find Out) Study. Issues such as participants' access and adherence, financing difficulties, sustainability and outcome evaluation were considered. The study involved documental research, systematic observation and interviews with key informants. Some of the UFO features that could contribute to the formulation of harm reduction policies in Brazil are highlighted. The UFO appears to be a successful example of harm reduction initiatives that successfully contact and guarantee the commitment of that risk group, ensuring its access to health services and reducing risks associated with drug use.

Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder

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Icro Maremmani

2015-11-01

Full Text Available Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention.

Effectiveness of Culturally Appropriate Initiative on Drug-Related Harm Reduction for Sex Workers on the Thai/Malaysian Border.

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Nunun, Worapol; Kanato, Manop

2015-07-01

Drug use can harm to sex workers. Abstinence intervention, however, may not be appropriate since drug use fosters their career performance. The objective was to develop the culturally appropriate model for sex workers participation on drug demand reduction at the Thailand/Malaysian border This study was a pre-post quasi-experimental design. Tripartite participation was used to develop the model aiming to reduce harm regarding drug use. The study carried out during June 2010-May 2011. Data were collected from 150 key informant interviews, 56 focus group discussions, 22 participant observations in various situations, and numerous related materials. Descriptive statistics, survival analysis and 95% confidence interval were utilizedfor quantitative data. Qualitative data were analyzed by content analysis. Drug related harm reduction was evaluated at two-week time along implementation period of 12 months. 89.5% of all sessions introduced could decrease drug related harm. Of all sex workers participated in the study, intended to treat analysis showed 86.9% success rate (95% CI; 77.1, 96.7). Of these, 32.6% became abstinence, 39.1% reduced most of drug related harm. 13.0% reduced partial drug related harm either lessfrequency, less quantity, less concentration, decrease types of drugs/switch to safe drugs or safer method of administration. 2.2% was infancy stage, which needed further support. Key success ofthe model was tripartite participation. With active leaders and strong support, sex workers were continually motivated to reduce harm regarding drug use.

Should the health community promote smokeless tobacco (snus as a harm reduction measure?

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Coral E Gartner

2007-07-01

Full Text Available BACKGROUND TO THE DEBATE: The tobacco control community is divided on whether or not to inform the public that using oral, smokeless tobacco (Swedish snus is less hazardous to health than smoking tobacco. Proponents of "harm reduction" point to the Swedish experience. Snus seems to be widely used as an alternative to cigarettes in Sweden, say these proponents, contributing to the low overall prevalence of smoking and smoking-related disease. Harm reduction proponents thus argue that the health community should actively inform inveterate cigarette smokers of the benefits of switching to snus. However, critics of harm reduction say that snus has its own risks, that no form of tobacco should ever be promoted, and that Sweden's experience is likely to be specific to that culture and not transferable to other settings. Critics also remain deeply suspicious that the tobacco industry will use snus marketing as a "gateway" to promote cigarettes. In the interests of promoting debate, the authors (who are collaborators on a research project on the future of tobacco control have agreed to outline the strongest arguments for and against promoting Swedish snus as a form of harm reduction.

Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK

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Kimergård, Andreas; McVeigh, Jim

2014-01-01

Objectives The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how ‘risk environments’ produce harm. Methods Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK. Re...

Strategies for an effective tobacco harm reduction policy in Indonesia

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Fariz Nurwidya

2014-12-01

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

Comparison of the toxicity of smoke from conventional and harm reduction cigarettes using human embryonic stem cells.

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Lin, Sabrina; Fonteno, Shawn; Weng, Jo-Hao; Talbot, Prue

2010-11-01

This study evaluated the hypothesis that smoke from harm reduction cigarettes impedes attachment and proliferation of H9 human embryonic stem cells (hESCs). Smoke from three harm reduction brands was compared with smoke from a conventional brand. Doses of smoke were measured in puff equivalents (PE) (1 PE = the amount of smoke in one puff that dissolves in 1 ml of medium). Cytotoxic doses were determined using morphological criteria and trypan blue staining, and apoptosis was confirmed using Magic Red staining. Attachment and proliferation of hESC were followed at a noncytotoxic dose in time-lapse videos collected using BioStation technology. Data were mined from videos either manually or using video bioinformatics subroutines developed with CL-Quant software. Mainstream (MS) and sidestream (SS) smoke from conventional and harm reduction cigarettes induced apoptosis in hESC colonies at 1 PE. At 0.1 PE (noncytotoxic), SS smoke from all brands inhibited attachment of hESC colonies to Matrigel with the strongest inhibition occurring in harm reduction brands. At 0.1 PE, SS smoke, but not MS smoke, from all brands inhibited hESC growth, and two harm reduction brands were more potent than the conventional brand. In general, hESC appeared more sensitive to smoke than their mouse ESC counterparts. Although harm reduction cigarettes are often marketed as safer than conventional brands, our assays show that SS smoke from harm reduction cigarettes was at least as potent or in some cases more potent than smoke from a conventional brand and that SS smoke was more inhibitory than MS smoke in all assays.

Mitigating the Harmful Effects of Violent Television

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Rosenkoetter, Lawrence I.; Rosenkoetter, Sharon E.; Ozretich, Rachel A.; Acock, Alan C.

2004-01-01

In an effort to minimize the harmful effects of violent TV, a yearlong intervention was undertaken with children in Grades 1 through 3 (N = 177). The classroom-based intervention consisted of 31 brief lessons that emphasized the many ways in which television distorts violence. As hypothesized, the intervention resulted in a reduction in children's…

Between harm reduction, loss and wellness: on the occupational hazards of work.

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Shepard, Benjamin C

2013-04-01

Those working in the fields of harm reduction, healthcare, and human services must cope with a range of stresses, including post traumatic stress and vicarious trauma. Pain and loss are just a part of the job. So is dealing with premature death as a result of HIV, hypertension, and even overdose. Faced with a range of challenges, some workers in the field even turn to self-medication. For some, it is about pleasure; for others it is about alleviating suffering. In recent years, several leaders in the AIDS and harm reduction fields have died ahead of their time. Some stopped taking their medications; others overdosed. Rather than weakness or pathology, French sociologist Emile Durkheim saw self-destructive behavior as a byproduct of social disorganization and isolation, as a way of contending with a breakdown of social bonds and alienation. There are any number of reasons why such behavior becomes part of work for those involved with battling the dueling epidemics of Hepatitis C, HIV, and related concerns. Forms of stress related to this work include secondary trauma, compassion fatigue, organizational conflict, burnout, complications of direct services, and lack of funding. Faced with day-to- day struggles over poverty, punitive welfare systems, drug use, the war on drugs, high risk behavior, structural violence, and illness, many in the field are left to wonder how to strive for wellness when taking on so much pain. For some, self-injury and self-medication are ways of responding. Building on ethnographic methods, this reflective analysis considers the stories of those who have suffered, as well as a few of the ways those in the field cope with harm and pain. The work considers the moral questions we face when we see our friends and colleagues suffer. It asks how we as practitioners strive to create a culture of wellness and support in the fields of harm reduction, healthcare, and human services. Through a brief review of losses and literature thereof, the essay

Harm reduction and viral hepatitis C in European prisons: a cross-sectional survey of 25 countries.

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Bielen, Rob; Stumo, Samya R; Halford, Rachel; Werling, Klára; Reic, Tatjana; Stöver, Heino; Robaeys, Geert; Lazarus, Jeffrey V

2018-05-11

Current estimates suggest that 15% of all prisoners worldwide are chronically infected with the hepatitis C virus (HCV), and this number is even higher in regions with high rates of injecting drug use. Although harm reduction services such as opioid substitution therapy (OST) and needle and syringe programs (NSPs) are effective in preventing the further spread of HCV and HIV, the extent to which these are available in prisons varies significantly across countries. The Hep-CORE study surveyed liver patient groups from 25 European countries in 2016 and mid-2017 on national policies related to harm reduction, testing/screening, and treatment for HCV in prison settings. Results from the cross-sectional survey were compared to the data from available reports and the peer-reviewed literature to determine the overall degree to which European countries implement evidence-based HCV recommendations in prison settings. Patient groups in nine countries (36%) identified prisoners as a high-risk population target for HCV testing/screening. Twenty-one countries (84%) provide HCV treatment in prisons. However, the extent of coverage of these treatment programs varies widely. Two countries (8%) have NSPs officially available in prisons in all parts of the country. Eleven countries (44%) provide OST in prisons in all parts of the country without additional requirements. Despite the existence of evidence-based recommendations, infectious disease prevention measures such as harm reduction programs are inadequate in European prison settings. Harm reduction, HCV testing/screening, and treatment should be scaled up in prison settings in order to progress towards eliminating HCV as a public health threat.

Features of alcohol harm reduction advertisements that most motivate reduced drinking among adults: an advertisement response study.

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

2017-04-20

To improve the effectiveness of alcohol harm reduction mass media campaigns, this study aimed to (1) identify existing advertisements (ads) with greatest potential to motivate reduced alcohol consumption, (2) assess consistency across audience subgroups in ad effectiveness and (3) identify ad features associated with effectiveness. Cross-sectional online ad response study with random assignment to view ads. 2174 Australian adult weekly drinkers recruited from an online panel. Participants were randomly assigned to view three of 83 English-language alcohol harm reduction ads. Each ad was viewed and rated by a mean of 79 participants. After viewing each ad, participants reported the extent to which they felt motivated to reduce their drinking. Ads were ranked from most to least motivating using predicted means adjusted for demographic characteristics and alcohol consumption. We compared the characteristics of the top-ranked 15% of ads (most motivating) with the middle 70% and bottom 15%. An ad about the link between alcohol and cancer (' Spread ') was most motivating, whereas an ad that encouraged drinking water instead of beer (' Add nothing ') was least motivating. Top-ranked ads were more likely than other ads to feature a 'why change' message and less likely to carry a 'how to change' message; more likely to address long-term harms; more likely to be aimed at the general adult drinking population and more likely to include drinking guidelines. There was substantial overlap in top-ranked ads for younger versus older adults, men versus women and high-risk versus low-risk drinker subgroups. The effectiveness of alcohol harm reduction campaigns may be improved by directly communicating alcohol's long-term harms to the general adult population of drinkers along with drinking guidelines. By doing so, campaigns can also efficiently influence high-risk drinkers and key demographic subgroups. Published by the BMJ Publishing Group Limited. For permission to use (where not

Contested space in the pharmacy: public attitudes to pharmacy harm reduction services in the West of Scotland.

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Gidman, Wendy; Coomber, Ross

2014-01-01

Internationally, community pharmacies have become increasingly involved in providing harm reduction services and health advice to people who use illicit drugs. This paper considers public opinion of community pharmacy services. It discusses attitudes to harm reduction services in the context of stigmatization of addiction and people who use drugs. This exploratory study involved twenty-six purposively sampled members of the public, from the West of Scotland, participating in one of 5 focus groups. The groups were composed to represent known groups of users and non-users of community pharmacy, none of whom were problem drug users. Three thematic categories were identified: methadone service users in community pharmacies; attitudes to harm reduction policies; contested space. Harm reduction service expansion has resulted in a high volume of drug users in and around some Scottish pharmacies. Even if harm reduction services are provided discretely users' behavior can differentiate them from other pharmacy users. Drug users' behavior in this setting is commonly perceived to be unacceptable and can deter other consumers from using pharmacy services. The results of this study infer that negative public opinion is highly suggestive of stereotyping and stigmatization of people who use drugs. Participants considered that (1) community pharmacies were unsuitable environments for harm reduction service provision, as they are used by older people and those with children; (2) current drug policy is perceived as ineffective, as abstinence is seldom achieved and methadone was reported to be re-sold; (3) people who use drugs were avoided where possible in community pharmacies. Community pharmacy harm reduction services increasingly bring together the public and drug users. Study participants were reluctant to share pharmacy facilities with drug users. This paper concludes by suggesting mechanisms to minimize stigmatization. Copyright © 2014 Elsevier Inc. All rights reserved.

Deficiencies in public understanding about tobacco harm reduction: results from a United States national survey.

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Kiviniemi, Marc T; Kozlowski, Lynn T

2015-07-02

Tobacco products differ in their relative health harms. The need for educating consumers about such harms is growing as different tobacco products enter the marketplace and as the FDA moves to regulate and educate the public about different products. However, little is known about the patterns of the public's knowledge of relative harms. Data were analyzed from the Health Information National Trends Survey (HINTS) 4 Cycle 2, a population-representative survey of US adults conducted between October 2012 and January 2013 (N = 3630). Participants reported their perceptions of the relative risks of e-cigarettes, smokeless tobacco, and different types of cigarettes compared to "traditional" cigarettes. Relative risk perceptions for each product type, as well as the consistency and accuracy of harm reduction beliefs, were analyzed. About 65% of the respondents accurately reported that no cigarettes were less harmful than any others. Slightly more than half of U.S. adults perceived e-cigarettes to be safer than regular cigarettes, a belief in line with current scientific evidence. By contrast, only 9% of respondents perceived some smokeless tobacco products to be safer, a belief strongly supported by the evidence. Only 3.5% of respondents had patterns of relative risk perceptions in line with current scientific evidence for all three modalities. The discrepancy between current evidence and public perceptions of relative risk of various tobacco/nicotine products was marked; for most tobacco types, a large proportion of the population held inaccurate harm reduction beliefs. Although there was substantial awareness that no cigarettes were safer than any other cigarettes, there could be benefits from increasing the percentage of the public that appreciates this fact, especially among current smokers. Given the potential benefits of tobacco risk reduction strategies, public health education efforts to increase understanding of basic harm reduction principles are needed to

Harm reduction interventions in HIV care: a qualitative exploration of patient and provider perspectives

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Suzanne Carlberg-Racich

2016-04-01

Full Text Available Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction—which removes judgment and operates at the patient’s stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38. A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen’s Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm

'Social evils' and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam.

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Hammett, Theodore M; Wu, Zunyou; Duc, Tran Tien; Stephens, David; Sullivan, Sheena; Liu, Wei; Chen, Yi; Ngu, Doan; Des Jarlais, Don C

2008-01-01

This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective 'champions' for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi-sectoral training, collaboration and support are also needed.

Assessing the tobacco harm reduction (THR debate: a systematic review

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Yogi Hendlin

2018-03-01

Full Text Available Background Tobacco Harm Reduction (THR has become synonymous with substituting alternative tobacco products for cigarettes. However, there exists much dissension among tobacco control professionals regarding accepting harm reduction methods prolonging nicotine addiction and profiting the tobacco, e-cigarette and pharmaceutical industries. We evaluate the influence of these industries on the academic THR literature and debate. Methods We undertook a comprehensive review of all peer-review papers published on the topic of tobacco harm reduction between 1992 and July 2016. Our initial search yielded 5,172 relevant hits, and after screening, we double-coded 1,067 full-text articles. Codes include the article's stand on THR (weakly or strongly pro-, anti-, or neutral/mixed, major themes, product type, country of author origin, article type (letter/commentary, RTC, longitudinal study, etc., journal quality, and funding source. These results were analyzed in STATA. Results Of the 498 articles we have coded so far, 379 were included. The results show that six percent of all articles are editorials, 36% letters or commentaries, and 21% are non-empirical articles while only 31% are original research and 6% reviews. Thirty-three percent of pro-THR articles disclosed some sort of industry funding. Of these, 30% were funded by the tobacco industry, 22% by the E-cigarette industry and 48% were funded by pharmaceutical industries. Conclusions The THR debate has been influenced by scientists funded by tobacco, electronic-cigarette and surprisingly pharmaceutical industries in the favor of product substitution. Moreover, the majority of this debate is occurring over 'opinion pieces' rather than on the basis of empirical research. Thus, more robust and unbiased scientific evidence is needed to evaluate these alternative products before endorsing them for the public.

The Global Fund to Fight AIDS, Tuberculosis and Malaria's investments in harm reduction through the rounds-based funding model (2002-2014).

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Bridge, Jamie; Hunter, Benjamin M; Albers, Eliot; Cook, Catherine; Guarinieri, Mauro; Lazarus, Jeffrey V; MacAllister, Jack; McLean, Susie; Wolfe, Daniel

2016-01-01

Harm reduction is an evidence-based, effective response to HIV transmission and other harms faced by people who inject drugs, and is explicitly supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. In spite of this, people who inject drugs continue to have poor and inequitable access to these services and face widespread stigma and discrimination. In 2013, the Global Fund launched a new funding model-signalling the end of the previous rounds-based model that had operated since its founding in 2002. This study updates previous analyses to assess Global Fund investments in harm reduction interventions for the duration of the rounds-based model, from 2002 to 2014. Global Fund HIV and TB/HIV grant documents from 2002 to 2014 were reviewed to identify grants that contained activities for people who inject drugs. Data were collected from detailed grant budgets, and relevant budget lines were recorded and analysed to determine the resources allocated to different interventions that were specifically targeted at people who inject drugs. 151 grants for 58 countries, plus one regional proposal, contained activities targeting people who inject drugs-for a total investment of US$ 620 million. Two-thirds of this budgeted amount was for interventions in the "comprehensive package" defined by the United Nations. 91% of the identified amount was for Eastern Europe and Asia. This study represents an updated, comprehensive assessment of Global Fund investments in harm reduction from its founding (2002) until the start of the new funding model (2014). It also highlights the overall shortfall of harm reduction funding, with the estimated global need being US$ 2.3 billion for harm reduction in 2015 alone. Using this baseline, the Global Fund must carefully monitor its new funding model and ensure that investments in harm reduction are maintained or scaled-up. There are widespread concerns regarding the withdrawal from middle-income countries where harm reduction remains

Students as effective harm reductionists and needle exchange organizers.

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Barbour, Kyle; McQuade, Miriam; Brown, Brandon

2017-03-17

Needle exchange programs are safe, highly effective programs for promoting health among people who inject drugs. However, they remain poorly funded, and often illegal, in many places worldwide due to fear and stigma surrounding drug use. Continued advocacy, education, and implementation of new needle exchanges are thus essential to improve public health and reduce structural inequality. We argue that students, and especially professional and graduate students, have the potential to play an important role in advancing harm reduction. Students benefit from the respect given to the professions they are training to enter, which gives them leverage to navigate the political hurdles often faced by needle exchange organizers, especially in areas that presently lack services. In addition, due to their relative simplicity, needle exchanges do not require much of the licensing, clinical knowledge, and infrastructure associated with more traditional student programs, such as student-run free medical clinics. Students are capable of learning harm reduction cultural approaches and techniques if they remain humble, open-minded, and seek the help of the harm reduction community. Consequently, students can generate tremendous benefits to their community without performing beyond their appropriate clinical limitations. Students benefit from organizing needle exchanges by gaining applied experience in advocacy, organization-building, and political finesse. Working in a needle exchange significantly helps erode stigma against multiple marginalized populations. Students in health-related professions additionally learn clinically-relevant knowledge that is often lacking from their formal training, such as an understanding of structural violence and inequality, root causes of substance use, client-centered approaches to health services, and interacting with clients as peers, rather than through the standard hierarchical medical interaction. We therefore encourage students to learn about

The scientific foundation for tobacco harm reduction, 2006-2011

OpenAIRE

Rodu, Brad

2011-01-01

Abstract Over the past five years there has been exponential expansion of interest in tobacco harm reduction (THR), with a concomitant increase in the number of published studies. The purpose of this manuscript is to review and analyze influential contributions to the scientific and medical literature relating to THR, and to discuss issues that continue to stimulate debate. Numerous epidemiologic studies and subsequent meta-analyses confirm that smokeless tobacco (ST) use is associated with m...

Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

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

2009-06-27

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

Education as networking: Rethinking the success of the harm reduction policy of Taiwan.

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Chen, Jia-shin

2015-05-01

The harm reduction policy of Taiwan has been considered a success. However, the HIV incidence among injection drug users declined before the nationwide needle and syringe program and drug substitution treatments were implemented. Thus, other factors in the policy might have contributed to its success. Some authors have suggested that education may have played a pivotal part. In this research, the purported significance of education in the success of the policy is conceptualized by reviewing the studies on harm reduction in Taiwan and reflecting upon my own fieldwork. Moreover, relevant literature is used as reference to reformulate this notion of education. This article shows that harm reduction education may be conducted in numerous forms, most of which are non-formal, improvisational, and contingent. Non-governmental organizations may play a role, but more actors, strategies, infrastructures, and interactions should be considered. This article draws from actor-network theory and refines the current thesis that attributes the policy success to education by utilizing three reflections, namely, appreciating materiality and spatiality, recognizing covert actors in the networking, and treating education as an outcome rather than a means. In conclusion, looking at education as a form of networking offers theoretical insight that increases understanding of its participants, mechanisms, processes, and permutations. © The Author(s) 2014.

A qualitative assessment of stakeholder perceptions and socio-cultural influences on the acceptability of harm reduction programs in Tijuana, Mexico

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Magis-Rodriguez Carlos

2008-11-01

Full Text Available Abstract Background The Mexico-U.S. border region is experiencing rising rates of blood-borne infections among injection drug users (IDUs, emphasizing the need for harm reduction interventions. Methods We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs, syringe vending machines, and safer injection facilities (SIFs – in Tijuana, Mexico. In-depth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societal-related themes. Results Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and socio-cultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies. Conclusion Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users.

Exploring the use and effects of deliberate self-harm websites: an Internet-based study.

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Harris, Isobel Marion; Roberts, Lesley Martine

2013-12-20

In the United Kingdom, rates of deliberate self-harm (DSH) are rising. Alongside this, there has been an increase in the number of websites available with DSH content, and the Internet is known as a valuable resource for those who feel isolated by their condition(s). However, there is little and contradictory evidence available on the effects of using such websites. Further research is therefore required to examine the use and effects of DSH websites. Our objectives were to explore (1) the reasons people engage in the use of self-harm forums/websites, (2) the beliefs of users of self-harm forums regarding the role of such websites, (3) how the use of self-harm forums/websites modulates self-harm behaviors, and (4) other ways that self-harm forums affect the lives of individuals who use them. Data were collected by a questionnaire hosted on 20 websites with self-harm content. Participants were self-selected from users of these sites. Results were analyzed using descriptive statistics and simple thematic analysis. In total, 329 responses were received with 91.8% (302/329) from female site users. The majority of participants (65.6%, 187/285) visited these sites at least twice per week, and most participants used the sites to find information (78.2%, 223/285) or participate in the forums (68.4%, 195/285). Positive effects of website use such as gaining help and support, isolation reduction, and a reduction in self-harm behaviors were reported by a large number of participants. However, smaller but important numbers reported negative effects including worsened self-harm, being triggered to self-harm, and additional negative physical and psychological effects. This is the first multisite study to explore DSH website use in depth. There are clear and important benefits to engaging in website use for many individuals; however, these are not experienced by all website users. Negative effects were experienced by moderate numbers following website use, and clinicians should

Public attitudes towards gambling product harm and harm reduction strategies: an online study of 16-88 year olds in Victoria, Australia.

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Thomas, Samantha L; Randle, Melanie; Bestman, Amy; Pitt, Hannah; Bowe, Steven J; Cowlishaw, Sean; Daube, Mike

2017-07-25

Gambling has quickly emerged as an important global public health issue. With new technologies used to develop high intensity gambling products and promotions aimed at driving consumption, public health organisations and researchers, community groups, and politicians have argued for a range of regulatory and education measures aimed at reducing gambling harm. However, there has been limited research seeking to understand community perceptions of the harms associated with gambling products and environments, and the level of community support for strategies designed to prevent and reduce gambling harm. An online study of 500 adolescents and adults (aged 16 and over) was conducted with a representative sample (by age and gender) of individuals who were current residents in the state of Victoria, Australia. Participants were asked a range of questions about their own gambling behaviours, with the Problem Gambling Severity Index (PGSI) used as a measure of problem gambling. Participants were asked about their perceptions of harms associated with electronic gambling machines (EGMs), sports betting, horse betting, and casino gambling. They were also asked about the extent to which they agreed or disagreed with gambling harm reduction strategies related to marketing and promotions, restrictions on gambling products and venues, and public education campaigns. Quantitative data were analysed using descriptive statistics and paired t tests, with thematic analysis used to interpret qualitative responses to open-ended questionnaire items. More than one third (n = 201, 40.2%) of participants were at risk of experiencing some level of harm from gambling (PGSI ≥ 1), with 83 participants (16.6%) recording scores that indicated problem gambling (PGSI ≥ 8). One in five participants gambled on EGMs at least monthly (n = 100, 20.0%). Those who gambled on sports did so frequently, with nearly 1 in 5 gambling on sport at least once a month (n = 87, 17.4%). Over

Cultural Approach to HIV/AIDS Harm Reduction in Muslim Countries

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Hasnain Memoona

2005-10-01

Full Text Available Abstract Muslim countries, previously considered protected from HIV/AIDS due to religious and cultural norms, are facing a rapidly rising threat. Despite the evidence of an advancing epidemic, the usual response from the policy makers in Muslim countries, for protection against HIV infection, is a major focus on propagating abstention from illicit drug and sexual practices. Sexuality, considered a private matter, is a taboo topic for discussion. Harm reduction, a pragmatic approach for HIV prevention, is underutilized. The social stigma attached to HIV/AIDS, that exists in all societies is much more pronounced in Muslim cultures. This stigma prevents those at risk from coming forward for appropriate counseling, testing, and treatment, as it involves disclosure of risky practices. The purpose of this paper is to define the extent of the HIV/AIDS problem in Muslim countries, outline the major challenges to HIV/AIDS prevention and treatment, and discuss the concept of harm reduction, with a cultural approach, as a strategy to prevent further spread of the disease. Recommendations include integrating HIV prevention and treatment strategies within existing social, cultural and religious frameworks, working with religious leaders as key collaborators, and provision of appropriate healthcare resources and infrastructure for successful HIV prevention and treatment programs in Muslim countries.

Review of epidemiologic data on the debate over smokeless tobacco's role in harm reduction

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Timberlake David S

2009-10-01

Full Text Available Abstract Some tobacco researchers have argued that the European Union should remove its ban on a form of low-nitrosamine smokeless tobacco referred to as Swedish 'snus'. This argument has developed in to an international debate over the use of smokeless tobacco as a measure of harm reduction for smokers. Leading authorities in the USA have firmly stated that there is no safe tobacco - a message which does not allow for any discussion of comparative tobacco risks. This commentary is intended to review the origin of the controversy over Swedish 'snus', to examine briefly the meta-analysis on cancer risks by Peter Lee and Jan Hamling (published in July in BMC Medicine and to discuss the anticipated direction of the debate on tobacco-harm reduction in the USA. We anticipate that much of the debate will shift from the discussion of epidemiologic data to the discussion of the marketing, health communication and economics of smokeless tobacco. While the Food and Drug Administration's newly approved authority over tobacco will undoubtedly affect the smokeless products, it may not be the sole determinant of harm reduction's fate in the USA. See associated research article by Lee and Hamling: http://www.biomedcentral.com/1741-7015/7/36

[Harm reduction strategy in tobacco control].

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Gorini, Giuseppe

2011-01-01

Potentially reduced exposure products (PREPs), already sold in USA and in some European Countries, are low-nitrosamine cigarettes, low-nitrosamine smokeless tobacco (e.g., the Swedish Snus), cigarette-like products, and medicinal nicotine products. Even e-cigarette delivers nicotine. With the exception of snus and medicinal nicotine, studies on the health effects of PREPs have not been carried out, although some PREPs are already sold and promoted as products that effectively reduce health risks. Thus, a second disaster similar to that occurred for light cigarettes could happen in the next years. Only medicinal nicotine and snus could be valid candidates to become PREPs, even if they pose some significant health risks. The World Health Organization, following a precautionary approach, has recently published a list of 9 carcinogens or toxicants recommended for mandated lowering (the tobacco-specific nitrosamines NNN and NNK, acetaldehyde, acrolein, benzene, benzo[a]pyrene, 1-3 butadiene, carbon monoxide, formaldehyde), and 9 carcinogens or toxicants for monitoring in usual cigarettes (not PREPs), underlining that tobacco companies cannot use this reduction strategy as a promotional message, as it occurred for light cigarettes in the 70s and 80s. The present status quo, in which cigarettes are freely available, medicinal nicotine, being a drug, is available under a regulated market, and Snus is prohibited, actually denies smokers the right to choose safer nicotine products. The solution suggested by the UK Royal College of Physicians is to balance the nicotine market, framing tobacco products and medicinal nicotine in the same regulation system; establishing a nicotine and tobacco regulatory authority;making medicinal nicotine more available; evaluating the feasibility of the introduction in the English market of Swedish Snus. California Government remarks that the nicotine maintenance is not a valid strategy, because it could induce smokers not to try to quit

Assessing the feasibility of harm reduction services for MSM: the late night breakfast buffet study

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Kellogg Timothy A

2006-10-01

Full Text Available Abstract Background Despite the leveling off in new HIV infections among men who have sex with men (MSM in San Francisco, new evidence suggests that many recent HIV infections are linked with the use of Methamphetamine (MA. Among anonymous HIV testers in San Francisco, HIV incidence among MA users was 6.3% compared to 2.1% among non-MA users. Of particular concern for prevention programs are frequent users and HIV positive men who use MA. These MSM pose a particular challenge to HIV prevention efforts due to the need to reach them during very late night hours. Methods The purpose of the Late Night Breakfast Buffet (LNBB was to determine the feasibility and uptake of harm reduction services by a late night population of MSM. The "buffet" of services included: needle exchange, harm reduction information, oral HIV testing, and urine based sexually transmitted infection (STI testing accompanied by counseling and consent procedures. The study had two components: harm reduction outreach and a behavioral survey. For 4 months during 2004, we provided van-based harm reduction services in three neighborhoods in San Francisco from 1 – 5 a.m. for anyone out late at night. We also administered a behavioral risk and service utilization survey among MSM. Results We exchanged 2000 needles in 233 needle exchange visits, distributed 4500 condoms/lubricants and provided 21 HIV tests and 12 STI tests. Fifty-five MSM enrolled in the study component. The study population of MSM was characterized by low levels of income and education whose ages ranged from 18 – 55. Seventy-eight percent used MA in the last 3 months; almost 25% used MA every day in the same time frame. Of the 65% who ever injected, 97% injected MA and 13% injected it several times a day. MA and alcohol were strong influences in the majority of unprotected sexual encounters among both HIV negative and HIV positive MSM. Conclusion We reached a disenfranchised population of MA-using MSM who are at

Comparison of toxicity of smoke from traditional and harm-reduction cigarettes using mouse embryonic stem cells as a novel model for preimplantation development.

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Lin, S; Tran, V; Talbot, P

2009-02-01

Embryonic stem cells (ESC), which originate from the inner cell mass of blastocysts, are valuable models for testing the effects of toxicants on preimplantation development. In this study, mouse ESC (mESC) were used to compare the toxicity of mainstream (MS) and sidestream (SS) cigarette smoke on cell attachment, survival and proliferation. In addition, smoke from a traditional commercial cigarette was compared with smoke from three harm-reduction brands. MS and SS smoke solutions were made using an analytical smoking machine and tested at three doses using D3 mESC plated on 0.2% gelatin. At 6 and 24 h, images were taken and the number of attached cells was evaluated. Both MS and SS smoke from traditional and harm-reduction cigarettes inhibited cell attachment, survival and proliferation dose dependently. For all brands, SS smoke was more potent than MS smoke. However, removal of the cigarette filter increased the toxicity of MS smoke to that of SS smoke. Both MS and SS smoke from harm-reduction cigarettes were as inhibitory, or more inhibitory, than their counterparts from the traditional brand. When preimplantation mouse embryos were cultured for 1 h in MS or SS smoke solutions from a harm-reduction brand, blastomeres became apoptotic, in agreement with the data obtained using mESC. mESC provide a valuable model for toxicological studies on the preimplantation stage of development and were used to show that MS and SS smoke from traditional and harm-reduction cigarettes are detrimental to embryonic cells prior to implantation.

The complexity of 'harm reduction' with smokeless tobacco as an approach to tobacco control in low-income and middle-income countries.

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Ayo-Yusuf, Olalekan A; Burns, David M

2012-03-01

To review the implications of recommending smokeless tobacco (ST) use as a harm reduction approach for low-income and middle-income countries (LMICs). Narrative review of published papers and other data sources (including conference abstracts and internet-based information) on the health risks posed by the use of ST products for individual smokers and for the population with a focus on their implications for LMICs. Swedish snus has a relatively lower toxicity profile than ST products available in other markets, including older products used in the US and products used in Africa and Asia. The experience with snus in Sweden provides information on the effects of snus use in a population where cigarette smoking was already culturally ingrained. However, population effects are likely to be different in those LMICs where smoking is not yet the dominant culturally accepted form of tobacco use. The total effect may be negative in countries where locally-popular ST products have substantially higher disease risks than Swedish snus and where there is limited regulatory and tobacco use surveillance capacity. Issues relating to how populations in LMICs respond to marketing efforts, the risks of the dual use of ST and smoking, and the capacity to regulate ST products need to be considered in making decisions about harm reduction strategies in LMICs. The public health effects of supporting ST as a harm reduction strategy may vary substantively in countries with different pre-existing tobacco use patterns.

"Word of mouse": indigenous harm reduction and online consumerism of the synthetic compound methoxphenidine.

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Van Hout, Marie Claire; Hearne, Evelyn

2015-01-01

Methoxphenidine (MXP) was one of several NMDA antagonists marketed in 2013 to replace the recently controlled compound Methoxetamine (MXE). A steep rise in user interest was recorded, despite vendor cautioning of limited user feedback. The study presented a phenomenological analysis of MXP experiences amongst recreational drug users as posted on public Internet fora. Internet searches were carried out using specific key words; "methoxphenidine," "MXP" and in combination with "experience," "report," "forum," and "trip." Seven self-reported experiences and 28 thread discussions relating sole use of MXP were analyzed using the Empirical Phenomenological Psychological method. Five themes and 61 categories emerged. MXP is marketed as a legal replacement for MXE, diphenidine, and ketamine, with a dissociative and stimulant wave outcome often lasting for days. Harm reduction tactics, awareness of prior tolerance to dissociative and optimal settings for use are discussed. Acute side-effects relate to hypertension and seizures. Chronic long-term memory loss and limb numbness is reported. Sense of empowerment occurs in the afterglow experience. Internet drug fora fuel information exchange and informed consumerism of synthetic compounds, and offer viable mechanisms for pre- and post-purchase decision making and indigenous harm reduction. Continued surveillance of synthetic market entries and user trends is warranted.

E-Cigarette as a Harm Reduction Approach among Tobacco Smoking Khat Chewers: A Promising Bullet of Multiple Gains.

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Kassim, Saba; Farsalinos, Konstantinos E

2016-02-19

Khat chewing/use, a green leaf with amphetamine-like effects is socially integrated in the Middle East and Africa. Khat chewing is often associated with tobacco smoking and occurs in closed places, such as a family home setting where the smoke-free laws cannot be implemented. Tobacco cigarette smoking among khat chewers is a significant concern, but there is also second-hand exposure to smoke at home or in places where khat users gather. Evidence suggests that e-cigarettes represent a significantly less harmful form of nicotine intake. Evaluating the effects of e-cigarettes among khat chewers could be important in understanding the impact of e-cigarettes as a harm reduction approach, with the potential to reduce the health risk associated with smoking.

E-Cigarette as a Harm Reduction Approach among Tobacco Smoking Khat Chewers: A Promising Bullet of Multiple Gains

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Saba Kassim

2016-02-01

Full Text Available Khat chewing/use, a green leaf with amphetamine-like effects is socially integrated in the Middle East and Africa. Khat chewing is often associated with tobacco smoking and occurs in closed places, such as a family home setting where the smoke-free laws cannot be implemented. Tobacco cigarette smoking among khat chewers is a significant concern, but there is also second-hand exposure to smoke at home or in places where khat users gather. Evidence suggests that e-cigarettes represent a significantly less harmful form of nicotine intake. Evaluating the effects of e-cigarettes among khat chewers could be important in understanding the impact of e-cigarettes as a harm reduction approach, with the potential to reduce the health risk associated with smoking.

Virtual harm reduction efforts for Internet gambling: effects of deposit limits on actual Internet sports gambling behavior.

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Broda, Anja; LaPlante, Debi A; Nelson, Sarah E; LaBrie, Richard A; Bosworth, Leslie B; Shaffer, Howard J

2008-08-06

In an attempt to reduce harm related to gambling problems, an Internet sports betting service provider, bwin Interactive Entertainment, AG (bwin), imposes limits on the amount of money that users can deposit into their online gambling accounts. We examined the effects of these limits on gambling behavior. We compared (1) gambling behavior of those who exceeded deposit limits with those who did not, and (2) gambling behavior before and after exceeding deposit limits. We analyzed 2 years of the actual sports gambling behavior records of 47000 subscribers to bwin. Only 160 (0.3%) exceeded deposit limits at least once. Gamblers who exceeded deposit limits evidenced higher average number of bets per active betting day and higher average size of bets than gamblers who did not exceed deposit limits. Comparing the gambling behavior before and after exceeding deposit limits revealed slightly more unfavorable gambling behavior after exceeding deposit limits. Our findings indicate that Internet gamblers who exceed deposit limits constitute a group of bettors willing to take high risks; yet, surprisingly, they appear to do this rather successfully because their percentage of losses is lower than others in the sample. However, some of these gamblers exhibit some poor outcomes. Deposit limits might be necessary harm reduction measures to prevent the loss of extremely large amounts of money and cases of bankruptcy. We discuss how these limits might be modified based on our findings.

Virtual harm reduction efforts for Internet gambling: effects of deposit limits on actual Internet sports gambling behavior

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Nelson Sarah E

2008-08-01

Full Text Available Abstract Background In an attempt to reduce harm related to gambling problems, an Internet sports betting service provider, bwin Interactive Entertainment, AG (bwin, imposes limits on the amount of money that users can deposit into their online gambling accounts. We examined the effects of these limits on gambling behavior. Methods We compared (1 gambling behavior of those who exceeded deposit limits with those who did not, and (2 gambling behavior before and after exceeding deposit limits. We analyzed 2 years of the actual sports gambling behavior records of 47000 subscribers to bwin. Results Only 160 (0.3% exceeded deposit limits at least once. Gamblers who exceeded deposit limits evidenced higher average number of bets per active betting day and higher average size of bets than gamblers who did not exceed deposit limits. Comparing the gambling behavior before and after exceeding deposit limits revealed slightly more unfavorable gambling behavior after exceeding deposit limits. Conclusion Our findings indicate that Internet gamblers who exceed deposit limits constitute a group of bettors willing to take high risks; yet, surprisingly, they appear to do this rather successfully because their percentage of losses is lower than others in the sample. However, some of these gamblers exhibit some poor outcomes. Deposit limits might be necessary harm reduction measures to prevent the loss of extremely large amounts of money and cases of bankruptcy. We discuss how these limits might be modified based on our findings.

The Case in Favor of E-Cigarettes for Tobacco Harm Reduction

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Joel L. Nitzkin

2014-06-01

Full Text Available A carefully structured Tobacco Harm Reduction (THR initiative, with e-cigarettes as a prominent THR modality, added to current tobacco control programming, is the most feasible policy option likely to substantially reduce tobacco-attributable illness and death in the United States over the next 20 years. E-cigarettes and related vapor products are the most promising harm reduction modalities because of their acceptability to smokers. There are about 46 million smokers in the United States, and an estimated 480,000 deaths per year attributed to cigarette smoking. These numbers have been essentially stable since 2004. Currently recommended pharmaceutical smoking cessation protocols fail in about 90% of smokers who use them as directed, even under the best of study conditions, when results are measured at six to twelve months. E-cigarettes have not been attractive to non-smoking teens or adults. Limited numbers non-smokers have experimented with them, but hardly any have continued their use. The vast majority of e-cigarette use is by current smokers using them to cut down or quit cigarettes. E-cigarettes, even when used in no-smoking areas, pose no discernable risk to bystanders. Finally, addition of a THR component to current tobacco control programming will likely reduce costs by reducing the need for counseling and drugs.

Effect of smokeless tobacco product marketing and use on population harm from tobacco use policy perspective for tobacco-risk reduction.

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Kozlowski, Lynn T

2007-12-01

This article presents policy perspectives on the marketing of smokeless tobacco products to reduce population harm from tobacco use. Despite consensus that smokeless tobacco products as sold in the United States are less dangerous than cigarettes, there is no consensus on how to proceed. Diverse factions have different policy concerns. While the tobacco industry is exempted from U.S. Food and Drug Administration (FDA) oversight, the pharmaceutical industry whose nicotine replacement therapy (NRT) medicines compete with smokeless tobacco as noncombustible nicotine-delivery systems are regulated by the FDA. Some public health experts support smokeless tobacco use to reduce population harm from tobacco; other public health experts oppose promoting smokeless tobacco for harm reduction. Adult consumers can freely purchase currently-marketed smokeless tobacco products and even more-deadly cigarettes. Concerns with and advantages of smokeless tobacco products are discussed. In that noncombustible medicinal nicotine-delivery systems have been proven to be effective smoking-cessation aids, smokeless tobacco, as another source of psychoactive doses of nicotine, could be used similarly, in a dose-response fashion as a smoking-cessation aid (consistent with FDA principles for evaluating generic versions of drugs). Price measures should be used on tobacco products to make costs to consumers proportional to product health risks (which would make smokeless tobacco much cheaper than cigarettes), and smokeless tobacco should be encouraged as an option for smoking cessation in adult smokers, particularly for those who have failed to stop smoking using NRT or other methods.

Assessing harmful effects in systematic Reviews

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Woolacott Nerys F

2004-07-01

Full Text Available Abstract Background Balanced decisions about health care interventions require reliable evidence on harms as well as benefits. Most systematic reviews focus on efficacy and randomised trials, for which the methodology is well established. Methods to systematically review harmful effects are less well developed and there are few sources of guidance for researchers. We present our own recent experience of conducting systematic reviews of harmful effects and make suggestions for future practice and further research. Methods We described and compared the methods used in three systematic reviews. Our evaluation focused on the review question, study designs and quality assessment. Results One review question focused on providing information on specific harmful effects to furnish an economic model, the other two addressed much broader questions. All three reviews included randomised and observational data, although each defined the inclusion criteria differently. Standard methods were used to assess study quality. Various practical problems were encountered in applying the study design inclusion criteria and assessing quality, mainly because of poor study design, inadequate reporting and the limitations of existing tools. All three reviews generated a large volume of work that did not yield much useful information for health care decision makers. The key areas for improvement we identified were focusing the review question and developing methods for quality assessment of studies of harmful effects. Conclusions Systematic reviews of harmful effects are more likely to yield information pertinent to clinical decision-making if they address a focused question. This will enable clear decisions to be made about the type of research to include in the review. The methodology for assessing the quality of harmful effects data in systematic reviews requires further development.

Outreach nurses in Harm Reduction projects: improving acceptability and availability of medical care to drug users

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Dvinskykh, Natalya

2012-07-01

Full Text Available BACKGROUND: Injection drug users (IDU remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers. Harm reduction projects in Ukraine partially address this problem by providing regular HIV and STI testing for their clients, and by referring them to medical institutions, where IDU can get free treatment for STI, TB, and ARV therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved. METHODS: During 2011, the new approach of ‘outreach nurses’ was piloted by All Ukrainian Harm Reduction Association (UHRA with support from ICF “International HIV/AIDS Alliance in Ukraine”. The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home. RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average. For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93 during the same period of time. CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of ‘outreach nurses’ to the package of services they provide.

Still "at risk": An examination of how street-involved young people understand, experience, and engage with "harm reduction" in Vancouver's inner city.

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Bozinoff, Nikki; Small, Will; Long, Cathy; DeBeck, Kora; Fast, Danya

2017-07-01

Vancouver is an international leader in implementing interventions to reduce harms related to drug use. However, street-involved young people who use drugs continue to be vulnerable to overdose death, hepatitis C (HCV) infection, and high rates of syringe sharing. To better understand this in the context of the intensive public health response, we examined how young people, who are involved in the 'street drug scene', understood, experienced and engaged with harm reduction. Twelve semi-structured interviews were conducted in 2013 with 13 young people (ages 17-28) recruited from the At-Risk Youth Study, a prospective cohort of street-involved and drug-using young people. These interviews were embedded within a larger, eight-year program of ethnographic research and explored participants' understandings of harm reduction, their use of specific services, and their ideas about improving their day-to-day lives. Interviews were transcribed verbatim and a thematic analysis was performed. Young peoples' ideas about harm reduction were diverse and expansive. They articulated the limitations of existing programs, indicating that while they are positioned to reduce the risk of HIV and HCV transmission, they offer little meaningful support to improve young peoples' broader life chances. Young people described strategies to mitigate risk and harm in their own lives, including transitioning to drugs deemed less harmful and attempting to gain access to drug treatment. Finally, young people indicated that spatial considerations (e.g., distance from Vancouver's Downtown Eastside) strongly determined access to services. In Vancouver, a large, well established harm reduction infrastructure seeks to reduce HIV and HCV transmission among street-involved young people. However, young peoples' multiple understandings, experiences and engagements with harm reduction in this setting illustrate the limitations of the existing infrastructure in improving their broader life chances. Copyright

Impacts of licensed premises trading hour policies on alcohol-related harms.

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Atkinson, Jo-An; Prodan, Ante; Livingston, Michael; Knowles, Dylan; O'Donnell, Eloise; Room, Robin; Indig, Devon; Page, Andrew; McDonnell, Geoff; Wiggers, John

2018-07-01

Evaluations of alcohol policy changes demonstrate that restriction of trading hours of both 'on'- and 'off'-licence venues can be an effective means of reducing rates of alcohol-related harm. Despite this, the effects of different trading hour policy options over time, accounting for different contexts and demographic characteristics, and the common co-occurrence of other harm reduction strategies in trading hour policy initiatives, are difficult to estimate. The aim of this study was to use dynamic simulation modelling to compare estimated impacts over time of a range of trading hour policy options on various indicators of acute alcohol-related harm. An agent-based model of alcohol consumption in New South Wales, Australia was developed using existing research evidence, analysis of available data and a structured approach to incorporating expert opinion. Five policy scenarios were simulated, including restrictions to trading hours of on-licence venues and extensions to trading hours of bottle shops. The impact of the scenarios on four measures of alcohol-related harm were considered: total acute harms, alcohol-related violence, emergency department (ED) presentations and hospitalizations. Simulation of a 3 a.m. (rather than 5 a.m.) closing time resulted in an estimated 12.3 ± 2.4% reduction in total acute alcohol-related harms, a 7.9 ± 0.8% reduction in violence, an 11.9 ± 2.1% reduction in ED presentations and a 9.5 ± 1.8% reduction in hospitalizations. Further reductions were achieved simulating a 1 a.m. closing time, including a 17.5 ± 1.1% reduction in alcohol-related violence. Simulated extensions to bottle shop trading hours resulted in increases in rates of all four measures of harm, although most of the effects came from increasing operating hours from 10 p.m. to 11 p.m. An agent-based simulation model suggests that restricting trading hours of licensed venues reduces rates of alcohol-related harm and extending trading hours of bottle

Mull it over: cannabis vaporizers and harm reduction.

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Gartner, Coral E

2015-11-01

Legalization of cannabis is likely to lead to greater use. Balanced regulation of potentially less harmful modes of administration, such as vaporizers, is needed. Further research is warranted not only on the direct health effects of vaping cannabis, but also on its potential to decrease co-administration of tobacco with cannabis.

HIV, Hepatitis C, TB, Harm Reduction, and Persons Deprived of Liberty: What Standards Does International Human Rights Law Establish?

