28 CFR 553.11 - Limitations on inmate personal property.

Science.gov (United States)

2010-07-01

... MANAGEMENT INMATE PROPERTY Inmate Personal Property § 553.11 Limitations on inmate personal property. (a... the inmate's own risk. Staff shall require that hobby shop items be removed from the living area when... inmate must be able to demonstrate proof of ownership. An inmate who purchases a radio or watch through a...

Transgender Inmates in Prisons.

Science.gov (United States)

Routh, Douglas; Abess, Gassan; Makin, David; Stohr, Mary K; Hemmens, Craig; Yoo, Jihye

2017-05-01

Transgender inmates provide a conundrum for correctional staff, particularly when it comes to classification, victimization, and medical and health issues. Using LexisNexis and WestLaw and state Department of Corrections (DOC) information, we collected state statutes and DOC policies concerning transgender inmates. We utilized academic legal research with content analysis to determine whether a statute or policy addressed issues concerning classification procedures, access to counseling services, the initiation and continuation of hormone therapy, and sex reassignment surgery. We found that while more states are providing either statutory or policy guidelines for transgender inmates, a number of states are lagging behind and there is a shortage of guidance dealing with the medical issues related to being transgender.

The vitamin D status of prison inmates.

Directory of Open Access Journals (Sweden)

Benjamin Udoka Nwosu

Full Text Available There is no comprehensive, systematic analysis of the vitamin D status of prisoners in the scientific literature.To investigate the vitamin D status and its determinants in US prison inmates.Given the uniformity of dietary intake amongst inmates, vitamin D status will be determined by non-dietary factors such as skin pigmentation, security level-, and the duration of incarceration.A retrospective study of 526 inmates (males, n=502, age 48.6 ± 12.5 years; females, n=24, age 44.1 ± 12.2 in Massachusetts prisons. Vitamin D sufficiency, insufficiency, and deficiency were respectively defined as a 25(OHD concentration 75 nmol/L; 50 to 75 nmol/L; and <50 nmol/L. The Massachusetts Department of Correction Statement of Nutritional Adequacy stated that each inmate received the recommended daily allowance of vitamin D daily. Security level of incarceration was designated as minimum, medium, and maximum. Racial groups were categorized as Black, white, Asian, and Others.Serum 25(OHD levels peaked in summer and autumn, and decreased in winter and spring. Vitamin D deficiency occurred in 50.5% of blacks, 29.3% of whites, and 14.3% of Asian inmates (p=0.007. Black inmates had significantly lower serum 25(OHD level than white inmates at the maximum security level (p=0.015, medium security level (p=0.001, but not at the minimum security level (p=0.40. After adjusting for covariates black inmates at a maximum security level had a four-fold higher risk for vitamin D deficiency than white inmates at the same security level (OR 3.9 [95% CI 1.3-11.7].The vitamin D status of prison inmates is determined by skin pigmentation, seasons, and the security level of incarceration.

28 CFR 545.23 - Inmate work/program assignment.

Science.gov (United States)

2010-07-01

... community living area, unless the pretrial inmate has signed a waiver of his or her right not to work (see... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmate work/program assignment. 545.23... WORK AND COMPENSATION Inmate Work and Performance Pay Program § 545.23 Inmate work/program assignment...

Patient Simulation for Assessment of Layperson Management of Opioid Overdose with Intranasal Naloxone in a Recently-Released Prisoner Cohort

Science.gov (United States)

Kobayashi, Leo; Green, Traci C.; Bowman, Sarah E.; Ray, Madeline C.; McKenzie, Michelle S.; Rich, Josiah D.