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Sander, Gen; Lines, Rick

2016-12-01

HIV, hepatitis C virus (HCV), and TB in prisons and other places of detention are serious public health concerns, with prevalence and incidence considerably higher than in the general community because of the overrepresentation of risky behavior, substandard conditions, overcrowding, people who inject drugs, and the wholly inadequate prevention, care, and treatment of these conditions, including the denial of harm reduction services. This is not only a severe public health crisis but also a serious human rights concern. This article works to clarify the standards established by human rights law with regards to HIV, HCV, TB, and harm reduction in prisons by examining international and regional case law, minimum standards on the treatment of prisoners and public health, as well as the work of UN treaty bodies, Special Rapporteurs, and prison monitoring bodies. It is imperative that urgent steps are taken to close the gap between human rights and public health standards on the one hand, and effective implementation in prison settings on the other.

Mobilizing Drug Consumption Rooms: inter-place networks and harm reduction drug policy.

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McCann, Eugene; Temenos, Cristina

2015-01-01

This article discusses the learning and politics involved in spreading Drug Consumption Rooms (DCRs) globally. DCRs are health facilities, operating under a harm reduction philosophy, where people consume illicit drugs in a supervised setting. Approximately 90 are located in almost 60 cities in 11 countries. They are intensely local attempts to improve the lives of specific populations and urban neighborhoods. DCRs are also global models that travel. This article examines the relationship between DCRs as facilities that are fixed in place and DCRs as globally-mobilized models of drug policy and public health practice. Drawing on research from seven countries, we apply concepts from the policy mobilities literature to analyze the travels of the DCR model and the political strategies involved in the siting of these public health service facilities. We detail the networked mobilization of the DCR model from Europe to Canada and Australia, the learning among facilities, the strategies used to mold the DCR model to local contexts, and the role of DCR staff in promoting continued proliferation of DCRs. We conclude by identifying some immobilities of DCRs to identify questions about practices, principles and future directions of harm reduction. Copyright © 2014 Elsevier Ltd. All rights reserved.

Contingencies of the will: Uses of harm reduction and the disease model of addiction among health care practitioners.

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Szott, Kelly

2015-09-01

The concept of addiction as a disease is becoming firmly established in medical knowledge and practice at the same time as the logics of the harm reduction approach are gaining broader acceptance. How health care practitioners understand and intervene upon drug use among their patients is complicated by these two models. While harm reduction can be understood as a form of governmentality wherein drug-taking individuals express their regulated autonomy through self-governance, the notion of addiction as a disease removes the option of self-governance through negating the will of the individual. Through analysis of qualitative interviews conducted with 13 health care practitioners who provide care for economically marginalized people who use drugs in New York City, it was found that the absence of will articulated in constructions of addiction as disease offered a gateway through which health care practitioners could bring in ideological commitments associated with harm reduction, such as the de-stigmatization of drug use. Despite differences in the attribution of agency, sewing together these two approaches allowed health care practitioners to work with drug-using patients in practical and compassionate ways. This resembles the strategic deployment of diverse subjectivities found in feminist, post-structural liberatory projects wherein differential subjectification proves tactical and productive. Although drug-using patients may enjoy the benefits of practical and compassionate health care, the conjoint facilitation and denouncement of their will occasioned by the use of both harm reduction and the disease model of addiction imply their management by both pastoral and disciplinary technologies of power. © The Author(s) 2014.

Contingencies of the will: Uses of harm reduction and the disease model of addiction among health care practitioners

Science.gov (United States)

Szott, Kelly

2015-01-01

The concept of addiction as a disease is becoming firmly established in medical knowledge and practice at the same time as the logics of the harm reduction approach are gaining broader acceptance. How health care practitioners understand and intervene upon drug use among their patients is complicated by these two models. While harm reduction can be understood as a form of governmentality wherein drug-taking individuals express their regulated autonomy through self-governance, the notion of addiction as a disease removes the option of self-governance through negating the will of the individual. Through analysis of qualitative interviews conducted with 13 health care practitioners who provide care for economically marginalized people who use drugs in New York City, it was found that the absence of will articulated in constructions of addiction as disease offered a gateway through which health care practitioners could bring in ideological commitments associated with harm reduction, such as the de-stigmatization of drug use. Despite differences in the attribution of agency, sewing together these two approaches allowed health care practitioners to work with drug-using patients in practical and compassionate ways. This resembles the strategic deployment of diverse subjectivities found in feminist, post-structural liberatory projects wherein differential subjectification proves tactical and productive. Although drug-using patients may enjoy the benefits of practical and compassionate health care, the conjoint facilitation and denouncement of their will occasioned by the use of both harm reduction and the disease model of addiction imply their management by both pastoral and disciplinary technologies of power. PMID:25394654

Harm reduction as a complex adaptive system: A dynamic framework for analyzing Tanzanian policies concerning heroin use.

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Ratliff, Eric A; Kaduri, Pamela; Masao, Frank; Mbwambo, Jessie K K; McCurdy, Sheryl A

2016-04-01

Contrary to popular belief, policies on drug use are not always based on scientific evidence or composed in a rational manner. Rather, decisions concerning drug policies reflect the negotiation of actors' ambitions, values, and facts as they organize in different ways around the perceived problems associated with illicit drug use. Drug policy is thus best represented as a complex adaptive system (CAS) that is dynamic, self-organizing, and coevolving. In this analysis, we use a CAS framework to examine how harm reduction emerged around heroin trafficking and use in Tanzania over the past thirty years (1985-present). This account is an organizational ethnography based on of the observant participation of the authors as actors within this system. We review the dynamic history and self-organizing nature of harm reduction, noting how interactions among system actors and components have coevolved with patterns of heroin us, policing, and treatment activities over time. Using a CAS framework, we describe harm reduction as a complex process where ambitions, values, facts, and technologies interact in the Tanzanian sociopolitical environment. We review the dynamic history and self-organizing nature of heroin policies, noting how the interactions within and between competing prohibitionist and harm reduction policies have changed with patterns of heroin use, policing, and treatment activities over time. Actors learn from their experiences to organize with other actors, align their values and facts, and implement new policies. Using a CAS approach provides researchers and policy actors a better understanding of patterns and intricacies in drug policy. This knowledge of how the system works can help improve the policy process through adaptive action to introduce new actors, different ideas, and avenues for communication into the system. Copyright © 2015 Elsevier B.V. All rights reserved.

Violence against female sex workers in Cameroon: accounts of violence, harm reduction, and potential solutions.

Science.gov (United States)

Lim, Sahnah; Peitzmeier, Sarah; Cange, Charles; Papworth, Erin; LeBreton, Matthew; Tamoufe, Ubald; Kamla, Aristide; Billong, Serge; Fokam, Pamella; Njindam, Iliassou; Decker, Michele R; Sherman, Susan G; Baral, Stefan

2015-03-01

Female sex workers (FSWs) in Cameroon, and West Africa generally, suffer a disproportionate burden of HIV. Although violence against FSWs has been documented extensively in other parts of the world, data on violence from West African countries are lacking. The aim of this study was to qualitatively document violence and harm reduction strategies from the perspective of FSWs in Cameroon as well as to understand how experiences of violence may increase FSWs' HIV risk. FSWs from 7 major cities in Cameroon (Douala, Yaounde, Bamenda, Bertoua, Nagoundere, Kribi, and Bafoussam) were purposively recruited. Data from 31 in-depth interviews and 7 focus groups (n = 70; with some overlapping participants from in-depth interviews) conducted with these FSWs in 6 of these 7 cities (excluding Kribi) were analyzed using a grounded theory approach. Transcripts revealed 3 primary themes related to violence: (1) sources and types of violence, including sexual, physical, and financial violence perpetrated by clients and police, (2) harm reduction strategies, including screening clients and safe work locations, receipt of payment before sexual act, and formation of an informal security network, and (3) recommendations on structural changes to reduce violence that emphasized sex work decriminalization and increased police accountability. As in other parts of the world, violence against FSWs is pervasive in Cameroon. Interventions targeting violence and HIV must address the forms of violence cited locally by FSWs and can build on FSWs' existing strengths and harm reduction strategies. Structural changes are needed to ensure access to justice for this population.

Evaluation of the Epidemiological Impact of Harm Reduction Programs on HIV in Vietnam

OpenAIRE

UNAIDS; World Bank

2010-01-01

Vietnam s HIV epidemic is concentrated, both in specific behavioral sub-populations and geographic regions. The key populations at higher risk for HIV infection in Vietnam are female sex workers (FSW) and their clients; injecting drug users (IDU); and men who have sex with men (MSM). Vietnam identified harm reduction interventions for IDU and FSW as a key component of its last 5-year Natio...

The Effectiveness of the Harm Reduction Group Therapy Based on Bandura's Self-Efficacy Theory on Risky Behaviors of Drug-Dependent Sex Worker Women.

Science.gov (United States)

Rabani-Bavojdan, Marjan; Rabani-Bavojdan, Mozhgan; Rajabizadeh, Ghodratollah; Kaviani, Nahid; Bahramnejad, Ali; Ghaffari, Zohreh; Shafiei-Bafti, Mehdi

2017-07-01

The aim of this study was to investigate the effectiveness of the harm reduction group therapy based on Bandura's self-efficacy theory on risky behaviors of sex workers in Kerman, Iran. A quasi-experimental two-group design (a random selection with pre-test and post-test) was used. A risky behaviors questionnaire was used to collect. The sample was selected among sex workers referring to drop-in centers in Kerman. Subjects were allocated to two groups and were randomly classified into two experimental and control groups. The sample group consisted of 56 subjects. The experimental design was carried out during 12 sessions, and the post-test was performed one month and two weeks after the completion of the sessions. The results were analyzed statistically. By reducing harm based on Bandura's self-efficacy theory, the risky behaviors of the experimental group, including injection behavior, sexual behavior, violence, and damage to the skin, were significantly reduced in the pre-test compared to the post-test (P group therapy based on Bandura's self-efficacy theory can reduce the risky behaviors of sex workers.

The state of harm reduction in the Middle East and North Africa: A focus on Iran and Morocco.

Science.gov (United States)

Himmich, Hakima; Madani, Navid

2016-05-01

HIV/AIDS and hepatitis C among people who inject drugs are on the rise in the Middle East and North Africa (MENA) region. But the regional response to the epidemic falls short both in terms of the quality and scale of response. From the threat of the death sentence for drug offenses to the burden of refugees fleeing conflict, there are many legal, political and social barriers that hinder the introduction and expansion of harm reduction in the region. However Iran and Morocco are two pioneering countries and over the last decade they have been providing evidence that harm reduction is feasible and acceptable in MENA. Using different approaches, these two countries have overcome various obstacles and encouraged discussion and collaboration among stakeholders, including government, health professionals, civil society and community-based organizations. In so doing they have created an enabling environment to endorse a national harm strategy. Copyright © 2016 Elsevier B.V. All rights reserved.

Drug education in victorian schools (DEVS: the study protocol for a harm reduction focused school drug education trial

Directory of Open Access Journals (Sweden)

Midford Richard

2012-02-01

Full Text Available Abstract Background This study seeks to extend earlier Australian school drug education research by developing and measuring the effectiveness of a comprehensive, evidence-based, harm reduction focused school drug education program for junior secondary students aged 13 to 15 years. The intervention draws on the recent literature as to the common elements in effective school curriculum. It seeks to incorporate the social influence of parents through home activities. It also emphasises the use of appropriate pedagogy in the delivery of classroom lessons. Methods/Design A cluster randomised school drug education trial will be conducted with 1746 junior high school students in 21 Victorian secondary schools over a period of three years. Both the schools and students have actively consented to participate in the study. The education program comprises ten lessons in year eight (13-14 year olds and eight in year nine (14-15 year olds that address issues around the use of alcohol, tobacco, cannabis and other illicit drugs. Control students will receive the drug education normally provided in their schools. Students will be tested at baseline, at the end of each intervention year and also at the end of year ten. A self completion questionnaire will be used to collect information on knowledge, patterns and context of use, attitudes and harms experienced in relation to alcohol, tobacco, cannabis and other illicit drug use. Multi-level modelling will be the method of analysis because it can best accommodate hierarchically structured data. All analyses will be conducted on an Intent-to-Treat basis. In addition, focus groups will be conducted with teachers and students in five of the 14 intervention schools, subsequent to delivery of the year eight and nine programs. This will provide qualitative data about the effectiveness of the lessons and the relevance of the materials. Discussion The benefits of this drug education study derive both from the knowledge

Effectiveness of lockouts in reducing alcohol-related harm: Systematic review.

Science.gov (United States)

Nepal, Smriti; Kypri, Kypros; Pursey, Kirrilly; Attia, John; Chikritzhs, Tanya; Miller, Peter

2018-05-01

Australian jurisdictions have introduced lockouts to prevent alcohol-related violence. Lockouts prohibit patrons from entering licensed premises after a designated time while allowing sale and consumption of alcohol to continue. Their purposes include managing the movement of intoxicated patrons, and preventing violence and disorder by dispersing times that patrons leave premises. We sought to evaluate the effectiveness of lockouts in preventing alcohol-related harm. We systematically searched electronic databases and reference lists and asked authors to identify relevant studies published to 1 June 2017. We deemed studies eligible if they evaluated lockouts, and if outcome measures included: assault, emergency department attendances, alcohol-related disorders or drink-driving offences. Two reviewers independently extracted data. After screening 244 records, we identified five studies from electronic databases, two from reference lists search and one from a Google search (N = 8). Two studies showed a decline in assaults; a third study showed reductions occurred only inside licensed premises; two studies showed an increase in assaults; and three studies showed no association. The studies had significant design and other limitations. Lockouts have been implemented across Australian jurisdictions as a strategy to prevent alcohol-related harm, despite limited evidence. In this systematic review, we synthesised findings from studies that evaluated lockouts as stand-alone interventions, to help clarify debate on their utility as a harm prevention strategy. There is not good evidence that lockouts prevent alcohol-related harm, in contrast to what is known about stopping the sale of alcohol earlier, for which there is evidence of effectiveness. © 2018 Australasian Professional Society on Alcohol and other Drugs.

The Global Fund to Fight AIDS, Tuberculosis and Malaria's investments in harm reduction through the rounds-based funding model (2002-2014)

DEFF Research Database (Denmark)

Bridge, Jamie; Hunter, Benjamin M; Albers, Eliot

2016-01-01

investment of US$ 620. million. Two-thirds of this budgeted amount was for interventions in the "comprehensive package" defined by the United Nations. 91% of the identified amount was for Eastern Europe and Asia. Conclusion: This study represents an updated, comprehensive assessment of Global Fund...... and inequitable access to these services and face widespread stigma and discrimination. In 2013, the Global Fund launched a new funding model-signalling the end of the previous rounds-based model that had operated since its founding in 2002. This study updates previous analyses to assess Global Fund investments...... investments in harm reduction from its founding (2002) until the start of the new funding model (2014). It also highlights the overall shortfall of harm reduction funding, with the estimated global need being US$ 2.3. billion for harm reduction in 2015 alone. Using this baseline, the Global Fund must...

Deconstructing anti-harm-reduction metaphors; mortality risk from falls and other traumatic injuries compared to smokeless tobacco use

Directory of Open Access Journals (Sweden)

Bergen Paul

2006-04-01

Full Text Available Abstract Anti-harm-reduction advocates sometimes resort to pseudo-analogies to ridicule harm reduction. Those opposed to the use of smokeless tobacco as an alternative to smoking sometimes suggest that the substitution would be like jumping from a 3 story building rather than 10 story, or like shooting yourself in the foot rather than the head. These metaphors are grossly inappropriate for several reasons, notably including the fact that they are misleading about the actual risk levels. Based on the available literature on mortality from falls, we estimate that smoking presents a mortality risk similar to a fall of about 4 stories, while mortality risk from smokeless tobacco is no worse than that from an almost certainly non-fatal fall from less than 2 stories. Other metaphors are similarly misleading. These metaphors, like other false and misleading anti-harm-reduction statements are inherently unethical attempts to prevent people from learning accurate health information. Moreover, they implicitly provide bad advice about health behavior priorities and are intended to persuade people to stick with a behavior that is more dangerous than an available alternative. Finally, the metaphors exhibit a flippant tone that seems inappropriate for a serious discussion of health science.

White slavery, whorehouse riots, venereal disease, and saving women: historical context of prostitution interventions and harm reduction in New York City during the Progressive Era.

Science.gov (United States)

Smolak, Alex

2013-01-01

Harm reduction and structural approaches to reduce HIV risk among sex workers face several barriers. One such barrier is based on moral arguments, and it has a rich historical context. This article examines the historical context of interventions with sex workers in New York City during the Progressive Era (1890-1920). Present at the time, though under a different name, the harm reduction approach was largely dismissed. These same moral underpinnings may be active today in driving interventions and policy toward those that are morally focused and away from those that focus on harm reduction and structural change.

How understanding and application of drug-related legal instruments affects harm reduction interventions in Cambodia: a qualitative study.

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Tuot, Sovannary; Ngin, Chanrith; Pal, Khuondyla; Sou, Sochenda; Sawez, Ghazal; Morgan, Phylicia; Srey, Mony; Chan, Tola; Chhoun, Pheak; Golichenko, Olga; Choub, Sok Chamreun; Yi, Siyan

2017-06-19

Harm reduction interventions in Cambodia face numerous obstacles because of conflicting understanding and interests and inconsistencies in the implementation by law enforcement officials. This study aims to examine how understanding and application of Drug Control Law (DCL) and Village/Commune Safety Policy (VCSP) affects harm reduction interventions in Cambodia from the standpoints of law enforcement officials, people who inject drugs and people who use drugs (PWID/PWUD), as well as other key stakeholders. This qualitative study was conducted in the capital city of Phnom Penh in 2015. We held five focus group discussions (FGDs) with groups of PWID/PWUD, police officers, Sangkat/commune officers, and local non-governmental organization (NGO) field staff. We also conducted ten key informant interviews (KIIs) with representatives from government agencies, donor agencies, and NGOs. FGDs and KIIs with Cambodian participants were transcribed in Khmer and translated into English. KIIs with foreign participants were transcribed in English. Transcripts were read and re-read to identify emerging themes, which were reviewed and refined to develop common and divergent patterns. There was a huge gap between what the DCL and VCSP say and how law enforcement officers and PWID/PWUD understood them. The gap was also evident in how law enforcement officers implemented the DCL and VCSP. Harm reduction services, including health- and non-health-related interventions, were limited and challenged by unsupportive attitudes, misinterpretation of the DCL and VCSP, and the lack of full engagement with NGOs in the development of these instruments. The needs of PWID/PWUD in accessing health care services were not met due to misconduct of authorities while practicing the DCL and VCSP. Further, the misconduct and enforcement of the law and policy lead to increased social discrimination and physical abuses against PWID/PWUD. There is a lack of common understanding of the drug-related law and

Alcohol Prevention: What Can Be Expected of a Harm Reduction Focused School Drug Education Programme?

Science.gov (United States)

Midford, Richard; Cahill, Helen; Ramsden, Robyn; Davenport, Gillian; Venning, Lynne; Lester, Leanne; Murphy, Bernadette; Pose, Michelle

2012-01-01

Aim: This pilot study investigated what alcohol prevention benefits could be achieved by a harm reduction focused school drug education intervention that addressed all drug use, both licit and illicit. Method: The study population comprised a cohort of 225 students in three intervention secondary schools and 93 students in a matched control school…

Syringe Decriminalization Advocacy in Red States: Lessons from the North Carolina Harm Reduction Coalition.

Science.gov (United States)

Cloud, David H; Castillo, Tessie; Brinkley-Rubinstein, Lauren; Dubey, Manisha; Childs, Robert

2018-05-08

Syringe access programs (SAPs) are cornerstone harm reduction interventions for combatting the national opioid epidemic. The goal of this paper is to describe effective advocacy strategies for enacting syringe decriminalization legislation to foster the expansion of SAPs in high-need areas amidst political opposition. Decades or research shows that SAPs prevent the transmission of HIV among people who inject drugs (PWID) and are a cost-effective tool for linking PWID to medical care, health education, and social services. In the USA, state laws criminalizing distribution and possession of syringes impede the expansion of SAPs into areas where they are sorely needed. In 2016, North Carolina became the first state to legalize SAPs with a Republican super majority. This paper distills strategies for community organizations seeking to advance syringe decriminalization legislation in politically conservative states with histories of prioritizing punitive sanctions over public health responses to drug use.

A harm-reduction model of abortion counseling about misoprostol use in Peru with telephone and in-person follow-up: A cohort study.

Science.gov (United States)

Grossman, Daniel; Baum, Sarah E; Andjelic, Denitza; Tatum, Carrie; Torres, Guadalupe; Fuentes, Liza; Friedman, Jennifer

2018-01-01

In Peru, abortion is legal only to preserve the life and health of the woman. A non-profit clinic system in Peru implemented a harm-reduction model for women with unwanted pregnancy that included pre-abortion care with instructions about misoprostol use and post-abortion care; they started offering telephone follow-up for clients in 2011. This study aimed to evaluate the effectiveness and safety of the harm-reduction model, and to compare outcomes by type of follow-up obtained. Between January 2012 and March 2013, 500 adult women seeking harm-reduction services were recruited into the study. Telephone surveys were conducted approximately four weeks after their initial harm-reduction counseling session with 262 women (response rate 52%); 9 participants were excluded. The survey focused on whether women pursued an abortion, and if so, what their experience was. Demographic and clinical data were also extracted from clinic records. Eighty-six percent of participants took misoprostol; among those taking misoprostol, 89% reported a complete abortion at the time of the survey. Twenty-two percent obtained an aspiration after taking misoprostol and 8% self-reported adverse events including hemorrhage without transfusion, infection, or severe pain. Among women who took misoprostol, 46% reported receiving in-person follow-up (in some cases both telephone and in-person), 34% received telephone only, and 20% did not report receiving any form of follow-up. Those who had in-person follow-up with the counselor were most likely to report a complete abortion (<0.001). Satisfaction with both types of follow-up was very high, with 81%-89% reporting being very satisfied. Liberalization of restrictive abortion laws is associated with improvements in health outcomes, but the process of legal reform is often lengthy. In the interim, giving women information about evidence-based regimens of misoprostol, as well as offering a range of follow-up options to ensure high quality post

Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: a pragmatic randomised controlled trial.

Science.gov (United States)

Priebe, Stefan; Bhatti, Nyla; Barnicot, Kirsten; Bremner, Stephen; Gaglia, Amy; Katsakou, Christina; Molosankwe, Iris; McCrone, Paul; Zinkler, Martin

2012-01-01

A primary goal of dialectical behaviour therapy (DBT) is to reduce self-harm, but findings from empirical studies are inconclusive. The aim of this study was to assess the effectiveness and cost-effectiveness of DBT in reducing self-harm in patients with personality disorder. Participants with a personality disorder and at least 5 days of self-harm in the previous year were randomised to receive 12 months of either DBT or treatment as usual (TAU). The primary outcome was the frequency of days with self-harm; secondary outcomes included borderline personality disorder symptoms, general psychiatric symptoms, subjective quality of life, and costs of care. Forty patients each were randomised to DBT and TAU. In an intention-to-treat analysis, there was a statistically significant treatment by time interaction for self-harm (incidence rate ratio 0.91, 95% CI 0.89-0.92, p self-harm decreased by 9% relative to TAU. There was no evidence of differences on any secondary outcomes. The economic analysis revealed a total cost of a mean of 5,685 GBP (6,786 EUR) in DBT compared to a mean of 3,754 GBP (4,481 EUR) in TAU, but the difference was not significant (95% CI -603 to 4,599 GBP). Forty-eight per cent of patients completed DBT. They had a greater reduction in self-harm compared to dropouts (incidence rate ratio 0.78, 95% CI 0.76-0.80, p self-harm in patients with personality disorder, possibly incurring higher total treatment costs. The effect is stronger in those who complete treatment. Future research should explore how to improve treatment adherence. Copyright © 2012 S. Karger AG, Basel.

The globalization of ayahuasca: harm reduction or benefit maximization?

Science.gov (United States)

Tupper, Kenneth W

2008-08-01

Ayahuasca is a tea made from two plants native to the Amazon, Banisteriopsis caapi and Psychotria viridis, which, respectively, contain the psychoactive chemicals harmala alkaloids and dimethyltryptamine. The tea has been used by indigenous peoples in countries such as Brazil, Ecuador and Peru for medicinal, spiritual and cultural purposes since pre-Columbian times. In the 20th century, ayahuasca spread beyond its native habitat and has been incorporated into syncretistic practices that are being adopted by non-indigenous peoples in modern Western contexts. Ayahuasca's globalization in the past few decades has led to a number of legal cases which pit religious freedom against national drug control laws. This paper explores some of the philosophical and policy implications of contemporary ayahuasca use. It addresses the issue of the social construction of ayahuasca as a medicine, a sacrament and a "plant teacher." Issues of harm reduction with respect to ayahuasca use are explored, but so too is the corollary notion of "benefit maximization."

Using the Theory of Planned Behavior to predict implementation of harm reduction strategies among MDMA/ecstasy users.

Science.gov (United States)

Davis, Alan K; Rosenberg, Harold

2016-06-01

This prospective study was designed to test whether the variables proposed by the Theory of Planned Behavior (TPB) were associated with baseline intention to implement and subsequent use of 2 MDMA/ecstasy-specific harm reduction interventions: preloading/postloading and pill testing/pill checking. Using targeted Facebook advertisements, an international sample of 391 recreational ecstasy users were recruited to complete questionnaires assessing their ecstasy consumption history, and their attitudes, subjective norms, perceived behavioral control, habit strength (past strategy use), and intention to use these two strategies. Attitudes, subjective norms, and perceived behavioral control were significantly associated with baseline intention to preload/postload and pill test/pill check. Out of the 391 baseline participants, 100 completed the two-month follow-up assessment. Baseline habit strength and frequency of ecstasy consumption during the three months prior to baseline were the only significant predictors of how often participants used the preloading/postloading strategy during the follow-up. Baseline intention to pill test/pill check was the only significant predictor of how often participants used this strategy during the follow-up. These findings provide partial support for TPB variables as both correlates of baseline intention to implement and predictors of subsequent use of these two strategies. Future investigations could assess whether factors related to ecstasy consumption (e.g., subjective level of intoxication, craving, negative consequences following consumption), and environmental factors (e.g., accessibility and availability of harm reduction resources) improve the prediction of how often ecstasy users employ these and other harm reduction strategies. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Managed alcohol as a harm reduction intervention for alcohol addiction in populations at high risk for substance abuse.

Science.gov (United States)

Muckle, Wendy; Muckle, Jamie; Welch, Vivian; Tugwell, Peter

2012-12-12

Managed alcohol programmes (MAP) are a harm reduction strategy used to minimise the personal harm and adverse societal effects that alcohol dependence can lead to by providing an alternative to zero-tolerance approaches that incorporate drinking goals (abstinence or moderation) that are compatible with the needs of the individual, and promoting access to services by offering low-threshold alternatives. This enables clients to gain access to services despite continued alcohol consumption and works to help the patient understand the risks involved in their behaviour and make decisions about their own treatment goals. To assess the effectiveness of MAP treatment regimens (serving limited quantities of alcohol daily to alcoholics) on their own or as compared to moderate drinking (self-controlled drinking), screening and brief intervention using a harm reduction approach, traditional abstinence-based interventions (12 step programmes) and no intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and PsycINFO up to March 2012. This search was expanded by handsearching of high-yield journals and conference proceedings that had not already been handsearched on behalf of The Cochrane Collaboration, searching reference lists of all papers and relevant reviews identified, references to ongoing and recently completed clinical trials in the National Research Register and IFPMA Clinical Trials Database (which contains ClinicalTrials.gov, Centerwatch, Current Controlled Trials and ClinicalStudyResults.gov, and Osservatorio Nazionale sulla Sperimentazione Clinica dei Medicinali). Trials registers, grey literature and reference lists were also searched. Individuals, organisations and experts in the field were contacted. Randomised control trials (RCT), controlled clinical trials (CCT), interrupted time series (ITS) studies, and control before and after (CBA) studies involving vulnerable people aged 18 years or older who were

Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study.

Science.gov (United States)

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

2018-06-01

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

Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer.

Directory of Open Access Journals (Sweden)

Ester Vilaprinyo

Full Text Available The one-size-fits-all paradigm in organized screening of breast cancer is shifting towards a personalized approach. The present study has two objectives: 1 To perform an economic evaluation and to assess the harm-benefit ratios of screening strategies that vary in their intensity and interval ages based on breast cancer risk; and 2 To estimate the gain in terms of cost and harm reductions using risk-based screening with respect to the usual practice. We used a probabilistic model and input data from Spanish population registries and screening programs, as well as from clinical studies, to estimate the benefit, harm, and costs over time of 2,624 screening strategies, uniform or risk-based. We defined four risk groups, low, moderate-low, moderate-high and high, based on breast density, family history of breast cancer and personal history of breast biopsy. The risk-based strategies were obtained combining the exam periodicity (annual, biennial, triennial and quinquennial, the starting ages (40, 45 and 50 years and the ending ages (69 and 74 years in the four risk groups. Incremental cost-effectiveness and harm-benefit ratios were used to select the optimal strategies. Compared to risk-based strategies, the uniform ones result in a much lower benefit for a specific cost. Reductions close to 10% in costs and higher than 20% in false-positive results and overdiagnosed cases were obtained for risk-based strategies. Optimal screening is characterized by quinquennial or triennial periodicities for the low or moderate risk-groups and annual periodicity for the high-risk group. Risk-based strategies can reduce harm and costs. It is necessary to develop accurate measures of individual risk and to work on how to implement risk-based screening strategies.

Effect of smoking reduction on lung cancer risk

DEFF Research Database (Denmark)

Godtfredsen, Nina S; Prescott, Eva; Osler, Merete

2005-01-01

Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases.......Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases....

Alleviation of harmful effect in stillage reflux in food waste ethanol fermentation based on metabolic and side-product accumulation regulation.

Science.gov (United States)

Ma, Hongzhi; Yang, Jian; Jia, Yan; Wang, Qunhui; Ma, Xiaoyu; Sonomoto, Kenji

2016-10-01

Stillage reflux fermentation in food waste ethanol fermentation could reduce sewage discharge but exert a harmful effect because of side-product accumulation. In this study, regulation methods based on metabolic regulation and side-product alleviation were conducted. Result demonstrated that controlling the proper oxidation-reduction potential value (-150mV to -250mV) could reduce the harmful effect, improve ethanol yield by 21%, and reduce fermentation time by 20%. The methods of adding calcium carbonate to adjust the accumulated lactic acid showed that ethanol yield increased by 17.3%, and fermentation time decreased by 20%. The accumulated glyceal also shows that these two methods can reduce the harmful effect. Fermentation time lasted for seven times without effect, and metabolic regulation had a better effect than side-product regulation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Harm reduction and knowledge exchange-a qualitative analysis of drug-related Internet discussion forums.

Science.gov (United States)

Soussan, Christophe; Kjellgren, Anette

2014-09-08

Novel psychoactive substances (NPS) are continuously and increasingly appearing on the international drug market. Global Internet forums are a publicly available reality where users anonymously discuss and share information about NPS. The aim of this study was to explore and characterize the discussions about NPS on international Internet forums. The most post-frequent NPS discussions were collected from three "leading edge" international Internet forums. A total of 13,082 posts from 60 threads of discussion were systematically examined and interpreted to reveal recurring topics and patterns. Each thread was coded with emerging topics and supporting quotations from the data set. Eventually, codes with coherent meaning were arranged into 51 broader categories of abstraction, which were combined into four overarching themes. Four themes emerged during the analysis: (1) uncovering the substance facts, (2) dosage and administration, (3) subjectively experienced effects, and (4) support and safety. The first theme dealt primarily with substance identification, pharmacology, and assessed not only purity but also legal status and acquisition. The second theme focused on administration techniques, dose recommendations, technical talk about equipment, and preferred settings for drug use. The third theme involved a multitude of self-reported experiences, in which many different aspects of intoxication were depicted in great detail. The users emphasized both positive and negative experiences. The last theme incorporated the efforts of the communities to prevent and minimize harm by sharing information about potential risks of the harmful effects or contraindications of a substance. Also, online support and guidance were given to intoxicated persons who experienced bad or fearful reactions. The findings showed that the discussions were characterized by a social process in which users supported each other and exchanged an extensive and cumulative amount of knowledge about NPS

Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

Directory of Open Access Journals (Sweden)

Fontanella Bruno José Barcellos

2005-01-01

Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

Directory of Open Access Journals (Sweden)

Bruno José Barcellos Fontanella

2005-12-01

Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

Love as harm reduction: fighting AIDS and stigma in Vietnam

Directory of Open Access Journals (Sweden)

Small Dan

2009-12-01

Full Text Available Abstract In the summer of 2009, I visited a humble orphanage for children with HIV/AIDS in Vietnam. Here, like many parts in the world, the very existence of marginalized people with stigmatized illness is hidden away. Relegated to the shadows of society, these children lacked something more fundamental than housing, shelter, nutrition and medications. They lacked families to love and care for them unconditionally. One might think it self-evident that a visit to an orphanage for children with HIV would be profound, but the profundity wasn't where I expected to find it. It was in how the children had created their own family, loving each other like brothers and sisters, and the way the priest who operated the shelters was more than a Father, he was a dad to dozens of children. This is an account of love as harm reduction in the Mai Tam orphanage in Ho Chi Minh City.

Accelerating harm reduction interventions to confront the HIV epidemic in the Western Pacific and Asia: the role of WHO (WPRO

Directory of Open Access Journals (Sweden)

Yifei Hu

2008-08-01

Full Text Available Abstract The epidemic of HIV/AIDS linked to injecting drug usage is one of the most explosive in recent years. After a historical epicentre in Europe, South and North America, at present it is clearly the main cause of dissemination of the epidemic in Eastern Europe and some key Asian countries. Recently, 10 African countries reported the spread of HIV through people who inject drugs (PWID, breaking one of the final geographical barriers to the globalization of the epidemic of HIV among and from PWID. Several countries of the Asia and Pacific Region have HIV epidemics that are driven by injecting drug usage. Harm reduction interventions have been implemented in many countries and potential barriers to implementation are being overcome. Harm reduction is no longer a marginal approach in the Region; instead, it is the core tool for responding to the HIV/AIDS epidemic among PWID. The development of a comprehensive response in the Region has been remarkable, including scaling up of needle and syringe programmes (NSPs, methadone maintenance treatment (MMT, and care, support and treatment for PWID. This development is being followed up by strong ongoing changes in policies and legislations. The main issue now is to enhance interventions to a level that can impact the epidemic. The World Health Organization (WHO is one of the leading UN agencies promoting harm reduction. Since the establishment of the Global Programme on AIDS, WHO has been working towards an effective response to the HIV epidemic among PWID. WHO's work is organized into a number of components: establishing an evidence base; advocacy; development of normative standards, tools and guidelines; providing technical support to countries; ensuring access to essential medicines, diagnostics and commodities; and mobilizing resources. In this paper, we trace the course of development of the HIV/AIDS epidemic among and from PWID in the Western Pacific and Asia Region (WPRO as well as WHO's role

Environmentally harmful subventions in the Federal Republic of Germany. Updating for the year 2016

International Nuclear Information System (INIS)

Koeder, Lea; Burger, Andreas

2016-12-01

The contribution on environmentally harmful subventions in the Federal Republic of Germany (Updating for the year 2016) includes the following issues: Why the reduction of environmentally harmful subventions is necessary; subventions and related processes; international initiatives for the reduction of environmentally harmful subventions, routes for the reduction of environmentally harmful subventions.

Effect of Smoking Abstinence and Reduction in Asthmatic Smokers Switching to Electronic Cigarettes: Evidence for Harm Reversal

Directory of Open Access Journals (Sweden)

Riccardo Polosa

2014-05-01

Full Text Available Electronic cigarettes (e-cigs are marketed as safer alternatives to tobacco cigarettes and have shown to reduce their consumption. Here we report for the first time the effects of e-cigs on subjective and objective asthma parameters as well as tolerability in asthmatic smokers who quit or reduced their tobacco consumption by switching to these products. We retrospectively reviewed changes in spirometry data, airway hyper-responsiveness (AHR, asthma exacerbations and subjective asthma control in smoking asthmatics who switched to regular e-cig use. Measurements were taken prior to switching (baseline and at two consecutive visits (Follow-up/1 at 6 (±1 and Follow-up/2 at 12 (±2 months. Eighteen smoking asthmatics (10 single users, eight dual users were identified. Overall there were significant improvements in spirometry data, asthma control and AHR. These positive outcomes were noted in single and dual users. Reduction in exacerbation rates was reported, but was not significant. No severe adverse events were noted. This small retrospective study indicates that regular use of e-cigs to substitute smoking is associated with objective and subjective improvements in asthma outcomes. Considering that e-cig use is reportedly less harmful than conventional smoking and can lead to reduced cigarette consumption with subsequent improvements in asthma outcomes, this study shows that e-cigs can be a valid option for asthmatic patients who cannot quit smoking by other methods.

Changes in HIV incidence among people who inject drugs in Taiwan following introduction of a harm reduction program: a study of two cohorts.

Directory of Open Access Journals (Sweden)

Yen-Fang Huang

2014-04-01

Full Text Available Harm reduction strategies for combating HIV epidemics among people who inject drugs (PWID have been implemented in several countries. However, large-scale studies using sensitive measurements of HIV incidence and intervention exposures in defined cohorts are rare. The aim of this study was to determine the association between harm reduction programs and HIV incidence among PWID.The study included two populations. For 3,851 PWID who entered prison between 2004 and 2010 and tested HIV positive upon incarceration, we tested their sera using a BED HIV-1 capture enzyme immunoassay to estimate HIV incidence. Also, we enrolled in a prospective study a cohort of 4,357 individuals who were released from prison via an amnesty on July 16, 2007. We followed them with interviews at intervals of 6-12 mo and by linking several databases. A total of 2,473 participants who were HIV negative in January 2006 had interviews between then and 2010 to evaluate the association between use of harm reduction programs and HIV incidence. We used survival methods with attendance at methadone clinics as a time-varying covariate to measure the association with HIV incidence. We used a Poisson regression model and calculated the HIV incidence rate to evaluate the association between needle/syringe program use and HIV incidence. Among the population of PWID who were imprisoned, the implementation of comprehensive harm reduction programs and a lower mean community HIV viral load were associated with a reduced HIV incidence among PWID. The HIV incidence in this population of PWID decreased from 18.2% in 2005 to 0.3% in 2010. In an individual-level analysis of the amnesty cohort, attendance at methadone clinics was associated with a significantly lower HIV incidence (adjusted hazard ratio: 0.20, 95% CI: 0.06-0.67, and frequent users of needle/syringe program services had lower HIV incidence (0% in high NSP users, 0.5% in non NSP users. In addition, no HIV seroconversions were

[Self-harm vs. harming others: the lived experiences of a dysfunctional family].

Science.gov (United States)

Wu, Hsiu-Chin; Lin, Mei-Feng; Yu, Shu-Hua

2007-10-01

The purpose of this study was to explore the lived experiences of self-harm and harm to others from the perspective of two adult offspring and a father, the latter of whom was prone to alcohol abuse and domestic violence and had attempted suicide. Written informed consents were obtained from the subjects after a detailed explanation of the research aims and procedures. A qualitative, phenomenological method was applied for the study. Three subjects were interviewed using a semi-structured interview guide designed by the researchers and based on the aims of the study over a six-month period of home care. A qualitative content analysis based on a phenomenological method was used to identify themes in the data. Two main categories emerged: (1) the mutual harm to the couple subsystem, (2) the misplaced parental-child subsystem. Subsequently, two to four themes were identified from each category. These results provide a better analysis and understanding of the perceived experiences of the harm to the spouse, parental, and sibling subsystems. They should also help health professionals to improve awareness of the lived experiences associated with the issues of self-harm and threats of harm to others. This study could serve as a valuable reference in promoting possible prevention strategies aiming at the reduction of self-harm and harm to others in dysfunctional families within the community.

Young people who use drugs engaged in harm reduction programs in New York City: Overdose and other risks.

Science.gov (United States)

Calvo, Michele; MacFarlane, Jessica; Zaccaro, Heather; Curtis, Matthew; Cabán, María; Favaro, Jamie; Passannante, Marian R; Frost, Taeko

2017-09-01

Little is known about the engagement of young people who use drugs (PWUD) in harm reduction programs (HRPs), and few studies have included non-opioid users and non-injectors. While HRPs have effectively engaged PWUD, young people are under-represented in their services. The Injection Drug Users Health Alliance Citywide Study (IDUCS) is the largest community-based study of PWUD in HRPs in the US. From 2014-2015, 2421 HRP participants across New York City (NYC) completed a cross-sectional survey. We investigated differences in socio-demographics, service utilization, and risk behaviors between young (aged 18-30) and older participants and examined factors associated with overdose among young participants. The study included 257 young participants. They were significantly more likely than older participants to be white, educated, uninsured, unstably housed or homeless, and have a history of incarceration and residential drug treatment. They were more likely to report recent overdose but less likely to report knowledge of naloxone. Young participants also had higher rates of alcohol, marijuana, benzodiazepine, and injection drug use, and related risk behaviors such as public injection. Factors associated with past year overdose among young participants included experiencing symptoms of psychological distress (AOR=9.71), being unstably housed or homeless (AOR=4.39), and utilizing detox (AOR=4.20). Young PWUD who access services at HRPs in NYC differ significantly from their older counterparts. New York City and other urban centers that attract young PWUD should consider implementing harm reduction oriented services tailored to the unique needs of young people. Copyright © 2017. Published by Elsevier B.V.

Effects of dram shop liability and enhanced overservice law enforcement initiatives on excessive alcohol consumption and related harms: Two community guide systematic reviews.

Science.gov (United States)

Rammohan, Veda; Hahn, Robert A; Elder, Randy; Brewer, Robert; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci L; Chattopadhyay, Sajal K; Zometa, Carlos

2011-09-01

Dram shop liability holds the owner or server(s) at a bar, restaurant, or other location where a patron, adult or underage, consumed his or her last alcoholic beverage responsible for harms subsequently inflicted by the patron on others. Liability in a state can be established by case law or statute. Overservice laws prohibit the sale of alcoholic beverages to intoxicated patrons drinking in on-premises retail alcohol outlets (i.e., premises where the alcohol is consumed where purchased); enhanced enforcement of these laws is intended to ensure compliance by premises personnel. Both of these interventions are ultimately designed to promote responsible beverage service by reducing sales to intoxicated patrons, underage youth, or both. This review assesses the effectiveness of dram shop liability and the enhanced enforcement of overservice laws for preventing excessive alcohol consumption and related harms. Studies assessing alcohol-related harms in states adopting dram shop laws were evaluated, as were studies assessing alcohol-related harms in regions with enhanced overservice enforcement. Methods previously developed for systematic reviews for the Guide to Community Preventive Services were used. Eleven studies assessed the association of state dram shop liability with various outcomes, including all-cause motor vehicle crash deaths, alcohol-related motor vehicle crash deaths (the most common outcome assessed in the studies reviewed), alcohol consumption, and other alcohol-related harms. There was a median reduction of 6.4% (range of values 3.7% to 11.3% reduction) in alcohol-related motor vehicle fatalities associated with the presence of dram shop liability in jurisdictions where premises are licensed. Other alcohol-related outcomes also showed a reduction. Only two studies assessed the effects of enhanced enforcement initiatives on alcohol-related outcomes; findings were inconsistent, some indicating benefit and others none. According to Community Guide rules

Chang'aa Drinking in Kibera Slum: The Harmful Effects of ...

African Journals Online (AJOL)

Chang'aa Drinking in Kibera Slum: The Harmful Effects of Contemporary Changes in the Production and Consumption of Traditional Spirits. ... African Journal of Drug and Alcohol Studies ... This article examines the harmful effects of drinking chang'aa, an illegal spirit produced locally, in Kibera slum in Nairobi, Kenya.

Prevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers.

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Hollingworth, William; Ebel, Beth E; McCarty, Carolyn A; Garrison, Michelle M; Christakis, Dimitri A; Rivara, Frederick P

2006-03-01

Harmful alcohol consumption is a leading cause of death in the United States. The majority of people who die from alcohol use begin drinking in their youth. In this study, we estimate the impact of interventions to reduce the prevalence of drinking among youth on subsequent drinking patterns and alcohol-attributable mortality. We first estimated the effect of public health interventions to decrease harmful drinking among youth from literature reviews and used life table methods to estimate alcohol-attributable years of life lost by age 80 years among the cohort of approximately 4 million U.S. residents aged 20 in the year 2000. Then, from national survey data on transitions in drinking habits by age, we modeled the impact of interventions on alcohol-attributable mortality. A tax increase and an advertising ban were the most effective interventions identified. In the absence of intervention, there would be 55,259 alcohol-attributable deaths over the lifetime of the cohort. A tax-based 17% increase in the price of alcohol of dollar 1 per six pack of beer could reduce deaths from harmful drinking by 1,490, equivalent to 31,130 discounted years of potential life saved or 3.3% of current alcohol-attributable mortality. A complete ban on alcohol advertising would reduce deaths from harmful drinking by 7,609 and result in a 16.4% decrease in alcohol-related life-years lost. A partial advertising ban would result in a 4% reduction in alcohol-related life-years lost. Interventions to prevent harmful drinking by youth can result in reductions in adult mortality. Among interventions shown to be successful in reducing youthful drinking prevalence, advertising bans appear to have the greatest potential for premature mortality reduction.

Effectiveness of policy changes to reduce harm from unrecorded alcohol in Russia between 2005 and now.

Science.gov (United States)

Neufeld, Maria; Rehm, Jürgen

2018-01-01

Consumption of unrecorded alcohol (alcohol that is not taxed and reflected in official statistics, but consumed as a beverage) has been identified as one of the main contributors to alcohol-attributable premature mortality in Russia. The problem was highlighted by a recent a mass poisoning with surrogate alcohol occurred in the Siberian city of Irkutsk. Based on key publications and legislative documents, a narrative review was undertaken about alcohol-related harm reduction policies in Russia for the period between 2005 and 2017, as well as the impact of these policies on the recorded and unrecorded alcohol consumption and alcohol market. Various policy measures mainly targeting availability and price of recorded and unrecorded alcohol have been introduced since 2005, which generally coincided with the decreases in alcohol-related mortality observed at that time. However, regulations on medicinal and cosmetic products have remained inconsistent providing the foundations for the continued existence of a legal industry of surrogates with broad availability and misuse. The Russian experiences of introducing alcohol policies demonstrate that there are effective measures to reduce unrecorded alcohol consumption and attributable harm. The government's multi-level strategy of alcohol consumption and harm reduction should be pursued stringently and all the possible loop-holes for producers, sellers and distributors of illegal and/or unrecorded alcohol should be eliminated or at least critically reduced. Copyright © 2017 Elsevier B.V. All rights reserved.

Reduction of Harmful Emissions During Start and Warming Up of the Engine

Science.gov (United States)

Volkov, N.; Chainikov, D.

2018-01-01

The question of decrease in harmful emissions when idling of a truck engine in the conditions of low temperatures is considered. The implementation of the thermogenerator for a power supply of electrical elements is offered in a design of the self-powered heater. The principle of the device operation is based on a thermoelectric effect at which there is heat absorption and thermo-EMF emergence. In a consequence of this process electricity is produced. The exhaust gases of the self-powered heater are the source of the absorbed heat and act as fuel for the thermogenerator. It allows developing energy for a power supply of electrical elements of the heater. It gives the chance not to start the engine for warming up during the long parking, thereby reducing harmful emissions.

Harmful effects on plants. 2. rev. ed.