2016-01-01

Introduction Investigators applied simulation to an experimental program that educated, trained and assessed at-risk, volunteering prisoners on opioid overdose (OD) prevention, recognition and layperson management with intranasal (IN) naloxone. Methods Consenting inmates were assessed for OD-related experience and knowledge then exposed on-site to standardized didactics and educational DVD (without simulation). Subjects were provided with IN naloxone kits at time of release and scheduled for post-release assessment. At follow-up, subjects were evaluated for their performance of layperson opioid OD resuscitative skills during video-recorded simulations. Two investigators independently scored each subject’s resuscitative actions with a 21-item checklist; post-hoc video reviews were separately completed to adjudicate subjects’ interactions for overall benefit or harm. Results One hundred and three prisoners completed the baseline assessment and study intervention then were prescribed IN naloxone kits. One-month follow-up and simulation data were available for 85 subjects (82.5% of trained recruits) who had been released and resided in the community. Subjects’ simulation checklist median score was 12.0 (IQR 11.0–15.0) out of 21 total indicated actions. Forty-four participants (51.8%) correctly administered naloxone; 16 additional subjects (18.8%) suboptimally administered naloxone. Non-indicated actions, primarily chest compressions, were observed in 49.4% of simulations. Simulated resuscitative actions by 80 subjects (94.1%) were determined post-hoc to be beneficial overall for patients overdosing on opioids. Conclusions As part of an opioid OD prevention research program for at-risk inmates, investigators applied simulation to 1-month follow-up assessments of knowledge retention and skills acquisition in post-release participants. Simulation supplemented traditional research tools for investigation of layperson OD management. PMID:28146450

Does Witnessing Animal Cruelty and Being Abused During Childhood Predict the Initial Age and Recurrence of Committing Childhood Animal Cruelty?

Science.gov (United States)

Browne, John A; Hensley, Christopher; McGuffee, Karen M

2017-12-01

The goal of the current study was to examine the association between demographic characteristics and childhood experiences on the respondents' age of committing childhood animal cruelty and its recurrency. Using data collected from 257 male inmates at a Southern medium-security state prison, the current study seeks to replicate a study by Hensley, Tallichet, and Dutkiewicz. Results revealed that those respondents who were physically abused as children reported engaging in recurrent animal cruelty. The younger the age of respondent for first witnessing animal cruelty, the sooner his initiation to hurting and killing animals occurred. In addition, those who reported witnessing a parent commit acts of animal abuse reported that they committed animal abuse themselves at an older age, while those who witnessed a brother/sister commit animal abuse reported engaging in it at an earlier age. Therefore, physical abuse and witnessing primary socializers engage in animal abuse seem to be important in understanding the respondents' age of onset and repeated childhood animal cruelty.

Risk factors for opioid overdose and awareness of overdose risk among veterans prescribed chronic opioids for addiction or pain.

Science.gov (United States)

Wilder, Christine M; Miller, Shannon C; Tiffany, Elizabeth; Winhusen, Theresa; Winstanley, Erin L; Stein, Michael D

2016-01-01

Rising overdose fatalities among U.S. veterans suggest veterans taking prescription opioids may be at risk for overdose. However, it is unclear whether veterans prescribed chronic opioids are aware of this risk. The objective of this study was to identify risk factors and determine awareness of risk for opioid overdose in veterans treated with opioids for chronic pain, using veterans treated with methadone or buprenorphine for opioid use disorder as a high-risk comparator group. In the current study, 90 veterans on chronic opioid medication, for either opioid use disorder or pain management, completed a questionnaire assessing risk factors, knowledge, and self-estimate of risk for overdose. Nearly all veterans in both groups had multiple overdose risk factors, although individuals in the pain management group had on average a significantly lower total number of risk factors than did individuals in the opioid use disorder group (5.9 versus 8.5, p opioid overdose risk factors (12.1 versus 13.5, p opioid overdose risk factors. Our results suggest that veterans in both groups underestimated their risk for opioid overdose. Expansion of overdose education to include individuals on chronic opioids for pain management and a shift in educational approaches to overdose prevention may be indicated.

Exploring the age of onset and recurrence of childhood animal cruelty: can animal cruelty be learned from witnessing others commit it?

Science.gov (United States)

Hensley, Christopher; Tallichet, Suzanne E; Dutkiewicz, Erik L

2012-06-01

Despite recent research, few studies have examined the specific social contexts in which animal cruelty may be learned. Using data collected from 180 inmates at a medium- and maximum-security prison in a southern state, the authors seek to replicate findings from the Hensley and Tallichet study that examined the potential for the onset and recurrence of childhood animal cruelty to become a learned behavior, specifically in terms of demographic characteristics and childhood experiences with witnessing animal abuse. In the current study, those who were younger when they first witnessed animal cruelty initially hurt or killed animals themselves at a younger age. Respondents who had witnessed a family member hurt or kill animals reported engaging in recurrent animal cruelty and were older when they committed their first act of animal cruelty.

Sexual Violence Among Male Inmates.

Science.gov (United States)

Hilinski-Rosick, Carly M; Freiburger, Tina L

2018-04-01

Inmate misconduct has been a widely studied topic for many decades. General studies of misconduct have found that there are certain factors that contribute to misconduct, including age, gender, sentence length, and facility type. Few studies, however, have examined the factors predicting sexual offenses in a prison conduct. Although many studies of victims of sexual offenses in prison have been conducted, there is a lack of studies examining the perpetrators of prison sexual violence. The current study attempted to expand this body of literature by examining the correlates of sexual misconduct among a sample of male inmates incarcerated in the state of North Carolina during 2010. Deprivation and importation theories of inmate behavior were used to guide the analysis, and measures of deprivation and importation factors were both included in the analytical models. Findings indicate that Black, nonmarried, younger inmates, who had more previous incarcerations and had been incarcerated longer, had greater odds of having a sexual infraction. Additional findings, as well as policy implications, are discussed.

28 CFR 345.42 - Inmate worker dismissal.

Science.gov (United States)

2010-07-01

... worker dismissal. The SOI may remove an inmate from Industries work status in cooperation with the unit team. (a) The SOI may remove an inmate from FPI work status according to the conditions outlined in the pay and benefits section of this policy and in cooperation with the unit team. (b) An inmate may be...

47 CFR 64.710 - Operator services for prison inmate phones.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Operator services for prison inmate phones. 64... services for prison inmate phones. (a) Each provider of inmate operator services shall: (1) Identify itself... authorities of a prison or other correctional institution for use by inmates. (3) Inmate operator services...

Drug overdose surveillance using hospital discharge data.

Science.gov (United States)

Slavova, Svetla; Bunn, Terry L; Talbert, Jeffery

2014-01-01

We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000-2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison.

Drug Overdose Surveillance Using Hospital Discharge Data

Science.gov (United States)

Bunn, Terry L.; Talbert, Jeffery

2014-01-01

Objectives We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. Methods We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000–2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Results Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. Conclusion The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison. PMID:25177055

Acute sirolimus overdose: a multicenter case series.

Directory of Open Access Journals (Sweden)

Alessandro Ceschi

Full Text Available There are few data relating to sirolimus overdose in the medical literature. Our objectives were to describe all cases of overdose with sirolimus reported to Swiss, German and Austrian Poisons Centres between 2002-2013.An observational case-series analysis was performed to determine circumstances, magnitude, management and outcome of sirolimus overdose.Five cases of acute sirolimus overdose were reported--three in young children and two in adults. Four were accidental and one was with suicidal intent. Two patients developed symptoms probably related to sirolimus overdose: mild elevation of alkaline phosphatase, fever and gastroenteritis in a 2.5-year-old male who ingested 3 mg, and mild changes in total cholesterol in an 18-year-old female after ingestion of 103 mg. None of these events were life-threatening. Serial blood concentration measurements were performed starting 24 h after ingestion of 103 mg in a single case, and these followed a similar pharmacokinetic time-course to measurements taken after dosing in the therapeutic range.Acute sirolimus overdose occurred accidentally in the majority of cases. Even large overdoses appeared to be well-tolerated, however children might be at greater risk of developing complications. Further study of sirolimus overdose is needed.

Overdose pattern and outcome in paracetamol-induced acute severe hepatotoxicity

Science.gov (United States)

Craig, Darren G N; Bates, Caroline M; Davidson, Janice S; Martin, Kirsty G; Hayes, Peter C; Simpson, Kenneth J