International Nuclear Information System (INIS)

Hock, B.; Elstner, E.F.

1988-01-01

The book deals with accidentally or purposefully induced harmful effects on plants, i.e. eukariyotes and fungi, with emphasis being placed on chemicals as the main pollutants. After discussing the quantification of damage as a prerequisite for detecting, defining, and possibly preventing, damage to plants by toxic substances in the environment, the second part of the book deals with the harmful effects that are purposefully induced, for example in agriculture or horticulture, by employment of pesticides (herbicides or fungicides). In this context, all aspects of uptake, metabolism, and detoxication are discussed, especially referring to the molecular conditions of relevance to a selective elimination of metabolic or developmental processes in the plants, which is explained by the effects of pesticides and antibiotics. Injuries caused by autogenous substances in the plants, upon exceeding a certain amount or dose are also explained, together with effects of physical factors (as e.g. ionizing radiation), or biogenic factors (as e.g. parasites). (ECB) [de

Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

Science.gov (United States)

McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

2012-05-17

Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

Serotonin selectively influences moral judgment and behavior through effects on harm aversion.

Science.gov (United States)

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

2010-10-05

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

Differentiating drugs by harm potential: the rational versus the feasible.

Science.gov (United States)

Kalant, H

1999-01-01

In an ideal harm reduction model, drugs would be ranked according to their potential to cause harm, with varying implications for control policies and interventions. In such a public health oriented approach, the maximum protection of the public from harm would be balanced with the least possible restriction of freedom. In reality, however, the accuracy and completeness of the necessary information for such a ranking is highly limited. Many other factors not readily incorporated in a rational model, such as values, beliefs, and traditions, also affect drug policy decisions. Thus, rather than relying on acquisition of the necessary knowledge, it may be preferable to focus efforts on developing effective nonlegal measures to reduce drug use and harm. [Translations are provided in the International Abstracts Section of this issue.

[Harmful alcohol consumption: prevalence, trends, health burden, reduction strategy].

Science.gov (United States)

Грузева, Татьяна С; Дуфинец, Василий А; Замкевич, Виктория Б

2016-01-01

with mental and behavioral disorders due to use of psychoactive substances wereregistered in health care facilities in 2014. Standardized mortality rate from causes related to alcohol in Ukraine (185.4 per 100 thousand.) is one of the largest in Europe, with only Kazakhstan (308.4) and Belarus (187.9) being behind. Regular work aiming at prevention of alcohol abuse is carried out by 49.4% of primary care professionals; 21.3% of physiciansinsist on reducing alcohol use on occasion. Alcohol abuse is a major factor of morbidity, epidemic of noncommunicable diseases in Ukraine, causing significant medical and social costs and economic losts.Ukraine ranks fifth in alcohol consumption per capita among WHO European Region countries. High level and unhealthy patterns of alcohol consumption in the population causes high morbidity and mortality from noncommunicable diseases, accidents, exceeding pan-European indices and indicators in the European Union. Primary health care facility staff has insufficient knowledge, skills and gaps in professional training regarding the prevention of harmful use of alcohol.There is a high need for effective strategies to reduce the prevalence of this risk factor in Ukraine. In developing the National Action Plan to reduce the harmful use of alcohol, a national context and WHO recommendationsshould be considered, including improving the efficiency of health services, high-quality prevention and effective treatment of disorders caused by alcohol, countermeasures on driving drunk, limiting the sale and availability of alcohol, prevention the spread of manufacturing and marketing of alcoholbeverages produced illegally, including falsification, the revitalization of local communities, weakening the impact of marketing of alcohol beverages.

Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities.

Science.gov (United States)

Giesbrecht, Norman; Wettlaufer, Ashley; Thomas, Gerald; Stockwell, Tim; Thompson, Kara; April, Nicole; Asbridge, Mark; Cukier, Samantha; Mann, Robert; McAllister, Janet; Murie, Andrew; Pauley, Chris; Plamondon, Laurie; Vallance, Kate

2016-05-01

Alcohol pricing is an effective prevention policy. This paper compares the 10 Canadian provinces on three research-based alcohol pricing policies-minimum pricing, pricing by alcohol content and maintaining prices relative to inflation. The selection of these three policies was based on systematic reviews and seminal research papers. Provincial data for 2012 were obtained from Statistics Canada and relevant provincial ministries, subsequently sent to provincial authorities for verification, and then scored by team members. All provinces, except for Alberta, have minimum prices for at least one beverage type sold in off-premise outlets. All provinces, except for British Columbia and Quebec, have separate (and higher) minimum pricing for on-premise establishments. Regarding pricing on alcohol content, western and central provinces typically scored higher than provinces in Eastern Canada. Generally, minimum prices were lower than the recommended $1.50 per standard drink for off-premise outlets and $3.00 per standard drink in on-premise venues. Seven of 10 provinces scored 60% or higher compared to the ideal on indexing prices to inflation. Prices for a representative basket of alcohol products in Ontario and Quebec have lagged significantly behind inflation since 2006. While examples of evidence-based alcohol pricing policies can be found in every jurisdiction in Canada, significant inter-provincial variation leaves substantial unrealised potential for further reducing alcohol-related harm and costs. This comparative assessment of alcohol price policies provides clear indications of how individual provinces could adjust their pricing policies and practices to improve public health and safety. [Giesbrecht N, Wettlaufer A, Thomas G, Stockwell T, Thompson K, April N, Asbridge M, Cukier S, Mann R, McAllister J, Murie A, Pauley C, Plamondon L, Vallance K. Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities. Drug Alcohol Rev

"Just Advil": Harm reduction and identity construction in the consumption of over-the-counter medication for chronic pain.

Science.gov (United States)

Eaves, Emery R

2015-12-01

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

Effects of Academic Service Learning in Drug Misuse and Addiction on Students’ Learning Preferences and Attitudes Toward Harm Reduction

Science.gov (United States)

Kabli, Noufissa; Liu, Ben; Seifert, Tricia

2013-01-01

Objective. To examine academic service-learning pedagogy on student learning and perceptions of drug misuse and addiction. Design. Third- and fourth-year pharmacology students were exposed to an academic service-learning pedagogy that integrated a community service experience with lectures, in-class discussions and debates, group projects, a final paper, and an examination. Reflective writing assignments throughout the course required students to assimilate and apply what they had learned in the classroom to what they learned in their community placement. Assessment. Changes in students’ responses on pre- and post-course survey instruments reflected shifts toward higher-order thinking. Also, subjective student-learning modalities shifted toward learning by writing. Students’ perspectives and attitudes allowed improved context of issues associated with drug misuse and harm reduction models. Conclusion. Academic service-learning pedagogy contributes to developing adaptable, well-rounded, engaged learners who become more compassionate and pragmatic in addressing scientific and social questions relating to drug addiction. PMID:23610481

A media information analysis for implementing effective countermeasure against harmful rumor

Science.gov (United States)

Nagao, Mitsuyoshi; Suto, Kazuhiro; Ohuchi, Azuma

2010-04-01

When large scale earthquake occurred, the word of "harmful rumor" came to be frequently heard. The harmful rumor means an economic damage which is caused by the action that people regard actually safe foods or areas as dangerous and then abort consumption or sightseeing. In the case of harmful rumor caused by earthquake, especially, tourism industry receives massive economic damage. Currently, harmful rumor which gives substantial economic damage have become serious social issue which must be solved. In this paper, we propose a countermeasure method for harmful rumor on the basis of media trend in order to implement speedy recovery from harmful rumor. Here, we investigate the amount and content of information which is transmitted to the general public by the media when an earthquake occurred. In addition, the media information in three earthquakes is treated as instance. Finally, we discuss an effective countermeasure method for dispeling harmful rumor through these analysis results.

Australian mental health care practitioners' practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness.

Science.gov (United States)

Sharma, Ratika; Meurk, Carla; Bell, Stephanie; Ford, Pauline; Gartner, Coral

2018-02-01

Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking-related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross-sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1-39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e-cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5-5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1-0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1-0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners. © 2017 Australian College of Mental Health Nurses Inc.

EFFECTIVENESS OF DIALECTICAL BEHAVIOR THERAPY VERSUS COLLABORATIVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY TREATMENT FOR REDUCTION OF SELF-HARM IN ADULTS WITH BORDERLINE PERSONALITY TRAITS AND DISORDER-A RANDOMIZED OBSERVER-BLINDED CLINICAL TRIAL.

Science.gov (United States)

Andreasson, Kate; Krogh, Jesper; Wenneberg, Christina; Jessen, Helle K L; Krakauer, Kristine; Gluud, Christian; Thomsen, Rasmus R; Randers, Lasse; Nordentoft, Merete

2016-06-01

Many psychological treatments have shown effect on reducing self-harm in adults with borderline personality disorder. There is a need of brief psychotherapeutical treatment alternative for suicide prevention in specialized outpatient clinics. The DiaS trial was designed as a pragmatic single-center, two-armed, parallel-group observer-blinded, randomized clinical superiority trial. The participants had at least two criteria from the borderline personality disorder diagnosis and a recent suicide attempt (within a month). The participants were offered 16 weeks of dialectical behavior therapy (DBT) versus up to 16 weeks of collaborative assessment and management of suicidality (CAMS) treatment. The primary composite outcome was the number of participants with a new self-harm (nonsuicidal self-injury [NSSI] or suicide attempt) at week 28 from baseline. Other exploratory outcomes were: severity of borderline symptoms, depressive symptoms, hopelessness, suicide ideation, and self-esteem. At 28 weeks, the number of participants with new self-harm in the DBT group was 21 of 57 (36.8%) versus 12 of 51 (23.5%) in the CAMS treatment (OR: 1.90; 95% CI: 0.80-4.40; P = .14). When assessing the effect of DBT versus CAMS treatment on the individual components of the primary outcome, we observed no significant differences in the number of NSSI (OR: 1.60; 95% CI: 0.70-3.90; P = .31) or number of attempted suicides (OR: 2.24; 95% CI: 0.80-7.50; P = .12). In adults with borderline personality traits and disorder and a recent suicide attempt, DBT does not seem superior compared with CAMS for reduction of number of self-harm or suicide attempts. However, further randomized clinical trials may be needed. © 2016 Wiley Periodicals, Inc.

The effect of information about the benefits and harms of mammography on women’s decision-making: study protocol for a randomized controlled trial

OpenAIRE

Misericòrdia, Carles; Martínez Alonso, Montserrat; Pons Rodríguez, Anna; Pérez Lacasta, María José; Perestelo Pérez, Lilisbeth; Sala, Maria; Vidal, Carmen; Garcia, Montse; Toledo Chávarri, Ana; Codern, Núria; Feijoo Cid, Maria; Romero, Anabel; Pla, Roger; Soler González, Jorge; Castells, Xavier

2017-01-01

Background The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening ...

[Efficacy and security of electronic cigarette for tobacco harm reduction: Systematic review and meta-analysis].

Science.gov (United States)

Vanderkam, Paul; Boussageon, Rémy; Underner, Michel; Langbourg, Nicolas; Brabant, Yann; Binder, Philippe; Freche, Bernard; Jaafari, Nematollah

2016-11-01

Smoking is the first cause of preventable death in France and in the world. Without help, it was shown that 80 % of smokers who try to quit smoking relapse after one month with a low long-term success rate. Smoking reduction can concern smokers who did not want to quit or failed in their attempt to weaning. The final aim is to increase attractiveness of drug therapies by developing new products, such as electronic cigarettes, that can compete cigarette without reproducing its harmful effects. Assess the capacity of electronic cigarettes to reduce or stop tobacco use among regular smokers. Consultations MEDLINE and COCHRANE databases. e-cigarette; electronic cigarettes; ENDD (electronic nicotine delivery system); ENDS (electronic nicotine delivery device); vaping were used. Randomized controlled trials (RCTs) comparing the electronic cigarette with nicotine versus placebo device. Two randomized controlled trials were included in the quantitative analysis. The nicotine electronic cigarette users have tobacco consumption significantly decreased compared to the placebo group (RR: 1.30, 95 % CI [1.02 to 1.66]) at 6 months. Smoking cessation rate at 3 months was greater with the electronic cigarette contains nicotine (RR: 2.55, 95 % CI [1.31 to 4.98]). The small number of RCTs included does not allow definitive conclusions about the effectiveness of electronic cigarettes, especially in the medium to long term. The use of electronic cigarette with nicotine decreases tobacco consumption among regular smokers. Further studies are needed to specify electronic cigarettes safety profile and its ability to cause a reduction in consumption and a long-term cessation in smokers. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Self-harm.

Science.gov (United States)

Skegg, Keren

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

Secondary harm mitigation: A more humanitarian framework for international drug law enforcement.

Science.gov (United States)

Blaustein, Jarrett; McLay, Miki; McCulloch, Jude

2017-08-01

This article introduces the concept of 'secondary harm mitigation' as a framework for improving the humanitarian credentials of international drug law enforcement agencies. The concept is rooted in a critical analysis of the compatibility of the harm reduction philosophy with Australia's international drug law enforcement practices. On a utilitarian level, the net benefits of international drug law enforcement are determined to be, at best inconclusive, arguably counterproductive and in most cases, incalculable. On a humanitarian level, international drug law enforcement is also determined to be problematic from a criminological standpoint because it generates secondary harms and it is indifferent to the vulnerability of individuals who participate in illicit drug trafficking. Accordingly, the article concludes that a philosophy of harm reduction grounded in the public health perspective is inadequate for mitigating secondary harms arising from Australia's efforts to combat international illicit drug trafficking. A tentative list of secondary harm mitigation principles is presented and the article argues that secondary harm mitigation should replace supply reduction as a core tenet of Australia's National Drug Strategy. The article also concludes that secondary harm mitigation may provide a viable framework for stimulating a productive dialogue between those who advocate prohibition and those who call for decriminalisation at the global level. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of soil moisture on sulphur accumulation in overground plant organs and their harm in emmission conditions

Energy Technology Data Exchange (ETDEWEB)

Navara, J; Horvath, I; Hauskrecht, I

1972-01-01

The effect of different soil moisture on sulphur accumulation in the overground organs of Fagopyrum esculentum, moench in immission conditions is dealt with in this paper. The results obtained have shown that even under equal soil conditions, equal nutrient supply and age evenness of the analyzed material the total sulphur content of leaves grown in immission conditions (sulphur oxides, hydrogen sulphide, carbon disulphide, etc.) at equal soil moisture was essentially higher when compared with unirrigated plants and corresponded also to the degree of harm and crop reduction of the experimental plants. Therefore it is necessary when utilizing sulphur content of indicating plants, which serves for a large-area diagnosis of vegetation harm with immissions, to take into consideration, in addition to other factors (soil, nutrition, age of plants), the soil moisture as well.

Effect of smoking reduction on lung cancer risk

DEFF Research Database (Denmark)

Godtfredsen, Nina S; Prescott, Eva; Osler, Merete

2005-01-01

Many smokers are unable or unwilling to completely quit smoking. A proposed means of harm reduction is to reduce the number of cigarettes smoked per day. However, it is not clear whether this strategy decreases the risk for tobacco-related diseases....

Ethics of tobacco harm reduction from a liberal perspective.

Science.gov (United States)

van der Eijk, Yvette

2016-05-01

Mixed evidence on the possible harms, benefits and usage patterns of electronic nicotine delivery systems (ENDS, or 'e-cigarettes'), has led to vigorous and ongoing debates on the issue. The ethical trade-off often represented is that, though smokers should be permitted access to ENDS as a less harmful alternative to smoking, this comes at the expense of non-smokers and children who may experiment with ENDS, become addicted to them, or experience health issues from long-term exposure to passive ENDS vapour. Lacking from many debates is a balanced analysis based on sound ethical reasoning, so this paper aims to examine the issue from a liberal perspective. More specifically, focus is on how ENDS policy can help to promote freedom in a broader sense, with 'freedom' considered as originating from having options and the necessary information and ability to autonomously choose between these options. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

More than just needles: An evidence-informed approach to enhancing harm reduction supply distribution in British Columbia

Directory of Open Access Journals (Sweden)

Mak Sunny

2008-12-01

Full Text Available Abstract Background The BC Harm Reduction Strategies and Services (HRSS policy states that each health authority (HA and their community partners will provide a full range of harm reduction (HR services to their jurisdictions and these HR products should be available to all who need them regardless of where they live and choice of drug. Preliminary analysis revealed wide variations between and within HAs. Methods The objective of this study is to analyze distribution of HR products by site using Geographic Information Systems (GIS and to investigate the range, adequacy and methods of HR product distribution using qualitative interviews. The BC Centre for Disease Control pharmacy database tracks HR supplies distributed to health units and community agencies. Additionally, eleven face-to-face interviews were conducted in eight mainland BC communities using an open-ended questionnaire. Results There is evidence in BC that HR supplies are not equally available throughout the province. There are variations within jurisdictions in how HR supplies are distributed, adequacy of current HR products, collection of used needles, alternative uses of supplies and community attitudes towards HR. GIS illustrates where HR supplies are ordered but with secondary distribution, true reach and availability of supplies cannot be determined. Conclusion Currently, a consultant is employed to develop a 'best practice' document; relevant health files, standard training and protocols within HAs are also being developed. There is a need to enhance the profile and availability of culturally appropriate HR services for Aboriginal populations. Distribution of crackpipe mouthpieces is being investigated.

Commentary: Understanding the origins of anger, contempt, and disgust in public health policy disputes: applying moral psychology to harm reduction debates.

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Alderman, Jess; Dollar, Katherine M; Kozlowski, Lynn T

2010-04-01

Scientific disputes about public health issues can become emotional battlefields marked by strong emotions like anger, contempt, and disgust. Contemporary work in moral psychology demonstrates that each of these emotions is a reaction to a specific type of moral violation. Applying this work to harm reduction debates, specifically the use of smokeless tobacco to reduce harm from tobacco use, we attempt to explain why some public health disputes have been so heated. Public health ethics tend to emphasize social justice concerns to the exclusion of other moral perspectives that value scientific authority, professional loyalty, and bodily purity. An awareness of their different emotional reactions and underlying moral motivations might help public health professionals better understand each others' viewpoints, ultimately leading to more productive dialogue.

Information sought, information shared: exploring performance and image enhancing drug user-facilitated harm reduction information in online forums.

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Tighe, Boden; Dunn, Matthew; McKay, Fiona H; Piatkowski, Timothy

2017-07-21

There is good evidence to suggest that performance and image enhancing drug (PIED) use is increasing in Australia and that there is an increase in those using PIEDs who have never used another illicit substance. Peers have always been an important source of information in this group, though the rise of the Internet, and the increased use of Internet forums amongst substance consumers to share harm reduction information, means that PIED users may have access to a large array of views and opinions. The aim of this study was to explore the type of information that PIED users seek and share on these forums. An online search was conducted to identify online forums that discussed PIED use. Three discussion forums were included in this study: aussiegymjunkies.com, bodybuildingforums.com.au, and brotherhoodofpain.com. The primary source of data for this study was the 'threads' from the online forums. Threads were thematically analysed for overall content, leading to the identification of themes. One hundred thirty-four threads and 1716 individual posts from 450 unique avatars were included in this analysis. Two themes were identified: (1) personal experiences and advice and (2) referral to services and referral to the scientific literature. Internet forums are an accessible way for members of the PIED community to seek and share information to reduce the harms associated with PIED use. Forum members show concern for both their own and others' use and, where they lack information, will recommend seeking information from medical professionals. Anecdotal evidence is given high credence though the findings from the scientific literature are used to support opinions. The engagement of health professionals within forums could prove a useful strategy for engaging with this population to provide harm reduction interventions, particularly as forum members are clearly seeking further reliable information, and peers may act as a conduit between users and the health and medical

Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review.

Science.gov (United States)

Hahn, Robert A; Middleton, Jennifer Cook; Elder, Randy; Brewer, Robert; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci L; Chattopadhyay, Sajal; Lawrence, Briana; Campbell, Carla Alexia

2012-04-01

Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms. The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and related harms. Using Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple databases up to December 2010. Reference lists of acquired articles and review papers were also scanned for additional studies. A total of 17 studies assessed the impact of privatizing retail alcohol sales on the per capita alcohol consumption, a well-established proxy for excessive alcohol consumption; 9 of these studies also examined the effects of privatization on the per capita consumption of alcoholic beverages that were not privatized. One cohort study in Finland assessed the impact of privatizing the sales of medium-strength beer (MSB) on self-reported alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median increase in the per capita sales of privatized beverages in locations that privatized retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile interval: -6.6% to -0.1%). Privatizing the sale of MSB in Finland was associated with a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per year. Re-monopolization of the sale of MSB in Sweden was associated with a general reduction in alcohol-related harms. According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol sales leads to increases in excessive alcohol consumption. Published by Elsevier Inc.

Environmentally harmful subventions in the Federal Republic of Germany. Updating for the year 2016; Umweltschaedliche Subventionen in Deutschland. Aktualisierte Ausgabe 2016

Energy Technology Data Exchange (ETDEWEB)

Koeder, Lea; Burger, Andreas

2016-12-15

The contribution on environmentally harmful subventions in the Federal Republic of Germany (Updating for the year 2016) includes the following issues: Why the reduction of environmentally harmful subventions is necessary; subventions and related processes; international initiatives for the reduction of environmentally harmful subventions, routes for the reduction of environmentally harmful subventions.

Harmful Algal Blooms

Science.gov (United States)

Graham, Jennifer L.

2007-01-01

What are Harmful Algal Blooms (HABs)? Freshwater and marine harmful algal blooms (HABs) can occur anytime water use is impaired due to excessive accumulations of algae. HAB occurrence is affected by a complex set of physical, chemical, biological, hydrological, and meteorological conditions making it difficult to isolate specific causative environmental factors. Potential impairments include reduction in water quality, accumulation of malodorous scums in beach areas, algal production of toxins potent enough to poison both aquatic and terrestrial organisms, and algal production of taste-and-odor compounds that cause unpalatable drinking water and fish. HABs are a global problem, and toxic freshwater and (or) marine algae have been implicated in human and animal illness and death in over 45 countries worldwide and in at least 27 U.S. States (Yoo and others, 1995; Chorus and Bartram, 1999; Huisman and others, 2005).

Minimising the harm from nicotine use: finding the right regulatory framework.

Science.gov (United States)

Borland, Ron

2013-05-01

The tobacco problem can be usefully conceptualised as two problems: eliminating the most harmful forms of nicotine use (certainly cigarettes, and probably all smoked tobacco), and minimising the use and/or harms from use of lower-harm, but addictive forms of nicotine. A possible target would be to effectively eliminate use of the most harmful forms of nicotine within the next decade and then turn our focus to a long-term strategy for the low-harm forms. This paper focuses on the administrative framework(s) needed to accomplish these twin tasks. For a phase-out taking a long time and/or for dealing with residually net harmful and addictive products, there are severe limitations to allowing for-profit marketing of tobacco because such an arrangement (the current one in most countries) can markedly slow down progress and because of the difficulty of constraining marketing in ways that minimise undesirable use. A harm reduction model where the marketing is under the control of a non-profit entity (a regulated market) is required to curtail the incredible power of for-profit marketing and to allow tobacco marketing to be done in ways that further the goal of minimising tobacco-related harm. Countries with a nationalised industry can move their industry onto a harm minimisation framework if they have the political will. Countries with a for-profit industry should consider whether the time and effort required to reconstruct the market may, in the longer term, facilitate achieving their policy goals.

Injecting drug use, sexual risk, HIV knowledge and harm reduction uptake in a large prison in Bali, Indonesia.

Science.gov (United States)

Sawitri, Anak Agung Sagung; Hartawan, Anak Agung Gede; Craine, Noel; Sari, Ayu Kartika; Septarini, Ni Wayan; Wirawan, Dewa Nyoman

2016-01-01

The purpose of this paper is to describe HIV-related risk behavior and knowledge of HIV among inmates of Kerobokan prison Bali, Indonesia. A cross-sectional survey of inmates of using a structured questionnaire and sample framework to reflect narcotic use among inmates and the prison gender mix. Among 230 inmates recruited to the study self-reported prevalence of injecting drug use was 7.4 percent (95 percent CI 4.0-10.8 percent). Respondents who participated in a prison based methadone treatment program were all still injecting drugs, these made up 13/17 of the IDU. In total, 47 percent (95 percent CIs 45-55 percent) of respondents who reported injecting also reported sharing needles within the last week. Sexual intercourse while in prison was reported by 3.0 percent (95 percent CI 0.82-5.26 percent) of study respondents. One-third of non-injectors were unaware of the preventative role of condom use. This study suggests that despite harm reduction initiatives within Kerobokan prison HIV risk behavior continues and there is a considerable lack of awareness of the importance of condom use in preventing HIV. The authors relied on self-reported risk behavior that may be subject to reporting bias. The sampling strategy may not reflect the true ratio inmates using or not using narcotics. The current harm reduction approach, including methadone substitution treatment should be optimized within the Indonesian prison setting. This is the first study reporting HIV-related risk behavior from an Indonesian prison with an established methadone substitution program.

Harm expectancy violation during exposure therapy for posttraumatic stress disorder.

Science.gov (United States)

de Kleine, Rianne A; Hendriks, Lotte; Becker, Eni S; Broekman, Theo G; van Minnen, Agnes

2017-06-01

Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of harm expectancies is a crucial mechanism of action in exposure therapy. But to date, changes in harm expectancies have not been examined during exposure therapy in PTSD. The goal of the current study was to examine harm expectancy violation as mechanism of change in exposure therapy for posttraumatic stress disorder (PTSD). Patients (N=50, 44 female) with a primary diagnosis of chronic PTSD received intensive exposure therapy. Harm expectancies, harm experiences and subjective units of distress (SUDs) were assessed at each imaginal exposure session, and PTSD symptoms were assessed pre- and posttreatment with the Clinician Administered PTSD Scale (CAPS). Results showed that harm expectancies were violated within and strongly declined in-between exposure therapy sessions. However, expectancy violation was not related to PTSD symptom change. Fear habituation measures were moderately related to PTSD symptom reductions. In line with theory, exposure therapy promotes expectancy violation in PTSD patients, but this is not related to exposure therapy outcome. More work is warranted to investigate mechanisms of change during exposure therapy in PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quantifying population-level health benefits and harms of e-cigarette use in the United States.

Directory of Open Access Journals (Sweden)

Samir S Soneji

Full Text Available Electronic cigarettes (e-cigarettes may help cigarette smokers quit smoking, yet they may also facilitate cigarette smoking for never-smokers. We quantify the balance of health benefits and harms associated with e-cigarette use at the population level.Monte Carlo stochastic simulation model. Model parameters were drawn from census counts, national health and tobacco use surveys, and published literature. We calculate the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation among current smokers and transition to long-term cigarette smoking among never smokers for the 2014 US population cohort.The model estimated that 2,070 additional current cigarette smoking adults aged 25-69 (95% CI: -42,900 to 46,200 would quit smoking in 2015 and remain continually abstinent from smoking for ≥7 years through the use of e-cigarettes in 2014. The model also estimated 168,000 additional never-cigarette smoking adolescents aged 12-17 and young adults aged 18-29 (95% CI: 114,000 to 229,000, would initiate cigarette smoking in 2015 and eventually become daily cigarette smokers at age 35-39 through the use of e-cigarettes in 2014. Overall, the model estimated that e-cigarette use in 2014 would lead to 1,510,000 years of life lost (95% CI: 920,000 to 2,160,000, assuming an optimistic 95% relative harm reduction of e-cigarette use compared to cigarette smoking. As the relative harm reduction decreased, the model estimated a greater number of years of life lost. For example, the model estimated-1,550,000 years of life lost (95% CI: -2,200,000 to -980,000 assuming an approximately 75% relative harm reduction and -1,600,000 years of life lost (95% CI: -2,290,000 to -1,030,000 assuming an approximately 50% relative harm reduction.Based on the existing scientific evidence related to e-cigarettes and optimistic assumptions about the relative harm of e-cigarette use compared to cigarette smoking, e-cigarette use currently

Sexually dimorphic effects of oxytocin receptor gene (OXTR variants on Harm Avoidance

Directory of Open Access Journals (Sweden)

Stankova Trayana

2012-07-01

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

Factors influencing perceived effectiveness in dealing with self-harming patients in a sample of emergency department staff.

Science.gov (United States)

Egan, Rachel; Sarma, Kiran M; O'Neill, Meena

2012-12-01

Past self-harming behavior is one of the most significant predictors of future suicide. Each year in Ireland there are approximately 11,000 presentations of self-harm to emergency departments (EDs) across the country. This study examines predictors of perceived personal effectiveness in dealing with self-harming patients as reported by ED staff. The predictors are derived from past research and are influenced by Bandura's Social Cognitive Theory. One hundred twenty-five ED medical staff (28 doctors and 97 nurses) from five EDs in the West and South of Ireland completed a questionnaire. Predictor variables included in the design, and informed by past research, included knowledge of self-harm and suicidal behavior and confidence in dealing with incidents of self-harm. Standard multiple regression suggested a statistically significant model fit between the two predictors and the criterion variable, accounting for 24% of total variance. Knowledge and Confidence were significant contributors to perceived personal effectiveness in dealing with self-harming patients. Little is known regarding specific factors that influence perceived effectiveness in dealing with self-harming patients in the ED setting. These findings have implications for psycho-education and training content for staff. The findings suggest that increasing knowledge of self-harm and confidence in dealing with self-harming patients can lead to more positive perceived personal effectiveness in responding to clients' needs. Copyright © 2012 Elsevier Inc. All rights reserved.

Are long physician working hours harmful to patient safety?

Science.gov (United States)

Ehara, Akira

2008-04-01

Pediatricians of Japanese hospitals including not only residents but also attending physicians work long hours, and 8% work for >79 h per week. Most of them work consecutively for >or=32 h when they are on call. The aim of the present study was to evaluate the effect of long work hours on patient safety. The electronic databases MEDLINE and EMBASE to searched identify the English- and Japanese-language literature for studies on work hours, medical errors, patient safety, and malpractice for years 1966-2005. Studies that analyzed the relationship between physician work hours and outcomes directly related to patient safety were selected. Seven studies met the criteria. Four studies suggest that reduction of work hours has a favorable effect on patient safety indicators. In the other three studies no significant changes of the indicators were observed, but no report found that shorter work hours were harmful to patient safety. Decrease of physician work hours is not harmful but favorable to patient safety.

Motivations for Using MDMA (Ecstasy/Molly) among African Americans: Implications for Prevention and Harm-Reduction Programs.

Science.gov (United States)

Rigg, Khary K

2017-01-01

Despite the growing popularity of MDMA (ecstasy/molly) among African Americans, their motives for using the drug are still largely unknown. The purpose of this study was to identify and describe the most salient motivations for using MDMA among this understudied population. In-depth interviews (n = 15) were conducted with a sample of African American young adults in Southwest Florida between August 2014 and November 2015. The primary motivations for using MDMA included: (1) altering the effects of marijuana and alcohol; (2) lasting longer sexually; (3) enhancing sexual pleasure; and (4) facilitating "freaky" sexual experiences. This is the first study to directly examine MDMA motivations specifically among African American drug users, and findings shed light on why some African Americans use MDMA. A better understanding of why African Americans use this drug should help to inform prevention and harm-reduction efforts. Study findings show the need for health messages that include the potential consequences of mixing MDMA with other drugs, and engaging in high-risk sexual behaviors after taking MDMA. These data contrast with motivations (e.g., introspection, self-enlightenment, getting into the music) commonly reported among groups of largely White MDMA users, suggesting that interventions tailored specifically for African American users are needed.

Maximising harm reduction in early specialty training for general practice: validation of a safety checklist.

Science.gov (United States)

Bowie, Paul; McKay, John; Kelly, Moya

2012-06-21

Making health care safer is a key policy priority worldwide. In specialty training, medical educators may unintentionally impact on patient safety e.g. through failures of supervision; providing limited feedback on performance; and letting poorly developed behaviours continue unchecked. Doctors-in-training are also known to be susceptible to medical error. Ensuring that all essential educational issues are addressed during training is problematic given the scale of the tasks to be undertaken. Human error and the reliability of local systems may increase the risk of safety-critical topics being inadequately covered. However adherence to a checklist reminder may improve the reliability of task delivery and maximise harm reduction. We aimed to prioritise the most safety-critical issues to be addressed in the first 12-weeks of specialty training in the general practice environment and validate a related checklist reminder. We used mixed methods with different groups of GP educators (n=127) and specialty trainees (n=9) in two Scottish regions to prioritise, develop and validate checklist content. Generation and refinement of checklist themes and items were undertaken on an iterative basis using a range of methods including small group work in dedicated workshops; a modified-Delphi process; and telephone interviews. The relevance of potential checklist items was rated using a 4-point scale content validity index to inform final inclusion. 14 themes (e.g. prescribing safely; dealing with medical emergency; implications of poor record keeping; and effective & safe communication) and 47 related items (e.g. how to safety-net face-to-face or over the telephone; knowledge of practice systems for results handling; recognition of harm in children) were judged to be essential safety-critical educational issues to be covered. The mean content validity index ratio was 0.98. A checklist was developed and validated for educational supervisors to assist in the reliable delivery of

Harmful Effects of Nanoparticles on Animals

Directory of Open Access Journals (Sweden)

Jean-Marie Exbrayat

2015-01-01

Full Text Available Since several years nanoparticles (NPs are produced by industries and used in several fields of activities. They are finally found in aquatic and terrestrial environments, where they are ingested by living organisms in which they accumulate, before being eliminated. In organisms, NPs represent foreign elements with their own physicochemical properties due to their small size. So NPs may interfere with the normal physiological mechanisms of the embryos, growing animals, and adults, and it is indispensable to understand their potentially direct or indirect harmful effects on living organisms. It has been already shown that NPs could be toxic to bacteria, algae, invertebrates, and vertebrates. In this review, several examples of recent studies are given. We will examine successively the effects of NPs on terrestrial and semiaquatic and aquatic vertebrate and invertebrate animals.

Obsolete tobacco control themes can be hazardous to public health: the need for updating views on absolute product risks and harm reduction

Directory of Open Access Journals (Sweden)

Lynn T. Kozlowski

2016-05-01

Full Text Available Abstract Background Leading themes have guided tobacco control efforts, and these themes have changed over the decades. When questions arose about health risks of tobacco, they focused on two key themes: 1 how bad is the problem (i.e., absolute risk and 2 what can be done to reduce the risk without cessation (i.e., prospects for harm reduction. Using the United States since 1964 as an example, we outline the leading themes that have arisen in response to these two questions. Initially, there was the recognition that “cigarettes are hazardous to health” and an acceptance of safer alternative tobacco products (cigars, pipes, light/lower-tar cigarettes. In the 1980s there was the creation of the seminal theme that “Cigarettes are lethal when used as intended and kill more people than heroin, cocaine, alcohol, AIDS, fires, homicide, suicide, and automobile crashes combined.” By around 2000, support for a less-dangerous light/lower tar cigarette was gone, and harm reduction claims were avoided for products like cigars and even for smokeless tobacco which were summarized as “unsafe” or “not a safe alternative to cigarettes.” Discussion The Surgeon General in 2014 concluded that by far the greatest danger to public health was from cigarettes and other combusted products. At the same time the evidence base for smokeless tobacco and alternative nicotine delivery systems (ANDS had grown. Product innovation and tobacco/nicotine bio-behavioral, epidemiological and public health sciences demonstrate that low nitrosamine smokeless tobacco (e.g., Swedish snus, and ANDS have substantially lower harms than cigarettes. Going forward, it is important to sharpen themes and key messages of tobacco control, while continuing to emphasize the extreme lethality of the inhaled smoke from cigarettes or from use of any combusting tobacco product. Summary Implications of updating the leading themes for regulation, policymaking and advocacy in tobacco control

The Role of Physical Activity in Harm Reduction among Betel Quid Chewers from a Prospective Cohort of 419,378 Individuals.

Directory of Open Access Journals (Sweden)

Feng En Lo

Full Text Available To assess the benefits of regular exercise in reducing harms associated with betel quid (BQ chewing.The study cohort, 419,378 individuals, participated in a medical screening program between 1994 and 2008, with 38,324 male and 1,495 female chewers, who consumed 5-15 quids of BQ a day. Physical activity of each individual, based on "MET-hour/week", was classified as "inactive" or "active", where activity started from a daily 15 minutes/day or more of brisk walking (≥3.75 MET-hour/week. Hazard ratios for mortality and remaining years in life expectancy were calculated.Nearly one fifth (18.7% of men, but only 0.7% of women were chewers. Chewers had a 10-fold increase in oral cancer risk; and a 2-3-fold increase in mortality from lung, esophagus and liver cancer, cardiovascular disease, and diabetes, with doubling of all-cause mortality. More than half of chewers were physically inactive (59%. Physical activity was beneficial for chewers, with a reduction of all-cause mortality by 19%. Inactive chewers had their lifespan shortened by 6.3 years, compared to non-chewers, but being active, chewers improved their health by gaining 2.5 years. The improvement, however, fell short of offsetting the harms from chewing.Chewers had serious health consequences, but being physically active, chewers could mitigate some of these adverse effects, and extend life expectancy by 2.5 years and reduce mortality by one fifth. Encouraging exercise, in addition to quitting chewing, remains the best advice for 1.5 million chewers in Taiwan.

What Goes Around: the process of building a community-based harm reduction research project.

Science.gov (United States)

Jalloh, Chelsea; Illsley, Shohan; Wylie, John; Migliardi, Paula; West, Ethan; Stewart, Debbie; Mignone, Javier

2017-11-16

Often, research takes place on underserved populations rather than with underserved populations. This approach can further isolate and stigmatize groups that are already made marginalized. What Goes Around is a community-based research project that was led by community members themselves (Peers). This research aimed to implement a community-based research methodology grounded in the leadership and growing research capacity of community researchers and to investigate a topic which community members identified as important and meaningful. Chosen by community members, this project explored how safer sex and safer drug use information is shared informally among Peers. Seventeen community members actively engaged as both community researchers and research participants throughout all facets of the project: inception, implementation, analysis, and dissemination of results. Effective collaboration between community researchers, a community organization, and academics facilitated a research process in which community members actively guided the project from beginning to end. The methods used in What Goes Around demonstrated that it is not only possible, but advantageous, to draw from community members' involvement and direction in all stages of a community-based research project. This is particularly important when working with a historically underserved population. Purposeful and regular communication among collaborators, ongoing capacity building, and a commitment to respect the experience and expertise of community members were essential to the project's success. This project demonstrated that community members are highly invested in both informally sharing information about safer sex and safer drug use and taking leadership roles in directing research that prioritizes harm reduction in their communities.

The effect of sodium hydroxide on drag reduction using banana peel as a drag reduction agent

Science.gov (United States)

Kaur, H.; Jaafar, A.

2018-02-01

Drag reduction is observed as reduced frictional pressure losses under turbulent flow conditions. Drag reduction agent such as polymers can be introduced to increase the flowrate of water flowing and reduce the water accumulation in the system. Currently used polymers are synthetic polymers, which will harm our environment in excessive use of accumulation. A more environmentally-friendly drag reduction agent such as the polymer derived from natural sources or biopolymer, is then required for such purpose. As opposed to the synthetic polymers, the potential of biopolymers as drag reduction agents, especially those derived from a local plant source are not extensively explored. The drag reduction of a polymer produced from a local plant source within the turbulent regime was explored and assessed in this study using a rheometer, where a reduced a torque produced was perceived as a reduction of drag. This method proposed is less time consuming and is more practical which is producing carboxymethylcellulose from the banana peel. The cellulose powder was converted to carboxymethylcellulose (CMC) by etherification process. The carboxymethylation reaction during the synthesizing process was then optimized against the reaction temperature, reaction time and solubility. The biopolymers were then rheologically characterized, where the viscoelastic effects and the normal stresses produced by these biopolymers were utilized to further relate and explain the drag reduction phenomena. The research was structured to focus on producing the biopolymer and to assess the drag reduction ability of the biopolymer produced. The rheological behavior of the biopolymers was then analyzed based on the ability of reducing drag. The results are intended to expand the currently extremely limited experimental database. Based on the results, the biopolymer works as a good DRA.

Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm

DEFF Research Database (Denmark)

Erlangsen, Annette; Lind, Bertel Dam; Stuart, Elizabeth A

2015-01-01

BACKGROUND: Although deliberate self-harm is a strong predictor of suicide, evidence for effective interventions is missing. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality. METHODS......: In this matched cohort study all people who, after deliberate self-harm, received a psychosocial therapy intervention at suicide prevention clinics in Denmark during 1992-2010 were compared with people who did not receive the psychosocial therapy intervention after deliberate self-harm. We applied propensity...... score matching with a 1:3 ratio and 31 matching factors, and calculated odds ratios for 1, 5, 10, and 20 years of follow-up. The primary endpoints were repeated self-harm, death by suicide, and death by any cause. FINDINGS: 5678 recipients of psychosocial therapy (followed up for 42·828 person...

Recommendations for international gambling harm-minimisation guidelines: comparison with effective public health policy.

Science.gov (United States)

Gainsbury, Sally M; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

2014-12-01

Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies.

Canada’s highest court unchains injection drug users; implications for harm reduction as standard of healthcare

Directory of Open Access Journals (Sweden)

Small Dan

2012-07-01

Full Text Available Abstract North America’s only supervised injection facility, Insite, opened its doors in September of 2003 with a federal exemption as a three-year scientific study. The results of the study, evaluated by an independent research team, showed it to be successful in engaging the target group in healthcare, preventing overdose death and HIV infections while increasing uptake and retention in detox and treatment. The research, published in peer-reviewed medical and scientific journals, also showed that the program did not increase public disorder, crime or drug use. Despite the substantial evidence showing the effectiveness of the program, the future of Insite came under threat with the election of a conservative federal government in 2006. As a result, the PHS Community Services Society (PHS, the non-profit organization that operates Insite, launched a legal case to protect the program. On 30 September 2011, Supreme Court of Canada ruled in favour of Insite and underscored the rights of people with addictions to the security of their person under section 7 of the Charter of Rights and Freedoms (Charter of Rights. The decision clears the ground for other jurisdictions in Canada, and perhaps North America, to implement supervised injection and harm reduction where it is epidemiologically indicated. The legal case validates the personhood of people with addictions while metaphorically unchaining them from the criminal justice system.

Effectiveness of policies restricting hours of alcohol sales in preventing excessive alcohol consumption and related harms.

Science.gov (United States)

Hahn, Robert A; Kuzara, Jennifer L; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci; Middleton, Jennifer Cook; Lawrence, Briana

2010-12-01

Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team's initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms. Published by Elsevier Inc.

Effectiveness of Policies Restricting Hours of Alcohol Sales in Preventing Excessive Alcohol Consumption and Related Harms

Science.gov (United States)

Hahn, Robert A.; Kuzara, Jennifer L.; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S.; Toomey, Traci; Middleton, Jennifer Cook; Lawrence, Briana

2013-01-01

Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team’s initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms. PMID:21084080

Mapeando Programas de Redução de Danos da Região Metropolitana de Porto Alegre / Mapping harm reduction programs in the metropolitan region of Porto Alegre

NARCIS (Netherlands)

R. Quadros Rigoni (Rafaela); H.C. Nardi (Henrique)

2009-01-01

textabstractThis study mapped and described 11 harm reduction interventions/programs in Greater Metropolitan Porto Alegre, Rio Grande do Sul State, Brazil, in 2004-2006. Mapping was based on interviews and analysis of available documents and comparison with a previous study with data from 2003. We

The scientific foundation for tobacco harm reduction, 2006-2011.

Science.gov (United States)

Rodu, Brad

2011-07-29

Over the past five years there has been exponential expansion of interest in tobacco harm reduction (THR), with a concomitant increase in the number of published studies. The purpose of this manuscript is to review and analyze influential contributions to the scientific and medical literature relating to THR, and to discuss issues that continue to stimulate debate. Numerous epidemiologic studies and subsequent meta-analyses confirm that smokeless tobacco (ST) use is associated with minimal risks for cancer and for myocardial infarction; a small increased risk for stroke cannot be excluded. Studies from Sweden document that ST use is not associated with benign gastrointestinal disorders and chronic inflammatory diseases. Although any form of nicotine should be avoided during pregnancy, the highest risks for the developing baby are associated with smoking. It is documented that ST use has been a key factor in the declining rates of smoking and of smoking-related diseases in Sweden and Norway. For other countries, the potential population health benefits of ST are far greater than the potential risks. In follow-up studies, dual users of cigarettes and ST are less likely than exclusive smokers to achieve complete tobacco abstinence, but they are also less likely to be smoking. The health risks from dual use are probably lower than those from exclusive smoking. E-cigarette users are not exposed to the many toxicants, carcinogens and abundant free radicals formed when tobacco is burned. Although laboratory studies have detected trace concentrations of some contaminants, it is a small problem amenable to improvements in quality control and manufacturing that are likely with FDA regulation as tobacco products. There is limited evidence from clinical trials that e-cigarettes deliver only small doses of nicotine compared with conventional cigarettes. However, e-cigarette use emulates successfully the cigarette handling rituals and cues of cigarette smoking, which produces

The scientific foundation for tobacco harm reduction, 2006-2011

Directory of Open Access Journals (Sweden)

Rodu Brad

2011-07-01

Full Text Available Abstract Over the past five years there has been exponential expansion of interest in tobacco harm reduction (THR, with a concomitant increase in the number of published studies. The purpose of this manuscript is to review and analyze influential contributions to the scientific and medical literature relating to THR, and to discuss issues that continue to stimulate debate. Numerous epidemiologic studies and subsequent meta-analyses confirm that smokeless tobacco (ST use is associated with minimal risks for cancer and for myocardial infarction; a small increased risk for stroke cannot be excluded. Studies from Sweden document that ST use is not associated with benign gastrointestinal disorders and chronic inflammatory diseases. Although any form of nicotine should be avoided during pregnancy, the highest risks for the developing baby are associated with smoking. It is documented that ST use has been a key factor in the declining rates of smoking and of smoking-related diseases in Sweden and Norway. For other countries, the potential population health benefits of ST are far greater than the potential risks. In follow-up studies, dual users of cigarettes and ST are less likely than exclusive smokers to achieve complete tobacco abstinence, but they are also less likely to be smoking. The health risks from dual use are probably lower than those from exclusive smoking. E-cigarette users are not exposed to the many toxicants, carcinogens and abundant free radicals formed when tobacco is burned. Although laboratory studies have detected trace concentrations of some contaminants, it is a small problem amenable to improvements in quality control and manufacturing that are likely with FDA regulation as tobacco products. There is limited evidence from clinical trials that e-cigarettes deliver only small doses of nicotine compared with conventional cigarettes. However, e-cigarette use emulates successfully the cigarette handling rituals and cues of cigarette

Subsidies which are harmful to the environment, a complex reality

International Nuclear Information System (INIS)

Pourquier, Francois-Xavier; Monnoyer-Smith, Laurence; Demeulenaere, Laurence

2017-12-01

As the reduction of public supports which are harmful to the environment is a major stake in terms of struggle against pollutions and greenhouse gases, this publication proposes a discussion of these subsidies which are still important in France despite recent improvements, notably regarding wastes and fuels. The author first discusses how these harmful subsidies are defined by international or research bodies. He outlines that some subsidies have been suppressed since 2013, that important reforms have been initiated, and that, however, the level of harmful subsidies remains high. Then, he discusses the necessary reconciliation of different objectives, and briefly evokes the German and Italian assessment examples

Harmful effects of ultraviolet radiation

International Nuclear Information System (INIS)

Anon.

1989-01-01

Tanning for cosmetic purposes by sunbathing or by using artificial tanning devices is widespread. The hazards associated with exposure to ultraviolet radiation are of concern to the medical profession. Depending on the amount and form of the radiation, as well as on the skin type of the individual exposed, ultraviolet radiation causes erythema, sunburn, photodamage (photoaging), photocarcinogenesis, damage to the eyes, alteration of the immune system of the skin, and chemical hypersensitivity. Skin cancers most commonly produced by ultraviolet radiation are basal and squamous cell carcinomas. There also is much circumstantial evidence that the increase in the incidence of cutaneous malignant melanoma during the past half century is related to increased sun exposure, but this has not been proved. Effective and cosmetically acceptable sunscreen preparations have been developed that can do much to prevent or reduce most harmful effects to ultraviolet radiation if they are applied properly and consistently. Other safety measures include (1) minimizing exposure to ultraviolet radiation, (2) being aware of reflective surfaces while in the sun, (3) wearing protective clothing, (4) avoiding use of artificial tanning devices, and (5) protecting infants and children

Reported Theory Use by Digital Interventions for Hazardous and Harmful Alcohol Consumption, and Association With Effectiveness: Meta-Regression

Science.gov (United States)

Crane, David; Brown, Jamie; Kaner, Eileen; Beyer, Fiona; Muirhead, Colin; Hickman, Matthew; Redmore, James; de Vocht, Frank; Beard, Emma; Michie, Susan

2018-01-01

Background Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this. Objective The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness. Methods Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models. Results Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I2=77.6%, Ptheory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations. Conclusions Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories. PMID:29490895

Harmful Waste Process

International Nuclear Information System (INIS)

Ki, Mun Bong; Lee, Shi Jin; Park, Jun Seok; Yoon, Seok Pyo; Lee, Jae Hyo; Jo, Byeong Ryeol

2008-08-01

This book gives descriptions of processing harmful waste, including concerned law and definition of harmful waste, current conditions and generation of harmful waste in Korea, international condition of harmful waste, minimizing of generation of harmful waste, treatment and storage. It also tells of basic science for harmful waste disposal with physics, chemistry, combustion engineering, microbiology and technique of disposal such as physical, chemical, biological process, stabilizing and solidification, incineration and waste in landfill.

The effectiveness of community action in reducing risky alcohol consumption and harm: a cluster randomised controlled trial.

Directory of Open Access Journals (Sweden)

Anthony Shakeshaft

2014-03-01

��= 2,977 and 2,255, respectively were the following: long-term risky drinking, short-term high-risk drinking, short-term risky drinking, weekly consumption, hazardous/harmful alcohol use, and experience of alcohol harm. At the 5% level of statistical significance, there was insufficient evidence to conclude that the interventions were effective in the experimental, relative to control, communities for alcohol-related crime, traffic crashes, and hospital inpatient admissions, and for rates of risky alcohol consumption and hazardous/harmful alcohol use. Although respondents in the experimental communities reported statistically significantly lower average weekly consumption (1.90 fewer standard drinks per week, 95% CI = -3.37 to -0.43, p = 0.01 and less alcohol-related verbal abuse (odds ratio = 0.58, 95% CI = 0.35 to 0.96, p = 0.04 post-intervention, the low survey response rates (40% and 24% for the pre- and post-intervention surveys, respectively require conservative interpretation. The main limitations of this study are as follows: (1 that the study may have been under-powered to detect differences in routinely collected data outcomes as statistically significant, and (2 the low survey response rates.This RCT provides little evidence that community action significantly reduces risky alcohol consumption and alcohol-related harms, other than potential reductions in self-reported average weekly consumption and experience of alcohol-related verbal abuse. Complementary legislative action may be required to more effectively reduce alcohol harms.Australian New Zealand Clinical Trials Registry ACTRN12607000123448.

The effectiveness of community action in reducing risky alcohol consumption and harm: a cluster randomised controlled trial.

Science.gov (United States)

Shakeshaft, Anthony; Doran, Christopher; Petrie, Dennis; Breen, Courtney; Havard, Alys; Abudeen, Ansari; Harwood, Elissa; Clifford, Anton; D'Este, Catherine; Gilmour, Stuart; Sanson-Fisher, Rob

2014-03-01

,255, respectively) were the following: long-term risky drinking, short-term high-risk drinking, short-term risky drinking, weekly consumption, hazardous/harmful alcohol use, and experience of alcohol harm. At the 5% level of statistical significance, there was insufficient evidence to conclude that the interventions were effective in the experimental, relative to control, communities for alcohol-related crime, traffic crashes, and hospital inpatient admissions, and for rates of risky alcohol consumption and hazardous/harmful alcohol use. Although respondents in the experimental communities reported statistically significantly lower average weekly consumption (1.90 fewer standard drinks per week, 95% CI = -3.37 to -0.43, p = 0.01) and less alcohol-related verbal abuse (odds ratio = 0.58, 95% CI = 0.35 to 0.96, p = 0.04) post-intervention, the low survey response rates (40% and 24% for the pre- and post-intervention surveys, respectively) require conservative interpretation. The main limitations of this study are as follows: (1) that the study may have been under-powered to detect differences in routinely collected data outcomes as statistically significant, and (2) the low survey response rates. This RCT provides little evidence that community action significantly reduces risky alcohol consumption and alcohol-related harms, other than potential reductions in self-reported average weekly consumption and experience of alcohol-related verbal abuse. Complementary legislative action may be required to more effectively reduce alcohol harms. Australian New Zealand Clinical Trials Registry ACTRN12607000123448.

Harmful effects of atmospheric nitrous acid on the physiological status of Scots pine trees

International Nuclear Information System (INIS)

Sakugawa, Hiroshi; Cape, J. Neil

2007-01-01

An open top chamber experiment was carried out in the summer of 2003 to examine the effect of nitrous acid (HONO) gas on the physiological status of Scots pine saplings (Pinus sylvestris). Four-year-old pine trees were exposed to two different levels of HONO gas (at ca. 2.5 ppb and 5.0 ppb) and a control (filtered air) from early evening to early morning (18:00-6:00), in duplicate open top chambers. Significant decreases in the ratios of chlorophylls a to b, an increase in the carbon to nitrogen (C/N) ratio, and a reduction of maximum yield of PS II (F v /F m ) in pine needles were also observed after the 2 months' fumigation. Cation contents of pine needles were also decreased by the fumigation with HONO gas. The results could be explained by the harmful effects of OH radicals, generated from photolysis of HONO gas, and/or aqueous phase HONO (NO 2 - /HONO), on the photosynthetic capacity of pine needles. - Exposure to HONO affects photosynthesis and nutrient status of pine trees

Peer engagement in harm reduction strategies and services: a critical case study and evaluation framework from British Columbia, Canada.

Science.gov (United States)

Greer, Alissa M; Luchenski, Serena A; Amlani, Ashraf A; Lacroix, Katie; Burmeister, Charlene; Buxton, Jane A

2016-05-27

Engaging people with drug use experience, or 'peers,' in decision-making helps to ensure harm reduction services reflect current need. There is little published on the implementation, evaluation, and effectiveness of meaningful peer engagement. This paper aims to describe and evaluate peer engagement in British Columbia from 2010-2014. A process evaluation framework specific to peer engagement was developed and used to assess progress made, lessons learned, and future opportunities under four domains: supportive environment, equitable participation, capacity building and empowerment, and improved programming and policy. The evaluation was conducted by reviewing primary and secondary qualitative data including focus groups, formal documents, and meeting minutes. Peer engagement was an iterative process that increased and improved over time as a consequence of reflexive learning. Practical ways to develop trust, redress power imbalances, and improve relationships were crosscutting themes. Lack of support, coordination, and building on existing capacity were factors that could undermine peer engagement. Peers involved across the province reviewed and provided feedback on these results. Recommendations from this evaluation can be applied to other peer engagement initiatives in decision-making settings to improve relationships between peers and professionals and to ensure programs and policies are relevant and equitable.

Harmful effects of DU in the offspring of the military personnel employed in DU contaminated regions

International Nuclear Information System (INIS)

Atlagic, N.; Lisov, Lj.; Barjaktarovic, V.; Djurovic, B.; Spasic, Jokic V.

2008-01-01

Full text: In 1999, during the NATO attacks on Kosovo, from AT-10 aircraft has been shot over 50000 30-mm projectiles which contained approximately 15 tones of DU. Besides DU, projectiles contained products of DU radioactive decay as well as americium, neptunium, plutonium and technetium. Due to DU contamination military personnel employed near hit targets could be contaminated and irradiated. Besides the harmful effects in exposed military personnel, harmful effects were noticed in their offsprings, too. DU can cause genetic and teratogenic harmful effects in the embryos/fetus. It is concentrated in semen of contaminated males and also can contaminate the embryo/fetus through placenta. DU, as a toxic and radioactive element, can cause variety of harmful effects, but the most important are the effects on DNA which are the cause of many diseases. The aim of this paper is to examine is there any change in the incidence in heritable effects, congenital malformations, malignant diseases, endocrine and immune disorders. For that reason we compared the incidence of these diseases in the offspring's of military personnel born from 1995-1999 (1204) with the children born from 2000-2004 (1131) / and 2005-2008. Our results showed higher incidence of congenital malformations and chromosomal abnormalities (12.55 % vs 4.57 %), with highest incidence of foot deformity-52.04 % and hip deformity. These abnormalities were followed with immunological disorders and dysfunction of the urine bladder. Endocrine diseases were increased too(2.16 % :1.63 %). In this period higher incidence of malignant diseases was not noticed, but in the second period (from 5-9 year) after 1999, higher incidence of malignant hematological diseases was noticed, as well as Down Sy. During the conflicts future parents as well as embryo/fetus are exposed to many harmfulness and it is very hard to separate the influence of each. Considering the fact that the effects of DU, could be delayed and synergistic with

Who is 'Molly'? MDMA adulterants by product name and the impact of harm-reduction services at raves.

Science.gov (United States)

Saleemi, Sarah; Pennybaker, Steven J; Wooldridge, Missi; Johnson, Matthew W

2017-08-01

Methylenedioxymethamphetamine (MDMA), often sold as 'Ecstasy' or 'Molly', is commonly used at music festivals and reported to be responsible for an increase in deaths over the last decade. Ecstasy is often adulterated and contains compounds that increase morbidity and mortality. While users and clinicians commonly assume that products sold as Molly are less-adulterated MDMA products, this has not been tested. Additionally, while pill-testing services are sometimes available at raves, the assumption that these services decrease risky drug use has not been studied. This study analyzed data collected by the pill-testing organization, DanceSafe, from events across the United States from 2010 to 2015. Colorimetric reagent assays identified MDMA in only 60% of the 529 samples collected. No significant difference in the percentage of samples testing positive for MDMA was determined between Ecstasy and Molly. Individuals were significantly less likely to report intent to use a product if testing did not identify MDMA (relative risk (RR) = 0.56, p = 0.01). Results suggest that Molly is not a less-adulterated substance, and that pill-testing services are a legitimate harm-reduction service that decreases intent to consume potentially dangerous substances and may warrant consideration by legislators for legal protection. Future research should further examine the direct effects of pill-testing services and include more extensive pill-testing methods.

EFFECTIVENESS OF DIALECTICAL BEHAVIOR THERAPY VERSUS COLLABORATIVE ASSESSMENT AND MANAGEMENT OF SUICIDALITY TREATMENT FOR REDUCTION OF SELF-HARM IN ADULTS WITH BORDERLINE PERSONALITY TRAITS AND DISORDER

DEFF Research Database (Denmark)

Andreasson, Kate; Krogh, Jesper; Wenneberg, Christina

2016-01-01

were: severity of borderline symptoms, depressive symptoms, hopelessness, suicide ideation, and self-esteem. RESULTS: At 28 weeks, the number of participants with new self-harm in the DBT group was 21 of 57 (36.8%) versus 12 of 51 (23.5%) in the CAMS treatment (OR: 1.90; 95% CI: 0.80-4.40; P = .14......BACKGROUND: Many psychological treatments have shown effect on reducing self-harm in adults with borderline personality disorder. There is a need of brief psychotherapeutical treatment alternative for suicide prevention in specialized outpatient clinics. METHODS/DESIGN: The DiaS trial was designed...... as a pragmatic single-center, two-armed, parallel-group observer-blinded, randomized clinical superiority trial. The participants had at least two criteria from the borderline personality disorder diagnosis and a recent suicide attempt (within a month). The participants were offered 16 weeks of dialectical...

A systematic and extensive literature search on crop production of host plants of seven organisms harmful to horticulture

NARCIS (Netherlands)

Derkx, M.P.M.; Brouwer, J.H.D.; Breda, van P.J.M.; Helm, van der F.P.M.; Hop, M.E.C.M.; Landzaat, K.M.; Wubben, C.F.M.

2012-01-01

The European Commission is currently seeking advice from EFSA, on the risk to plant health for the EU territory including the evaluation of the effectiveness of risk reduction options of seven organisms harmful to horticulture (both food- and non food) plants: Liriomyza trifolii, Liriomyza

Aiming at Tobacco Harm Reduction: A survey comparing smokers differing in readiness to quit

Directory of Open Access Journals (Sweden)

Sarafidou Jasmin-Olga

2006-03-01

Full Text Available Abstract Background Greece has the highest smoking rates (in the 15-nation bloc in Europe. The purpose of this study was to investigate Greek smokers' intention and appraisal of capability to quit employing the theoretical frameworks of Decisional Balance (DB and Cognitive Dissonance (CD. Methods A cross-sectional study including 401 Greek habitual smokers (205 men and 195 women, falling into four groups according to their intention and self-appraised capability to quit smoking was carried out. Participants completed a questionnaire recording their attitude towards smoking, intention and self appraised capability to quit smoking, socio-demographic information, as well as a DB and a CD scale. Results The most numerous group of smokers (38% consisted of those who neither intended nor felt capable to quit and these smokers perceived more benefits of smoking than negatives. DB changed gradually according to smokers' "readiness" to quit: the more ready they felt to quit the less the pros of smoking outnumbered the cons. Regarding relief of CD, smokers who intended but did not feel capable to quit employed more "excuses" compared to those who felt capable. Additionally smokers with a past history of unsuccessful quit attempts employed fewer "excuses" even though they were more frequently found among those who intended but did not feel capable to quit. Conclusion Findings provide support for the DB theory. On the other hand, "excuses" do not appear to be extensively employed to reduce the conflict between smoking and concern for health. There is much heterogeneity regarding smokers' intention and appraised capability to quit, reflecting theoretical and methodological problems with the distinction among stages of change. Harm reduction programs and interventions designed to increase the implementation of smoking cessation should take into account the detrimental effect of past unsuccessful quit attempts.

Harm reduction program use, psychopathology and medical severity in patients with methadone maintenance treatment.

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Martínez-Luna, Nieves Gudelia; Rodríguez-Cintas, Laia; Esojo, Abderraman; Palma-Álvarez, Raúl Felipe; Robles-Martínez, María; Grau-López, Lara; Perea, Marta; Roncero, Carlos

2018-01-15

Methadone maintenance programs (MMP) for opioid dependence treatment have been widely used due to their effective therapeutic outcomes. Harm reduction programs (HRP) are complementary programs for severe patients with high risk behaviors and when abstinence is not possible. This study aims to compare patients in MMP that use HRP (MMP-HRP) and patients in MMP who do not use HRP (MMP-NO HRP). The sample was composed of 143 patients (MMP-HRP = 42 vs. MMP-NO HRP = 101). An additional subanalysis was performed with patients under 45 years of age (n = 116; MMP-HRP = 38 vs. MMP-NO HRP = 78). All patients were assessed with an ad hoc socio-demographic questionnaire, EuropASI, SCID-I, and SCID-II. Results show that MMP-HRP patients were younger with more frequent use of intravenous drugs and with a high prevalence of Cluster B personality disorders. MMP-NO HRP patients had lower methadone doses compared to MMP-HRP patients and preferred to use drugs by smoked route more frequently. In the subanalysis of patients under 45, MMP-HRP patients were younger, had a higher prevalence of liver diseases, more intravenous drug use, greater severity on the drug use scale, less social and family support in the suescales of EUROP-ASI than compared to patients under 45 years in the group MMP-NO HRP. In conclusion, MMP-HRP patients are younger compared to MMP-NO HRP patients, they also receive higher doses of methadone and had more intravenous use. The above findings imply that the early onset of high risk drug use and long-term exposure to heroin have more severe outcomes such as higher comorbidities (e.g. infectious diseases, medical and psychiatric disorders), and consequently, these patients are a more vulnerable group with a worse prognosis.

Caring for self-harming patients in general practice.

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Rowe, Joanne; Jaye, Chrystal

2017-12-01

INTRODUCTION Intentional self-harm is an international public health issue with high personal, social and financial costs to society. Poor relationship dynamics are known to have a negative influence on the psyche of people who self-harm, and this can increase anxiety and decrease self-esteem, both shown to be significant contributors to self-harm behaviours. Positive and functional social supports have been proposed as a cost-effective and constructive approach in diminishing self-harming behaviours. AIM This qualitative study investigated the aspects of professional, social, familial and romantic relationships that people who have self-harmed identified as having a positive and constructive effect on their self-harm behaviour. METHODS Twelve participants with a history of self-harming behaviours were recruited through free press advertising in primary care and interviewed. The participants ranged in age from 19 to 70 years, and represented New Zealand (NZ) European and Māori from across the Southern region of NZ. RESULTS This study shows that constructive relationships that inhibit self-harm behaviours are characterised by participants' perceptions of authenticity in their relationships, and knowing that other people genuinely care. Feeling cared for within an authentic therapeutic relationship enabled participants to overcome their perception of being damaged selves and gave them the skills and confidence to develop functional relationships within their communities. A relationship-centred care approach may be useful for general practitioners seeking to develop more effective therapeutic relationships with patients who deliberately self-harm.

"Organic," "natural," and "additive-free" cigarettes: Comparing the effects of advertising claims and disclaimers on perceptions of harm.

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Baig, Sabeeh A; Byron, M Justin; Lazard, Allison J; Brewer, Noel T

2018-02-26

The U.S. Tobacco Control Act restricts advertising or labeling that suggests one tobacco product is less harmful than another. We sought to examine how "organic," "natural," and "additive-free" advertising claims and corresponding disclaimers affect perceptions of cigarettes' harm. Participants were a national probability sample of adults in the U.S. (n = 1,114, including 344 smokers). We conducted a 5 (claim) × 2 (disclaimer) between-subjects factorial experiment. Participants viewed a Natural American Spirit cigarettes ad claiming they were "organic," "natural," "additive-free," "light," or "regular;" and with or without a corresponding disclaimer. The outcome was perceived harm of the advertised cigarettes. Among smokers, we also assessed interest in switching within their current brand to cigarettes with this characteristic (e.g., "additive-free"). Claims in the ad had a large effect on perceived harm (Cohen's d = 0.87, 95% CI: 0.47-1.29). Claims of cigarettes being "organic," "natural," or "additive-free" reduced perceived harm from the advertised cigarettes, as compared to "regular" and "light" claims. Disclaimers had a small effect, increasing perceived harm (d = 0.25, 95% CI: 0.08-0.41). The problematic claims also increased smokers' interest in switching. Disclaimers had no effect on smokers' interest in switching. "Organic," "natural," and "additive-free" claims may mislead people into thinking that the advertised cigarettes are less harmful than other cigarettes. Disclaimers did not offset misperceptions of harm created by false claims. The U.S. Food and Drug Administration should restrict the use of these misleading claims in tobacco advertising.

Effectiveness of policies maintaining or restricting days of alcohol sales on excessive alcohol consumption and related harms.

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Middleton, Jennifer Cook; Hahn, Robert A; Kuzara, Jennifer L; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci; Lawrence, Briana

2010-12-01

Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol consumption and related harms of laws and policies maintaining or reducing the days when alcoholic beverages may be sold. Outcomes assessed in 14 studies that met qualifying criteria were excessive alcohol consumption and alcohol-related harms, including motor vehicle injuries and deaths, violence-related and other injuries, and health conditions. Qualifying studies assessed the effects of changes in days of sale in both on-premises settings (at which alcoholic beverages are consumed where purchased) and off-premises settings (at which alcoholic beverages may not be consumed where purchased). Eleven studies assessed the effects of adding days of sale, and three studies assessed the effects of imposing a ban on sales on a given weekend day. The evidence from these studies indicated that increasing days of sale leads to increases in excessive alcohol consumption and alcohol-related harms and that reducing the number of days that alcoholic beverages are sold generally decreases alcohol-related harms. Based on these findings, when the expansion of days of sale is being considered, laws and policies maintaining the number of days of the week that alcoholic beverages are sold at on- and off-premises outlets in local, state, and national jurisdictions are effective public health strategies for preventing excessive alcohol consumption and related harms. Published by Elsevier Inc.

Effectiveness of Policies Maintaining or Restricting Days of Alcohol Sales on Excessive Alcohol Consumption and Related Harms

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Middleton, Jennifer Cook; Hahn, Robert A.; Kuzara, Jennifer L.; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S.; Toomey, Traci; Lawrence, Briana

2013-01-01

Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol consumption and related harms of laws and policies maintaining or reducing the days when alcoholic beverages may be sold. Outcomes assessed in 14 studies that met qualifying criteria were excessive alcohol consumption and alcohol-related harms, including motor vehicle injuries and deaths, violence-related and other injuries, and health conditions. Qualifying studies assessed the effects of changes in days of sale in both on-premises settings (at which alcoholic beverages are consumed where purchased) and off-premises settings (at which alcoholic beverages may not be consumed where purchased). Eleven studies assessed the effects of adding days of sale, and three studies assessed the effects of imposing a ban on sales on a given weekend day. The evidence from these studies indicated that increasing days of sale leads to increases in excessive alcohol consumption and alcohol-related harms and that reducing the number of days that alcoholic beverages are sold generally decreases alcohol-related harms. Based on these findings, when the expansion of days of sale is being considered, laws and policies maintaining the number of days of the week that alcoholic beverages are sold at on- and off-premises outlets in local, state, and national jurisdictions are effective public health strategies for preventing excessive alcohol consumption and related harms. PMID:21084079

Self-harm

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Self-harm refers to a person's harming their own body on purpose. About 1 in 100 people hurts himself or herself in this way. More females hurt themselves than males. A person who self-harms usually does not mean to kill himself or herself. But they are at higher risk of attempting suicide if they do ...

Mammography screening. Benefits, harms, and informed choice.

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Jørgensen, Karsten Juhl

2013-04-01

The rationale for breast cancer screening with mammography is deceptively simple: catch it early and reduce mortality from the disease and the need for mastectomies. But breast cancer is a complex problem, and complex problems rarely have simple solutions. Breast screening brings forward the time of diagnosis only slightly compared to the lifetime of a tumour, and screen-detected tumours have a size where metastases are possible. A key question is if screening can prevent metastases, and if the screen-detected tumours are small enough to allow breast conserving surgery rather than mastectomy. A mortality reduction can never justify a medical intervention in its own right, but must be weighed against the harms. Overdiagnosis is the most important harm of breast screening, but has gained wider recognition only in recent years. Screening leads to the detection and treatment of breast cancers that would otherwise never have been detected because they grow very slowly or not at all and would not have been detected in the woman's lifetime in the absence of screening. Screening therefore turns women into cancer patients unnecessarily, with life-long physical and psychological harms. The debate about the justification of breast screening is therefore not a simple question of whether screening reduces breast cancer mortality. This dissertation quantifies the primary benefits and harms of screening mammography. Denmark has an unscreened "control group" because only two geographical regions offered screening over a long time-period, which is unique in an international context. This was used to study breast cancer mortality, overdiagnosis, and the use of mastectomies. Also, a systematic review of overdiagnosis in five other countries allowed us to show that about half of the screen-detected breast cancers are overdiagnosed. An effect on breast cancer mortality is doubtful in today's setting, and overdiagnosis causes an increase in the use of mastectomies. These findings are

Effectiveness of assertive case management on repeat self-harm in patients admitted for suicide attempt: Findings from ACTION-J study.

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Furuno, Taku; Nakagawa, Makiko; Hino, Kosuke; Yamada, Tomoki; Kawashima, Yoshitaka; Matsuoka, Yutaka; Shirakawa, Osamu; Ishizuka, Naoki; Yonemoto, Naohiro; Kawanishi, Chiaki; Hirayasu, Yoshio

2018-01-01

Self-harm is an important risk factor for subsequent suicide and repetition of self-harm, and a common cause of emergency department presentations. However, there still remains limited evidence on intervention in emergency department settings for individuals who self-harm. This multicentre, randomised controlled trial was conducted at 17 general hospitals in Japan. In total, 914 adult patients admitted to emergency departments for a suicide attempt and had a DSM-IV-TR axis I disorder were randomly assigned to two groups, to receive either assertive case management (intervention) or enhanced usual care (control). Assertive case management was introduced by the case manager during emergency department admissions for suicide attempts, and continued after discharge. Interventions were provided until the end of the study period (for at least 18 months and up to 5 years). The number of overall self-harm episodes per person-year was significantly lower in the intervention group (adjusted incidence risk ratio (IRR) 0.88, 95%CI 0.80-0.96, p=0.0031). Subgroup analysis showed a greater reduction of overall self-harm episodes among patients with no previous suicide attempt at baseline (adjusted IRR 0.73, 95% CI 0.53-0.98, p=0.037). Patients younger than 20 years and patients who self-harmed but were not admitted to an emergency department were excluded. The present study showed that assertive case management following emergency admission for a suicide attempt reduced the incident rate of repeat overall self-harm. Copyright © 2017 Elsevier B.V. All rights reserved.

Children's Hospitals' Solutions for Patient Safety Collaborative Impact on Hospital-Acquired Harm.

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Lyren, Anne; Brilli, Richard J; Zieker, Karen; Marino, Miguel; Muething, Stephen; Sharek, Paul J

2017-09-01

To determine if an improvement collaborative of 33 children's hospitals focused on reliable best practice implementation and culture of safety improvements can reduce hospital-acquired conditions (HACs) and serious safety events (SSEs). A 3-year prospective cohort study design with a 12-month historical control population was completed by the Children's Hospitals' Solutions for Patient Safety collaborative. Identification and dissemination of best practices related to 9 HACs and SSE reduction focused on key process and culture of safety improvements. Individual hospital improvement teams leveraged the resources of a large, structured children's hospital collaborative using electronic, virtual, and in-person interactions. Thirty-three children's hospitals from across the United States volunteered to be part of the Children's Hospitals' Solutions for Patient Safety collaborative. Thirty-two met all the data submission eligibility requirements for the HAC improvement objective of this study, and 21 participated in the high-reliability culture work aimed at reducing SSEs. Significant harm reduction occurred in 8 of 9 common HACs (range 9%-71%; P collaborative dedicated to implementing HAC-related best-practice prevention bundles and culture of safety interventions designed to increase the use of high-reliability organization practices resulted in significant HAC and SSE reductions. Structured collaboration and rapid sharing of evidence-based practices and tools are effective approaches to decreasing hospital-acquired harm. Copyright © 2017 by the American Academy of Pediatrics.

The effect of information about the benefits and harms of mammography on women's decision-making: study protocol for a randomized controlled trial.

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Carles, Misericòrdia; Martínez-Alonso, Montserrat; Pons, Anna; Pérez-Lacasta, Maria José; Perestelo-Pérez, Lilisbeth; Sala, Maria; Vidal, Carmen; Garcia, Montse; Toledo-Chávarri, Ana; Codern, Núria; Feijoo-Cid, Maria; Romero, Anabel; Pla, Roger; Soler-González, Jorge; Castells, Xavier; Rué, Montserrat

2017-09-12

The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening. A two-stage, randomized controlled trial (RCT). In the first stage, 40 Basic Health Areas (BHAs) will be selected and randomized to intervention or control. In the second stage, women within each BHA will be randomly selected (n = 400). Four breast cancer screening programs (BCSPs) of the Spanish public health system, three in Catalonia and one in the Canary Islands will participate in the study. Women in the intervention arm will receive a leaflet with detailed information on the benefits and harms of screening using mammography. Women in the control arm will receive a standard leaflet that does not mention harms and recommends accepting the invitation to participate in the biennial examinations of the BCSP. The primary outcome is informed choice, a dichotomous variable that combines knowledge, attitudes, and intentions. Secondary outcomes include decisional conflict; confidence in the decision made; anxiety about screening participation; worry about breast cancer; anticipated regret; time perspective; perceived importance of benefits/harms of screening; perceived risk of breast cancer; and leaflet acceptability. Primary and secondary outcomes are assessed 2-3 weeks after the intervention. This is the first RCT that assesses the effect of informing about the benefits and harms of breast cancer screening in Spain in women facing the decision to be screened using mammography. It aims to assess the

Impact of alcohol harm reduction strategies in community sports clubs: pilot evaluation of the Good Sports program.

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Rowland, Bosco; Allen, Felicity; Toumbourou, John W

2012-05-01

Approximately 4.5 million Australians are involved in community sports clubs. A high level of alcohol consumption tends to be commonplace in this setting. The only program of its type in the world, the Good Sports program was designed to reduce harmful alcohol consumption in these Australian community sports clubs. The program offers a staged accreditation process to encourage the implementation of alcohol harm-reduction strategies. We conducted a postintervention adoption study to evaluate whether community sports club accreditation through the Good Sports program was associated with lower rates of alcohol consumption. We examined alcohol consumption rates in 113 clubs (N = 1,968 participants) and compared these to consumption rates in the general community. We hypothesized that members of clubs with more advanced implementation of the Good Sports accreditation program (Stage Two) would consume less alcohol than those with less advanced implementation (Stage One). Multilevel modeling (MLM) indicated that on days when teams competed, Stage Two club members consumed 19% less alcohol than Stage One club members. MLM also indicated that the length of time a club had been in the Good Sports program was associated with reduced rates of weekly drinking that exceeded Australian short-term risky drinking guidelines. However consumption rates for all clubs were still higher than the general community. Higher accreditation stage also predicted reduced long-term risky drinking by club members. Our findings suggest that community sports clubs show evidence of higher levels of alcohol consumption and higher rates of risky consumption than the general community. Implementation of the Good Sports accreditation strategy was associated with lower alcohol consumption in these settings.

Social control as supplyside harm reduction strategy The case of an indigenous coca growing community in Peru

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GARCIA-YI, Jaqueline

2014-05-01

Full Text Available Traditional coca uses have taken place in Peru and Bolivia from three thousand years. International organizations have urged the implementation of “zero-coca” growing policies in those countries, although without tangible results. Supply-side harm reduction strategies are currently being implemented in Bolivia, which rely on social control to limit, although not totally abolish coca growing. In this article, the different motivations for traditional coca growing are extensively reviewed, and the data from a survey conducted with 496 farmers in an indigenous community is examined, in order to provide a comprehensive overview of the coca-growing problem and to evaluate if social control could potentially influence the scale of coca growing in Peru. The results suggest that social control variables, such as attachment, involvement, and beliefs, seem to limit coca-growing areas. Those factors have been largely overlooked and may offer an opportunity to reduce coca areas if explicitly considered in anti-drug policy design.

What’s the Harm? Harms in Research with Adults with Intellectual Disability

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McDonald, Katherine E.; Conroy, Nicole E.; Olick, Robert S.

2017-01-01

Scientific advances can improve the lives of adults with intellectual disability, yet concerns that research participation may impose harm impede scientific progress. What counts as harmful can be subjective and perceptions of harm may vary among stakeholders. We studied perspectives on the harmfulness of research events among adults with intellectual disability, family members and friends, disability service providers, researchers, and Institutional Review Board members. We found considerable variance. For example, adults with intellectual disability see exclusion from research as more harmful, but most psychosocial harms as less significant than others. All stakeholders agree that having someone else make the participation decision is harmful. Findings provide insights into the concept of harm and ethical research with adults with intellectual disability. PMID:28095059

The influence of marketing on the sports betting attitudes and consumption behaviours of young men: implications for harm reduction and prevention strategies.

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Deans, Emily G; Thomas, Samantha L; Derevensky, Jeffrey; Daube, Mike

2017-01-19

Gambling can cause significant health and social harms for individuals, their families, and communities. While many studies have explored the individual factors that may lead to and minimise harmful gambling, there is still limited knowledge about the broader range of factors that may contribute to gambling harm. There are significant regulations to prevent the marketing of some forms of gambling but comparatively limited regulations relating to the marketing of newer forms of online gambling such as sports betting. There is a need for better information about how marketing strategies may be shaping betting attitudes and behaviours and the range of policy and regulatory responses that may help to prevent the risky or harmful consumption of these products. We conducted qualitative, semi-structured interviews with 50 Australian men (aged 20-37 years) who gambled on sports. We explored their attitudes and opinions regarding sports betting marketing, the embedding of marketing within sports and other non-gambling community environments, and the implications this had for the normalisation of betting. Our findings indicate that most of the environments in which participants reported seeing or hearing betting advertisements were not in environments specifically designed for betting. Participants described that the saturation of marketing for betting products, including through sports-based commentary and sports programming, normalised betting. Participants described that the inducements offered by the industry were effective marketing strategies in getting themselves and other young men to bet on sports. Inducements were also linked with feelings of greater control over betting outcomes and stimulated some individuals to sign up with more than one betting provider. This research suggests that marketing plays a strong role in the normalisation of gambling in sports. This has the potential to increase the risks and subsequent harms associated with these products

The impact of harm reduction programs and police interventions on the number of syringes collected from public spaces. A time series analysis in Barcelona, 2004-2014.

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Espelt, A; Villalbí, J R; Bosque-Prous, M; Parés-Badell, O; Mari-Dell'Olmo, M; Brugal, M T

2017-12-01

To estimate the effect of opening two services for people who use drugs and three police interventions on the number of discarded syringes collected from public spaces in Barcelona between 2004 and 2014. We conducted an interrupted time-series analysis of the monthly number of syringes collected from public spaces during this period. The dependent variable was the number of syringes collected per month. The main independent variables were month and five dummy variables (the opening of two facilities with safe consumption rooms, and three police interventions). To examine which interventions affected the number of syringes collected, we performed an interrupted time-series analysis using a quasi-Poisson regression model, obtaining relative risks (RR) and 95% confidence intervals (CIs). The number of syringes collected per month in Barcelona decreased from 13,800 in 2004 to 1655 in 2014 after several interventions. For example, following the closure of an open drug scene in District A of the city, we observed a decreasing trend in the number of syringes collected [RR=0.88 (95% CI: 0.82-0.95)], but an increasing trend in the remaining districts [RR=1.11 (95% CI: 1.05-1.17) and 1.08 (95% CI: 0.99-1.18) for districts B and C, respectively]. Following the opening of a harm reduction facility in District C, we observed an initial increase in the number collected in this district [RR=2.72 (95% CI: 1.57-4.71)] and stabilization of the trend thereafter [RR=0.97 (95% CI: 0.91-1.03)]. The overall number of discarded syringes collected from public spaces has decreased consistently in parallel with a combination of police interventions and the opening of harm reduction facilities. Copyright © 2017 Elsevier B.V. All rights reserved.

The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial.

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Parcesepe, Angela M; L Engle, Kelly L; Martin, Sandra L; Green, Sherri; Sinkele, William; Suchindran, Chirayath; Speizer, Ilene S; Mwarogo, Peter; Kingola, Nzioki

2016-04-01

To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers (FSWs) in Mombasa, Kenya. Randomized controlled trial. HIV prevention drop-in centers in Mombasa, Kenya. 818 women 18 or older in Mombasa who visited HIV prevention drop-in centers, were moderate-risk drinkers and engaged in transactional sex in past six months (410 and 408 in intervention and control arms, respectively). 6 session alcohol harm reduction intervention. 6 session non-alcohol related nutrition intervention. In-person interviews were conducted at enrollment, immediately post-intervention and 6-months post-intervention. General linear mixed models examined associations between intervention assignment and recent violence (physical violence, verbal abuse, and being robbed in the past 30 days) from paying and non-paying sex partners and engagement in sex work in the past 30 days. The alcohol intervention was associated with statistically significant decreases in physical violence from paying partners at 6 months post-intervention and verbal abuse from paying partners immediately post-intervention and 6-months post-intervention. Those assigned to the alcohol intervention had significantly reduced odds of engaging in sex work immediately post-intervention and 6-months post-intervention. The alcohol intervention was associated with reductions in some forms of violence and with reductions in engagement in sex work among FSWs in Mombasa, Kenya. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

What is the evidence for harm minimisation measures in gambling venues?

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Angela Rintoul

2014-06-01

Full Text Available The use of electronic gambling machines (EGMs in Australia and New Zealand constitutes the largest sector of the gambling industry. The costs arising from the harms of gambling detract significantly from its benefits, and in all Australian jurisdictions various policy measures have been implemented to reduce these harms. If successful, these would maximise the net benefits associated with EGM gambling. This article reviews the available evidence for a range of these practices, particularly those implemented within EGM venues via ‘codes of practice’. These codes of practice are intended to give effect to the principles of ‘responsible gambling’ within EGM venues. These measures are: self-exclusion, signage, messages, interaction with gamblers, the removal of ATMs from gambling venues, and ‘responsible gambling’ assessed overall in a venue context. In addition, we review the evidence in support of two major recommendations of the Productivity Commission’s 2010 report into gambling, pre-commitment and one-dollar maximum wagers. We conclude that there is a modest level of evidence supporting some measures, notably self-exclusion and, to a greater extent, the removal of ATMs. There is also some evidence that ‘responsible gambling’ measures have, collectively, reduced the harms associated with gambling. However, there is limited evidence to confirm the effectiveness of most individual ‘responsible gambling’ measures actually implemented in venues. Further, policy measures implemented outside the control of venues (such as ATM removal, reduction in bet limits, and the prohibition of smoking appear to be associated with more significant effects, based on analysis of EGM revenue data in Victoria. The evidence for prospective measures is necessarily limited since the ultimate test is post-implementation efficacy, but there is growing evidence to suggest that pre-commitment, one-dollar maximum bets or other machine design changes may

Reducing harm from HIV/AIDS misconceptions among female sex workers in Tijuana and Ciudad Juarez, Mexico: A cross sectional analysis.

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Robertson, Angela M; Ojeda, Victoria D; Nguyen, Lucie; Lozada, Remedios; Martínez, Gustavo A; Strathdee, Steffanie A; Patterson, Thomas L

2012-08-06

HIV prevalence is increasing among female sex workers (FSWs) in Mexico's Northern border region, who experience multiple occupational risks. Improving vulnerable populations' education, empowerment, and access to preventive services are important components of harm reduction strategies. Given the increasing interest in adapting harm reduction principles from drug use to sex work and other public health responses to the HIV epidemic, we used a sex work harm reduction framework to guide our investigation of FSWs' HIV knowledge. From 2004-2006, FSWs aged ≥18 years in Tijuana and Ciudad Juarez participated in a behavioral intervention study and completed structured interviews. Measures included HIV knowledge assessment and factors within each domain of our theoretical framework for sex work harms: (1) socio-demographic factors that may lead to sex work, (2) sex work characteristics and behaviors that may lead to harm, and (3) mutually reinforcing harms that lead to sex work and result from it (e.g., drug abuse). Negative binomial regression identified factors independently associated with suboptimal HIV knowledge (i.e., incorrect responses during the HIV knowledge assessment). Among 924 FSWs, the median proportion of incorrect responses was nearly one third (28% incorrect). Examination of item responses revealed misconceptions regarding specific transmission and prevention mechanisms, including prevention of mother to child transmission. Suboptimal HIV knowledge was independently associated with older age, lower education, living in Tijuana (vs. Ciudad Juarez), inconsistent condom use for vaginal sex with male clients, and lacking prior HIV testing. Our application of a sex work harm reduction framework to the study of FSWs' HIV knowledge is an important first step in enhancing HIV prevention efforts in Northern Mexican border cities. Our findings imply that interventions should identify and discredit local HIV misconceptions to improve knowledge of specific HIV

The Effects of the 2004 Reduction in the Price of Alcohol on Alcohol-Related Harm in Finland – a Natural Experiment Based on Register Data

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Kimmo Herttua

2010-01-01

disadvantage on the area level and interpersonal violence, although the differences in the effects of the price reduction between the different areas were small.  The findings of the present study suggest that that a reduction in alcohol prices may lead to a substantial increase in alcohol-related mortality and morbidity. However, large population group differences were observed regarding responsiveness to the price changes. In particular, the less privileged, such as the unemployed, were most sensitive. In contrast, at least in the Finnish context, the younger generations and the employed do not appear to be adversely affected, and those in the older age groups may even benefit from cheaper alcohol in terms of decreased rates of CVD mortality. The results also suggest that reductions in alcohol prices do not necessarily affect interpersonal violence. The population group differences in the effects of the price changes on alcohol-related harm should be acknowledged, and therefore the policy actions should focus on the population subgroups that are primarily responsive to the price reduction.

Algae as test organisms of harmful effects of various radiations

International Nuclear Information System (INIS)

Necas, J.

1989-01-01

The report describes a complex biotest in which algae serve as the test organisms and where a variety of algal characteristics are employed as indicators of the effects of harmful radiations on the cultures and single organisms. Rules for a successful choice of a suitable algal organism are discussed and the preparation of the latter for the test as well as the growth and morphogenic tests and some physiological responses of algae to harmful radiation are described. The survival and lethality are related to the interpretation of the test results particularly from the physiological and genetic points of view. The complex biotest concerns not only toxic but also mutagenic effects of the factors tested. Some easily detectable mutations in algae are mentioned and their spectra are recommended. The stability of the mutations and the possibility of their delayed manifestation are considered. The possibility of occurrence of teratogenic effects is also dealt with and the negative role of phenocopies in the correct evaluation of the mutation effects is mentioned. Advice for the breeding and laboratory maintenance of suitable algal strains for the biotest is given. Practical use of the biotest is demonstrated on the results of a test using modified samples of waste water from uranium industries. It is recommended that biotests confined to the evaluation of single characteristics of the test organism be replaced by this complex biotest whose results can be interpreted more extensively and exhibit a higher reliability. (author). 268 refs., 1 tab., 9 figs

Effect of alcohol dose on deliberate self-harm in men and women.

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Berman, Mitchell E; Fanning, Jennifer R; Guillot, Casey R; Marsic, Angelika; Bullock, Joshua; Nadorff, Michael R; McCloskey, Michael S

2017-09-01

Nonexperimental survey and field research support the notion that alcohol use may be associated with deliberate self-harm (DSH) across the spectrum of lethality, from nonsuicidal self-injury (NSSI) through suicide. Nonexperimental studies, however, provide limited information about potential causal relationships between alcohol consumption and DSH. Two previous experiments showed that a relatively high-dose of alcohol increases the likelihood of engaging in DSH in men, with DSH defined by the self-administration of a "painful" shock (the self-aggression paradigm [SAP]; Berman & Walley, 2003; McCloskey & Berman, 2003). In this study, we examined whether (a) lower doses of alcohol also elicit DSH, (b) this effect occurs for women as well as men, and (c) individual differences in past nonsuicidal self-injury (NSSI) moderate alcohol's effects on DSH. Nonalcohol dependent men and women (N = 210) were assigned either to .00%, .05%, .075%, or .100% blood alcohol concentration (BAC) drink conditions and completed a self-rating scale of NSSI (the Deliberate Self-Harm Inventory [DSHI]; Gratz, 2001). As in previous SAP studies, DSH was operationalized by shock setting behavior during a competitive reaction time (RT) game. Overall, a greater proportion of participants in the .075% and .100% (but not .050%) alcohol conditions self-selected a "painful" shock to administer compared to participants in the placebo condition. NSSI predicted self-administration of painful shocks, but did not moderate the alcohol effect. Results provide experimental evidence to support the notion that interventions for self-harm should include processes to monitor and limit alcohol intake. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Reported Theory Use by Digital Interventions for Hazardous and Harmful Alcohol Consumption, and Association With Effectiveness: Meta-Regression.

Science.gov (United States)

Garnett, Claire; Crane, David; Brown, Jamie; Kaner, Eileen; Beyer, Fiona; Muirhead, Colin; Hickman, Matthew; Redmore, James; de Vocht, Frank; Beard, Emma; Michie, Susan

2018-02-28

Applying theory to the design and evaluation of interventions is likely to increase effectiveness and improve the evidence base from which future interventions are developed, though few interventions report this. The aim of this paper was to assess how digital interventions to reduce hazardous and harmful alcohol consumption report the use of theory in their development and evaluation, and whether reporting of theory use is associated with intervention effectiveness. Randomized controlled trials were extracted from a Cochrane review on digital interventions for reducing hazardous and harmful alcohol consumption. Reporting of theory use within these digital interventions was investigated using the theory coding scheme (TCS). Reported theory use was analyzed by frequency counts and descriptive statistics. Associations were analyzed with meta-regression models. Of 41 trials involving 42 comparisons, half did not mention theory (50% [21/42]), and only 38% (16/42) used theory to select or develop the intervention techniques. Significant heterogeneity existed between studies in the effect of interventions on alcohol reduction (I 2 =77.6%, Ptheory use and intervention effectiveness in unadjusted models, though the meta-regression was underpowered to detect modest associations. Digital interventions offer a unique opportunity to refine and develop new dynamic, temporally sensitive theories, yet none of the studies reported refining or developing theory. Clearer selection, application, and reporting of theory use is needed to accurately assess how useful theory is in this field and to advance the field of behavior change theories. ©Claire Garnett, David Crane, Jamie Brown, Eileen Kaner, Fiona Beyer, Colin Muirhead, Matthew Hickman, James Redmore, Frank de Vocht, Emma Beard, Susan Michie. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.02.2018.

A Model for Protective Behavior against the Harmful Effects of Radiation based on Medical Institution Classifications

International Nuclear Information System (INIS)

Han, Eun Ok; Kwon, Deok Mun; Dong, Kyung Rae; Han, Seung Moo

2010-01-01

This study surveyed a total of 1,322 radiation technologist in health care institutions throughout Korea. This is a comparative study conducted on the levels of protective behavior against the harmful effects of radiation in heath care institutions which indicated that university hospitals and general hospitals showed higher level of protective behavior than for medical practitioners. This study found university hospitals have the following 7 characteristics to manage protective behavior against the harmful effects of radiation, protective environment, self-efficacy by distinction of task , self-efficacy, expectation of the protective behavior, the number of patients, level of the education related to the protection of the harmful effects of radiation and protective attitude. While general hospitals have the following 3 characteristics protective environment, expectation of the protective behavior and protective attitude. Hospitals have the following 4 characteristics protective environment, expectation of the protective behavior, protective attitude and self-efficacy and medical clinics have characteristics protective environment

A Model for Protective Behavior against the Harmful Effects of Radiation based on Medical Institution Classifications

Energy Technology Data Exchange (ETDEWEB)

Han, Eun Ok; Kwon, Deok Mun [Daegu Health College, Daegu (Korea, Republic of); Dong, Kyung Rae [Gwangju Health College University, Gwangju (Korea, Republic of); Han, Seung Moo [Kyung Hee University, Seoul (Korea, Republic of)

2010-12-15

This study surveyed a total of 1,322 radiation technologist in health care institutions throughout Korea. This is a comparative study conducted on the levels of protective behavior against the harmful effects of radiation in heath care institutions which indicated that university hospitals and general hospitals showed higher level of protective behavior than for medical practitioners. This study found university hospitals have the following 7 characteristics to manage protective behavior against the harmful effects of radiation, protective environment, self-efficacy by distinction of task , self-efficacy, expectation of the protective behavior, the number of patients, level of the education related to the protection of the harmful effects of radiation and protective attitude. While general hospitals have the following 3 characteristics protective environment, expectation of the protective behavior and protective attitude. Hospitals have the following 4 characteristics protective environment, expectation of the protective behavior, protective attitude and self-efficacy and medical clinics have characteristics protective environment.