2011-01-01

AIMS Paracetamol (acetaminophen) hepatotoxicity is the commonest cause of acute liver failure (ALF) in the UK. Conflicting data regarding the outcomes of paracetamol-induced ALF resulting from different overdose patterns are reported. METHODS Using prospectively defined criteria, we have analysed the impact of overdose pattern upon outcome in a cohort of 938 acute severe liver injury patients admitted to the Scottish Liver Transplantation Unit. RESULTS Between 1992 and 2008, 663 patients were admitted with paracetamol-induced acute severe liver injury. Of these patients, 500 (75.4%) had taken an intentional paracetamol overdose, whilst 110 (16.6%) had taken an unintentional overdose. No clear overdose pattern could be determined in 53 (8.0%). Unintentional overdose patients were significantly older, more likely to abuse alcohol, and more commonly overdosed on compound narcotic/paracetamol analgesics compared with intentional overdose patients. Unintentional overdoses had significantly lower admission paracetamol and alanine aminotransferase concentrations compared with intentional overdoses. However, unintentional overdoses had greater organ dysfunction at admission, and subsequently higher mortality (unintentional 42/110 (38.2%), intentional 128/500 (25.6%), P paracetamol overdose is associated with increased mortality compared with intentional paracetamol overdose, despite lower admission paracetamol concentrations. Alternative prognostic criteria may be required for unintentional paracetamol overdoses. PMID:21219409

The vitamin D status of prison inmates.

Science.gov (United States)

Nwosu, Benjamin Udoka; Maranda, Louise; Berry, Rosalie; Colocino, Barbara; Flores, Carlos D; Folkman, Kerry; Groblewski, Thomas; Ruze, Patricia

2014-01-01

There is no comprehensive, systematic analysis of the vitamin D status of prisoners in the scientific literature. To investigate the vitamin D status and its determinants in US prison inmates. Given the uniformity of dietary intake amongst inmates, vitamin D status will be determined by non-dietary factors such as skin pigmentation, security level-, and the duration of incarceration. A retrospective study of 526 inmates (males, n=502, age 48.6 ± 12.5 years; females, n=24, age 44.1 ± 12.2) in Massachusetts prisons. Vitamin D sufficiency, insufficiency, and deficiency were respectively defined as a 25(OH)D concentration 75 nmol/L; 50 to 75 nmol/L; and prison inmates is determined by skin pigmentation, seasons, and the security level of incarceration.

Contac overdose

Science.gov (United States)

Symptoms of a Contac overdose include: Blurred vision Depression Delirium Disorientation, nervousness, hallucinations Drowsiness Enlarged pupils Fever Inability to urinate or completely empty the bladder Increased ...

Paracetamol overdose: the liver unit perspective.

LENUS (Irish Health Repository)

Iqbal, M

2012-09-01

Liver failure resulting from deliberate or accidental paracetamol overdose continues to be an important reason for referral to liver transplant centres. Severe hepatic dysfunction often appears 72-96 h after overdose. Liver injury can be prevented by timely administration of the specific antidote, N-acetylcysteine. Unfortunately, administration of N-acetylcysteine is frequently delayed due to late presentation or late administration. While N-acetylcysteine works best if given within 8 h of overdose, it is beneficial at any time period and should always be given if there is concern about significant overdose, irrespective of interval from time of ingestion. Early discussion with liver transplant unit is suggested if there is any doubt or evidence of liver failure.

Personality Traits among Inmates of Aba Prison in Nigeria: Influence ...

African Journals Online (AJOL)

Aim: To assess the personality traits of inmates in Aba prison. Methods: Four hundred and six inmates were studied. Each inmate completed a semi-structured sociodemographic questionnaire and personality traits were assessed with the 44-item Big Five Inventory. Results: The majority (72.7%) of the inmates were within ...

Administrative Segregation for Mentally Ill Inmates

Science.gov (United States)

O'Keefe, Maureen L.

2007-01-01

Largely the result of prison officials needing to safely and efficiently manage a volatile inmate population, administrative segregation or supermax facilities are criticized as violating basic human needs, particularly for mentally ill inmates. The present study compared Colorado offenders with mental illness (OMIs) to nonOMIs in segregated and…

Prescription Painkiller Overdoses PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the July 2013 CDC Vital Signs report. Prescription painkiller overdoses are an under-recognized and growing problem among women. This program includes things that women and health care providers can do to reduce the risk of overdose.

28 CFR 545.27 - Inmate vacations.

Science.gov (United States)

2010-07-01

... full-time for 12 consecutive months on an institution work assignment is eligible to take a five-day... shall approve the request if the inmate's work performance qualifies for vacation credit. (b) Staff... favorable adjustment (custody reduction); or (2) The inmate is placed in a new work assignment in the...

GUIDE FOR INMATE EDUCATION. REVISED EDITION.

Science.gov (United States)

WILKINSON, FRED T.