[Self-harming behaviour].

Science.gov (United States)

Kool, Nienke; Pollen, Wim; van Meijel, Berno

2010-01-01

To gain a better understanding of self-harm, a 28-year-old female patient and a 19-year-old female patient with self-harming behaviour are presented. The first patient refused treatment of cut wounds when the doctor enquired about the reason for self-harm. The second patient was referred for mental health care. These cases illustrate the complexity of this behaviour for the patient and the caregiver. Self-harm is often a symbol of underlying problems and serves multiple psychological functions. It is mostly used by patients to cope with unbearable emotions for which they have no other solution. The self-harm invokes different feelings in caregivers which tend to influence the attitude of the caregiver towards the patient. It is very important that caregivers are aware of their feelings and use them professionally. People who self-harm should not be judged, but treated respectfully and attention should be paid to their suffering.

Observed Benefits to On-site Medical Services during an Annual 5-day Electronic Dance Music Event with Harm Reduction Services.

Science.gov (United States)

Munn, Matthew Brendan; Lund, Adam; Golby, Riley; Turris, Sheila A

2016-04-01

With increasing attendance and media attention, large-scale electronic dance music events (EDMEs) are a subset of mass gatherings that have a unique risk profile for attendees and promoters. Shambhala Music Festival (Canada) is a multi-day event in a rural setting with a recognized history of providing harm reduction (HR) services alongside medical care. Study/Objective This manuscript describes the medical response at a multi-day electronic music festival where on-site HR interventions and dedicated medical care are delivered as parallel public health measures. This study was a descriptive case report. Medical encounters and event-related data were documented prospectively using an established event registry database. In 2014, Shambhala Music Festival had 67,120 cumulative attendees over a 7-day period, with a peak daily attendance of 15,380 people. There were 1,393 patient encounters and the patient presentation rate (PPR) was 20.8 per one thousand. The majority of these (90.9%) were for non-urgent complaints. The ambulance transfer rate (ATR) was 0.194 per one thousand and 0.93% of patient encounters were transferred by ambulance. No patients required intubation and there were no fatalities. Harm reduction services included mobile outreach teams, distribution of educational materials, pill checking facilities, a dedicated women's space, and a "Sanctuary" area that provided non-medical peer support for overwhelmed guests. More than 10,000 encounters were recorded by mobile and booth-based preventive and educational services, and 2,786 pills were checked on-site with a seven percent discard rate. Dedicated medical and HR services represent two complementary public health strategies to minimize risk at a multi-day electronic music festival. The specific extent to which HR strategies reduce the need for medical care is not well understood. Incorporation of HR practices when planning on-site medical care has the potential to inform patient management, reduce

Recommendations for international gambling harm-minimisation guidelines: comparison with effective public health policy

NARCIS (Netherlands)

Gainsbury, Sally M.; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

2014-01-01

Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of

Recommendations for international gambling harm-minimisation guidelines : comparison with effective public health policy

NARCIS (Netherlands)

Gainsbury, Sally M; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

2014-01-01

Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of

The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms.

Science.gov (United States)

Elder, Randy W; Lawrence, Briana; Ferguson, Aneeqah; Naimi, Timothy S; Brewer, Robert D; Chattopadhyay, Sajal K; Toomey, Traci L; Fielding, Jonathan E

2010-02-01

A systematic review of the literature to assess the effectiveness of alcohol tax policy interventions for reducing excessive alcohol consumption and related harms was conducted for the Guide to Community Preventive Services (Community Guide). Seventy-two papers or technical reports, which were published prior to July 2005, met specified quality criteria, and included evaluation outcomes relevant to public health (e.g., binge drinking, alcohol-related crash fatalities), were included in the final review. Nearly all studies, including those with different study designs, found that there was an inverse relationship between the tax or price of alcohol and indices of excessive drinking or alcohol-related health outcomes. Among studies restricted to underage populations, most found that increased taxes were also significantly associated with reduced consumption and alcohol-related harms. According to Community Guide rules of evidence, these results constitute strong evidence that raising alcohol excise taxes is an effective strategy for reducing excessive alcohol consumption and related harms. The impact of a potential tax increase is expected to be proportional to its magnitude and to be modified by such factors as disposable income and the demand elasticity for alcohol among various population groups. Published by Elsevier Inc.

An Empirical Analysis of Internet Message Boards for Self-Harming Behavior.

Science.gov (United States)

Eichenberg, Christiane; Schott, Markus

2017-01-01

Much debate surrounds the potential effects of self-harm forum use. Arguments in favor highlight factors such as providing access to a supportive community. However critical voice highlighting potential dangers such as forums serving as a platform to promote self-harm, clearly dominate the debate. Using an online questionnaire, the goal of the current study was to examine sociodemographic characteristics, the psychopathology of forum users, motives for participating, and subjective effects of self-harm forum use. A total of 309 self-harm forum users participated in this study. 3 heterogeneous user types with differing motives for visiting the forum and different usage effects were identified. The results question the assumptions that self-harm forums are a source of harm and point to their predominantly constructive and preventive functions.

Venous access and care: harnessing pragmatics in harm reduction for people who inject drugs.

Science.gov (United States)

Harris, Magdalena; Rhodes, Tim

2012-06-01

To explore the facilitators of long-term hepatitis C avoidance among people who inject drugs. We employed a qualitative life history design. Recruitment took place through low-threshold drug services and drug user networks in South East and North London. Participants were interviewed at the recruitment services or in their homes. The sample comprised 35 people who inject drugs, 20 of whom were hepatitis C antibody-negative. Participants' average injecting trajectory was 19 years (6-33), with 66% primarily injecting heroin, and 34% a crack and heroin mix. Nine (26%) of the sample were female and the average age was 39 years (23-53). Two interviews were conducted with each participant, with the second interview incorporating reference to a computer-constructed life history time-line. Interview accounts were audiorecorded, transcribed verbatim and analysed thematically. Hepatitis C risk awareness was recent and deprioritized by the majority of participants. The facilitation of venous access and care was an initial and enduring rationale for safe injecting practices. Difficult venous access resulted in increased contamination of injecting environments and transitions to femoral injecting. Participants expressed an unmet desire for non-judgemental venous access information and advice. Harm reduction interventions which attend to the immediate priorities of people who inject drugs, such as venous access and care, have the potential to re-engage individuals who are jaded or confused by hepatitis C prevention messages. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Mitigating Harmful Cyanobacterial Blooms in a Human- and Climatically-Impacted World

Directory of Open Access Journals (Sweden)

Hans W. Paerl

2014-12-01

Full Text Available Bloom-forming harmful cyanobacteria (CyanoHABs are harmful from environmental, ecological and human health perspectives by outcompeting beneficial phytoplankton, creating low oxygen conditions (hypoxia, anoxia, and by producing cyanotoxins. Cyanobacterial genera exhibit optimal growth rates and bloom potentials at relatively high water temperatures; hence, global warming plays a key role in their expansion and persistence. CyanoHABs are regulated by synergistic effects of nutrient (nitrogen:N and phosphorus:P supplies, light, temperature, vertical stratification, water residence times, and biotic interactions. In most instances, nutrient control strategies should focus on reducing both N and P inputs. Strategies based on physical, chemical (nutrient and biological manipulations can be effective in reducing CyanoHABs; however, these strategies are largely confined to relatively small systems, and some are prone to ecological and environmental drawbacks, including enhancing release of cyanotoxins, disruption of planktonic and benthic communities and fisheries habitat. All strategies should consider and be adaptive to climatic variability and change in order to be effective for long-term control of CyanoHABs. Rising temperatures and greater hydrologic variability will increase growth rates and alter critical nutrient thresholds for CyanoHAB development; thus, nutrient reductions for bloom control may need to be more aggressively pursued in response to climatic changes globally.

The District Nursing Clinical Error Reduction Programme.

Science.gov (United States)

McGraw, Caroline; Topping, Claire

2011-01-01

The District Nursing Clinical Error Reduction (DANCER) Programme was initiated in NHS Islington following an increase in the number of reported medication errors. The objectives were to reduce the actual degree of harm and the potential risk of harm associated with medication errors and to maintain the existing positive reporting culture, while robustly addressing performance issues. One hundred medication errors reported in 2007/08 were analysed using a framework that specifies the factors that predispose to adverse medication events in domiciliary care. Various contributory factors were identified and interventions were subsequently developed to address poor drug calculation and medication problem-solving skills and incorrectly transcribed medication administration record charts. Follow up data were obtained at 12 months and two years. The evaluation has shown that although medication errors do still occur, the programme has resulted in a marked shift towards a reduction in the associated actual degree of harm and the potential risk of harm.

Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm.

Science.gov (United States)

van de Plas, Afke; Slikkerveer, Mariëlle; Hoen, Saskia; Schrijnemakers, Rick; Driessen, Johanna; de Vries, Frank; van den Bemt, Patricia

2017-01-01

In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined. During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward. Implemented improvement strategies, based on major causes of too fast administration of bolus injections, were: Substitution of bolus injections by infusions, education, availability of administration information and drug round tabards. Post intervention, on the control ward in 76 (76%) administrations at least one error was made (RR 1.03; CI95:0.77-1.38), with a potential risk of harm in 14 (14%) administrations (RR 0.45; CI95:0.20-1.02). In 40 (68%) administrations on the intervention ward at least one error occurred (RR 1.47; CI95:0.80-2.71) but no administrations were associated with a potential risk of harm. A shift in wrong duration administration errors from bolus injections to infusions, with a reduction of potential risk of harm, seems to have occurred on the intervention ward. Although data are insufficient to prove an effect, Lean Six Sigma was experienced as a suitable strategy to select tailored improvements. Further studies are required to prove the effect of the strategy on parenteral medication administration errors.

Deliberate Self Harm Behavior

Directory of Open Access Journals (Sweden)

Fatma Gul Helvaci Celik

2017-06-01

Full Text Available The deliberate self-harm behaviour which defined as attempting to own body resulting in tisue damage without conscious desire of peolple to die, is a major public health problem worldwide. The causes of deliberate self- harm, risk factors, the relationship between mental disorders and treatment strategies are not fully known. Deliberate self- harm can be observed together with psychiatric disorders such as borderline personality disorder, histrionic personality disorder, eating disorders and mood disorders. Also, deliberate self-harm must be distinguished from suicidal behavior. Psychologi-cal trauma has been suggested as a risk factor for deliberate self- harm behavior. Trauma and traumatic events have long been associated with deliberate self- harm behavior. The aim of this review article is to investigate the etiology and epidemiology of deliberate self-harm behaviour and relationship between psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000: 209-226

Developing, implementing and evaluating a model for an outpatient self-harm service.

Science.gov (United States)

Brand, Fiona; Lascelles, Karen

2017-05-10

Aim To reduce the incidence of self-harming behaviour and improve well-being and experience of care for individuals who present regularly to the emergency department in one hospital following self-harm, by providing outpatient care. Method This was a 12-month nurse-led practice development project to develop, implement and evaluate a brief-intervention outpatient service for individuals who presented to the emergency department following self-harm and who were identified as being at risk of further self-harm. The service improvement was informed by an action research process and the principles of appreciative inquiry. Findings The project provided a short-term outpatient follow-up service, known as Brief Interventions in Repeat Self Harm (BIRSH), to patients who presented to the emergency department following self-harm, and who were considered at risk of further self-harm. The intervention enabled the clinician to validate the patient's distress and offer them short-term outpatient follow-up care. The BIRSH sessions were offered to 38 patients. A total of 26 patients attended one or more BIRSH session, and all of these individuals showed a reduction in the number of presentations to the emergency department following self-harm in the six months following the intervention, compared to the six months before the intervention. Conclusion The BIRSH outpatient service appears to have been a contributory factor in reducing self-harm for patients who engaged with the service. The service improvement was informed by an action research process and the principles of appreciative inquiry, which provided a positive, focused approach to the practice development project.

Effects of Harmful Algae on the Physiology of Fishes

DEFF Research Database (Denmark)

Svendsen, Morten Bo Søndergaard

Blooms of harmful planktonic algae causing adverse effects in aquatic environments are a global problem, causing both human morbidity and killing aquatic lifeforms worldwide. Focusing on fish kills, it is largely unknown what mechanisms of the fish’s physiology are affected during exposure...... is deemed unlikely on basis of rainbow trout (Onchorhyncus mykiss) not recovering. The specific toxicity of Pseudochattonella spp. is unknown, but by studying the effects of Pseudochattonella spp. on fish during a natural bloom occurring at a trout farm an adverse outcome could be created. The adverse...... Alexandrium monilatum has been studied intensively the effects of Alexandrium monilatum on fish is largely unknown. In the Chesapeake Bay, Eastern U.S.A., fishes are further challenged in late summer by an oxygen squeeze from deep part of the water column, limiting their utilizable habitat to mid...

Cutting and Self-Harm

Science.gov (United States)

... Your feelings Feeling sad Cutting and self-harm Cutting and self-harm Self-harm, sometimes called self- ... There are many types of self-injury, and cutting is one type that you may have heard ...

Unleaded gasoline with reduction in benzene and aromatics

International Nuclear Information System (INIS)

Ahmed, I.

2003-01-01

The trend today is towards making gasoline more environment and human friendly or in other words making gasoline a really clean fuel. This paper covers the ill effects of benzene and aromatics and the driving force behind their reduction in gasoline worldwide. It addresses health concerns specifically, and the theme is unleaded gasoline without simultaneously addressing reduction in benzene and aromatics is more harmful. The paper cites worldwide case studies, and also the World Bank (WB), Government of Pakistan (GoP), and United Nations (UN) efforts in this area in Pakistan. (author)

Future Climate Impacts on Harmful Algal Blooms in an Agriculturally Dominated Ecosystem

Science.gov (United States)

Aloysius, N. R.; Martin, J.; Ludsin, S.; Stumpf, R. P.

2015-12-01

Cyanobacteria blooms have become a major problem worldwide in aquatic ecosystems that receive excessive runoff of limiting nutrients from terrestrial drainage. Such blooms often are considered harmful because they degrade ecosystem services, threaten public health, and burden local economies. Owing to changing agricultural land-use practices, Lake Erie, the most biologically productive of the North American Great Lakes, has begun to undergo a re-eutrophication in which the frequency and extent of harmful algal blooms (HABs) has increased. Continued climate change has been hypothesized to magnify the HAB problem in Lake Erie in the absence of new agricultural management practices, although this hypothesis has yet to be formally tested empirically. Herein, we tested this hypothesis by predicting how the frequency and extent of potentially harmful cyanobacteria blooms will change in Lake Erie during the 21st century under the Intergovernmental Panel on Climate Change Fifth Assessment climate projections in the region. To do so, we used 80 ensembles of climate projections from 20 Global Climate Models (GCMs) and two greenhouse gas emission scenarios (moderate reduction, RCP4.5; business-as-usual, RCP8.5) to drive a spatiotemporally explicit watershed-hydrology model that was linked to several statistical predictive models of annual cyanobacteria blooms in Lake Erie. Owing to anticipated increases in precipitation during spring and warmer temperatures during summer, our ensemble of predictions revealed that, if current land-management practices continue, the frequency of severe HABs in Lake Erie will increase during the 21st century. These findings identify a real need to consider future climate projections when developing nutrient reduction strategies in the short term, with adaptation also needing to be encouraged under both greenhouse gas emissions scenarios in the absence of effective nutrient mitigation strategies.

Nonsuicidal Self-Harm among Community Adolescents: Understanding the "Whats" and "Whys" of Self-Harm

Science.gov (United States)

Laye-Gindhu, Aviva; Schonert-Reichl, Kimberly A.

2005-01-01

This study examines self-harm in a community sample of adolescents. More specifically, the study identifies the prevalence and types of self-harm, elucidates the nature and underlying function of self-harm, and evaluates the relation of psychological adjustment, sociodemographic, and health-risk variables to self-harm. Self-report questionnaires…

Online Patient-Provider E-cigarette Consultations: Perceptions of Safety and Harm.

Science.gov (United States)

Brown-Johnson, Cati G; Burbank, Andrea; Daza, Eric J; Wassmann, Arianna; Chieng, Amy; Rutledge, Geoffrey W; Prochaska, Judith J

2016-12-01

E-cigarettes are popular and unregulated. Patient-provider communications concerning e-cigarettes were characterized to identify patient concerns, provider advice and attitudes, and research needs. An observational study of online patient-provider communications was conducted January 2011-June 2015 from a network providing free medical advice, and analyzed July 2014-May 2016. Patient and provider themes, and provider attitudes toward e-cigarettes (positive, negative, or neutral) were coded qualitatively. Provider attitudes were analyzed with cumulative logit modeling to account for clustering. Patient satisfaction with provider responses was expressed via a Thank function. An increase in e-cigarette-related questions was observed over time. Patient questions (N=512) primarily concerned specific side effects and harms (34%); general safety (27%); e-cigarettes as quit aids (19%); comparison of e-cigarette harms relative to combusted tobacco (18%); use with pre-existing medical conditions (18%); and nicotine-free e-cigarettes (14%). Half of provider responses discussed e-cigarettes as a harm reduction option (48%); 26% discussed them as quit aids. Overall, 47% of providers' responses represented a negative attitude toward e-cigarettes; 33% were neutral (contradictory or non-committal); and 20% were positive. Attitudes did not differ statistically by medical specialty; provider responses positive toward e-cigarettes received significantly more Thanks. Examination of online patient-provider communications provides insight into consumer health experience with emerging alternative tobacco products. Patient concerns largely related to harms and safety, and patients preferred provider responses positively inclined toward e-cigarettes. Lacking conclusive evidence of e-cigarette safety or efficacy, healthcare providers encouraged smoking cessation and recommended first-line cessation treatment approaches. Copyright © 2016 American Journal of Preventive Medicine. Published by

Alcohol industry corporate social responsibility initiatives and harmful drinking: a systematic review.

Science.gov (United States)

Mialon, Melissa; McCambridge, Jim

2018-04-25

There is growing awareness of the detrimental effects of alcohol industry commercial activities, and concern about possible adverse impacts of its corporate social responsibility (CSR) initiatives, on public health. The aims of this systematic review were to summarize and examine what is known about CSR initiatives undertaken by alcohol industry actors in respect of harmful drinking globally. We searched for peer-reviewed studies published since 1980 of alcohol industry CSR initiatives in seven electronic databases. The basic search strategy was organized around the three constructs of 'alcohol', 'industry' and 'corporate social responsibility'. We performed the searches on 21 July 2017. Data from included studies were analyzed inductively, according to the extent to which they addressed specified research objectives. A total of 21 studies were included. We identified five types of CSR initiatives relevant to the reduction of harmful drinking: alcohol information and education provision; drink driving prevention; research involvement; policy involvement and the creation of social aspects organizations. Individual companies appear to undertake different CSR initiatives than do industry-funded social aspects organizations. There is no robust evidence that alcohol industry CSR initiatives reduce harmful drinking. There is good evidence, however, that CSR initiatives are used to influence the framing of the nature of alcohol-related issues in line with industry interests. This research literature is at an early stage of development. Alcohol policy measures to reduce harmful drinking are needed, and the alcohol industry CSR initiatives studied so far do not contribute to the attainment of this goal.

Ionizing radiation biological effects and the proper protective measures against it's harmful effects

International Nuclear Information System (INIS)

Hhalel, A.M.

1990-01-01

This book intrduces a good knowledge in specifications of ionizing radiation biological effects and the proper protective measures againest harmful effectes. The book is devided in to five main sections, the first one introduces the hostorical bachground of the contributions of a number of scietists in the basic knolwledge of radiation and its biological effects. The second section deals with the physical and chemical principles of radiation the third one talks about radiation detection. While the fourth section talks (via seven chapter) about the effectes of ionizing radiation on living organisms molecules cells, tissues organs systems and the living organism the fifth section talks about the uses of radiation sources, the probability of radiation accidents, protective measures, international recommendations related to doses and safe use of ionizing radiation. (Abed Al-wali Al-ajlouni). 53 refs., 107 figs., 13 tabs

Weathering product-harm crises

NARCIS (Netherlands)

Cleeren, K.; Dekimpe, M.G.; Helsen, K.

2008-01-01

To counter the negative effects of a product-harm crisis, brands hope to capitalize on their equity, and often use advertising as a communication device to regain customers’ lost trust. We study how consumer characteristics and advertising influence consumers’ first-purchase decisions for two

Managing Product-Harm Crises

NARCIS (Netherlands)

H.J. van Heerde (Harald); K. Helsen; M.G. Dekimpe (Marnik)

2005-01-01

textabstractProduct-harm crises are among a firm’s worst nightmares. Since marketing investments may be instrumental to convince consumers to purchase the firm's products again, it is important to provide an adequate measurement of the effectiveness of these investments, especially after the crisis.

Harm avoidance and disability in old age.

Science.gov (United States)

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

2006-01-01

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

Potential harmful effects on agricultural environments of sewage sludge utilization as a fertilizer

International Nuclear Information System (INIS)

Suess, A.

1997-01-01

There can be harmful effects of sewage-sludge utilization in agriculture. However, these can be overcome by treatment of the sludge and by appropriate farm-management practices. Sewage sludge is of increasing potential importance to farmers because of its value as a fertilizer. But some compounds in sludge can be harmful for plants, animals and man. Heavy metals may be taken up by plants, and the higher the content in the soil, the greater the uptake. There are substantial differences in heavy-metal accumulation and tolerance among plant species. With respect to pathogens (for example Salmonella) in sludge, recent developments in decontamination processes can provide greater guarantee of preservation of the environment. Gamma-radiation treatment at a dose of 3 kGy has been proven effective. The use of sewage sludge in agriculture is attractive from the economical and environmental points of view. It is therefore important that farmers are provided not only with more information about the nutrient effects, but also about risks, if any, of leaching of heavy metals and microbial condition to groundwater. To achieve this, there must be close co-operation between farmers and the authorities responsible for disposal of sewage sludge. (author)

Effects of 20 Selected Fruits on Ethanol Metabolism: Potential Health Benefits and Harmful Impacts.

Science.gov (United States)

Zhang, Yu-Jie; Wang, Fang; Zhou, Yue; Li, Ya; Zhou, Tong; Zheng, Jie; Zhang, Jiao-Jiao; Li, Sha; Xu, Dong-Ping; Li, Hua-Bin

2016-04-01

The consumption of alcohol is often accompanied by other foods, such as fruits and vegetables. This study is aimed to investigate the effects of 20 selected fruits on ethanol metabolism to find out their potential health benefits and harmful impacts. The effects of the fruits on ethanol metabolism were characterized by the concentrations of ethanol and acetaldehyde in blood, as well as activities of alcohol dehydrogenase and acetaldehyde dehydrogenase in liver of mice. Furthermore, potential health benefits and harmful impacts of the fruits were evaluated by biochemical parameters including aspartate transaminase (AST), alanine transferase (ALT), malondialdehyde, and superoxide dismutase. Generally, effects of these fruits on ethanol metabolism were very different. Some fruits (such as Citrus limon (yellow), Averrhoa carambola, Pyrus spp., and Syzygium samarangense) could decrease the concentration of ethanol in blood. In addition, several fruits (such as Cucumis melo) showed hepatoprotective effects by significantly decreasing AST or ALT level in blood, while some fruits (such as Averrhoa carambola) showed adverse effects. The results suggested that the consumption of alcohol should not be accompanied by some fruits, and several fruits could be developed as functional foods for the prevention and treatment of hangover and alcohol use disorder.

Effect of ergonomics training on agreement between expert and nonexpert ratings of the potential for musculoskeletal harm in manufacturing tasks.

Science.gov (United States)

Fethke, Nathan B; Merlino, Linda; Gerr, Fred

2013-12-01

To evaluate the effect of ergonomics training on non-ergonomists' ability to recognize and characterize the potential for musculoskeletal harm in manufacturing tasks. Ergonomics training was delivered to members of a participatory ergonomics team in a manufacturing facility. Before and after training, participatory ergonomics team members and the research team rated the potential for musculoskeletal harm for each of 30 tasks. Measures of agreement included Pearson, concordance, and intraclass correlation coefficients. Measures of agreement generally improved after training. The greatest agreement was observed for ratings of the potential for musculoskeletal harm to the low back. The greatest improvement in agreement was observed for ratings of the potential for musculoskeletal harm to the neck/shoulder. The training seemed to improve non-experts' ability to identify the potential for musculoskeletal harm.

Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study

Science.gov (United States)

Ruocco, Anthony C.; Rodrigo, Achala H.; McMain, Shelley F.; Page-Gould, Elizabeth; Ayaz, Hasan; Links, Paul S.

2016-01-01

Self-harm is a potentially lethal symptom of borderline personality disorder (BPD) that often improves with dialectical behavior therapy (DBT). While DBT is effective for reducing self-harm in many patients with BPD, a small but significant number of patients either does not improve in treatment or ends treatment prematurely. Accordingly, it is crucial to identify factors that may prospectively predict which patients are most likely to benefit from and remain in treatment. In the present preliminary study, 29 actively self-harming patients with BPD completed brain-imaging procedures probing activation of the prefrontal cortex (PFC) during impulse control prior to beginning DBT and after 7 months of treatment. Patients that reduced their frequency of self-harm the most over treatment displayed lower levels of neural activation in the bilateral dorsolateral prefrontal cortex (DLPFC) prior to beginning treatment, and they showed the greatest increases in activity within this region after 7 months of treatment. Prior to starting DBT, treatment non-completers demonstrated greater activation than treatment-completers in the medial PFC and right inferior frontal gyrus. Reductions in self-harm over the treatment period were associated with increases in activity in right DLPFC even after accounting for improvements in depression, mania, and BPD symptom severity. These findings suggest that pre-treatment patterns of activation in the PFC underlying impulse control may be prospectively associated with improvements in self-harm and treatment attrition for patients with BPD treated with DBT. PMID:27242484

Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study

Directory of Open Access Journals (Sweden)

Anthony Charles Ruocco

2016-05-01

Full Text Available Self-harm is a potentially lethal symptom of borderline personality disorder (BPD that often improves with dialectical behavior therapy (DBT. While DBT is effective for reducing self-harm in many patients with BPD, a small but significant number of patients either does not improve in treatment or ends treatment prematurely. Accordingly, it is crucial to identify factors that may prospectively predict which patients are most likely to benefit from and remain in treatment. In the present preliminary study, twenty-nine actively self-harming patients with BPD completed brain-imaging procedures probing activation of the prefrontal cortex during impulse control prior to beginning DBT and after seven months of treatment. Patients that reduced their frequency of self-harm the most over treatment displayed lower levels of neural activation in the bilateral dorsolateral prefrontal cortex prior to beginning treatment, and they showed the greatest increases in activity within this region after seven months of treatment. Prior to starting DBT, treatment non-completers demonstrated greater activation than treatment-completers in the medial prefrontal cortex and right inferior frontal gyrus. Reductions in self-harm over the treatment period were associated with increases in activity in right dorsolateral prefrontal cortex even after accounting for improvements in depression, mania, and BPD symptom severity. These findings suggest that pre-treatment patterns of activation in the prefrontal cortex underlying impulse control may be prospectively associated with improvements in self-harm and treatment attrition for patients with BPD treated with DBT.

Predicting Treatment Outcomes from Prefrontal Cortex Activation for Self-Harming Patients with Borderline Personality Disorder: A Preliminary Study.

Science.gov (United States)

Ruocco, Anthony C; Rodrigo, Achala H; McMain, Shelley F; Page-Gould, Elizabeth; Ayaz, Hasan; Links, Paul S

2016-01-01

Self-harm is a potentially lethal symptom of borderline personality disorder (BPD) that often improves with dialectical behavior therapy (DBT). While DBT is effective for reducing self-harm in many patients with BPD, a small but significant number of patients either does not improve in treatment or ends treatment prematurely. Accordingly, it is crucial to identify factors that may prospectively predict which patients are most likely to benefit from and remain in treatment. In the present preliminary study, 29 actively self-harming patients with BPD completed brain-imaging procedures probing activation of the prefrontal cortex (PFC) during impulse control prior to beginning DBT and after 7 months of treatment. Patients that reduced their frequency of self-harm the most over treatment displayed lower levels of neural activation in the bilateral dorsolateral prefrontal cortex (DLPFC) prior to beginning treatment, and they showed the greatest increases in activity within this region after 7 months of treatment. Prior to starting DBT, treatment non-completers demonstrated greater activation than treatment-completers in the medial PFC and right inferior frontal gyrus. Reductions in self-harm over the treatment period were associated with increases in activity in right DLPFC even after accounting for improvements in depression, mania, and BPD symptom severity. These findings suggest that pre-treatment patterns of activation in the PFC underlying impulse control may be prospectively associated with improvements in self-harm and treatment attrition for patients with BPD treated with DBT.

Suicide Following Deliberate Self-Harm.

Science.gov (United States)

Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Gerhard, Tobias; Blanco, Carlos

2017-08-01

The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined. Hazard ratios of repeat self-harm and suicide were estimated by Cox proportional hazard models. During the 12 months after nonfatal self-harm, the rate of repeat self-harm was 263.2 per 1,000 person-years and the rate of completed suicide was 439.1 per 100,000 person-years, or 37.2 times higher than in a matched general population cohort. The hazard of suicide was higher after initial self-harm events involving violent as compared with nonviolent methods (hazard ratio=7.5, 95% CI=5.5-10.1), especially firearms (hazard ratio=15.86, 95% CI=10.7-23.4; computed with poisoning as reference), and to a lesser extent after events of patients who had recently received outpatient mental health care (hazard ratio=1.6, 95% CI=1.2-2.0). Compared with self-harm patients using nonviolent methods, those who used violent methods were at significantly increased risk of suicide during the first 30 days after the initial event (hazard ratio=17.5, 95% CI=11.2-27.3), but not during the following 335 days. Adults treated for deliberate self-harm frequently repeat self-harm in the following year. Patients who use a violent method for their initial self-harm, especially firearms, have an exceptionally high risk of suicide, particularly right after the initial event, which highlights the importance of careful assessment and close follow-up of this group.

Does clinical management improve outcomes following self-harm? Results from the multicentre study of self-harm in England.

Directory of Open Access Journals (Sweden)

Nav Kapur

Full Text Available Evidence to guide clinical management of self-harm is sparse, trials have recruited selected samples, and psychological treatments that are suggested in guidelines may not be available in routine practice.To examine how the management that patients receive in hospital relates to subsequent outcome.We identified episodes of self-harm presenting to three UK centres (Derby, Manchester, Oxford over a 10 year period (2000 to 2009. We used established data collection systems to investigate the relationship between four aspects of management (psychosocial assessment, medical admission, psychiatric admission, referral for specialist mental health follow up and repetition of self-harm within 12 months, adjusted for differences in baseline demographic and clinical characteristics.35,938 individuals presented with self-harm during the study period. In two of the three centres, receiving a psychosocial assessment was associated with a 40% lower risk of repetition, Hazard Ratios (95% CIs: Centre A 0.99 (0.90-1.09; Centre B 0.59 (0.48-0.74; Centre C 0.59 (0.52-0.68. There was little indication that the apparent protective effects were mediated through referral and follow up arrangements. The association between psychosocial assessment and a reduced risk of repetition appeared to be least evident in those from the most deprived areas.These findings add to the growing body of evidence that thorough assessment is central to the management of self-harm, but further work is needed to elucidate the possible mechanisms and explore the effects in different clinical subgroups.

Addiction, agency, and the politics of self-control: doing harm reduction in a heroin users' group.

Science.gov (United States)

Gowan, Teresa; Whetstone, Sarah; Andic, Tanja

2012-04-01

Our 2007-2009 ethnography describes and analyses the practice of harm reduction in a heroin users' group in the midwestern United States. While dominant addiction interventions conceptualize the addict as powerless - either through moral or physical weakness - this group contested such "commonsense," treating illicit drug use as one of many ways that modern individuals attempt to "fill the void." Insisting on the destigmatization of addiction and the normalization of illicit drug use, the group helped its members work on incremental steps toward self-management. Although "Connection Points" had very limited resources to improve the lives of its members, our work suggests that the users' group did much to restore self-respect, rational subjectivity, and autonomy to a group historically represented as incapable of reason and self-control. As the users cohered as a community, they developed a critique of the oppressions suffered by "junkies," discussed their rights and entitlements, and even planned the occasional political action. Engaging with literature on the cultural construction of agency and responsibility, we consider, but ultimately complicate, the conceptualization of needle exchange as a "neoliberal" form of population management. Within the context of the United States' War on Drugs, the group's work on destigmatization, health education, and the practice of incremental control showed the potential for reassertions of social citizenship within highly marginal spaces. Copyright © 2012 Elsevier Ltd. All rights reserved.

Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of harmful effects in non-randomised studies

DEFF Research Database (Denmark)

Jakob, Storebø Ole; Nadia, Pedersen; Erica, Ramstad

2016-01-01

This is the protocol for a review and there is no abstract. The objectives are as follows:To assess the harmful effects of methylphenidate treatment for children and adolescents with attention deficit hyperactivity disorder (ADHD) in non-randomised studies.......This is the protocol for a review and there is no abstract. The objectives are as follows:To assess the harmful effects of methylphenidate treatment for children and adolescents with attention deficit hyperactivity disorder (ADHD) in non-randomised studies....

Cutting Class Harms Grades

Science.gov (United States)

Taylor, Lewis A., III

2012-01-01

An accessible business school population of undergraduate students was investigated in three independent, but related studies to determine effects on grades due to cutting class and failing to take advantage of optional reviews and study quizzes. It was hypothesized that cutting classes harms exam scores, attending preexam reviews helps exam…

Characterizing use patterns and perceptions of relative harm in dual users of electronic and tobacco cigarettes

Science.gov (United States)

Rass, Olga; Pacek, Lauren R.; Johnson, Patrick S.; Johnson, Matthew W.

2015-01-01

Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk (MTurk). Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others’ health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms. PMID:26389638

Social acceptance of technologies in relation to their benefit and harm

International Nuclear Information System (INIS)

Sobajima, Makoto

2001-03-01

The progress and popularization of scientific techniques have brought large effects on peoples' life. In those effects, the realization of benefit (advantage) that scientific techniques for bringing abundance and convenience are aiming at and the appearance of unintentional harm spreading on the back coexist in many cases. So it can not be overlooked that the harm side is affecting people as large damages as technologies develop to higher level and more complicated. The common cause of them is thought to be lack of preliminary assessment and regulation before introducing those new technologies with the background of pursuit of mass production and mass consumption. In this research, many of examples of various effects are surveyed in literatures and analyzed to first contrast benefit and harm brought by scientific techniques. As for the harm, damage actually suffered and the possibility of hazard are classified from the view point of risks and methodologies of social risk management are discussed. In addition, externalities in environment as a kind of harm are evaluated. On this basis, policy requirements on social system for minimizing the harm brought by technologies and promoting people's acceptance of technologies in the future society are proposed as political attainment. (author)

Effectiveness of Mass Media Campaigns to Reduce Alcohol Consumption and Harm: A Systematic Review

Science.gov (United States)

Lewis, Sarah; Katikireddi, Srinivasa Vittal; Bauld, Linda; Stead, Martine; Angus, Kathryn; Campbell, Mhairi; Hilton, Shona; Thomas, James; Hinds, Kate; Ashie, Adela; Langley, Tessa

2018-01-01

Abstract Aims To assess the effectiveness of mass media messages to reduce alcohol consumption and related harms using a systematic literature review. Methods Eight databases were searched along with reference lists of eligible studies. Studies of any design in any country were included, provided that they evaluated a mass media intervention targeting alcohol consumption or related behavioural, social cognitive or clinical outcomes. Drink driving interventions and college campus campaigns were ineligible. Studies quality were assessed, data were extracted and a narrative synthesis conducted. Results Searches produced 10,212 results and 24 studies were included in the review. Most campaigns used TV or radio in combination with other media channels were conducted in developed countries and were of weak quality. There was little evidence of reductions in alcohol consumption associated with exposure to campaigns based on 13 studies which measured consumption, although most did not state this as a specific aim of the campaign. There were some increases in treatment seeking and information seeking and mixed evidence of changes in intentions, motivation, beliefs and attitudes about alcohol. Campaigns were associated with increases in knowledge about alcohol consumption, especially where levels had initially been low. Recall of campaigns was high. Conclusion Mass media health campaigns about alcohol are often recalled by individuals, have achieved changes in knowledge, attitudes and beliefs about alcohol but there is little evidence of reductions in alcohol consumption. Short summary There is little evidence that mass media campaigns have reduced alcohol consumption although most did not state that they aimed to do so. Studies show recall of campaigns is high and that they can have an impact on knowledge, attitudes and beliefs about alcohol consumption. PMID:29329359

Effectiveness of Mass Media Campaigns to Reduce Alcohol Consumption and Harm: A Systematic Review.

Science.gov (United States)

Young, Ben; Lewis, Sarah; Katikireddi, Srinivasa Vittal; Bauld, Linda; Stead, Martine; Angus, Kathryn; Campbell, Mhairi; Hilton, Shona; Thomas, James; Hinds, Kate; Ashie, Adela; Langley, Tessa

2018-05-01

To assess the effectiveness of mass media messages to reduce alcohol consumption and related harms using a systematic literature review. Eight databases were searched along with reference lists of eligible studies. Studies of any design in any country were included, provided that they evaluated a mass media intervention targeting alcohol consumption or related behavioural, social cognitive or clinical outcomes. Drink driving interventions and college campus campaigns were ineligible. Studies quality were assessed, data were extracted and a narrative synthesis conducted. Searches produced 10,212 results and 24 studies were included in the review. Most campaigns used TV or radio in combination with other media channels were conducted in developed countries and were of weak quality. There was little evidence of reductions in alcohol consumption associated with exposure to campaigns based on 13 studies which measured consumption, although most did not state this as a specific aim of the campaign. There were some increases in treatment seeking and information seeking and mixed evidence of changes in intentions, motivation, beliefs and attitudes about alcohol. Campaigns were associated with increases in knowledge about alcohol consumption, especially where levels had initially been low. Recall of campaigns was high. Mass media health campaigns about alcohol are often recalled by individuals, have achieved changes in knowledge, attitudes and beliefs about alcohol but there is little evidence of reductions in alcohol consumption. There is little evidence that mass media campaigns have reduced alcohol consumption although most did not state that they aimed to do so. Studies show recall of campaigns is high and that they can have an impact on knowledge, attitudes and beliefs about alcohol consumption.

The Effect of Carbonaceous Reductant Selection on Chromite Pre-reduction

Science.gov (United States)

Kleynhans, E. L. J.; Beukes, J. P.; Van Zyl, P. G.; Bunt, J. R.; Nkosi, N. S. B.; Venter, M.

2017-04-01

Ferrochrome (FeCr) production is an energy-intensive process. Currently, the pelletized chromite pre-reduction process, also referred to as solid-state reduction of chromite, is most likely the FeCr production process with the lowest specific electricity consumption, i.e., MWh/t FeCr produced. In this study, the effects of carbonaceous reductant selection on chromite pre-reduction and cured pellet strength were investigated. Multiple linear regression analysis was employed to evaluate the effect of reductant characteristics on the aforementioned two parameters. This yielded mathematical solutions that can be used by FeCr producers to select reductants more optimally in future. Additionally, the results indicated that hydrogen (H)- (24 pct) and volatile content (45.8 pct) were the most significant contributors for predicting variance in pre-reduction and compressive strength, respectively. The role of H within this context is postulated to be linked to the ability of a reductant to release H that can induce reduction. Therefore, contrary to the current operational selection criteria, the authors believe that thermally untreated reductants ( e.g., anthracite, as opposed to coke or char), with volatile contents close to the currently applied specification (to ensure pellet strength), would be optimal, since it would maximize H content that would enhance pre-reduction.

Problems of harmful habits and dependences of students.

Directory of Open Access Journals (Sweden)

Gorobey Nikolaj Petrovich

2011-11-01

Full Text Available The analysis of data of modern scientific literature is conducted on issue of harmful habits and dependences of students. It is shown that considerable part of student young people have harmful habits and dependences. Negative influence of harmful habits and dependences of students is exposed on the state of their health. Importance of delivering is well-proven from addiction behavior in practice of healthy way of life of students. It is set that one of foreground jobs of present time there is an increase of level of education of student young people on questions abandonment from harmful habits and dependences. The ways of decision of problem of addiction behavior of students are offered as an effective condition of improvement of the state of their health.

The Effect of Sodium Hydroxide on Drag Reduction using a Biopolymer.

Directory of Open Access Journals (Sweden)

Singh Harvin Kaur A/P Gurchran

2014-07-01

Full Text Available Drag reduction is observed as reduced frictional pressure losses under turbulent flow conditions and hence, substantially increases the flowrate of the fluid. Practical application includes water flooding system, pipeline transport and drainage system. Drag reduction agent, such as polymers, can be introduced to increase the flowrate of water flowing, reducing the water accumulation in the system and subsequently lesser possibility of heavy flooding. Currently used polymer as drag reduction agents is carboxymethylcellulose, to name one. This is a synthetic polymer which will seep into the ground and further harm our environment in excessive use of accumulation. A more environmentally-friendly drag reduction agent, such as the polymer derived from natural sources or biopolymer, is then required for such purpose. As opposed to the synthetic polymers, the potential of biopolymers as drag reduction agents, especially those derived from a local plant source, are not extensively explored. The drag reduction of a polymer produced from a local plant source within the turbulent regime will be explored and assessed in this study using a rheometer where a reduced a torque produced can be perceived as a reduction of drag. The cellulose powder was converted to carboxymethylcellulose (CMC by etherification process using sodium monochloroacetate and sodium hydroxide. The carboxymethylation reaction then was optimized against concentration of NaOH. The research is structured to focus on producing the biopolymer and also assess the drag reduction ability of the biopolymer produced against concentration of sodium hydroxide.

Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the Multicentre Study of Self-harm in England.

Science.gov (United States)

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

2012-12-01

Self-harm (intentional self-poisoning and self-injury) in children and adolescents is often repeated and is associated with increased risk of future suicide. We have investigated factors associated with these outcomes. We used data collected in the Multicentre Study of Self-harm in England on all self-harm hospital presentations by individuals aged 10-18 years between 2000 and 2007, and national death information on these individuals to the end of 2010. Cox hazard proportional models were used to identify independent and multivariable predictors of repetition of self-harm and of suicide. Repetition of self-harm occurred in 27.3% of individuals (N = 3920) who presented between 2000 and 2005 and were followed up until 2007. Multivariate analysis showed that repetition was associated with age, self-cutting, and previous self-harm and psychiatric treatment. Of 51 deaths in individuals who presented between 2000 and 2007 and were followed up to 2010 (N = 5133) half (49.0%) were suicides. The method used was usually different to that used for self-harm. Multivariate analysis showed that suicide was associated with male gender [Hazard ratio (HR) = 2.4, 95% CI 1.2-4.8], self-cutting (HR = 2.1, 95% CI 1.1-3.7) and prior psychiatric treatment at initial presentation (HR = 4.2, 95% CI 1.7-10.5). It was also associated with self-cutting and history of psychiatric treatment at the last episode before death, and history of previous self harm. Self-cutting as a method of self-harm in children and adolescents conveys greater risk of suicide (and repetition) than self-poisoning although different methods are usually used for suicide. The findings underline the need for psychosocial assessment in all cases. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies

Directory of Open Access Journals (Sweden)

David P. G. van den Berg

2016-09-01

Full Text Available Background: Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. Objective: This feasibility study explores the impact of specialized training on therapists’ beliefs about trauma-focused treatment within a randomized controlled trial. Method: Therapist-rated (n=16 credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed. Results: Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists’ expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD in patients with psychotic disorders (n=79, pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists. Conclusions: These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists’ credibility, burden, and harm beliefs concerning trauma-focused treatment.

Social acceptance of technologies in relation to their benefit and harm

Energy Technology Data Exchange (ETDEWEB)

Sobajima, Makoto [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

2001-03-01

The progress and popularization of scientific techniques have brought large effects on peoples' life. In those effects, the realization of benefit (advantage) that scientific techniques for bringing abundance and convenience are aiming at and the appearance of unintentional harm spreading on the back coexist in many cases. So it can not be overlooked that the harm side is affecting people as large damages as technologies develop to higher level and more complicated. The common cause of them is thought to be lack of preliminary assessment and regulation before introducing those new technologies with the background of pursuit of mass production and mass consumption. In this research, many of examples of various effects are surveyed in literatures and analyzed to first contrast benefit and harm brought by scientific techniques. As for the harm, damage actually suffered and the possibility of hazard are classified from the view point of risks and methodologies of social risk management are discussed. In addition, externalities in environment as a kind of harm are evaluated. On this basis, policy requirements on social system for minimizing the harm brought by technologies and promoting people's acceptance of technologies in the future society are proposed as political attainment. (author)

Bomb reduction of uranium tetrafluoride. Part II: Influence of the addition elements in the reduction process

International Nuclear Information System (INIS)

Anca Abati, R.; Lopez Rodriguez, M.

1962-01-01

This work shows the influence of uranium oxide and uranyl fluoride in the reduction of uranium with Ca and Mg. These additions are more harmful when using smaller bombs. The uranyl fluoride has influence in the reduction process; the curves yield-concentration shows two regions depending upon the salt concentration. The behaviour of this addition in these regions can be explained following the different decompositions that can take place during the reduction process. (Author) 9 refs

Measuring emergency department nurses' attitudes towards deliberate self-harm using the Self-Harm Antipathy Scale.

LENUS (Irish Health Repository)

Conlon, Mary

2012-01-31

The emergency department is an important gateway for the treatment of self-harm patients. Nurses\\' attitudes towards patients who self-harm can be negative and often nurses experience frustration, helplessness, ambivalence and antipathy. Patients are often dissatisfied with the care provided, and meeting with positive or negative attitudes greatly influences whether they seek additional help. A quantitative design was utilised to measure emergency department nurses\\' attitudes towards deliberate self-harm. The \\'Self-Harm Antipathy Scale\\

Impact of the recent recession on self-harm: Longitudinal ecological and patient-level investigation from the Multicentre Study of Self-harm in England.

Science.gov (United States)

Hawton, Keith; Bergen, Helen; Geulayov, Galit; Waters, Keith; Ness, Jennifer; Cooper, Jayne; Kapur, Navneet

2016-02-01

Economic recessions are associated with increases in suicide rates but there is little information for non-fatal self-harm. To investigate the impact of the recent recession on rates of self-harm in England and problems faced by patients who self-harm. Analysis of data from the Multicentre Study of Self-harm in England for 2001-2010 and local employment statistics for Oxford, Manchester and Derby, including interrupted time series analyses to estimate the effect of the recession on rates of self-harm. Rates of self-harm increased in both genders in Derby and in males in Manchester in 2008-2010, but not in either gender in Oxford, results which largely followed changes in general population unemployment. More patients who self-harm were unemployed in 2008-10 compared to before the recession. The proportion in receipt of sickness or disability allowances decreased. More patients of both genders had employment and financial problems in 2008-2010 and more females also had housing problems, changes which were also largely found in employed patients. We have assumed that the recession began in 2008 and information on problems was only available for patients having a psychosocial assessment. Increased rates of self-harm were found in areas where there were greater rises in rates of unemployment. Work, financial and housing problems increased in people who self-harmed. Changes in welfare benefits may have contributed. None. Copyright © 2015 Elsevier B.V. All rights reserved.

HARMFUL ALGAL BLOOMS IN THE MEDITERRANEAN SEA: EFFECTS ON HUMAN HEALTH.

Directory of Open Access Journals (Sweden)

Margherita Ferrante

2013-01-01

Full Text Available A harmful algal bloom (HAB is defined as a bloom that has deleterious effects on plants, animals or humans. Marine algal toxins are responsible for an array of human illnesses associated with consumption of seafood or exposure to aerosolized toxins. The effects of algal toxins are generally observed as acute intoxications, whereas the environmental health effects of chronic exposure to low levels of algal toxins are, to date, only poorly documented and an emerging issue. Consumption of seafood contaminated with algal toxins can result in five types of seafood poisoning syndromes: paralytic shellfish poisoning, neurotoxic shellfish poisoning, amnesic shellfish poisoning, diarrhetic shellfish poisoning and ciguatera fish poisoning. The aim of this paper is to provide an overview on HAB-related issues in the Mediterranean Sea.

E-cigarette Advertising Exposure, Explicit and Implicit Harm Perceptions, and E-Cigarette use Susceptibility Among Non-Smoking Young Adults.

Science.gov (United States)

Pokhrel, Pallav; Herzog, Thaddeus A; Fagan, Pebbles; Unger, Jennifer B; Stacy, Alan W

2018-02-10

This study tested whether exposure to e-cigarette advertising increases e-cigarette use susceptibility among non-smoking young adults by promoting explicit and implicit attitudes towards e-cigarettes as a safer and healthier alternative to combustible cigarettes. Young adult current non-smokers who had never used an e-cigarette (N = 393; Mean age = 22.1, Standard Deviation = 3.9; 66% Women) were randomly assigned to one of the 3 conditions that involved viewing real-world, print e-cigarette ads. Two of the 3 conditions were experimental conditions where ads with different predominant themes [harm-reduction ("Health") vs. social enhancement ("Social") focused] were interspersed among ads of everyday objects. The third condition was the control condition involving ads of everyday objects only. Participants provided data on explicit (i.e., self-reported harm perceptions) and implicit (i.e., Implicit Association Test) attitudes towards e-cigarette use and e-cigarette use intentions. Hypotheses were tested using structural equation modeling. Relative to Control participants, participants in Health and Social conditions were more likely to show higher implicit attitudes towards e-cigarettes as a safer alternative to cigarettes. Only the Social condition, relative to Control, had a significant effect on lower explicit harm perceptions of e-cigarette versus cigarette use. The Social condition had a significant indirect effect on e-cigarette use susceptibility, mediated by explicit harm perceptions. Social enhancement-themed ads may communicate the reduced-harm messages more strongly among young adults so as to affect both explicit and implicit attitudes and, through these, e-cigarette use susceptibility. Regulatory bodies may need to scrutinize reduced-harm claims communicated through social enhancement-themed ads. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions

Characterizing use patterns and perceptions of relative harm in dual users of electronic and tobacco cigarettes.

Science.gov (United States)

Rass, Olga; Pacek, Lauren R; Johnson, Patrick S; Johnson, Matthew W

2015-12-01

Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk. Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others' health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also as more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Harm and the Boundaries of Disease.

Science.gov (United States)

McGivern, Patrick; Sorial, Sarah

2017-08-01

What is the relationship between harm and disease? Discussions of the relationship between harm and disease typically suffer from two shortcomings. First, they offer relatively little analysis of the concept of harm itself, focusing instead on examples of clear cases of harm such as death and dismemberment. This makes it difficult to evaluate such accounts in borderline cases, where the putative harms are less severe. Second, they assume that harm-based accounts of disease must be understood normatively rather than naturalistically, in the sense that they are inherently value based. This makes such accounts vulnerable to more general objections of normative accounts of disease. Here we draw on an influential account of harm from the philosophy of law to develop a harm-based account of disease that overcomes both of these shortcomings. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Long-Term Effectiveness of a Selective, Personality-Targeted Prevention Program in Reducing Alcohol Use and Related Harms: A Cluster Randomized Controlled Trial

Science.gov (United States)

Newton, Nicola C.; Conrod, Patricia J.; Slade, Tim; Carragher, Natacha; Champion, Katrina E.; Barrett, Emma L.; Kelly, Erin V.; Nair, Natasha K.; Stapinski, Lexine; Teesson, Maree

2016-01-01

Background: This study investigated the long-term effectiveness of Preventure, a selective personality-targeted prevention program, in reducing the uptake of alcohol, harmful use of alcohol, and alcohol-related harms over a 3-year period. Methods: A cluster randomized controlled trial was conducted to assess the effectiveness of Preventure.…

Will growth in cryptomarket drug buying increase the harms of illicit drugs?

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Aldridge, Judith; Stevens, Alex; Barratt, Monica J

2018-05-01

Cryptomarkets-on-line, anonymous market-places for illicit goods and services that specialize mainly in drugs-account for a small but rapidly growing share of the illicit drug market in many countries. Policy responses so far are based generally on the assumption that their rise will only increase drug harms. In this contribution for debate, we question this assumption. We provide a narrative review of the emerging literature connected to drug cryptomarkets. We use MacCoun & Reuter's formula to understand the effect of population-level increases in use on total harm as depending on the level of harm associated with each unit of use. We then consider the potential for cryptomarkets to increase or decrease the harms and benefits related to each unit of drug use, with specific attention to the quality of drugs sold and the non-drug-related harms and benefits for customers. It is likely that cryptomarkets will increase both the amount and the range of substances that are sold. However, we argue that the effects on harms will depend upon whether cryptomarkets also increase the quality and safety of products that are sold, provide harm-reducing information to consumers and reduce transactional conflict involved in drug purchasing. There is an emerging and rapidly growing evidence base connected to the macro and micro harms and benefits of cryptomarkets for drug users. Future researchers should use appropriately matched comparative designs to establish more firmly the differential harms and benefits of sourcing drugs both on- and off-line. While it is unlikely that the on-line drug trade can be eradicated completely, cryptomarkets will respond to regulation and enforcement in ways that have complex, and sometimes unanticipated, effects on both harms and benefits. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Prison suicides and self-harming behaviours in Italy, 1990-2002.

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Preti, Antonio; Cascio, Maria Teresa

2006-04-01

Data on suicides, attempted suicides and other self-harming behaviours that occurred in Italian prisons from 1990 to 2002 was studied on official records, as documented by the Ministry of Justice. Over the study interval, completed suicide rates in Italian prisons were constantly about ten times higher than among the general population, but over time they did not increase significantly despite nearly a doubling in the absolute number of inmates. The rate of completed suicides in overcrowded prisons was about ten times higher than in non-overcrowded ones. Attempted suicides were about ten times higher than completed suicides, with females being significantly more likely to attempt to take their own lives and males being more likely to complete suicide. Self-injuring acts without the intent to die involve about one in every ten individuals, with foreigners (non-EU citizens mostly) being twice as likely to self-harm than residents. A better identification of the people suffering from mental disorders and a reduction in prison overcrowding are two key issues that need to be implemented to reduce the impact of suicide and self-harming behaviours among convicts.

Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data.

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Katikireddi, Srinivasa Vittal; Whitley, Elise; Lewsey, Jim; Gray, Linsay; Leyland, Alastair H

2017-06-01

Alcohol-related mortality and morbidity are high in socioeconomically disadvantaged populations compared with individuals from advantaged areas. It is unclear if this increased harm reflects differences in alcohol consumption between these socioeconomic groups, reverse causation (ie, downward social selection for high-risk drinkers), or a greater risk of harm in individuals of low socioeconomic status compared with those of higher status after similar consumption. We aimed to investigate whether the harmful effects of alcohol differ by socioeconomic status, accounting for alcohol consumption and other health-related factors. The Scottish Health Surveys are record-linked cross-sectional surveys representative of the adult population of Scotland. We obtained baseline demographics and data for alcohol consumption (units per week and binge drinking) from Scottish Health Surveys done in 1995, 1998, 2003, 2008, 2009, 2010, 2011, and 2012. We matched these data to records for deaths, admissions, and prescriptions. The primary outcome was alcohol-attributable admission or death. The relation between alcohol-attributable harm and socioeconomic status was investigated for four measures (education level, social class, household income, and area-based deprivation) using Cox proportional hazards models. The potential for alcohol consumption and other risk factors (including smoking and body-mass index [BMI]) mediating social patterning was explored in separate regression models. Reverse causation was tested by comparing change in area deprivation over time. 50 236 participants (21 777 men and 28 459 women) were included in the analytical sample, with 429 986 person-years of follow-up. Low socioeconomic status was associated consistently with strikingly raised alcohol-attributable harms, including after adjustment for weekly consumption, binge drinking, BMI, and smoking. Evidence was noted of effect modification; for example, relative to light drinkers living in

Radiation sterilization of harmful algae in water

International Nuclear Information System (INIS)

Byung Chull An; Jae-Sung Kim; Seung Sik Lee; Shyamkumar Barampuram; Eun Mi Lee; Byung Yeoup Chung

2007-01-01

Complete text of publication follows. Objective: Drinking water, water used in food production and for irrigation, water for fish farming, waste water, surface water, and recreational water have been recently recognized as a vector for the transmission of harmful micro-organisms. The human and animal harmful algae is a waterborne risk to public health and economy because the algae are ubiquitous and persistent in water and wastewater, not completely removed by physical-chemical treatment processes, and relatively resistant to chemical disinfection. Gamma and electron beam radiation technology is of growing in the water industry since it was demonstrated that gamma and electron beam radiation is very effective against harmful algae. Materials and Methods: Harmful algae (Scenedesmus quadricauda(Turpin) Brebisson 1835 (AG10003), Chlorella vulgaris Beijerinck 1896 (AG30007) and Chlamydomonas sp. (AG10061)) were distributed from Korean collection for type cultures (KCTC). Strains were cultured aerobically in Allen's medium at 25□ and 300 umol/m2s for 1 week using bioreactor. We investigated the disinfection efficiency of harmful algae irradiated with gamma (0.05 to 10 kGy for 30 min) and electron beam (1 to 19 kGy for 5 sec) rays. Results and Conclusion: We investigated the disinfection efficiency of harmful algae irradiated with gamma and electron beam rays of 50 to 19000 Gy. We established the optimum sterilization condition which use the gamma and electron beam radiation. Gamma ray disinfected harmful algae at 400 Gy for 30 min. Also, electron beam disinfected at 1000 Gy for 5 sec. This alternative disinfection practice had powerful disinfection efficiency. Hence, the multi-barrier approach for drinking water treatment in which a combination of various disinfectants and filtration technologies are applied for removal and inactivation of different microbial pathogens will guarantee a lower risk of microbial contamination.

Harmful Algal Blooms (HABs)

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... toxins that may harm or kill fish and marine animals. Humans who eat shellfish contaminated with HAB toxins ... toxins that may harm or kill fish and marine animals. Humans who eat shellfish containing toxins produced by ...

Implementation and evaluation of a harm-reduction model for clinical care of substance using pregnant women

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Wright Tricia E

2012-01-01

Full Text Available Abstract Background Methamphetamine (MA use during pregnancy is associated with many pregnancy complications, including preterm birth, small for gestational age, preeclampsia, and abruption. Hawaii has lead the nation in MA use for many years, yet prior to 2007, did not have a comprehensive plan to care for pregnant substance-using women. In 2006, the Hawaii State Legislature funded a pilot perinatal addiction clinic. The Perinatal Addiction Treatment Clinic of Hawaii was built on a harm-reduction model, encompassing perinatal care, transportation, child-care, social services, family planning, motivational incentives, and addiction medicine. We present the implementation model and results from our first one hundred three infants (103 seen over 3 years of operation of the program. Methods Referrals came from community health centers, hospitals, addiction treatment facilities, private physician offices, homeless outreach services and self-referral through word-of-mouth and bus ads. Data to describe sample characteristics and outcome was obtained prospectively and retrospectively from chart abstraction and delivery data. Drug use data was obtained from the women's self-report and random urine toxicology during the pregnancy, as well as urine toxicology at the time of birth on mothers, and urine and meconium toxicology on the infants. Post-partum depression was measured in mothers with the Edinburgh Post-Partum depression scale. Data from Path clinic patients were compared with a representative cohort of women delivering at Kapiolani Medical Center for Women and Children during the same time frame, who were enrolled in another study of pregnancy outcomes. Ethical approval for this study was obtained through the University of Hawaii Committee for Human Studies. Results Between April 2007 and August 2010, 213 women with a past or present history of addiction were seen, 132 were pregnant and 97 delivered during that time. 103 live-born infants were

Implementation and evaluation of a harm-reduction model for clinical care of substance using pregnant women.

Science.gov (United States)

Wright, Tricia E; Schuetter, Renee; Fombonne, Eric; Stephenson, Jessica; Haning, William F

2012-01-19

Methamphetamine (MA) use during pregnancy is associated with many pregnancy complications, including preterm birth, small for gestational age, preeclampsia, and abruption. Hawaii has lead the nation in MA use for many years, yet prior to 2007, did not have a comprehensive plan to care for pregnant substance-using women. In 2006, the Hawaii State Legislature funded a pilot perinatal addiction clinic. The Perinatal Addiction Treatment Clinic of Hawaii was built on a harm-reduction model, encompassing perinatal care, transportation, child-care, social services, family planning, motivational incentives, and addiction medicine. We present the implementation model and results from our first one hundred three infants (103) seen over 3 years of operation of the program. Referrals came from community health centers, hospitals, addiction treatment facilities, private physician offices, homeless outreach services and self-referral through word-of-mouth and bus ads. Data to describe sample characteristics and outcome was obtained prospectively and retrospectively from chart abstraction and delivery data. Drug use data was obtained from the women's self-report and random urine toxicology during the pregnancy, as well as urine toxicology at the time of birth on mothers, and urine and meconium toxicology on the infants. Post-partum depression was measured in mothers with the Edinburgh Post-Partum depression scale. Data from Path clinic patients were compared with a representative cohort of women delivering at Kapiolani Medical Center for Women and Children during the same time frame, who were enrolled in another study of pregnancy outcomes. Ethical approval for this study was obtained through the University of Hawaii Committee for Human Studies. Between April 2007 and August 2010, 213 women with a past or present history of addiction were seen, 132 were pregnant and 97 delivered during that time. 103 live-born infants were delivered. There were 3 first-trimester Spontaneous

Adolescent self-harm and risk factors.

Science.gov (United States)

Zhang, Jixiang; Song, Jianwei; Wang, Jing

2016-12-01

This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.

Group problem-solving skills training for self-harm: randomised controlled trial.

Science.gov (United States)

McAuliffe, Carmel; McLeavey, Breda C; Fitzgerald, Tony; Corcoran, Paul; Carroll, Bernie; Ryan, Louise; O'Keeffe, Brian; Fitzgerald, Eva; Hickey, Portia; O'Regan, Mary; Mulqueen, Jillian; Arensman, Ella

2014-01-01

Rates of self-harm are high and have recently increased. This trend and the repetitive nature of self-harm pose a significant challenge to mental health services. To determine the efficacy of a structured group problem-solving skills training (PST) programme as an intervention approach for self-harm in addition to treatment as usual (TAU) as offered by mental health services. A total of 433 participants (aged 18-64 years) were randomly assigned to TAU plus PST or TAU alone. Assessments were carried out at baseline and at 6-week and 6-month follow-up and repeated hospital-treated self-harm was ascertained at 12-month follow-up. The treatment groups did not differ in rates of repeated self-harm at 6-week, 6-month and 12-month follow-up. Both treatment groups showed significant improvements in psychological and social functioning at follow-up. Only one measure (needing and receiving practical help from those closest to them) showed a positive treatment effect at 6-week (P = 0.004) and 6-month (P = 0.01) follow-up. Repetition was not associated with waiting time in the PST group. This brief intervention for self-harm is no more effective than treatment as usual. Further work is required to establish whether a modified, more intensive programme delivered sooner after the index episode would be effective.

Pollutants in drinking water - sources, harmful effects and removal procedures

International Nuclear Information System (INIS)

Qadeer, R.

2005-01-01

The underground water resources available for human consumption are being continuously contaminated by the natural sources and anthropogenic activities. The pollutants include toxic microorganism, inorganic and organic chemicals and radionuclide etc. This is an acute problem in our country, where free style way of disposal of industrial effluents into the natural water bodies contaminates the surface and ground water. These contaminants make their way into human body through contaminated drinking water, which leads to the malfunctioning of the body organs. Details of some pollutants present in drinking water, their source and harmful effects on human beings are reviewed in this communication Merits and demerits of methods used to remove the pollutants from drinking water are also discussed. (author)

Recent self-harm and psychological measures in the emergency department

Directory of Open Access Journals (Sweden)

Jason R. Randall

2014-11-01

Full Text Available The assessment of self-harm risk is a common, difficult, and perplexing task for many physicians, especially those working in emergency departments (ED. Attempts have been made to determine objective methods for assessing patients with suicidal ideation or self-harm though there is still a lack of knowledge about objective assessments of these patients. A study was conducted where 181 suicidal patients were enrolled in two EDs within the city of Edmonton, Canada. Initial interviews were conducted in the ED which collected basic demographics and medical history as well as psychometric measures including the Beck Hopelessness Scale, Barratt Impulsiveness Scale, Brief Symptom Inventory, Drug Abuse Screening Test 10, and CAGE questionnaire. The results of these measures were compared between those who presented to the ED with self-harm and those who presented only with ideation. Those with recent self-harm scored lower on many of the scales and subscales of distress and impulsivity measured compared to those with no recent self-harm. Possible explanations for this difference include differences in psychological traits between the two groups and possible cathartic effects of self-harm. The lower scores obtained by those that present with self-harm may complicate attempts to use psychometric tools to determine future self-harm risk.

Potential Harmful Effects of PM2.5 on Occurrence and Progression of Acute Coronary Syndrome: Epidemiology, Mechanisms, and Prevention Measures

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Xu Meng

2016-07-01

Full Text Available The harmful effects of particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5 and its association with acute coronary syndrome (ACS has gained increased attention in recent years. Significant associations between PM2.5 and ACS have been found in most studies, although sometimes only observed in specific subgroups. PM2.5-induced detrimental effects and ACS arise through multiple mechanisms, including endothelial injury, an enhanced inflammatory response, oxidative stress, autonomic dysfunction, and mitochondria damage as well as genotoxic effects. These effects can lead to a series of physiopathological changes including coronary artery atherosclerosis, hypertension, an imbalance between energy supply and demand to heart tissue, and a systemic hypercoagulable state. Effective strategies to prevent the harmful effects of PM2.5 include reducing pollution sources of PM2.5 and population exposure to PM2.5, and governments and organizations publicizing the harmful effects of PM2.5 and establishing air quality standards for PM2.5. PM2.5 exposure is a significant risk factor for ACS, and effective strategies with which to prevent both susceptible and healthy populations from an increased risk for ACS have important clinical significance in the prevention and treatment of ACS.

Emotion regulation, depression and self-harming behaviours in people with borderline personality disorder: the moderating role of action vs. state orientation

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Sybilla Blasczyk-Schiep

2016-01-01

Full Text Available Background The aim of this research is to determine the level of emotion regulation, studied through the method of variable action orientation vs. state and its relationship with depressiveness and dimension of the reasons for living and self-harming behaviour of patients with borderline personality disorder. Participants and procedure The research studied 61 patients diagnosed with an emotionally unstable personality of borderline type. The research used the Polish adaptation of tests to measure the action vs. state orientation (SSI-K, the self-harming behaviour (SHI, depression (BDI and the reasons for living vs. suicidal tendency (RFL-I. Results In people with borderline personality disorder, the level of emotion regulation (action vs. state orientation, reasons for living and depression are predictors of self-harming behaviour. The experience of a depressive episode or lack thereof does not have a relationship with the increase of self-harming. Analysis of the interaction between variables showed that the reasons for living and the action orientation after failure are related to the reduction of self-harming behaviour in all subjects. In depressed people, state orientation is associated with an increase in the action orientation with decreased self-destructive behaviours. Conclusions High levels of reasons for living in interaction with the action orientation have a negative relationship with the self-harming behaviour of patients diagnosed with borderline personality disorder. Among those subjects, depressive patients, a statistically lower level of self-harm is related to the action orientation. These results suggest that therapeutic treatment is important to activate both reasons for living as well as action orientation as effective dimensions in preventing self-harming.

Stock Market Fluctuations and Self-Harm among Children and Adolescents in Hong Kong.

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Wong, Wilfred Hing-Sang; Lee, James Chun-Yin; Ho, Frederick Ka-Wing; Li, Tim Man-Ho; Ip, Patrick; Chow, Chun-Bong

2017-06-09

Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and self-harm among children and adolescents in Hong Kong. Daily self-harm attendance records were retrieved from all 18 local Accident and Emergency Departments (AED) from 2001 to 2012. 4931 children and adolescents who committed self-harm were included. The results indicated positive correlation between daily change in stock market index, Hang Seng Index (∇HSI, per 300 points), and daily self-harm incident risk of children and adolescents, without time lag between the two. The incident risk ratio for ∇HSI was 1.09 ( p = 0.0339) in children and 1.06 ( p = 0.0246) in adolescents. Importantly, non-trading days were found to impose significant protective effect in both groups against self-harm risk. Our results showed that stock market fluctuations were related to self-harm behaviors in children and adolescents. Parents and professionals should be educated about the potential harm of stock market fluctuations and the importance of effective parenting in reducing self-harm among children and adolescents.

Digital Self-Harm Among Adolescents.

Science.gov (United States)

Patchin, Justin W; Hinduja, Sameer

2017-12-01

Despite increased media and scholarly attention to digital forms of aggression directed toward adolescents by their peers (e.g., cyberbullying), very little research has explored digital aggression directed toward oneself. "Digital self-harm" is the anonymous online posting, sending, or otherwise sharing of hurtful content about oneself. The current study examined the extent of digital self-harm among adolescents. Survey data were obtained in 2016 from a nationally representative sample of 5,593 American middle and high school students (12-17 years old). Logistic regression analysis was used to identify correlates of participation in digital self-harm. Qualitative responses were also reviewed to better understand motivations for digital self-harm. About 6% of students have anonymously posted something online about themselves that was mean. Males were significantly more likely to report participation (7.1% compared to 5.3%). Several statistically significant correlates of involvement in digital self-harm were identified, including sexual orientation, experience with school bullying and cyberbullying, drug use, participation in various forms of adolescent deviance, and depressive symptoms. Digital self-harm is a new problem that demands additional scholarly attention. A deeper inquiry as to the motivations behind this behavior, and how it correlates to offline self-harm and suicidal ideation, can help direct mental health professionals toward informed prevention approaches. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Coping styles adopted in stressful situations by self-harming adolescents

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Karolina Jabłkowska

2010-03-01

Full Text Available The state of stress and styles of coping with stress constitute an important component of life of every human being, particularly during adolescence. Effective coping mechanisms enable reduction of severity of stress experienced, while inability to manage stressful situations results in alterations in emotional and physiological domains, disturbances of mental well-being, somatic health and social functioning. Since a few years, we are witnessing a significant aggravation of the phenomenon of auto-aggression among children and adolescents, particularly in populations already undergoing psychiatric treatment. Such behaviours fulfil several functions: they may represent a way to express emotions, a means of adaptation or a style of coping with difficulties encountered in everyday life and emotional tension associated therewith. The aim of this study was to analyse predominating styles of coping with stressful situations, adopted by adolescen patients performing self-harm. The study population encompassed 35 patients, aged 16.60±0.18 years, there of 27 girls and 8 boys, hospitalised at the Department of Adolescent Psychiatry of the Medical University in Łódź, who had a history of deliberate self-harm (DSH. Control group included 32 healthy volunteers aged 16.91±0.16 years, thereof 23 girls and 9 boys. In view of the size of study population, it was subdivided into subgroups depending on whether episodes of DSH were sporadic or repetitive. Data were collected using the Coping Inventory for Stressful Situations (CISS. This questionnaire was designed specifically to explore styles of coping with stress. Self-harming adolescents, both girls and boys, significantly more often adopted emotion-oriented style. Patients with repetitive DSH (over 4 episodes significantly more often adopted emotion-oriented style and/or avoidance-oriented style, particularly in the form of seeking social contacts – social diversion, as compared with those committing

How Teacher Turnover Harms Student Achievement

Science.gov (United States)

Ronfeldt, Matthew; Loeb, Susanna; Wyckoff, James

2013-01-01

Researchers and policymakers often assume that teacher turnover harms student achievement, though recent studies suggest this may not be the case. Using a unique identification strategy that employs school-by-grade level turnover and two classes of fixed-effects models, this study estimates the effects of teacher turnover on over 850,000 New York…

Childhood physical abuse, non-suicidal self-harm and attempted suicide amongst regular injecting drug users.

Science.gov (United States)

Darke, Shane; Torok, Michelle

2013-12-01

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

Deprivation as un-experienced harm?

DEFF Research Database (Denmark)

Keerus, Külli; Gjerris, Mickey; Röcklinsberg, Helena

2017-01-01

Tom Regan encapsulated his principle of harm as a prima facie direct duty not to harm experiencing subjects of a life. However, his consideration of harm as deprivation, one example of which is loss of freedom, can easily be interpreted as a harm, which may not be experienced by its subject....... This creates a gap between Regan’s criterion for moral status and his account of what our duties are. However, in comparison with three basic paradigms of welfare known in nonhuman animal welfare science, Regan’s understanding coheres with a modified version of a feelings-based paradigm: not only the immediate...... feelings of satisfaction, but also future opportunities to have such feelings, must be taken into account. Such an interpretation is compatible with Regan’s understanding of harm as deprivation. The potential source of confusion, however, lies in Regan’s own possible argumentative mistakes....

Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

Science.gov (United States)

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

2017-08-01

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

Anaerobic reductive dehalogenation of polychlorinated dioxins

Energy Technology Data Exchange (ETDEWEB)

Bunge, Michael [Aarhus Univ. (DK). Dept. of Biological Sciences, Microbiology, and Interdisciplinary Nanoscience Centre (iNANO); Lechner, Ute [Halle-Wittenberg Univ., Halle (Germany). Inst. of Biology/Microbiology

2009-09-15

Polychlorinated dibenzo-p-dioxins and -furans (PCDD/Fs) are among the most harmful environmental contaminants. Their widespread distribution due to unintentional or unknown release coincides with environmental persistence, acute and chronic toxicity to living organisms, and long-term effects due to the compounds' tendency for bioaccumulation and biomagnification. While microbial aerobic degradation of PCDD/Fs is mainly reported for the turnover of low chlorinated congeners, this review focuses on anaerobic reductive dehalogenation, which may constitute a potential remediation strategy for polychlorinated compounds in soils and sediments. Microorganisms in sediments and in microcosms or enrichment cultures have been shown to be involved in the reductive dechlorination of dioxins. Bacteria related to the genus Dehalococcoides are capable of the reductive transformation of dioxins leading to lower chlorinated dioxins including di- and monochlorinated congeners. Thus, reductive dehalogenation might be one of the very few mechanisms able to mediate the turnover of polychlorinated dioxins by reducing their toxicity and paving the way for a subsequent breakdown of the carbon skeleton. (orig.)

Characteristics of Self-Harm Behaviour among Identified Self-Harming Youth in Care

Science.gov (United States)

Grenville, Jeffrey; Goodman, Deborah; Macpherson, Alison K.

2012-01-01

The objective of this study was to describe deliberate self-harming (DSH) characteristics in a child-welfare population identified as having threatened or completed self-harm. Secondary data from 621 serious occurrence reports (SOR) that documented 2004-2007 DSH incidents and DSH threats with 252 Canadian youth in care (Y-INC) of the Children's…

Electronic cigarette, effective or harmful for quitting smoking and respiratory health: A quantitative review papers

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Gholamreza Heydari

2017-01-01

Full Text Available Background: In recent years, electronic cigarettes (ECs have been heavily advertised as an alternative smoking device as well as a possible cessation method. We aimed to review all published scientific literature pertaining to ECs and to present a simple conclusion about their effects for quitting smoking and respiratory health. Methods: This was a cross-sectional study with a search of PubMed, limited to English publications upto September 2014. The total number of papers which had ECs in its title and their conclusions positive or negative regarding ECs effects were computed. The number of negative papers was subtracted from the number of positive ones to make a score. Results: Of the 149 articles, 137 (91.9% were accessible, of which 68 did not have inclusion criteria. In the 69 remaining articles, 24 studies supported ECs and 45 considered these to be harmful. Finally, based on this evidence, the score of ECs (computed result with positive minus negative was −21. Conclusion: Evidence to suggest that ECs may be effective and advisable for quitting smoking or a safe alternative for smoking is lacking and may instead harm the respiratory system. However, further studies are needed.

Non-suicidal reasons for self-harm: A systematic review of self-reported accounts.

Science.gov (United States)

Edmondson, Amanda J; Brennan, Cathy A; House, Allan O

2016-02-01

Self-harm is a major public health problem yet current healthcare provision is widely regarded as inadequate. One of the barriers to effective healthcare is the lack of a clear understanding of the functions self-harm may serve for the individual. The aim of this review is to identify first-hand accounts of the reasons for self-harm from the individual's perspective. A systematic review of the literature reporting first-hand accounts of the reasons for self-harm other than intent to die. A thematic analysis and 'best fit' framework synthesis was undertaken to classify the responses. The most widely researched non-suicidal reasons for self-harm were dealing with distress and exerting interpersonal influence. However, many first-hand accounts included reasons such as self-validation, and self-harm to achieve a personal sense of mastery, which suggests individuals thought there were positive or adaptive functions of the act not based only on its social effects. Associations with different sub-population characteristics or with the method of harm were not available from most studies included in the analysis. Our review identified a number of themes that are relatively neglected in discussions about self-harm, which we summarised as self-harm as a positiveexperience and defining the self. These self-reported "positive" reasons may be important in understanding and responding especially to repeated acts of self-harm. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Effects of rising CO₂ on the harmful cyanobacterium Microcystis

NARCIS (Netherlands)

Sandrini, G.

2016-01-01

The waters of our planet are full with cyanobacteria that use CO₂, water and light for photosynthesis. Cyanobacteria form the base of the food web and have a strong impact on all life on Earth. Yet, not all cyanobacteria are beneficial. Harmful cyanobacteria (also known as ‘blue-green algae’) can

Parental restriction reduces the harmful effects of in-bedroom electronic devices.

Science.gov (United States)

Fu, King-Wa; Ho, Frederick Ka Wing; Rao, Nirmala; Jiang, Fan; Li, Sophia Ling; Lee, Tatia Mei-Chun; Chan, Sophelia Hoi-Shan; Yung, Ada Wing-Yan; Young, Mary Eming; Ip, Patrick

2017-12-01

To investigate whether school readiness could be affected by placing electronic devices (EDs) in children's bedroom and whether the relationship was moderated by parental restriction and family socioeconomic status (SES). This is a cross-sectional study with bedroom ED placement and parental restriction reported by parents. Multiple linear regressions were used to test the relationship between school readiness and ED placement. Multiple regression with interaction terms were used to test whether the effect was consistent with and without parental restriction. Kindergartens randomly selected from two districts of different socioeconomic backgrounds in Hong Kong, China. 556 young children attending the third year of kindergarten. Children's school readiness was rated by teachers using the Chinese Early Development Instrument. 556 preschoolers (mean age 5.46; 51.8% girls) from 20 kindergartens participated in this study. About 30% of parents placed at least one ED in their children's bedroom. After controlling for sex and SES, the placement of television in the bedroom was associated with lower overall school readiness (β -1.11, 95% CI -1.80 to -0.42) and the placement of game console was associated with lower social competence (β-0.94, 95% CI -1.74 to -0.15). Such harmful effect was more prominent among lower SES families and could be partially alleviated with parental restriction. ED placement in children's bedroom was associated with lower school readiness, particularly among lower SES families. Parental restriction might help to alleviate the harm. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Helping Self-Harming Students

Science.gov (United States)

Selekman, Matthew D.

2009-01-01

Approximately 14 to 17 percent of adolescents today self-harm, deliberately cutting, burning, or bruising themselves. Most self-harming adolescents use the behavior as a coping strategy to get immediate relief from emotional distress or other stressors in their lives. Stressors include fitting in with peers, activity and homework overload, fears…

Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment.

Science.gov (United States)

Salloum, Ramzi G; Louviere, Jordan J; Getz, Kayla R; Islam, Farahnaz; Anshari, Dien; Cho, Yoojin; O'Connor, Richard J; Hammond, David; Thrasher, James F

2017-07-13

The US Food and Drug Administration (FDA) has regulatory authority to use inserts to communicate with consumers about harmful and potentially harmful constituents (HPHCs) in tobacco products; however, little is known about the most effective manner for presenting HPHC information. In a discrete choice experiment, participants evaluated eight choice sets, each of which showed two cigarette packages from four different brands and tar levels (high vs low), accompanied by an insert that included between-subject manipulations (ie, listing of HPHCs vs grouping by disease outcome and numeric values ascribed to HPHCs vs no numbers) and within-subject manipulations (ie, 1 of 4 warning topics; statement linking an HPHC with disease vs statement with no HPHC link). For each choice set, participants were asked: (1) which package is more harmful and (2) which motivates them to not smoke; each with a 'no difference' option. Alternative-specific logit models regressed choice on attribute levels. 1212 participants were recruited from an online consumer panel (725 18-29-year-old smokers and susceptible non-smokers and 487 30-64-year-old smokers). Participants were more likely to endorse high-tar products as more harmful than low-tar products, with a greater effect when numeric HPHC information was present. Compared with a simple warning statement, the statement linking HPHCs with disease encouraged quit motivation. Numeric HPHC information on inserts appears to produce misunderstandings that some cigarettes are less harmful than others. Furthermore, brief narratives that link HPHCs to smoking-related disease may promote cessation versus communications that do not explicitly link HPHCs to disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Harmed patients gaining voice: challenging dominant perspectives in the construction of medical harm and patient safety reforms.

Science.gov (United States)

Ocloo, Josephine Enyonam

2010-08-01

Patient safety is a central issue in healthcare. In the United Kingdom, where there is more accurate information on National Health Service (NHS) hospitals than on primary care or the private sector, the evidence on adverse incidents shows that avoidable medical harm is a major concern. This paper looks at the occurrence of medical harm and argues that in the construction of patient safety reforms, it is important to be aware of alternative narratives about issues of power and accountability from harmed patients and self-help groups, that challenge dominant perspectives on the issues. The paper draws upon evidence from two sources. First, the paper draws on experiences of self-help groups set up as a result of medical harm and part of a campaigning network, where evidence was gathered from 14 groups over more than 2 years. In addition, data were obtained from 21 individuals affected by harm that attended a residential workshop called the Break Through Programme; 18 questionnaires were completed from participants and a written narrative account of their experiences and observational data were gathered from a range of workshop sessions. Looking at the issues from harmed patients' perspectives, the research illustrates that a model of medical harm focussing predominantly upon the clinical markers and individual agency associated with a medical model operates to obscure a range of social processes. These social processes, connected to the power and dominance of the medical profession and the activities of a wider state, are seen to be a major part of the construction of harm that impacts upon patients, which is further compounded by its concealment. Understanding the experiences of harmed patients is therefore seen as an important way of generating knowledge about the medical and social processes involved in harm, that can lead to a broader framework for addressing patient safety. Copyright 2010 Elsevier Ltd. All rights reserved.

Assessment of the exposure to harmful and potentially harmful constituents in healthy Japanese smokers using a novel tobacco vapor product compared with conventional cigarettes and smoking abstinence.

Science.gov (United States)

Yuki, Dai; Takeshige, Yuki; Nakaya, Kyoko; Futamura, Yasuyuki

2018-07-01

The objectives of this clinical study were to demonstrate a reduction in exposure to selected harmful and potentially harmful constituents (HPHCs), and to assess product use behavior, in Japanese healthy adult smokers who switched to a novel tobacco vapor product (NTV). 60 smokers were randomly assigned for 5 days to either (a) a group who switched to an NTV (n = 20), (b) a group who continued to smoke their own brand of conventional cigarettes (CC, n = 20) or (c) a smoking abstinence group (SA, n = 20). Fifteen biomarkers of exposure (BoEs) to 14 HPHCs and pyrene were measured at baseline, day 3 and 5. Product use behavior was assessed by measuring product consumption, nicotine uptake and puffing topography. During investigations, increases were observed in product consumption and total puff volume in NTV group subjects as compared to baseline. Additionally, nicotine uptake in the NTV group was approximately half that observed in the CC group. BoE values were significantly reduced in the NTV group as compared to those in the CC group. Significantly, the magnitude of the reduction in exposure to HPHCs observed in the NTV group (49-94%) was close to that observed for the SA group (39-95%). Copyright © 2018 Elsevier Inc. All rights reserved.

Individual and school level effects of perceived harm, perceived availability, and community size on marijuana use among 12th-grade students: a random effects model.

Science.gov (United States)

Swaim, Randall C

2003-06-01

A hierarchical linear model was used to estimate the individual and school level effects for marijuana use among a national sample of 12th-grade students. School effects were small in comparison to individual level effects, accounting for 2.9% of the variance in marijuana use. At the individual level, perceived harm, perceived availability, and their interaction were significant predictors, each of which varied randomly across schools. Among two school-level predictors, the normative environment for perceived harm was not significant, but normative perceived availability predicted level of marijuana use. The effect of perceived availability on marijuana use was stronger in larger, compared to smaller communities. Results are discussed in light of the use of random regression methods for identifying school-specific patterns of risk and protection for prevention planning.

Perception of e-cigarette harm and its correlation with use among U.S. adolescents.

Science.gov (United States)

Amrock, Stephen M; Zakhar, Joseph; Zhou, Sherry; Weitzman, Michael

2015-03-01

U.S. adolescents increasingly use e-cigarettes. The perceived harm of e-cigarettes has not been described, nor has the correlation between harm perception and e-cigarette use been assessed. This study examines correlates of e-cigarette harm perception and use of e-cigarettes in a national survey. We used cross-sectional nationally representative data from the 2012 National Youth Tobacco Survey (n = 24,658). Cross-tabulations and multivariate ordered probit and logistic regression models were employed to assess relative harm perception and e-cigarette use. Half of U.S. adolescents had heard of e-cigarettes. Of these, 13.2% (95% confidence interval [CI] = 11.7-14.9) and 4.0% (95% CI = 3.4-4.7) reported ever or currently using e-cigarettes, respectively. Of those aware of e-cigarettes, 34.2% (95% CI = 32.8-35.6) believed e-cigarettes were less harmful than cigarettes. Among those trying e-cigarettes, 71.8% (95% CI = 69.0-74.5) believed e-cigarettes were comparatively less harmful. Females and those ≥ 17 years old were more likely to perceive e-cigarettes as more harmful relative to cigarettes, while on average Whites, users of other tobacco products, and those with family members who used tobacco were more likely to perceive e-cigarettes as comparatively safer. Among cigarette-naive e-cigarette users, use of other tobacco products and perceived harm reduction by e-cigarettes were, respectively, on average associated with 1.6 and 4.1 percentage-point increases in e-cigarette use. Perception of e-cigarettes as less harmful than conventional cigarettes was associated with increased e-cigarette use, including among cigarette-naive e-cigarette users. These findings should prompt further scientific investigation and merit attention from regulators. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Detecting the Killer Toxin (Harmful Algal Blooms)

International Nuclear Information System (INIS)

Quevenco, Rodolfo

2011-01-01

IAEA is stepping up efforts to help countries understand the phenomenon and use more reliable methods for early detection and monitoring so as to limit harmful algal blooms (HABs) adverse effects on coastal communities everywhere.

Biomanipulation with quagga mussels (Dreissena rostriformis bugensis) to control harmful algal blooms in eutrophic urban ponds

NARCIS (Netherlands)

Waajen, Guido W. A. M.; Van Bruggen, Niek C. B.; Pires, L. Miguel Dionisio; Lengkeek, Wouter; Lurling, Miquel

Many urban ponds in The Netherlands and other countries suffer from eutrophication, resulting in harmful algal blooms which are often dominated by cyanobacteria. A sufficient reduction of nutrients, as prerequisite to mitigate cyanobacterial blooms in urban ponds, is not always feasible. Water

Biomanipulation with quagga mussels (Dreissena rostriformis bugensis) to control harmful algal blooms in eutrophic urban ponds

NARCIS (Netherlands)

Waajen, Guido W.A.M.; Bruggen, Van Niek C.B.; Pires, Miguel Dionisio L.; Lengkeek, Wouter; Lurling, Miguel

2016-01-01

Many urban ponds in The Netherlands and other countries suffer from eutrophication, resulting in harmful algal blooms which are often dominated by cyanobacteria. A sufficient reduction of nutrients, as prerequisite to mitigate cyanobacterial blooms in urban ponds, is not always feasible. Water

Sunscreens: topical and systemic approaches for protection of human skin against harmful effects of solar radiation

International Nuclear Information System (INIS)

Pathak, M.A.

1982-01-01

This review deals with topical and systemic approaches for protection of human skin against the harmful effects of solar radiation. Two concerns about the deleterious effects of sun exposure involve: (1) acute effects (e.g., sunburn and drug-induced phototoxicity) and (2) potential long-term risks of repeated sun exposures leading to development of solar elastosis, keratoses, induction of both nonmelanoma and melanoma skin cancer, and alteration of immune responses and functions. Action spectra of normal and abnormal reactions of human skin to acute and chronic effects of solar radiation are presented with a view to helping the physician prescribe the appropriate sunscreens. Factors that influence acute effects of sunburn are reviewed. Various artificial methods effective in minimizing or preventing harmful effects of solar radiation, both in normal individuals and in patients with photosensitivity-related problems, are discussed. Emphasis is placed on the commercially available chemical sunscreens and their properties. Sun protection factor (SPF) values of several brand-name formulations determined with a solar simulator under indoor conditions (laboratory) and with solar radiation under natural, field conditions are presented. Factors responsible for variations of SPF values observed under indoor and outdoor conditions are reviewed. Systemic photoprotective agents and their limitations are outlined. The photobiology of melanin pigmentation (the tanning reaction) is briefly discussed, with emphasis on the dangers of using quick-tanning lotions for stimulation of the tanning reaction

Learning-Based Detection of Harmful Data in Mobile Devices

Directory of Open Access Journals (Sweden)

Seok-Woo Jang

2016-01-01

Full Text Available The Internet has supported diverse types of multimedia content flowing freely on smart phones and tablet PCs based on its easy accessibility. However, multimedia content that can be emotionally harmful for children is also easily spread, causing many social problems. This paper proposes a method to assess the harmfulness of input images automatically based on an artificial neural network. The proposed method first detects human face areas based on the MCT features from the input images. Next, based on color characteristics, this study identifies human skin color areas along with the candidate areas of nipples, one of the human body parts representing harmfulness. Finally, the method removes nonnipple areas among the detected candidate areas using the artificial neural network. The experimental results show that the suggested neural network learning-based method can determine the harmfulness of various types of images more effectively by detecting nipple regions from input images robustly.

Effectiveness of an anti-algal compound in eliminating an aquatic unicellular harmful algal Phaeocystis globosa

Directory of Open Access Journals (Sweden)

Huajun eZhang

2016-04-01

Full Text Available Phaeocystis globosa blooms can have negative effects on higher trophic levels in the marine ecosystem and consequently influence human activities. Strain KA22, identified as the bacterium Hahella, was isolated from coastal surface water and used to control P. globosa growth. A methanol extract from the bacteral cells showed strong algicidal activity. After purification, the compound showed a similar structure to prodigiosin when identified with Q-Exactive Orbitrap MS and nuclear magnetic resonance spectra. The compound showed algicidal activity against P. globosa with a 50% Lethal Dose (LD50 of 2.24 μg/mL. The prodigiosin was stable under heat and acid environment, and it could be degraded under alkaline environment and natural light condition. The growth rates of strain KA22 was fast in 2216E medium and the content of prodigiosin in this medium was more than 70 μg/mL after 16 h incubation. The compound showed particularly strong algicidal activity against Prorocentrum donghaiense, P. globosa and Heterosigma akashiwo, but having little effect on three other phytoplankton species tested. The results of our research could increase our knowledge on harmful algal bloom control compound and lead to further study on the mechanisms of the lysis effect on harmful algae.

Early marriage in Africa--trends, harmful effects and interventions.

Science.gov (United States)

Walker, Judith-Ann

2012-06-01

This article explores the pattern of early marriage in Africa. It focuses on the sub-Saharan region as an area with the highest rates of early marriage in the world. The harmful effects of early marriage are explored in terms of impact on the health, education and economic well-being of young girls. The paper outlines a framework for analyzing global, regional and local initiatives to curb early marriage and examines the application of these interventions in sub-Saharan countries. Regional patterns are then examined and countries which have made progress in reducing age of marriage are compared to countries in which age of marriage amongst girls has reminded low. The paper concludes on the note that countries with the highest rates of early marriage are also the countries with the highest rates of poverty and highest population growth rates. The paper argues for a sub-regional strategy to address the problem of early marriage in the zone with the highest incidence.

Pollutants in drinking water: their sources, harmful effects and removal procedures

International Nuclear Information System (INIS)

Qadeer, R.

2004-01-01

The underground water resources available for human consumption are being continuously contaminated by the natural sources and anthropogenic activities. The pollutants include toxic microorganism, inorganic and organic chemical and radionuclide etc. this is an acute problem in our country, where free style way of disposal of industrial effluents into the natural water bodies contaminates the surface and ground water. These contaminants make their way into human body through contaminated drinking water, which leads to the malfunctioning of the body organs. Details of some pollutants present in drinking water, their source and harmful effects on human beings are reviewed in this communication. Merits and demerits of methods used to remove the pollutants from drinking water are also discussed. (author)

Is Personality Associated with Secondhand Harm from Drinking?

Science.gov (United States)

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

2017-09-01

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

Harm mediates the disgust-immorality link.

Science.gov (United States)

Schein, Chelsea; Ritter, Ryan S; Gray, Kurt

2016-09-01

Many acts are disgusting, but only some of these acts are immoral. Dyadic morality predicts that disgusting acts should be judged as immoral to the extent that they seem harmful. Consistent with this prediction, 3 studies reveal that perceived harm mediates the link between feelings of disgust and moral condemnation-even for ostensibly harmless "purity" violations. In many cases, accounting for perceived harm completely eliminates the link between disgust and moral condemnation. Analyses also reveal the predictive power of anger and typicality/weirdness in moral judgments of disgusting acts. The mediation of disgust by harm holds across diverse acts including gay marriage, sex acts, and religious blasphemy. Revealing the endogenous presence and moral relevance of harm within disgusting-but-ostensibly harmless acts argues against modular accounts of moral cognition such as moral foundations theory. Instead, these data support pluralistic conceptions of harm and constructionist accounts of morality and emotion. Implications for moral cognition and the concept of "purity" are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

How and Why Young People Use Social Media in Relation to Self Harm and to What Effect?

OpenAIRE

Brett-Taylor, Lucy

2015-01-01

Social media use and self-harm prevalence are both highest among young people. Many explanatory models of self-harm have been proposed which are helpful in understanding the functions self-harm serve. Social media is a relatively new phenomenon requiring further research to increase understanding of the psychological processes associated with its use. The connection between self-harm and social media has received increased media attention in recent years and is of clinical and social importan...

Risk estimates of stochastic effects due to exposure to radiation - a stochastic harm index

International Nuclear Information System (INIS)

Gonen, Y.G.

1980-01-01

The effects of exposure to low level radiation on the survival probability and life expectancy were investigated. The 1977 vital statistics of Jewish males in Israel were used as a baseline, mainly the data on normalized survival probability and life expectation as functions of age. Assumed effects of exposure were superposed on these data and the net differences calculated. It was found that the realistic rate effects of exposure to radiation are generally less than calculated by multiplying the collective dose by the risk factor. The effects are strongly age-dependent, decreasing sharply with age at exposure. The assumed harm due to exposure can be more than offset by improvements in medical care and safety. (H.K.)

Lifetime Self-Harm Behaviors Are Not More Prevalent in Bariatric Surgery Candidates than in Community Controls with Obesity

Directory of Open Access Journals (Sweden)

Astrid Müller

2018-04-01

Full Text Available Objective: The study aimed at investigating the lifetime prevalence of 22 self-harm behaviors in bariatric surgery candidates (pre-bariatric surgery group; PSG compared to community controls with obesity (obese community group; OCG. Methods: The Self-Harm Inventory (SHI was administered to the PSG (n = 139, BMI ≥ 35 kg/m2 and to the OCG (n = 122, BMI ≥ 35 kg/m2. Results: Group comparison of cumulative SHI scores indicated a trend towards less endorsed SHI items in the PSG compared to the OCG (medianPSG = 1.00, IQRPSG = 2.00, medianOCG = 1.00, IQROCG = 2.25, U = 7.241, p = 0.033, η2 = 0.02. No significant group differences were found with regard to the rate of suicide attempts (12.4% vs. 9.4% for OCG vs. PSG. At least one type of lifetime self-harm behavior was admitted by 51.8% of the PSG and 63.9% of the OCG (χ2(1 = 3.91, p = 0.048. The results of logistic regressions using Firth's bias reduction method with at least one SHI item endorsed as dependent variable, group as categorical predictor (PSG as baseline, and age or BMI or PHQ-4 as continuous control variable indicated that only PHQ-4 had a positive effect on the odds ratio. Conclusion: The results suggest that self-harm (including suicidal attempts is not more prevalent in bariatric surgery candidates than in community control participants with obesity. Further studies are needed to investigate self-harm in bariatric surgery patients, prior and following surgery, compared to non-operated patients with obesity.

Applying 'Evidence-Based Medicine' Theory to Interventional Radiology.Part 2: A Spreadsheet for Swift Assessment of Procedural Benefit and Harm

International Nuclear Information System (INIS)

MacEneaney, Peter M.; Malone, Dermot E.

2000-01-01

AIM: To design a spreadsheet program to analyse interventional radiology (IR) data rapidly produced in local research or reported in the literature using 'evidence-based medicine' (EBM) parameters of treatment benefit and harm. MATERIALS AND METHODS: Microsoft Excel TM was used. The spreadsheet consists of three worksheets. The first shows the 'Levels of Evidence and Grades of Recommendations' that can be assigned to therapeutic studies as defined by the Oxford Centre for EBM. The second and third worksheets facilitate the EBM assessment of therapeutic benefit and harm. Validity criteria are described. These include the assessment of the adequacy of sample size in the detection of possible procedural complications. A contingency (2 x 2) table for raw data on comparative outcomes in treated patients and controls has been incorporated. Formulae for EBM calculations are related to these numerators and denominators in the spreadsheet. The parameters calculated are benefit -- relative risk reduction, absolute risk reduction, number needed to treat (NNT). Harm -- relative risk, relative odds, number needed to harm (NNH). Ninety-five per cent confidence intervals are calculated for all these indices. The results change automatically when the data in the therapeutic outcome cells are changed. A final section allows the user to correct the NNT or NNH in their application to individual patients. RESULTS: This spreadsheet can be used on desktop and palmtop computers. The MS Excel TM version can be downloaded via the Internet from the URL ftp://radiography.com/pub/TxHarm00.xls. CONCLUSION: A spreadsheet is useful for the rapid analysis of the clinical benefit and harm from IR procedures. MacEneaney, P.M. and Malone, D.E

Are benefits and harms in mammography screening given equal attention in scientific articles? A cross-sectional study.

Science.gov (United States)

Jørgensen, Karsten Juhl; Klahn, Anders; Gøtzsche, Peter C

2007-05-30

relative risk reduction than an absolute risk reduction, where quantified (45 articles (31%) versus 6 articles (3%) (P articles tend to emphasize the major benefits of mammography screening over its major harms. This imbalance is related to the authors' affiliation.

Self-harm and ethnicity: A systematic review.

Science.gov (United States)

Al-Sharifi, Ali; Krynicki, Carl R; Upthegrove, Rachel

2015-09-01

This review will focus on the rates, clinical characteristics, risk factors and methods of self-harm and suicide in different ethnic groups in the United Kingdom, providing an update synthesis of recent literature. Studies that met the inclusion criteria between 2003 and 2013 were reviewed using the following databases: MEDLINE, PsycINFO, EMBASE and CINAHL. The methodological quality of each study was then assessed using a structured scoring system. A total of 2,362 articles were retrieved, 10 of which matched the inclusion criteria were reviewed. Significant differences were found in the rates of self-harm between ethnic groups with Asian males being least likely to self-harm and Black females being most likely to self-harm. Also, Black and South Asian people were less likely to repeat self-harm. Factors that may help protect or predispose individuals to self-harm or attempt suicide (such as religion, mental health and coping styles) also differ between ethnic groups. There are clear ethnic differences in self-harm and suicide, which may be affected by factors such as cultural pressures and prevalence of mental illness. An awareness of these differences is vital to help prevent further attempts of self-harm and suicide. Further research into differences between ethnic and cultural groups and self-harm continues to be important. © The Author(s) 2015.

Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching

DEFF Research Database (Denmark)

Lind, Bertel; Erlangsen, Anette; Stuart, Elisabeth

2014-01-01

Background Although deliberate self-harm is a strong predictor of suicide, evidence for effective interventions is missing. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality. Methods...... In this matched cohort study all people who, after deliberate self-harm, received a psychosocial therapy intervention at suicide prevention clinics in Denmark during 1992—2010 were compared with people who did not receive the psychosocial therapy intervention after deliberate self-harm. We applied propensity...... score matching with a 1:3 ratio and 31 matching factors, and calculated odds ratios for 1, 5, 10, and 20 years of follow-up. The primary endpoints were repeated self-harm, death by suicide, and death by any cause. Findings 5678 recipients of psychosocial therapy (followed up for 42·828 person...

The Effects of Faulty or Potentially Harmful Products on Brand Reputation and Social Responsibility of Business

Directory of Open Access Journals (Sweden)

Claudiu-Cătălin Munteanu

2014-02-01

Full Text Available Building a strong brand requires a good management of brand reputation over time. Social responsibility of business is a key factor in evoking a positive brand reputation. Both the product itself and brand related actions and communications define brand reputation in the eyes of consumers, thus influencing perceived corporate social responsibility. As a consequence, it can be easily hindered or endangered by many product related issues such as faulty products or potentially harmful products. The purpose of this article is to provide an insight on the link between brand reputation and social responsibility in order to help organizations provide better services and protection for consumers. We examined how brand reputation is influenced by the negative bias generated by brand related communications regarding potentially harmful products. This study also analyzes how under normal consumption circumstances, consumers' experiences related to faulty products can influence brand reputation. To investigate this, we propose a model based on perceptual brand constructs and possible outcomes of brand reputation. In both circumstances, negative spillover effects are highlighted using structural equation modeling. The findings reveal that both faulty products and potentially harmful products have a negative bias on brand reputation, but affected perceptual brand constructs are different.

Dangerous anthropogenic interference, dangerous climatic change, and harmful climatic change. Non-trivial distinctions with significant policy implications

International Nuclear Information System (INIS)

Harvey, L.D.D.

2007-01-01

Article 2 of the United Nations Framework Convention on Climate Change (UNFCCC) calls for stabilization of greenhouse gas (GHG) concentrations at levels that prevent dangerous anthropogenic interference (DAI) in the climate system. However, some of the recent policy literature has focused on dangerous climatic change (DCC) rather than on DAI. DAI is a set of increases in GHGs concentrations that has a non-negligible possibility of provoking changes in climate that in turn have a non-negligible possibility of causing unacceptable harm, including harm to one or more of ecosystems, food production systems, and sustainable socio-economic systems, whereas DCC is a change of climate that has actually occurred or is assumed to occur and that has a non-negligible possibility of causing unacceptable harm. If the goal of climate policy is to prevent DAI, then the determination of allowable GHG concentrations requires three inputs: the probability distribution function (pdf) for climate sensitivity, the pdf for the temperature change at which significant harm occurs, and the allowed probability ('risk') of incurring harm previously deemed to be unacceptable. If the goal of climate policy is to prevent DCC, then one must know what the correct climate sensitivity is (along with the harm pdf and risk tolerance) in order to determine allowable GHG concentrations. DAI from elevated atmospheric CO2 also arises through its impact on ocean chemistry as the ocean absorbs CO2. The primary chemical impact is a reduction in the degree of supersaturation of ocean water with respect to calcium carbonate, the structural building material for coral and for calcareous phytoplankton at the base of the marine food chain. Here, the probability of significant harm (in particular, impacts violating the subsidiary conditions in Article 2 of the UNFCCC) is computed as a function of the ratio of total GHG radiative forcing to the radiative forcing for a CO2 doubling, using two alternative pdfs for

The role of fear and disgust in predicting the effectiveness of television advertisements that graphically depict the health harms of smoking.

Science.gov (United States)

Jónsdóttir, Harpa Lind; Holm, Jeffrey E; Poltavski, Dmitri; Vogeltanz-Holm, Nancy

2014-12-11

Antismoking television advertisements that depict the graphic health harms of smoking are increasingly considered best practices, as exemplified by the Centers for Disease Control and Prevention's current national campaign. Evaluation of responses to these widely used advertisements is important to determine advertisements that are most effective and their mechanisms of action. Our study tested the hypothesis that advertisements rated highest in fear- and disgust-eliciting imagery would be rated as the most effective. Our laboratory study included 144 women and men aged 18 to 33; 84% were current nonsmokers. All participants viewed 6 antismoking television advertisements that depicted the health harms of smoking; they rated their responses of fear and disgust and the effectiveness of the advertisements. We used multilevel modeling to test the effects of the following in predicting effectiveness: fear, disgust, the fear-disgust interaction, the advertisement, and the participant's sex and smoking status. Follow-up analyses examined differences in ratings of fear, disgust, and effectiveness. Advertisement, fear, disgust, and the fear-disgust interaction were each significant predictors of effectiveness. Smoking status and sex were not significant predictors. The 3 advertisements that elicited the highest ratings of fear and disgust were rated the most effective. Our findings support the hypothesis that antismoking advertisements of health harms that elicit the greatest responses of fear or disgust are the most effective. When advertisements elicit high ratings of both fear and disgust, advertisements with graphic imagery are effective, whereas advertisements without graphic imagery are not.

The index of harm: a useful measure for comparing occupational risk across industries

International Nuclear Information System (INIS)

Solomon, K.A.; Abraham, S.C.

1980-01-01

This paper presents an index of harm methodology which compares occupational risk among workers exposed to radiological and nonradiological harms. It extends the work of the International Commission on Radiological Protection by considering American rather than European and Japanese industry groups, by treating the relative importance of various occupational harms as a parameter rather than an arbitrary constant, and by identifying several ways in which both the methodology and the data base could be improved. In the analysis, the risk affects are examined of six occupational harms-three nonradiological (death, accidental injury and disease or illness) and three radiological (somatic effects, genetic effects, and somatic effects to the fetus or embryo of pregnant women). The analysis was performed under five different assumptions about the relative importance of degree of aversion of the six harms in question. The results of this analysis show that radiological workers exposed to the current industry average of 0.35 rem/yr are among the safest of all industry groupings, and the riskiest industries appear to be mining; agriculture, fishing and farming; construction; transportation; and manufacturing, roughly in that order. (author)

Youth Justice staff attitudes towards screening for self-harm.

Science.gov (United States)

Knowles, Sarah E; Townsend, Ellen; Anderson, Martin P

2012-09-01

Young offenders are recognised as a high-risk group for suicidal behaviour. It is essential that the screening used to identify those at risk and refer them to mental health services is effective, especially in community settings where service utilisation is low. Staff attitudes towards screening for suicide and self-harm are likely to influence how a young offender engages with the screening process. Our study is the first to explore community youth justice staff attitudes towards, and perceptions of, screening for self-harmful behaviour. Eight semi-structured interviews were conducted at an English Youth Offending Team in June 2006 with staff who had used the suicide screening tool with young offenders. Data were analysed using Interpretative Phenomenological Analysis. Staff attitudes towards working within the screening system varied along two dimensions. The first 'active/passive' dimension related to perceived confidence in dealing with self-harm. The second 'positive/negative' dimension related to perceptions of the benefits of screening and the effectiveness of mental health provision for young offenders. Results indicate that barriers to effective screening must be tackled at both individual and organisational levels. The model of attitudes presented here could be used to increase understanding of how staff can be supported to engage effectively with the screening system. © 2012 Blackwell Publishing Ltd.

Psychological characteristics, stressful life events and deliberate self-harm: findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

Science.gov (United States)

Madge, Nicola; Hawton, Keith; McMahon, Elaine M; Corcoran, Paul; De Leo, Diego; de Wilde, Erik Jan; Fekete, Sandor; van Heeringen, Kees; Ystgaard, Mette; Arensman, Ella

2011-10-01

There is evidence to suggest that both psychological characteristics and stressful life events are contributory factors in deliberate self-harm among young people. These links, and the possibility of a dose-response relationship between self-harm and both psychological health and life events, were investigated in the context of a seven-country school-based study. Over 30,000, mainly 15 and 16 year olds, completed anonymous questionnaires at secondary schools in Belgium, England, Hungary, Ireland, the Netherlands, Norway and Australia. Pupils were asked to report on thoughts and episodes of self-harm, complete scales on depression and anxiety symptoms, impulsivity and self-esteem and indicate stressful events in their lives. Level and frequency of self-harm was judged according to whether they had thought about harming themselves or reported single or multiple self-harm episodes. Multinomial logistic regression assessed the extent to which psychological characteristics and stressful life events distinguished between adolescents with different self-harm histories. Increased severity of self-harm history was associated with greater depression, anxiety and impulsivity and lower self-esteem and an increased prevalence of all ten life event categories. Female gender, higher impulsivity and experiencing the suicide or self-harm of others, physical or sexual abuse and worries about sexual orientation independently differentiated single-episode self-harmers from adolescents with self-harm thoughts only. Female gender, higher depression, lower self-esteem, experiencing the suicide or self-harm of others, and trouble with the police independently distinguished multiple- from single-episode self-harmers. The findings reinforce the importance of psychological characteristics and stressful life events in adolescent self-harm but nonetheless suggest that some factors are more likely than others to be implicated.

Do Coping Strategies Mediate the Relationship Between Parental Attachment and Self-Harm in Young People?

Science.gov (United States)

Glazebrook, Katie; Townsend, Ellen; Sayal, Kapil

2016-01-01

Insecure attachment is associated with self-harm in young people, but little research has explored the pathways through which this relationship develops. We investigated whether attachment impacts on self-harm via its effect on coping strategies and appraisal of problem-solving abilities. A total of 314 students aged 18-20 years completed an online survey with measures of parental attachment, emotion-focused and problem-focused coping strategies, and psychological distress and self-harm. A mediational model was not supported as there were no direct effects between parental attachment and self-harm. However, analysis of specific indirect pathways revealed that perceived parental attachment impacts on self-harm through problem-focused coping. Higher quality of attachment was associated with greater reliance on problem-focused (adaptive) coping, which in turn was associated with a decreased risk of having self-harmed. Furthermore, poorer paternal attachment was associated with lower appraisal of problem-solving skills, which in turn was associated with an increased risk of having self-harmed. Individuals with insecure attachment may be more vulnerable to self-harm because they lack other more constructive coping strategies for relieving stress.

The Effect of Cognitive Behavior Therapy on Decision Making in Adolescents Who Self-Harm: A Pilot Study

Science.gov (United States)

Oldershaw, Anna; Simic, Mima; Grima, Emanuela; Jollant, Fabrice; Richards, Clair; Taylor, Lucy; Schmidt, Ulrike

2012-01-01

Research shows poor decision making in adolescents who self-harm and a positive correlation between decision-making abilities and duration since last self-harm episode. This exploratory study investigated whether decision making in self-harming adolescents could be improved through treatment with a novel cognitive behavior therapy (CBT). It also…

Improving communication and practical skills in working with inpatients who self-harm : A pre-test/post-test study of the effect of a training programme

NARCIS (Netherlands)

Ad Kerkhof; Bauke Koekkoek; prof Berno van Meijel; Jaap van der Bijl; Nienke Kool

2014-01-01

Background Differing perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and

Improving communication and practical skills in working with inpatients who self-harm: a pre-test/post-test study of the effects of a training programme

NARCIS (Netherlands)

Kool, N.; van Meijel, B.; Koekkoek, B.; van der Bijl, J.; Kerkhof, A.J.F.M.

2014-01-01

Background:Differing perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and

Mental health nurses' attitudes toward self-harm: Curricular implications

Directory of Open Access Journals (Sweden)

David G. Shaw

2016-10-01

Methods: The study aimed to explore the attitudes of mental health nurses toward service users who self-harm in secure environments, and to inform mental health curriculum development. It was conducted in a large forensic mental health unit, containing medium and low secure facilities, to the west of London, UK. A qualitative multi-method approach was adopted, underpinned by interpretative phenomenological analysis. Data were obtained from mental health nurses using individual interviews and focus groups, and analysis followed a step-by-step thematic approach using interpretative phenomenological analysis. Results: Nurses' attitudes toward self-harm varied but were mainly negative, and this was usually related to limited knowledge and skills. The results of the study, framed by the Theory of Planned Behaviour, led to the development of a proposed educational model entitled ‘Factors Affecting Self-Harming Behaviours’ (FASH. Conclusion: The FASH Model may inform future curriculum innovation. Adopting a holistic approach to education of nurses about self-harm may assist in developing attitudes and skills to make care provision more effective in secure mental health settings.

Benefits and harms of perioperative beta-blockade

DEFF Research Database (Denmark)

Wetterslev, Jørn; Juul, Anne Benedicte

2006-01-01

randomized trials. However, confidence intervals of the intervention effects in the meta-analyses are wide, leaving room for both benefits and harms. The largest observational study performed suggests that perioperative beta-blockade is associated with higher mortality in patients with low cardiac risk...

Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial.

Science.gov (United States)

Mehlum, Lars; Tørmoen, Anita J; Ramberg, Maria; Haga, Egil; Diep, Lien M; Laberg, Stine; Larsson, Bo S; Stanley, Barbara H; Miller, Alec L; Sund, Anne M; Grøholt, Berit

2014-10-01

We examined whether a shortened form of dialectical behavior therapy, dialectical behavior therapy for adolescents (DBT-A) is more effective than enhanced usual care (EUC) to reduce self-harm in adolescents. This was a randomized study of 77 adolescents with recent and repetitive self-harm treated at community child and adolescent psychiatric outpatient clinics who were randomly allocated to either DBT-A or EUC. Assessments of self-harm, suicidal ideation, depression, hopelessness, and symptoms of borderline personality disorder were made at baseline and after 9, 15, and 19 weeks (end of trial period), and frequency of hospitalizations and emergency department visits over the trial period were recorded. Treatment retention was generally good in both treatment conditions, and the use of emergency services was low. DBT-A was superior to EUC in reducing self-harm, suicidal ideation, and depressive symptoms. Effect sizes were large for treatment outcomes in patients who received DBT-A, whereas effect sizes were small for outcomes in patients receiving EUC. Total number of treatment contacts was found to be a partial mediator of the association between treatment and changes in the severity of suicidal ideation, whereas no mediation effects were found on the other outcomes or for total treatment time. DBT-A may be an effective intervention to reduce self-harm, suicidal ideation, and depression in adolescents with repetitive self-harming behavior. Clinical trial registration information-Treatment for Adolescents With Deliberate Self Harm; http://ClinicalTrials.gov/; NCT00675129. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Toxic Effects of Prodigiosin Secreted by Hahella sp. KA22 on Harmful Alga Phaeocystis globosa

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Huajun Zhang

2017-06-01

Full Text Available Application of algicidal compounds secreted by bacteria is a promising and environmentally friendly strategy to control harmful algal blooms (HABs. Years ago prodigiosin was described as an efficient algicidal compound, but the details about the effect of prodigiosin on algal cells are still elusive. Prodigiosin shows high algicidal activity on Phaeocystis globosa, making it a potential algicide in HAB control. When P. globosa were treated with prodigiosin at 5 μg/mL, algae cells showed cytoplasmic hypervacuolization, chloroplast and nucleus rupture, flagella missing, and cell fracture, when observed by scanning electron microscope and transmission electron microscopy. Prodigiosin induced a reactive oxygen species (ROS burst in P. globosa at 2 h, which could result in severe oxidative damage to algal cells. Chlorophyll a (Chl a fluorescence decreased significantly after prodigiosin treatment; about 45.3 and 90.0% of algal cells lost Chl a fluorescence at 24 and 48 h. The Fv/Fm value, reflecting the status of the photosystem II electron flow also decreased after prodigiosin treatment. Quantitative polymerase chain reaction (PCR analysis psbA and rbcS expression indicated that photosynthesis process was remarkably inhibited by prodigiosin. The results indicated that the inhibition of photosynthesis may produce excessive ROS causing cell necrosis. This study is the first report about algal lysis mechanism of prodigiosin on harmful algae. Our results could increase our knowledge on the interaction between algicidal compounds and harmful algae, which could lead to further studies in the microcosm.

Self-harm and attempted suicide within inpatient psychiatric services: a review of the literature.

Science.gov (United States)

James, Karen; Stewart, Duncan; Bowers, Len

2012-08-01

Self harm is a major public health concern, yet there are considerable challenges in providing support for those who self harm within psychiatric inpatient services. This paper presents the first review of research into self harm within inpatient settings. Searches of the main electronic databases were conducted using key words for self harm and inpatient care. There was substantial variation in the rates of self-harm and attempted suicide between studies, but rates were highest on forensic wards. There was no evidence of differences in prevalence of self-harm between men and women; women, however, were at increased risk of attempting suicide. People were more likely to self-harm in private areas of the ward and in the evening hours, and often self-harmed in response to psychological distress, or elements of nursing care that restricted their freedom. Wards used a variety of strategies to prevent self-harm; however, there is little research into their effectiveness. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

The concept of "harm" in Internet gaming disorder.

Science.gov (United States)

King, Daniel L; Delfabbro, Paul H

2018-05-23

Internet gaming disorder (IGD) is a proposed condition that refers to persistent gaming leading to clinically significant impairment. However, there have been few attempts to study the different types and degrees of harm caused by IGD. This commentary describes some of the negative intrapersonal and interpersonal effects of an extreme time investment in gaming activities in the context of IGD. Future research should examine the way in which IGD harms may occur at different levels and degrees. This may enhance the screening of individuals whose behavior is suspected to meet the definition of the proposed IGD criteria.

Evaluation of knowledge, attitude, and behavior about harmful effects of the sun and sun protection among patients attending an outpatient clinic

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Sevim Terzi

2017-03-01

Full Text Available Background and Design: The aim of the study was to evaluate harmful effects of sun exposure and knowledge, attitude and behaviors related to sun protection among patients attending our outpatient clinic. Materials and Methods: A total of 400 patients (171 male and 229 female aged between 16 and 89 years were included in this study. Subjects were requested to fill out a questionnaire composed of 52 questions. In the first part of the questionnaire, patients’ socio-demographic characteristics, history of sunburn, first-degree relatives with a history of skin cancer; in the second part, knowledge about harmful effects of sun and sun protection were inquired. In the third part, patient attitude and behaviors related to sun protection was evaluated. Results: Our results revealed that 69.25% of patients had satisfactory level of knowledge. While the level of knowledge was not affected by economic status, place of residence, skin type and presence of skin cancer in participants or their first-degree relatives, it was found to be increased with increasing educational level. The patients were found to prefer avoiding mid-day sun (75.5% and staying in the shade (64.8% chiefly as sun protection methods and 45.3% of patients were found to use sunscreens. Most frequently preferred sources of information about harmful effects of the sun and sun protection methods were found to be television, magazines and newspapers (76.3%, doctor’s advice and internet, respectively. Conclusion: Although a satisfactory level of knowledge about harmful effects of the sun and protection methods was found, it was observed that individuals could not convert their knowledge into the sun protection behavior

Benefit-to-harm ratio of the Danish breast cancer screening programme

DEFF Research Database (Denmark)

Beau, Anna-Belle; Lynge, Elsebeth; Njor, Sisse Helle

2017-01-01

cancer deaths prevented divided by the number of overdiagnosed breast cancer cases, varied considerably. The objective of the study was to estimate the benefit-to-harm ratio of breast cancer screening in Denmark. The numbers of breast cancer deaths prevented and overdiagnosed cases [invasive and ductal...... to age 69 and followed until age 79, we estimated that 5.4 breast cancer deaths would be prevented and 2.1 cases overdiagnosed, under the observed scenario in Denmark of a breast cancer mortality reduction of 23.4% and 2.3% of the breast cancer cases being overdiagnosed. The estimated benefit......-to-harm ratio was 2.6 for invited women and 2.5 for screened women. Hence, 2-3 women would be prevented from dying from breast cancer for every woman overdiagnosed with invasive breast cancer or DCIS. The difference between the previous published ratios and 2.6 for Denmark is probably more a reflection...

Self-harm and overcrowding among prisoners in Geneva, Switzerland.

Science.gov (United States)

Wolff, Hans; Casillas, Alejandra; Perneger, Thomas; Heller, Patrick; Golay, Diane; Mouton, Elisabeth; Bodenmann, Patrick; Getaz, Laurent

2016-01-01

must be looked into further as contributors. Additionally, qualitative methods such as semi-structured interviews and focus groups could delineate the impact of overcrowding on prisoner well-being and self-harm potential. The authors observed a significant increase in self-harm and self-strangulation/hangings over time, and overcrowding was significantly associated with self-strangulation/hangings (but not with all self-harm events). Overcrowding can impose destructive effects on the psychological and behavioral well being of inmates in prison, influencing a myriad of emotional and livelihood factors that predispose to harmful behavior. This report should alert public health and prison authorities to this issue, and garner resources to address such an alarming rise. The findings from this short report demonstrate the need for a further examination of the mechanisms affecting self-harm among prisoners in this population, particularly the relationship between self-strangulations/hangings and overcrowding.

The cost of harmful alcohol use in South Africa.

Science.gov (United States)

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

2014-02-01

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

Potential Benefits and Harms of Intermittent Energy Restriction and Intermittent Fasting Amongst Obese, Overweight and Normal Weight Subjects—A Narrative Review of Human and Animal Evidence

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Michelle Harvie

2017-01-01

Full Text Available Intermittent energy restriction (IER has become popular as a means of weight control amongst people who are overweight and obese, and is also undertaken by normal weight people hoping spells of marked energy restriction will optimise their health. This review summarises randomised comparisons of intermittent and isoenergetic continuous energy restriction for weight loss to manage overweight and obesity. It also summarises the potential beneficial or adverse effects of IER on body composition, adipose stores and metabolic effects from human studies, including studies amongst normal weight subjects and relevant animal experimentation. Six small short term (<6 month studies amongst overweight or obese individuals indicate that intermittent energy restriction is equal to continuous restriction for weight loss, with one study reporting greater reductions in body fat, and two studies reporting greater reductions in HOMA insulin resistance in response to IER, with no obvious evidence of harm. Studies amongst normal weight subjects and different animal models highlight the potential beneficial and adverse effects of intermittent compared to continuous energy restriction on ectopic and visceral fat stores, adipocyte size, insulin resistance, and metabolic flexibility. The longer term benefits or harms of IER amongst people who are overweight or obese, and particularly amongst normal weight subjects, is not known and is a priority for further investigation.

Potential Benefits and Harms of Intermittent Energy Restriction and Intermittent Fasting Amongst Obese, Overweight and Normal Weight Subjects-A Narrative Review of Human and Animal Evidence.

Science.gov (United States)

Harvie, Michelle; Howell, Anthony

2017-01-19

Intermittent energy restriction (IER) has become popular as a means of weight control amongst people who are overweight and obese, and is also undertaken by normal weight people hoping spells of marked energy restriction will optimise their health. This review summarises randomised comparisons of intermittent and isoenergetic continuous energy restriction for weight loss to manage overweight and obesity. It also summarises the potential beneficial or adverse effects of IER on body composition, adipose stores and metabolic effects from human studies, including studies amongst normal weight subjects and relevant animal experimentation. Six small short term (<6 month) studies amongst overweight or obese individuals indicate that intermittent energy restriction is equal to continuous restriction for weight loss, with one study reporting greater reductions in body fat, and two studies reporting greater reductions in HOMA insulin resistance in response to IER, with no obvious evidence of harm. Studies amongst normal weight subjects and different animal models highlight the potential beneficial and adverse effects of intermittent compared to continuous energy restriction on ectopic and visceral fat stores, adipocyte size, insulin resistance, and metabolic flexibility. The longer term benefits or harms of IER amongst people who are overweight or obese, and particularly amongst normal weight subjects, is not known and is a priority for further investigation.

Potential Benefits and Harms of Intermittent Energy Restriction and Intermittent Fasting Amongst Obese, Overweight and Normal Weight Subjects—A Narrative Review of Human and Animal Evidence

Science.gov (United States)

Harvie, Michelle; Howell, Anthony

2017-01-01

Intermittent energy restriction (IER) has become popular as a means of weight control amongst people who are overweight and obese, and is also undertaken by normal weight people hoping spells of marked energy restriction will optimise their health. This review summarises randomised comparisons of intermittent and isoenergetic continuous energy restriction for weight loss to manage overweight and obesity. It also summarises the potential beneficial or adverse effects of IER on body composition, adipose stores and metabolic effects from human studies, including studies amongst normal weight subjects and relevant animal experimentation. Six small short term (obese individuals indicate that intermittent energy restriction is equal to continuous restriction for weight loss, with one study reporting greater reductions in body fat, and two studies reporting greater reductions in HOMA insulin resistance in response to IER, with no obvious evidence of harm. Studies amongst normal weight subjects and different animal models highlight the potential beneficial and adverse effects of intermittent compared to continuous energy restriction on ectopic and visceral fat stores, adipocyte size, insulin resistance, and metabolic flexibility. The longer term benefits or harms of IER amongst people who are overweight or obese, and particularly amongst normal weight subjects, is not known and is a priority for further investigation. PMID:28106818

Soil contamination in south Backa region of Serbia with dangerous and harmful substances

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Maksimović Livija

2012-01-01

Full Text Available Soil samples in disturbed state were taken in order to control fertility and monitor contents of harmful and hazardous substances in Vojvodina soils and possibilities of soil degradation in general. Moderately contaminated soils were selected for examination. Microbial activity in contaminated soil and the impact of harmful and hazardous substances (pesticides on soil microorganisms were observed and most resistant microorganisms were isolated. Vegetation experiments were organized to study the effect of chelating agents EDTA and EDDS on copper adoption and translocation in rapeseed and sunflower. Importance of some ions in the complexation of copper chelators and their undesirable effects on copper uptake were established. Field trials were organized to study the effect of hydrogel on water uptakes by plants, increase in rate and the increase in rate of removal of hazardous and harmful substances from soil solution. At all phases of the project, we monitored the effectiveness of soil bioremediation soils by means of the application of chelating agents, stimulative preparations such as hydrogel and certain microorganisms. It effectiveness was measured in terms of plant growth rate and intensity in removal of hazardous and harmful substances from contaminated soil.

Dialectical Behavior Therapy Compared With Enhanced Usual Care for Adolescents With Repeated Suicidal and Self-Harming Behavior: Outcomes Over a One-Year Follow-Up.

Science.gov (United States)

Mehlum, Lars; Ramberg, Maria; Tørmoen, Anita J; Haga, Egil; Diep, Lien M; Stanley, Barbara H; Miller, Alec L; Sund, Anne M; Grøholt, Berit

2016-04-01

We conducted a 1-year prospective follow-up study of posttreatment clinical outcomes in adolescents with recent and repetitive self-harm who had been randomly allocated to receive 19 weeks of either dialectical behavior therapy adapted for adolescents (DBT-A) or enhanced usual care (EUC) at community child and adolescent psychiatric outpatient clinics. Assessments of self-harm, suicidal ideation, depression, hopelessness, borderline symptoms, and global level of functioning were made at the end of the 19-week treatment period and at follow-up 1 year later. Altogether 75 of the 77 (97%) adolescents participated at both time points. Frequencies of hospitalizations, emergency department visits and other use of mental health care during the 1-year follow-up period were recorded. Change analyses were performed using mixed effects linear spline regression and mixed effect Poisson regression with robust variance. Over the 52-week follow-up period, DBT-A remained superior to EUC in reducing the frequency of self-harm. For other outcomes such as suicidal ideation, hopelessness, and depressive or borderline symptoms and for the global level of functioning, inter-group differences apparent at the 19-week assessment were no longer observed, mainly due to participants in the EUC group having significantly improved on these dimensions over the follow-up year, whereas DBT-A participants remained unchanged. A stronger long-term reduction in self-harm and a more rapid recovery in suicidal ideation, depression, and borderline symptoms suggest that DBT-A may be a favorable treatment alternative for adolescents with repetitive self-harming behavior. Treatment for Adolescents With Deliberate Self Harm; http://clinicaltrials.gov/; NCT00675129. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

European rating of drug harms

NARCIS (Netherlands)

van Amsterdam, Jan; Nutt, David; Phillips, Lawrence; van den Brink, Wim

2015-01-01

The present paper describes the results of a rating study performed by a group of European Union (EU) drug experts using the multi-criteria decision analysis model for evaluating drug harms. Forty drug experts from throughout the EU scored 20 drugs on 16 harm criteria. The expert group also assessed

Brief Report: The Self Harm Questionnaire--A New Tool Designed to Improve Identification of Self Harm in Adolescents

Science.gov (United States)

Ougrin, Dennis; Boege, Isabel

2013-01-01

The Self Harm Questionnaire (SHQ) aiming at identification of self-harm in adolescents has been developed and piloted in a sample of 12-17 year olds (n = 100). The adolescents were recruited from both in- and outpatient psychiatric services. Concurrent validity of the SHQ was evaluated by comparing the SHQ results with recorded self harm in the…

The insured victim effect: When and why compensating harm decreases punishment recommendations

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Philippe P. F. M. van de Calseyde

2013-03-01

Full Text Available An insurance policy may not only affect the consequences for victims but also for perpetrators. In six experiments we find that people recommend milder punishments for perpetrators when the victim was insured, although people believe that a sentence should not depend on the victim's insurance status. The robustness of this effect is demonstrated by showing that recommendations can even be more lenient for crimes that are in fact more serious but in which the victim was insured. Moreover, even when harm was possible but did not materialize, people still prefer to punish crimes less severely when the (potential victim was insured. The final two experiments suggest that the effect is associated with a change in (1 compassion for the victim and (2 perceived severity of the transgression. Implications of this phenomenon are briefly discussed.

Perceived harmfulness of substance use: A pilot study

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Siddharth Sarkar

2014-01-01

Full Text Available Background: Harm ratings of substances help in understanding the perception toward substance use and formulating policies. Evidence of such harm ratings by substance users and their caregivers provides a clearer perspective of those who experience and observe such harm closely. Materials and Methods: Substance users and their caregivers were recruited from the Drug De-addiction and Treatment Centre of PGIMER, Chandigarh. Sociodemographic details of the subjects were noted. The subjects were then asked to rate a list of psychoactive preparations according to the harms they thought the preparation caused. The list of substances was developed taking into consideration substance commonly encountered in the geographical area. The harm ratings were transformed on a scale of 0-100. Results: All subjects were males and majority of them were educated above 10 th standard, were not employed and belonged to urban background. Most of them had taken psychoactive substances in their lifetimes but were currently abstinent. Most of the subjects endorsed intravenous drugs as the most harmful, followed by heroin. Beer and chewable tobacco considered the least harmful substances. Greater degree of education was associated with lower harm rankings for heroin, cannabis, dextropropoxyphene, and raw opium; while urban residence was associated with greater harm ratings for cannabis and raw opium. Differences in the harms were perceived for different preparations of the same active compound for alcohol and nicotine. Conclusion: Harm ratings of substances can be a useful guide while formulating policies and allocating resources. Need for further research extending this pilot study is emphasized.

Fabrication of Zr-2.5Nb pressure tubes to minimise the harmful effects of trace elements

International Nuclear Information System (INIS)

Theaker, J.R.; Coleman, C.E.; Davis, L.; Graham, R.A.

1994-03-01

Trace elements can reduce the fracture resistance of Zr-2.5Nb pressure tubes. The effects of hydrogen as hydrides and oxygen as an alloy-strengthening agent are well known, but the contribution of carbon, phosphorus, chlorine and segregated oxygen has only recently been recognized. Carbides and phosphides are brittle particles, while chlorine segregates to form planes of weakness that produce fissures is associated with low toughness. With long hold times in the (α + β) region, oxygen partitions in the α-grains; such grains are hard, and if they survive fabrication may reduce the toughness of the finished tube. Through a co-operative program involving AECL and manufacturers, a series of manufacturing innovations and controls has been introduced that minimize these harmful effects. Hydrogen is present in Zr sponge as water, can be absorbed at each stage of tube fabrication, and needs to be carefully controlled, particularly during ingot breakdown and subsequent forging. Hydrogen concentrations in finished tubes have been reduced by a factor of three through the optimization of manufacturing processes and the implementation of new technology. Multiple vacuum arc melting, use of selected raw materials and intermediate ingot surface conditioning have resulted in much improved fracture toughness through the reduction of chlorine and phosphorus concentrations. Optimum distribution of oxygen may be achieved through changes to the extrusion process cycle. An understanding of the Zr-2.5Nb-C phase diagram, particularly the solubility of carbon at low concentrations, has resulted in the specification of a lower carbon concentration. (author). 12 refs., 6 tabs., 10 figs

A Smartphone App (BlueIce) for Young People Who Self-Harm: Open Phase 1 Pre-Post Trial

Science.gov (United States)

Porter, Joanna; Grist, Rebecca

2018-01-01

Background Recent years have seen a significant increase in the availability of smartphone apps for mental health problems. Despite their proliferation, few apps have been specifically developed for young people, and almost none have been subject to any form of evaluation. Objective This study aimed to undertake a preliminary evaluation of a smartphone app (BlueIce), coproduced with young people and designed to help young people manage distress and urges to self-harm. We aimed to assess the acceptability, safety, and use of BlueIce and to explore the effects on the primary outcome of self-harm and the secondary outcomes of psychological functioning. Methods We undertook an open trial where we recruited young people aged 12 to 17 years attending specialist child and adolescent mental health services (CAMHS) who were currently self-harming or had a history of self-harm. Eligible participants were assessed at baseline and then given BlueIce. They were assessed 2 weeks later (post familiarization) and again at 12 weeks (post use). A behavior-screening questionnaire (Strengths and Difficulties Questionnaire) was completed along with standardized measures of depression (Mood and Feelings Questionnaire or MFQ) and anxiety (Revised Child Anxiety and Depression Scale or RCADS), taking into account self-reports of self-harm, app helpfulness, and safety. Results All core CAMHS professional groups referred at least 1 young person. Out of 40 young people recruited, 37 (93%) elected to use BlueIce after familiarization, with 29 out of 33 (88%) wanting to keep it at the end of the study. No young person called the emergency numbers during the 12-week trial, and no one was withdrawn by his or her clinician due to increased risk of suicide. Almost three-quarters (73%) of those who had recently self-harmed reported reductions in self-harm after using BlueIce for 12 weeks. There was a statistically significant mean difference of 4.91 (t31=2.11; P=.04; 95% CI 0.17-9.64) on postuse

Australian governments' spending on preventing and responding to drug abuse should target the main sources of drug-related harm and the most cost-effective interventions.

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McDonald, David

2011-01-01

A notable feature of Australian drug policy is the limited public and professional attention given to the financial costs of drug abuse and to the levels and patterns of government expenditures incurred in preventing and responding to this. Since 1991, Collins and Lapsley have published scholarly reports documenting the social costs of drug abuse in Australia and their reports also contain estimates of governments' drug budgets: revenue and expenditures. They show that, in 2004-2005, Australian governments expended at least $5288 million on drug abuse, with 50% of the expenditure directed to preventing and dealing with alcohol-related problems, 45% to illicit drugs and just 5% to tobacco. Some 60% of the expenditure was directed at drug crime and 37% at health interventions. This pattern of resource allocation does not adequately reflect an evidence-informed policy orientation in that it largely fails to focus on the drug types that are the sources of the most harm (tobacco and alcohol rather than illicit drugs), and the sectors for which we have the strongest evidence of the cost-effectiveness of the available interventions (treatment and harm reduction rather than legislation and law enforcement). The 2010-2014 phase of Australia's National Drug Strategy should include incremental changes to the resource allocation mix, and not simply maintain the historical resource allocation formulae. © 2010 Australasian Professional Society on Alcohol and other Drugs.

Screening and Brief Interventions for Hazardous and Harmful Alcohol Use among University Students in South Africa: Results from a Randomized Controlled Trial

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Hendry van der Heever

2013-05-01

Full Text Available The aim of this study was to assess the effectiveness of Screening and Brief Intervention (SBI for alcohol problems among university students in South Africa. The study design for this efficacy study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting. The unit of randomization is the individual university student identified as a hazardous or harmful drinker attending public recruitment venues in a university campus. University students were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counseling session on alcohol risk reduction, while the control group received a health education leaflet. Results indicate that of the 722 screened for alcohol and who agreed to participate in the trial 152 (21.1% tested positive for the Alcohol Use Disorder Identification Test (AUDIT (score 8 or more. Among the 147 (96.7% university students who also attended the 12-month follow-up session, the intervention effect on the AUDIT score was −1.5, which was statistically significant (P = 0.009. Further, the depression scores marginally significantly decreased over time across treatment groups, while other substance use (tobacco and cannabis use, self-rated health status and Posttraumatic Stress Disorder (PTSD scores did not change over time across treatment groups. The study provides evidence of effective brief intervention by assistant nurses with hazardous and harmful drinkers in a university setting in South Africa. The short duration of the brief intervention makes it a realistic candidate for use in a university setting.

Perceived Risk of Harm from Marijuana Use among Youth in the USA.

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Danseco, Evangeline R.; Kingery, Paul M.; Coggeshall, Mark

1999-01-01

Reviews studies that examined perceived risk or beliefs about harmful effects associated with marijuana use. Perceived risk was construed as consisting of at least four areas (physical harm; parental disapproval; peer disapproval; fear of arrest). Perception of risk varied with several factors including age and gender. Secondary data analysis was…

Collaborative Modeling of the Benefits and Harms Associated With Different U.S. Breast Cancer Screening Strategies.

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

2016-02-16

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

Harmful Freshwater Algal Blooms, With an Emphasis on Cyanobacteria

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Hans W. Paerl

2001-01-01

zooplankton to further up the food chain. Both N2- and non-N2-fixing genera participate in mutualistic and symbiotic associations with microorganisms, higher plants, and animals. These associations appear to be of great benefit to their survival and periodic dominance. In this review, we address the ecological impacts and environmental controls of harmful blooms, with an emphasis on the ecology, physiology, and management of cyanobacterial bloom taxa. Combinations of physical, chemical, and biotic features of natural waters function in a synergistic fashion to determine the sensitivity of water bodies. In waters susceptible to blooms, human activities in water- and airsheds have been linked to the extent and magnitudes of blooms. Control and management of cyanobacterial and other phytoplankton blooms invariably includes nutrient input constraints, most often focused on nitrogen (N and/or phosphorus (P. The types and amount of nutrient input constraints depend on hydrologic, climatic, geographic, and geologic factors, which interact with anthropogenic and natural nutrient input regimes. While single nutrient input constraints may be effective in some water bodies, dual N and P input reductions are usually required for effective long-term control and management of harmful blooms. In some systems where hydrologic manipulations (i.e., plentiful water supplies are possible, reducing the water residence time by enhanced flushing and artificial mixing (in conjunction with nutrient input constraints can be particularly effective alternatives. Implications of various management strategies, based on combined ecophysiological and environmental considerations, are discussed.

Effects of E-cigarette Advertising Messages and Cues on Cessation Outcomes.

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Jo, Catherine L; Golden, Shelley D; Noar, Seth M; Rini, Christine; Ribisl, Kurt M

2018-01-01

We examined effects of e-cigarette ad messages and visual cues on outcomes related to combustible cigarette smoking cessation: smoking cessation intention, smoking urges, and immediate smoking behavior. US adult smokers (N = 3293) were recruited through Amazon Mechanical Turk and randomized to condition in a 3 (message: e-cigarette use anywhere, harm reduction, control) × 2 (e-cigarette cue presence or absence) between-subjects experiment. Stimuli were print ads for cigarette-like e-cigarettes ("cigalikes") that were manipulated for the experimental conditions. We conducted ANOVA and logistic regression analyses to investigate effects of the manipulations. Message effects on cessation intention and smoking urges were not statistically significant. There was no evidence of cue effects or message × cue interactions across outcomes. Contrary to expectations, e-cigarette use anywhere and harm reduction messages were associated with lower odds of immediate smoking than the control message (AOR EUA = 0.75, 95%CI = 0.58, 0.97, p = .026; AOR HR = 0.72, 95%CI = 0.55, 0.93, p = .013). E-cigarette use anywhere and harm reduction messages may encourage smoking cessation, given the observed reduction in immediate smoking. E-cigarette cues may not influence smoking cessation outcomes. Future studies should investigate whether message effects are a result of smokers believing e-cigarettes to be effective cessation aids.

Boundaries between Fair and Harmful Tax Competition

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Paweł Szwajdler

2016-12-01

Full Text Available The aim of this paper is to show boundaries between fair and harmful tax competition. The author analyses OECD’s reports and literature related to the tax competition. In the beginning, the author presents the notion of tax competition and its division into fair and unfair tax competition. Differences between tax heaven and preferential tax regime are also discussed. In the summary, the author highlights that boundaries between fair and harmful tax competition are not obvious, but there are well-known guidelines, which let distinguish above-mentioned issues. The author considers that there are real tax burden, effective exchange of tax information and transparency in the fair tax regime. The author states that taxpayer can do justified tax planning in such tax system.

First Episode of Self-Harm in Older Age : A Report From the 10-Year Prospective Manchester Self-Harm Project

NARCIS (Netherlands)

Voshaar, Richard C. Oude; Cooper, Jayne; Murphy, Elizabeth; Steeg, Sarah; Kapur, Nay; Purandare, Nitin B.

Objective: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm

First episode of self-harm in older age: a report from the 10-year prospective Manchester Self-Harm project

NARCIS (Netherlands)

Oude Voshaar, R.C.; Cooper, J.; Murphy, E.; Steeg, S.; Kapur, N.; Purandare, N.B.

2011-01-01

OBJECTIVE: Self-harm is closely related to completed suicide, especially in older age. As empirical research of self-harm in older age is scarce, with no studies confined to first-ever episodes in older age, we examined the clinical characteristics and the risk of repetition in first-ever self-harm

Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review.

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Carter, Emily; Bryce, Jennifer; Perin, Jamie; Newby, Holly

2015-08-18

correct management of diarrheal disease in children and result in treatment failure, sustained nutritional deficits, and increased diarrhea mortality. The lack of consistency in sampling, measurement, and reporting identified in this literature review highlights the need to document harmful practices using standard methods of measurement and reporting for the continued reduction of diarrhea mortality.

The impact of self-harm by young people on parents and families: a qualitative study

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Ferrey, Anne E; Hughes, Nicholas D; Simkin, Sue; Locock, Louise; Stewart, Anne; Kapur, Navneet; Gunnell, David; Hawton, Keith

2016-01-01

Objectives: Little research has explored the full extent of the impact of self-harm on the family. This study aimed to explore the emotional, physical and practical effects of a young person’s self-harm on parents and family. Design and Participants: We used qualitative methods to explore the emotional, physical and practical effects of a young person’s self-harm on their parents and family. We conducted a thematic analysis of thirty-seven semi-structured narrative interviews with parents...

Authority dependence and judgments of utilitarian harm.

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Piazza, Jared; Sousa, Paulo; Holbrook, Colin

2013-09-01

Three studies tested the conditions under which people judge utilitarian harm to be authority dependent (i.e., whether its right or wrongness depends on the ruling of an authority). In Study 1, participants judged the right or wrongness of physical abuse when used as an interrogation method anticipated to yield useful information for preventing future terrorist attacks. The ruling of the military authority towards the harm was manipulated (prohibited vs. prescribed) and found to significantly influence judgments of the right or wrongness of inflicting harm. Study 2 established a boundary condition with regards to the influence of authority, which was eliminated when the utility of the harm was definitely obtained rather than forecasted. Finally, Study 3 replicated the findings of Studies 1-2 in a completely different context-an expert committee's ruling about the harming of chimpanzees for biomedical research. These results are discussed as they inform ongoing debates regarding the role of authority in moderating judgments of complex and simple harm. Copyright © 2013 Elsevier B.V. All rights reserved.

Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints

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Karolien Adriaens

2014-10-01

Full Text Available Background: Smoking reduction remains a pivotal issue in public health policy, but quit rates obtained with traditional quit-smoking therapies remain disappointingly low. Tobacco Harm Reduction (THR, aiming at less harmful ways of consuming nicotine, may provide a more effective alternative. One promising candidate for THR are electronic cigarettes (e-cigs. The aim of this study was to investigate the efficacy of second-generation e-cigs both in terms of acute craving-reduction in the lab and in terms of smoking reduction and experienced benefits/complaints in an eight-month Randomized Controlled Trial (RCT. Design: RCT with three arms. Methods: Participants (N = 48 unwilling to quit smoking were randomized into two e-cig groups and one control group. During three lab sessions (over two months participants, who had been abstinent for four hours, vaped/smoked for five minutes, after which we monitored the effect on craving and withdrawal symptoms. eCO and saliva cotinine levels were also measured. In between lab sessions, participants in the e-cig groups could use e-cigs or smoke ad libitum, whereas the control group could only smoke. After the lab sessions, the control group also received an e-cig. The RCT included several questionnaires, which repeatedly monitored the effect of ad libitum e-cig use on the use of tobacco cigarettes and the experienced benefits/complaints up to six months after the last lab session. Results: From the first lab session on, e-cig use after four hours of abstinence resulted in a reduction in cigarette craving which was of the same magnitude as when a cigarette was smoked, while eCO was unaffected. After two months, we observed that 34% of the e-cig groups had stopped smoking tobacco cigarettes, versus 0% of the control group (difference p < 0.01. After five months, the e-cig groups demonstrated a total quit-rate of 37%, whereas the control group showed a quit rate of 38% three months after initiating e-cig use. At

The paradox of public holidays: Hospital-treated self-harm and associated factors.

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Griffin, Eve; Dillon, Christina B; O'Regan, Grace; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

2017-08-15

Recent research on the patterns of self-harm around public holidays is lacking. This study used national data to examine the patterns of hospital-treated self-harm during public holidays, and to examine associated factors. Data on self-harm presentations to all emergency departments were obtained from the National Self-Harm Registry Ireland. The association between self-harm presentations and public holidays was examined using univariate and multivariate Poisson regression analyses. A total of 104,371 presentations of self-harm were recorded between 2007 and 2015. The mean number of self-harm presentations was 32 on public holidays. St. Patrick's Day had the highest number of presentations compared to all other public holidays, with a daily mean of 44 presentations. Across all years, self-harm presentations during public holidays had a 24% increased risk of involving alcohol consumption compared to all other days and this effect was most pronounced during the Christmas period. The association with alcohol remained significant at a multivariate level. Presentations on public holidays were more likely to attend out of normal working hours. An increase in male presentations involving self-cutting was observed on public holidays and there was an over-representation of males presenting for the first time. It is likely that extent of alcohol involvement in self-harm presentations reported here is an underestimate, as it was dependent on the information being recorded by the attending clinician. Public holidays are associated with an elevated number of self-harm presentations to hospital, with presentations to hospital involving alcohol significantly increased on these days. Hospital resources should be targeted to address increases during public holidays, including during out-of-hours. Involvement of alcohol may delay delivery of care to these patients in emergency settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Harming ourselves and defiling others: what determines a moral domain?

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Alek Chakroff

Full Text Available Recent work has distinguished "harm" from "purity" violations, but how does an act get classified as belonging to a domain in the first place? We demonstrate the impact of not only the kind of action (e.g., harmful versus impure but also its target (e.g., oneself versus another. Across two experiments, common signatures of harm and purity tracked with other-directed and self-directed actions, respectively. First, participants judged self-directed acts as primarily impure and other-directed acts as primarily harmful. Second, conservatism predicted harsher judgments of self-directed but not other-directed acts. Third, while participants delivered harsher judgments of intentional versus accidental acts, this effect was smaller for self-directed than other-directed acts. Finally, participants judged self-directed acts more harshly when focusing on the actor's character versus the action itself; other-directed acts elicited the opposite pattern. These findings suggest that moral domains are defined not only by the kind of action but also by the target of the action.

Child poverty. Ways forward for the paediatrician: A comprehensive overview of poverty reduction strategies requiring paediatric support.

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Sharma, Suparna; Ford-Jones, Elizabeth

2015-05-01

The harmful effects of child poverty are well documented. Despite this, progress in poverty reduction in Canada has been slow. A significant gap exists between what is known about eradicating poverty and its implementation. Paediatricians can play an important role in bridging this gap by understanding and advancing child poverty reduction. Establishment of a comprehensive national poverty reduction plan is essential to improving progress. The present review identifies the key components of an effective poverty reduction strategy. These elements include effective poverty screening, promoting healthy child development and readiness to learn, ensuring food and housing security, providing extended health care coverage for the uninsured and using place-based solutions and team-level interventions. Specific economic interventions are also reviewed. Addressing the social determinants of health in these ways is crucial to narrowing disparities in wealth and health so that all children in Canada reach their full potential.

Self-harm in patients with schizophrenia spectrum disorders.

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

2012-01-01

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

Harmful Tax Competition in the EU with Reference to Croatia

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Saša Drezgić

2005-08-01

Full Text Available The process of globalisation has led, among other things, to harmful tax competition. This paper considers the efforts within the EU in combating harmful tax competition (Code of Conduct on Business Taxation and their effects when taking into account the EU regulations in relation to state aids. Considering a number of problems in the implementation of the Code, and the numerous criticisms with regard to the validity of the combat against harmful tax competition – it is difficult to give a final answer about its success. Croatian tax system, and the corporation tax in particular, are analysed in the light of the aforementioned problems. The advantages of the equal treatment of domestic and foreign investors, as well as the certain elements of state aids in tax benefits, are pointed out.

What's the Harm? The Coverage of Ethics and Harm Avoidance in Research Methods Textbooks

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Dixon, Shane; Quirke, Linda

2018-01-01

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

Embodied harms: gender, shame, and technology-facilitated sexual violence.

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Henry, Nicola; Powell, Anastasia

2015-06-01

Criminality in cyberspace has been the subject of much debate since the 1990s, yet comparatively little attention has been paid to technology-facilitated sexual violence and harassment (TFSV). The aim of this article is to explore the ways in which retraditionalized gender hierarchies and inequalities are manifested in online contexts, and to conceptualize the cause and effects of TFSV as "embodied harms." We argue that problematic mind/body and online/off-line dualisms result in a failure to grasp the unique nature of embodied harms, precluding an adequate understanding and theorization of TFSV. © The Author(s) 2015.

Impact of Potassium Foliar Application in Alleviating the Harmful Effects of Salinity in Spinach

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Amirhooshang jalali

2017-02-01

Full Text Available Introduction: Spinach is an important leafy vegetable in the cold season, and despite the fact that is considered as low-calorie food source contains significant amount of minerals such as iron, and vitamin A and C. According to the University of Utah 3.8 dS m-1 is salinity tolerance threshold for the spinach and yield decrease that have been reported by 10%, 25% and 50% at 5.5, 7 and 8 dS m-1 salinity. The necessity to supply adequate potassium has been demonstrated in salinity conditions. In salt stress conditions, foliar application of K in spinach, reduces the harmful effects of salt and increase the ratio of potassium to sodium (1.61 to 2.72. Foliar application of K with prevent of potassium transfer from root to shoot is causing continuation of photosynthesis and reduce the effects of salinity. Absorption of potassium from the leaves depends on the type of used compound. In this context, characteristics of plant (leaves with a waxy composition, duration of growth and leaf area are important. 100 kg ha-1 of potassium in salt stress conditions by reducing the absorption of sodium, increased salt tolerance on the sunflower. Materials and Methods: In order to evaluate the foliar application of K on the yield and yield components of spinach in salt stress condition, a study was conducted in 2012 by using split plot randomized based on complete block design with four replications at Isfahan Agricultural and Natural Resources Research Station. Three levels of irrigation water salinity consisted of a control (2 dS m-1, well water with salinity (4 dS m-1 and well water with salinity (8dS m-1 arranged in main plots and two levels of control and foliar applications of potassium fertilizer containing potassium oxide solubility in water (2.5 ml per liter arranged in subplots. Statistical analysis was conducted by using SAS software and statistical tests were compared with Duncan at 5 percent. Result and Discussions: The results showed that the yield of

High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan

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Memon Ashraf

2007-02-01

Full Text Available Abstract Background Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004–5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004–5 also indicate 104/395 (26.3% IDUs HIV positive in the city. Methods We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October–November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA method. Syphilis tests (RPR & TPHA were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. Results Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5% IDUs. Over half 94 (58.3% reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%. 1 of 161 was HIV positive (0.6%. The prevalence of hepatitis B was 12 (7.5%, hepatitis C 151 (94.3% and syphilis 21 (13.1%. IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom

Clinical experience using intranasal ketamine in the treatment of pediatric bipolar disorder/fear of harm phenotype.

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Papolos, Demitri F; Teicher, Martin H; Faedda, Gianni L; Murphy, Patricia; Mattis, Steven

2013-05-01

Intravenous ketamine, a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist, has been shown to exert a rapid antidepressant effect in adults with treatment resistant depression. Children with bipolar disorder (BD) often respond poorly to pharmacotherapy, including polypharmacy. A pediatric-onset Fear of Harm (FOH) phenotype has been described, and is characterized by severe clinical features and resistance to accepted treatments for BD. The potential efficacy and safety of intranasal ketamine in children with BD with FOH-phenotype were assessed by a systematic retrospective chart review of a case series from the private practice of one of the authors, including cases with clear refractoriness to mood stabilizers, antipsychotics and benzodiazepines. A comparison was made between routinely collected symptom measures 1-2 weeks prior to and after the administration of ketamine, in 12 treatment-refractory youth, 10 males 2 females ages 6-19years. Ketamine administration was associated with a substantial reduction in measures of mania, fear of harm and aggression. Significant improvement was observed in mood, anxiety and behavioral symptoms, attention/executive functions, insomnia, parasomnias and sleep inertia. Treatment was generally well-tolerated. Intranasal ketamine administration in treatment-resistant youth with BD-FOH produced marked improvement in all symptomatic dimensions. A rapid, substantial therapeutic response, with only minimal side effects was observed. Formal clinical trials to assess safety and efficacy are warranted. Copyright © 2012 Elsevier B.V. All rights reserved.

Impulsivity and self-harm in adolescence: a systematic review.

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Lockwood, Joanna; Daley, David; Townsend, Ellen; Sayal, Kapil

2017-04-01

Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.

Adolescents' Deliberate Self-Harm, Interpersonal Stress, and the Moderating Effects of Self-Regulation: A Two-Wave Longitudinal Analysis

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Jutengren, Goran; Kerr, Margaret; Stattin, Hakan

2011-01-01

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

Fasting: Benefits and probable health harmfulness from the Islamic perspective

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Mahdi Ebrahimi

2015-06-01

Medical science can determine the effects and consequences of thirst and hunger during the month of Ramadan. In the religious perspective, it has been emphasized that fasting is for achieving the divine virtue, and this shouldn’t be in conflict with maintaining man’s health. Therefore, the conditions in which there is the probability of harmfulness to man’s health due to fasting, man shouldn’t fast. As a result, medical science could recognize the conditions in which there is probable harmfulness to man’s health.

The effect of humus on biological cleaning of soils - association of harmful organic substances from mineral oil contaminators

International Nuclear Information System (INIS)

Richnow, H.H.; Seifert, R.; Michaelis, W.

1993-01-01

The association of organic harmful substances and particularly their metabolites with the humin fraction is a process which has great ecological importance. The knowledge of the type and extent of such associations of harmful substances with the humin fraction of the soil plays a central part in the assessment of loading by harmful substances or the success of biological cleaning up measures. (orig.) [de

PREP advertisement features affect smokers’ beliefs regarding potential harm

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Strasser, Andrew A; Tang, Kathy Z; Tuller, Michael D; Cappella, Joseph N

2014-01-01

Background The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. Objective To determine the effect of altering advertisement features on smokers’ beliefs of the harm exposure from a PREP. Methods A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a “red” condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a “no text” condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using “incorrect,” “unsure” and “correct” as outcomes, and advertisement type and covariates as predictors, was used for analyses. Results Participants randomised to the “no text” advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, healthier and make smoking safer. Conclusions Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising. PMID:18768457

PREP advertisement features affect smokers' beliefs regarding potential harm.

Science.gov (United States)

Strasser, A A; Tang, K Z; Tuller, M D; Cappella, J N

2008-09-01

The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. To determine the effect of altering advertisement features on smokers' beliefs of the harm exposure from a PREP. A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a "red" condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a "no text" condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using "incorrect," "unsure" and "correct" as outcomes, and advertisement type and covariates as predictors, was used for analyses. Participants randomised to the "no text" advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer. Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

Alcohol and self-harm in Anuradhapura

DEFF Research Database (Denmark)

Sørensen, Jane Brandt; Jayasena, Chandima; Agampodi, Thilini Chanchala

the personal network of the drinker and lead to secondary traumatization. This can appear as emotional distress, financial difficulties and lead to domestic violence and in some cases self-harm and suicide. This interplay between alcohol and self-harm was investigated in individuals, families and communities...

Nonlinear charge reduction effect in strongly coupled plasmas

International Nuclear Information System (INIS)

Sarmah, D; Tessarotto, M; Salimullah, M

2006-01-01

The charge reduction effect, produced by the nonlinear Debye screening of high-Z charges occurring in strongly coupled plasmas, is investigated. An analytic asymptotic expression is obtained for the charge reduction factor (f c ) which determines the Debye-Hueckel potential generated by a charged test particle. Its relevant parametric dependencies are analysed and shown to predict a strong charge reduction effect in strongly coupled plasmas

Getting out of (self-) harm's way: A study of factors associated with self-harm among asylum seekers in Australian immigration detention.

Science.gov (United States)

Hedrick, Kyli

2017-07-01

The monitoring of self-harm among asylum seekers in Australian immigration detention has not occurred routinely or transparently. Thus whilst concerns regarding rates of self-harm among asylum seekers have been frequently raised, a paucity of systematic information regarding key factors associated with self-harm among asylum seekers exists. The present study was designed therefore to fill a number of gaps in government monitoring by examining the government's own archived self-harm data. Via a descriptive analysis of self-harm incident reports from all operational Australian immigration detention facilities over a 20-month period to May 2011, obtained under Freedom of Information, the present study identified that 959 incidents of self-harm occurred during this period. A gender bias towards men was also found. In addition to this, 10 different methods of self-harm were identified, the four most common being: cutting (47%), attempted hanging (19%), head hitting (12%) and self-poisoning by medication (6%). Seven different precipitating factors for self-harm were also identified, the four most common were: detention conditions (39%), processing arrangements (27%), negative decisions (24%) and family separation (3%). These findings point strongly to the health benefits of considering alternatives to held immigration detention, such as community based processing. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

How people who self-harm negotiate the inpatient environment: the mental healthcare workers perspective.

Science.gov (United States)

Thomas, J B; Haslam, C O

2017-09-01

WHAT IS KNOWN ABOUT THE SUBJECT?: Self-harm plays a function, commonly in the form of distress management. There has been little focussed exploration of how individuals who use self-harm to manage distress cope when prevented from self-harm in an inpatient environment and how staff respond to this issue. This paper uses the experiences of mental health staff to add to the existing knowledge that self-harm has a functional role and supports the notion that interventions for self-harm should focus on the origins of distress. It describes the potential consequences that focussing on prevention of self-harm as opposed to actually managing distress may have on service-users, how staff attempt to manage these consequences and factors that may impact on staff interventions to prevent further distress/harm. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that mental healthcare staff should aim to understand the function of self-harm, use this understanding to develop an individualized care plan with the aim of managing distress and identify barriers to the effectiveness of the interventions so they can be worked around. Introduction Literature describes self-harm as functional and meaningful. This creates difficulties for service-users detained in an inpatient environment where self-harm is prevented. Aim Mental healthcare staff were interviewed to build on existing evidence of issues with the prevention approach and explore, from a staff perspective, how self-harm prevention impacts on service-users, how they manage distress and how this impacts on staff and their approach to care. Methods Qualitative methods were used to allow unexpected themes to arise. Ten semi-structured interviews were carried out with mental healthcare staff and thematically analysed. Findings and discussion The findings provide new evidence on the benefits and limitations of the inpatient environment for individuals who self-harm. Findings indicate that being unable to self-harm can

Mitigating cyanobacterial harmful algal blooms in aquatic ecosystems impacted by climate change and anthropogenic nutrients.

Science.gov (United States)

Paerl, Hans W; Gardner, Wayne S; Havens, Karl E; Joyner, Alan R; McCarthy, Mark J; Newell, Silvia E; Qin, Boqiang; Scott, J Thad

2016-04-01

Mitigating the global expansion of cyanobacterial harmful blooms (CyanoHABs) is a major challenge facing researchers and resource managers. A variety of traditional (e.g., nutrient load reduction) and experimental (e.g., artificial mixing and flushing, omnivorous fish removal) approaches have been used to reduce bloom occurrences. Managers now face the additional effects of climate change on watershed hydrologic and nutrient loading dynamics, lake and estuary temperature, mixing regime, internal nutrient dynamics, and other factors. Those changes favor CyanoHABs over other phytoplankton and could influence the efficacy of control measures. Virtually all mitigation strategies are influenced by climate changes, which may require setting new nutrient input reduction targets and establishing nutrient-bloom thresholds for impacted waters. Physical-forcing mitigation techniques, such as flushing and artificial mixing, will need adjustments to deal with the ramifications of climate change. Here, we examine the suite of current mitigation strategies and the potential options for adapting and optimizing them in a world facing increasing human population pressure and climate change. Copyright © 2015 Elsevier B.V. All rights reserved.

A pragmatic randomised controlled trial and economic evaluation of family therapy versus treatment as usual for young people seen after second or subsequent episodes of self-harm: the Self-Harm Intervention - Family Therapy (SHIFT) trial.

Science.gov (United States)

Cottrell, David J; Wright-Hughes, Alex; Collinson, Michelle; Boston, Paula; Eisler, Ivan; Fortune, Sarah; Graham, Elizabeth H; Green, Jonathan; House, Allan O; Kerfoot, Michael; Owens, David W; Saloniki, Eirini-Christina; Simic, Mima; Tubeuf, Sandy; Farrin, Amanda J

2018-03-01

Self-harm in adolescents is common and repetition rates high. There is limited evidence of the effectiveness of interventions to reduce self-harm. To assess the clinical effectiveness and cost-effectiveness of family therapy (FT) compared with treatment as usual (TAU). A pragmatic, multicentre, individually randomised controlled trial of FT compared with TAU. Participants and therapists were aware of treatment allocation; researchers were blind to allocation. Child and Adolescent Mental Health Services (CAMHS) across three English regions. Young people aged 11-17 years who had self-harmed at least twice presenting to CAMHS following self-harm. Eight hundred and thirty-two participants were randomised to manualised FT delivered by trained and supervised family therapists ( n  = 415) or to usual care offered by local CAMHS following self-harm ( n  = 417). Rates of repetition of self-harm leading to hospital attendance 18 months after randomisation. Out of 832 young people, 212 (26.6%) experienced a primary outcome event: 118 out of 415 (28.4%) randomised to FT and 103 out of 417 (24.7%) randomised to TAU. There was no evidence of a statistically significant difference in repetition rates between groups (the hazard ratio for FT compared with TAU was 1.14, 95% confidence interval 0.87 to 1.49; p  = 0.3349). FT was not found to be cost-effective when compared with TAU in the base case and most sensitivity analyses. FT was dominated (less effective and more expensive) in the complete case. However, when young people's and caregivers' quality-adjusted life-year gains were combined, FT incurred higher costs and resulted in better health outcomes than TAU within the National Institute for Health and Care Excellence cost-effectiveness range. Significant interactions with treatment, indicating moderation, were detected for the unemotional subscale on the young person-reported Inventory of Callous-Unemotional Traits ( p  = 0.0104) and the affective involvement

Protective and harmful effects of physical activity for low back pain

DEFF Research Database (Denmark)

Pinheiro, Marina B.; Ferreira, Manuela L; Refshauge, Kathryn M

2016-01-01

Low back pain (LBP) is a major health problem globally, but approaches to prevention are not yet clearly identified because modifiable risk factors are not well established. Although physical activity is one promising modifiable risk factor, it is still not known what types and doses of physical...... activity are protective or harmful for LBP. The aim of this study is to establish the feasibility of a definitive cohort study that will investigate the effects of different types and doses of physical activity on the risk of developing recurrent LBP while accounting for genetic factors....... This will be a pilot longitudinal twin study and twins will be recruited from the Australian Twin Registry, and will be followed over 1 year. Thirty adult complete twin pairs with a history of LBP, but symptom free at recruitment, will be included. Data on physical activity (predictor) will be collected using four...

76 FR 5387 - Guidance for Industry and Food and Drug Administration Staff; “`Harmful and Potentially Harmful...

Science.gov (United States)

2011-01-31

... of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville... harmful constituents, including smoke constituents, to health in each tobacco product by brand and by quantity in each brand and subbrand.'' The guidance discusses the meaning of the term ``harmful and...

The flaws and human harms of animal experimentation.

Science.gov (United States)

Akhtar, Aysha

2015-10-01

Nonhuman animal ("animal") experimentation is typically defended by arguments that it is reliable, that animals provide sufficiently good models of human biology and diseases to yield relevant information, and that, consequently, its use provides major human health benefits. I demonstrate that a growing body of scientific literature critically assessing the validity of animal experimentation generally (and animal modeling specifically) raises important concerns about its reliability and predictive value for human outcomes and for understanding human physiology. The unreliability of animal experimentation across a wide range of areas undermines scientific arguments in favor of the practice. Additionally, I show how animal experimentation often significantly harms humans through misleading safety studies, potential abandonment of effective therapeutics, and direction of resources away from more effective testing methods. The resulting evidence suggests that the collective harms and costs to humans from animal experimentation outweigh potential benefits and that resources would be better invested in developing human-based testing methods.

A Model for Protective Behavior Against the Harmful Effects of Radiation for Radiological Technologists in Medical Radiological Technologists in Medical Centers

International Nuclear Information System (INIS)

Han, Eun Ok; Moon, In Ok

2009-01-01

Protective behavior of radiological technologists against radiation exposure is important to achieve reduction of the patient doses without compromising medical achievements. This study attempts to provide a basic model for the sophisticated intervention strategy that increases the level of the protective behavior of the technologists. The model was applied to real situations in Korea to demonstrate its utility. The results of this study are summarized as follows: First, the protective environment showed the highest relationship in the factors considered, r=0.637 (p<0.01). Secondly, the important factors were protective environment in environment characteristics, expectation for the protective behavior 0.228 (p<0.001), self efficacy 0.142 (p<0.001), and attitude for the protective behavior 0.178 (p<0.001) in personal characteristics, and daily patient -0.112 (p<0.001) and number of the participation in the education session for the protective behavior 0.074 (p<0.05). Thirdly, the final protective behavior model by a path analysis method had direct influence on the attitude 0.171 (p<0.01) and environment 0.405 (p<0.01) for the protective behavior, self efficacy 0.122 (p<0.01), expectation for the protective behavior 0.16 (p<0.01), and self-efficacy in the specialty of projects 0.154 (p<0.01). The acceptance of the model determined by the absolute fit index (GFI), 0.969, and by the incremental fit index (CFI), 0.943, showed very significant levels. Value of 2/df that is a factor applied to verify the acceptance of the model was 37, which implies that the result can be accepted in the desirable range. In addition, the parsimonious fit index configured by AGFI (0.890) and TLI (0.852) was also considered as a scale that accepts the model in practical applications. In case of the establishment of some specific intervention strategies based on the protective behavior model against harmful radiation effects proposed in this study, the strategy will provide an effective way

A Model for Protective Behavior Against the Harmful Effects of Radiation for Radiological Technologists in Medical Radiological Technologists in Medical Centers

Energy Technology Data Exchange (ETDEWEB)

Han, Eun Ok [Daegu Health College, Daegu (Korea, Republic of); Moon, In Ok [Ewha Woman' s University, Seoul (Korea, Republic of)

2009-09-15

Protective behavior of radiological technologists against radiation exposure is important to achieve reduction of the patient doses without compromising medical achievements. This study attempts to provide a basic model for the sophisticated intervention strategy that increases the level of the protective behavior of the technologists. The model was applied to real situations in Korea to demonstrate its utility. The results of this study are summarized as follows: First, the protective environment showed the highest relationship in the factors considered, r=0.637 (p<0.01). Secondly, the important factors were protective environment in environment characteristics, expectation for the protective behavior 0.228 (p<0.001), self efficacy 0.142 (p<0.001), and attitude for the protective behavior 0.178 (p<0.001) in personal characteristics, and daily patient -0.112 (p<0.001) and number of the participation in the education session for the protective behavior 0.074 (p<0.05). Thirdly, the final protective behavior model by a path analysis method had direct influence on the attitude 0.171 (p<0.01) and environment 0.405 (p<0.01) for the protective behavior, self efficacy 0.122 (p<0.01), expectation for the protective behavior 0.16 (p<0.01), and self-efficacy in the specialty of projects 0.154 (p<0.01). The acceptance of the model determined by the absolute fit index (GFI), 0.969, and by the incremental fit index (CFI), 0.943, showed very significant levels. Value of 2/df that is a factor applied to verify the acceptance of the model was 37, which implies that the result can be accepted in the desirable range. In addition, the parsimonious fit index configured by AGFI (0.890) and TLI (0.852) was also considered as a scale that accepts the model in practical applications. In case of the establishment of some specific intervention strategies based on the protective behavior model against harmful radiation effects proposed in this study, the strategy will provide an effective way

Intrapersonal factors of adolescents self-harming behaviour

OpenAIRE

Volodko, Liubov

2014-01-01

Researches often differentiate two groups of self-harming adolescents: those who attempters a suicide, and those who are harming themselves in a non-suicidal way, and they don‘t seek the death. However just a few community-based research, which would directly compare these groups, were done so far, and therefore information about the differences of the psychological peculiarity and self-harming behavior‘s internal factors between the groups is ambivalent. Lifestyle and Coping Skills Questionn...

Mental health nurses' attitudes toward self-harm: Curricular implications

Directory of Open Access Journals (Sweden)

David G. Shaw

2016-12-01

Conclusion: The FASH Model may inform future curriculum innovation. Adopting a holistic approach to education of nurses about self-harm may assist in developing attitudes and skills to make care provision more effective in secure mental health settings.

Reducing Alcohol Harm. International Benchmark

Science.gov (United States)

2008-01-01

last 10 years.12 Apart from the cost of medical care, the cost of alcohol use can also be associated with absenteeism and property damage. Alcohol...related harms cost British industry approximately £2 billion a year13 and the NHS about £1.7 billion a year14. Alcohol affects labour and productivity...Harmful drinking, Factsheet, June (2007). 15 “ Absenteeism due to drink”, Healthcare Today Magazine, September 19th, 2007. (Accessed on 19/09/07, at

Harmful algal blooms

Digital Repository Service at National Institute of Oceanography (India)

Bhat, S.R.; PrabhaDevi; DeSouza, L.; Verlecar, X.N.; Naik, C.G.

as harmful algal bloom. Bloom formation is a natural process and it enhances biological productivity, but turns worrisome when caused by toxic species, leading to massive fish mortalities and hazards to human health. Incidences of'red tide' are increasing...

Self-Harm Intervention: Family Therapy (SHIFT), a study protocol for a randomised controlled trial of family therapy versus treatment as usual for young people seen after a second or subsequent episode of self-harm.

Science.gov (United States)

Wright-Hughes, Alexandra; Graham, Elizabeth; Farrin, Amanda; Collinson, Michelle; Boston, Paula; Eisler, Ivan; Fortune, Sarah; Green, Jonathan; House, Allan; Owens, David; Simic, Mima; Tubeuf, Sandy; Nixon, Jane; McCabe, Christopher; Kerfoot, Michael; Cottrell, David

2015-11-04

Self-harm is common in the community with a lifetime prevalence of 13 %. It is associated with an elevated risk of overall mortality and suicide. People who harm themselves are high users of public services. Estimates of the 1-year risk of repetition vary between 5 and 15 % per year. Currently, limited evidence exists on the effectiveness of clinical interventions for young people who engage in self-harm. Recent reviews have failed to demonstrate any effect on reducing repetition of self-harm among adolescents receiving a range of treatment approaches. Family factors are particularly important risk factors associated with fatal and non-fatal self-harm among children and adolescents. Family therapy focuses on the relationships, roles and communication patterns between family members, but there have been relatively few studies of specifically family-focused interventions with this population. The Self-Harm Intervention: Family Therapy (SHIFT) Trial was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (grant no. 07/33/01) following a commissioned call for this research. SHIFT is a pragmatic, phase III, multicentre, individually randomised, controlled trial comparing Family Therapy (FT) with treatment as usual (TAU) for adolescents aged 11 to 17 who have engaged in at least two episodes of self-harm. Both therapeutic interventions were delivered within the National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) in England. Participants and therapists were, of necessity, aware of treatment allocation, but the researchers were blind to the allocations to allow unbiased collection of follow-up data. Primary outcome data (repetition of self-harm leading to hospital attendance 18 months post-randomisation) were collected from the Health and Social Care Information Centre (HSCIC), augmented by directed searches of medical records at Acute Trusts. Secondary outcome data (including suicidal intent

Epidemiologic perspectives on smokeless tobacco marketing and population harm.

Science.gov (United States)

Tomar, Scott L

2007-12-01

Moist snuff is the most popular form of orally-used smokeless tobacco in North America and parts of Europe. Because moist snuff use conveys lower risks for morbidity or mortality than does cigarette smoking, its use has been proposed as a tobacco harm-reduction strategy. This article critically reviews new and published epidemiologic evidence on health effects of moist snuff and its patterns of use relative to smoking in the United States, Sweden, and Norway. The available evidence suggests that: (1) moist snuff is a human carcinogen and toxin, (2) increased promotion of moist snuff has led to increased sales in those countries, (3) the uptake of moist snuff in these three countries during the past several decades has occurred primarily among adolescent and young adult men, (4) increased prevalence of snuff use has not been associated consistently with a reduction in smoking initiation or prevalence, (5) moist snuff use apparently plays a very minor role in smoking cessation in the U.S. and an inconsistent role in Sweden, (6) U.S. states with the lowest smoking prevalence also tend to have the lowest prevalence of snuff use, (7) there are no data on the efficacy of snuff as a smoking-cessation method, (8) the prevalence of cigarette smoking is relatively high among people who use snuff, and (9) snuff use is more consistently associated with partial substitution for smoking than with complete substitution. The evidence base for promotion of snuff use as a public health strategy is weak and inconsistent.

Household Factors Associated with Self-Harm in Johannesburg, South African Urban-Poor Households.

Directory of Open Access Journals (Sweden)

Nisha Naicker

Full Text Available Low and middle income countries bear the majority burden of self-harm, yet there is a paucity of evidence detailing risk-factors for self-harm in these populations. This study aims to identify environmental, socio-economic and demographic household-level risk factors for self-harm in five impoverished urban communities in Johannesburg, South Africa.Annual serial cross-sectional surveys were undertaken in five impoverished urban communities in Johannesburg for the Health, Environment and Development (HEAD study. Logistic regression analysis using the HEAD study data (2006-2011 was conducted to identify household-level risk factors associated with self-harm (defined as a self-reported case of a fatal or non-fatal suicide attempt within the household during the preceding year. Stepwise multivariate logistic regression analysis was employed to identify factors associated with self-harm.A total of 2 795 household interviews were conducted from 2006 to 2011. There was no significant trend in self-harm over time. Results from the final model showed that self-harm was significantly associated with households exposed to a violent crime during the past year (Adjusted Odds Ratio (AOR 5.72; 95% CI 1.64-19.97; that have a member suffering from a chronic medical condition (AOR 8.95; 95% 2.39-33.56 and households exposed to indoor smoking (AOR 4.39; CI 95% 1.14-16.47.This study provides evidence on household risk factors of self-harm in settings of urban poverty and has highlighted the potential for a more cost-effective approach to identifying those at risk of self-harm based on household level factors.

Benefits, harms and evidence - reflections from UK primary healthcare.

Science.gov (United States)

McCartney, Margaret

2018-01-01

In this paper I examine the relationship between benefits, harms and evidence-based medicine in the context of British primary healthcare. First, I will examine: 'What is a benefit and what is a harm?' Second, what should we know about where the balance of risk and benefit appear to lie? Third, what should we do with this knowledge, particularly in the context of the biopsychosocial gaze of primary care? I conclude that even perfect knowledge about benefits and harms requires to be translated in the context of the individual patient: it also requires to be interpreted according to what that persons' wishes are. By reiterating again and again how biases are stacked in favour of recommending treatments and interventions well beyond their rational evidence, my hope is that more honest medicine will result in less but higher value medicine. Stopping doing things that don't work, or work rarely, or come with an unacceptable burden of side effects or appointments should make room for the pleasure of practicing medicine. •Even perfect knowledge about benefits and harms requires to be translated in the context of the individual patient: it also requires to be interpreted according to what that persons' wishes are.•In the real, messy frontline world of general practice, we will always have uncertainty about where the balance of risk and benefit might lie.

"No Harm Done"

DEFF Research Database (Denmark)

Bloomfield, Kim

2016-01-01

It has been difficult to secure funding in Denmark to conduct research on third party harm from alcohol. The author relates her experiences in this area and challenges Danish society to examine how other societies have begun to examine this problem....

Handoffs causing patient harm: a survey of medical and surgical house staff.

Science.gov (United States)

Kitch, Barrett T; Cooper, Jeffrey B; Zapol, Warren M; Marder, Jessica E; Karson, Andrew; Hutter, Matt; Campbell, Eric G

2008-10-01

Communication lapses at the time of patient handoffs are believed to be common, and yet the frequency with which patients are harmed as a result of problematic handoffs is unknown. Resident physicians were surveyed about their handoffpractices and the frequency with which they perceive problems with handoffs lead to patient harm. A survey was conducted in 2006 of all resident physicians in internal medicine and general surgery at Massachusetts General Hospital (MGH) concerning the quality and effects of handoffs during their most recent inpatient rotations. Surveys were sent to 238 eligible residents; 161 responses were obtained (response rate, 67.6%). Fifty-nine percent of residents reported that one or more patients had been harmed during their most recent clinical rotation because of problematic handoffs, and 12% reported that this harm had been major. Overall quality of handoffs was reported to be fair or poor by 31% of residents. A minority of residents (26%) reported that handoffs usually or always took place in a quiet setting, and 37% reported that one or more interruptions during the receipt of handoffs occurred either most of the time or always. Although handoffs have long been recognized as potentially hazardous, further scrutiny of handoffs has followed recent reports that handoffs are often marked by missing, incomplete, or inaccurate information and are associated with adverse events. In this study, reports of harm to patients from problematic handoffs were common among residents in internal medicine and general surgery. Many best-practice recommendations for handoffs are not observed, although the extent to which improvement of these practices could reduce patient harm is not known. MGH has recently launched a handoff-safety educational program, along with other interventions designed to improve the safety and effectiveness of handoffs, for its house staff and clinical leadership.

Trends in self-harm in Kuala Lumpur, 2005–2011

OpenAIRE

Armitage, Christopher J.; Abdul Rahim, Wirda; Rowe, Richard; O'Connor, Rory C.

2016-01-01

Acts of self-harm are not routinely tracked in Malaysia. The present study investigates the prevalence of self-harm in Kuala Lumpur, Malaysia, over a 7-year period. The aims were to: (a) assess the prevalence of self-harm; (b) examine any changes over a period of 7 years, and (c) identify correlates of methods of self-harm. Data were extracted from the hospital records of Kuala Lumpur Hospital to review trends in self-harm between 2005 and 2011. There were 918 episodes of self-harm across the...

Level ofaggression and sense of control inself-harming youth receiving psychiatric treatment

Directory of Open Access Journals (Sweden)

Agnieszka Gmitrowicz

2011-12-01

Full Text Available Acts of autoaggression are a more and more frequent reason for psychiatric hospitalisation of adolescents. Within the last years the number of patients committing acts of deliberate self‑harm without suicidal intensions almost doubled. Deliberate self‑harm (DSH is defined as an act of direct destructiveness, in which a person wants to commit self‑harm immediately, without an intention of killing her/himself. In this paper we present the results of the study on the level and direction of aggression and the sense of control among inpatients (N=187 of the Department of Adolescent Psychiatry, Central University Hospital in Łódź. The studied group consisted of patients with deliberate self‑harm (DSH group, N=88, whereas the control group comprised the patients without such behaviours (non‑DSH group, N=99. For the study we recruited patients who were admitted to the hospital due to various mental disorders – 58 boys, mean age 16.81, SD=1.25, and 129 girls, mean age 16.5, SD=1.38. The mean age of all patients was 16.59 (SD=1.35. Patients with men‑ tal retardation were excluded from the study, due to expected difficulties with understanding the questions. We used the IPSA (Inventory of Psychological Syndrome of Aggression and “Delta” (test invented by Drwal, designed for evalua‑ tion of the sense of control. In the DSH group we found a significantly higher level of aggression, directed both inwards and outwards, a greater tendency of retaliatory behaviours and by far lower sense of internal control of one’s behaviours, as compared to the non‑DSH group. Therapeutic programs for patients with DSH should aim at the reduction of aggres‑ sion and the development of internal control over one’s behaviours.

Pregnancy Cravings Can Harm Your Oral Health

Science.gov (United States)

... 2018 About | Contact InfoBites Quick Reference Learn more Oral Health and Overal Health Gum Disease and Cardiovascular Health ... your desktop! more... Pregnancy Cravings Can Harm Your Oral Health Article Chapters Pregnancy Cravings Can Harm Your Oral ...

Self-harming behavior of a parent with borderline personality disorder assessed using revealed preference and attributional approaches: a case study.

Science.gov (United States)

Tustin, R Don

2002-08-01

This article discusses a case study involving a parent with Borderline Personality Disorder who exhibited self-harming behaviors. Assessment and intervention were based both on a review of the client's attributions about causes of her own behavior as being either internalizing or externalizing, and on a review of motivation of the behaviors using functional analysis. Antecedent situations for self-harming behaviors were identified to provide a basis for reviewing the client's attributions of reasons for disordered behavior. A new technique of functional analysis was applied using the principle of revealed preference arising from behavioral economics. Revealed preference identified outcomes that were valued by the client, enabling new responses to be identified to attain these reinforcers. Attribution re-training was provided. Significant reductions in self-harming behaviors were achieved during brief therapy and were maintained during follow-up.

A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown.

Directory of Open Access Journals (Sweden)

Amanda Marchant

Full Text Available Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people.We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis.Forty-six independent studies (51 articles of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants; negative for 18 studies (119524 participants; and mixed for 17 studies (35235 participants. In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified.There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach

A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown

Science.gov (United States)

Marchant, Amanda; Hawton, Keith; Stewart, Ann; Montgomery, Paul; Singaravelu, Vinod; Lloyd, Keith; Purdy, Nicola; Daine, Kate

2017-01-01

Background Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. Methods We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. Results Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. Conclusions There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery

A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown.

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Marchant, Amanda; Hawton, Keith; Stewart, Ann; Montgomery, Paul; Singaravelu, Vinod; Lloyd, Keith; Purdy, Nicola; Daine, Kate; John, Ann

2017-01-01

Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach). Young people

Internet Addiction among Adolescents May Predict Self-Harm/Suicidal Behavior: A Prospective Study.

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Pan, Pei-Yin; Yeh, Chin-Bin

2018-06-01

To explore the role of Internet addiction in the development of self-harm/suicidal behavior among adolescents after 1-year of follow-up. We conducted this 1-year, prospective cohort study of 1861 adolescents (mean age 15.93 years) attending a senior high school in Taiwan; 1735 respondents (93.2%) were classified as having no history of self-harm/suicidal attempts in the initial assessment and were referred to as the "noncase" cohort. The Chen Internet Addiction Scale was used to identify individuals with Internet addiction. The participants were evaluated for self-harm/suicidal behavior again 1 year later and the "noncase" cohort was selected for statistical analysis. To examine the relationship between Internet addiction and self-harm/suicidal behavior, multivariate logistic regression analysis was performed using Internet addiction at baseline as the predictor for newly developed self-harm/suicidal behavior in the next year, after adjustment for potential confounding variables. The prevalence rate of Internet addiction at baseline was 23.0%. There were 59 students (3.9%) who were identified as having developed new self-harm/suicidal behaviors on follow-up assessments. After controlling for the effects of potential confounders, the relative risk of newly emerging self-harm/suicidal behavior for participants who were classified as Internet addicted was 2.41 (95% CI 1.16-4.99, P = .018) when compared with those without Internet addiction. Our findings indicate that Internet addiction is prospectively associated with the incidence of self-harm/suicidal behavior in adolescents. Copyright © 2018 Elsevier Inc. All rights reserved.

Dose-related beneficial and harmful effects of gabapentin in postoperative pain management – post hoc analyses from a systematic review with meta-analyses and trial sequential analyses

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Fabritius ML

2017-11-01

Full Text Available Maria Louise Fabritius,1 Jørn Wetterslev,2 Ole Mathiesen,3 Jørgen B Dahl1 1Department of Anaesthesiology and Intensive Care, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark; 2Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark; 3Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark Background: During the last 15 years, gabapentin has become an established component of postoperative pain treatment. Gabapentin has been employed in a wide range of doses, but little is known about the optimal dose, providing the best balance between benefit and harm. This systematic review with meta-analyses aimed to explore the beneficial and harmful effects of various doses of gabapentin administered to surgical patients.Materials and methods: Data in this paper were derived from an original review, and the subgroup analyses were predefined in an International Prospective Register of Systematic Reviews published protocol: PROSPERO (ID: CRD42013006538. The methods followed Cochrane guidelines. The Cochrane Library’s CENTRAL, PubMed, EMBASE, Science Citation Index Expanded, Google Scholar, and FDA database were searched for relevant trials. Randomized clinical trials comparing gabapentin versus placebo were included. Four different dose intervals were investigated: 0–350, 351–700, 701–1050, and >1050 mg. Primary co-outcomes were 24-hour morphine consumption and serious adverse events (SAEs, with emphasis put on trials with low risk of bias. Results: One hundred and twenty-two randomized clinical trials, with 8466 patients, were included. Sixteen were overall low risk of bias. No consistent increase in morphine-sparing effect was observed with increasing doses of gabapentin from the trials with low risk of bias. Analyzing all trials, the smallest and the highest dose subgroups demonstrated numerically the most prominent reduction in morphine consumption

Effects of Beverages on Alcohol Metabolism: Potential Health Benefits and Harmful Impacts

Directory of Open Access Journals (Sweden)

Fang Wang

2016-03-01

Full Text Available Nonalcoholic beverages are usually consumed accompanying alcoholic drinks, and their effects on alcohol metabolism are unclear in vivo. In this study, the effects of 20 nonalcoholic beverages on alcohol metabolism and liver injury caused by alcohol were evaluated in mice. Kunming mice were orally fed with alcohol (52%, v/v and beverages. The concentrations of ethanol and acetaldehyde in blood as well as the activities of alcohol dehydrogenase (ADH and aldehyde dehydrogenase (ALDH in liver were assessed to indicate alcohol metabolism. The levels of aspartate aminotransferase (AST and alanine transaminase (ALT in serum as well as the levels of malonaldehyde (MDA and superoxide dismutase (SOD in liver were measured to reflect the alcohol-induced liver injury. The results showed that the treatment of soda water, green tea and honey chrysanthemum tea could accelerate ethanol metabolism and prevent liver injuries caused by alcohol when companied with excessive alcohol drinking. They might be potential dietary supplements for the alleviation of harmful effects from excessive alcohol consumption. On the contrary, some beverages such as fresh orange juice and red bull are not advised to drink when companied with alcohol consumption due to their adverse effects on ethanol induced liver injury.

Reducing the harms associated with risk assessments

International Nuclear Information System (INIS)

Montague, Peter

2004-01-01

Risk assessments are the intellectual products of dedicated public health and environmental professionals. Like many other products, risk assessments carry with them the potential for both good and harm. This paper briefly examines some of the harms to which risk assessments have contributed, and then suggests that the legal 'duty to warn' doctrine offers a logical and practical way to reduce some of these harms. The paper suggests concepts that could be incorporated into warnings accompanying every formal risk assessment as routine 'boiler plate' addenda, just as other potentially harmful products, such as lawn mowers and cook stoves, are accompanied by warnings. Finally, the paper briefly examines the 'Code of Ethics and Standards of Practice for Environmental Professionals' (promulgated by the National Association of Environmental Professionals) and shows that the suggested warnings are consistent with recommended practices for environmental professionals

The Association Between Secondhand Harms From Alcohol and Mental Health Outcomes Among Postsecondary Students.

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Thompson, Kara; Davis-MacNevin, Parnell; Teehan, Michael; Stewart, Sherry

2017-01-01

There is a paucity of research on the prevalence and consequences of secondhand harms from alcohol. The current study (a) investigated whether secondhand harms can be clustered into latent factors that reflect distinct but related types of harms and (b) examined the associations between experiencing secondhand harms and mental health outcomes, including anxiety, depression, and subjective mental well-being, among first-year Canadian postsecondary students. The moderating effect of living arrangement (i.e., living on campus or not) on the associations was also tested. The sample included 1,885 first-year undergraduate students (49.8% female; mean age = 18.31 years) from three Canadian universities. Exploratory and confirmatory factor analyses were used to determine the factor structure of the harms measure. Path analysis was used to assess the association between harms and mental health outcomes. Models accounted for age, sex, and frequency of heavy drinking. Seventy-one percent of the sample reported experiencing at least one type of secondhand harm. The harms examined clustered into two distinct but related factors: strains (e.g., interrupted sleep) and threats (e.g., being harassed or insulted). Both threats and strains were associated with higher levels of anxiety and depression and poorer subjective well-being. Associations were stronger for threats and did not differ by living arrangement. Experiencing secondhand harms from alcohol, particularly threats, may have negative implications for student mental health over and above students' own drinking. Programs and policies on university campuses targeting both alcohol use and mental health should consider how to reduce both the prevalence and impact of secondhand harms from alcohol on students.

Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis.

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Ferner, R E; Aronson, J K