AN EDUCATIONAL PROGRAM IN AN INSTITUTION CONCERNED WITH THE REHABILITATION OF AN INMATE MUST BE SOCIALLY AND VOCATIONALLY ORIENTED, WITH VOCATIONAL EMPHASIS ON THE TOTAL EDUCATIONAL PROCESS. SINCE THE MAJORITY OF INMATES ARE FUNCTIONALLY ILLITERATE, AND SINCE 90 PERCENT WILL EVENTUALLY RETURN TO SOCIETY, COURSES IN GENERAL EDUCATION ARE INTERWOVEN…

28 CFR 522.14 - Inmates serving civil contempt commitments.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmates serving civil contempt... ADMISSION, CLASSIFICATION, AND TRANSFER ADMISSION TO INSTITUTION Civil Contempt of Court Commitments § 522.14 Inmates serving civil contempt commitments. We treat inmates serving civil contempt commitments in...

Heroin and fentanyl overdoses in Kentucky: Epidemiology and surveillance.

Science.gov (United States)

Slavova, Svetla; Costich, Julia F; Bunn, Terry L; Luu, Huong; Singleton, Michael; Hargrove, Sarah L; Triplett, Jeremy S; Quesinberry, Dana; Ralston, William; Ingram, Van

2017-08-01

The study aims to describe recent changes in Kentucky's drug overdose trends related to increased heroin and fentanyl involvement, and to discuss future directions for improved drug overdose surveillance. The study used multiple data sources (death certificates, postmortem toxicology results, emergency department [ED] records, law enforcement drug submissions, and prescription drug monitoring records) to describe temporal, geographic, and demographic changes in drug overdoses in Kentucky. Fentanyl- and heroin-related overdose death rates increased across all age groups from years 2011 to 2015 with the highest rates consistently among 25-34-year-olds. The majority of the heroin and fentanyl overdose decedents had histories of substantial exposures to legally acquired prescription opioids. Law enforcement drug submission data were strongly correlated with drug overdose ED and mortality data. The 2016 crude rate of heroin-related overdose ED visits was 104/100,000, a 68% increase from 2015 (62/100,000). More fentanyl-related overdose deaths were reported between October, 2015, and September, 2016, than ED visits, in striking contrast with the observed ratio of >10 to 1 heroin-related overdose ED visits to deaths. Many fatal fentanyl overdoses were associated with heroin adulterated with fentanyl; fentanyl and other synthetic drugs. In order to inform coordinated public health and safety responses, drug overdose surveillance must move from a reactive to a proactive mode, utilizing the infrastructure for electronic health records. Copyright © 2017 Elsevier B.V. All rights reserved.

75 FR 9544 - Inmate Work and Performance Pay Program

Science.gov (United States)

2010-03-03

... inmate may receive performance pay only for that portion of the month that the inmate was working... Inmate Work and Performance Pay Program AGENCY: Bureau of Prisons, Justice. ACTION: Proposed rule... work and performance pay by removing redundant language and provisions that relate solely to staff...

Caffeine overdose

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002579.htm Caffeine overdose To use the sharing features on this page, please enable JavaScript. Caffeine is a substance that exists naturally in certain ...

Dextromethorphan overdose

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002628.htm Dextromethorphan overdose To use the sharing features on this page, please enable JavaScript. Dextromethorphan is a medicine that helps stop coughing. It ...

Piroxicam overdose

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002534.htm Piroxicam overdose To use the sharing features on this page, please enable JavaScript. Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) used ...

Ibuprofen overdose

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002655.htm Ibuprofen overdose To use the sharing features on this page, please enable JavaScript. Ibuprofen is a type of nonsteroidal anti-inflammatory drug ( ...

28 CFR 541.48 - Search of control unit inmates.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Search of control unit inmates. 541.48... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.48 Search of control unit inmates. (a) The Warden at an institution housing a control unit may order a digital or simple instrument...

Hyponatremia following acute overdose with paroxetine

DEFF Research Database (Denmark)

Johnsen, C R; Hoejlyng, N

1998-01-01

This case illustrates severe hyponatremia following an acute overdose of paroxetine. An 83-year-old woman was admitted to our hospital after an attempt to commit suicide. She had consumed an overdose of 360 mg paroxetine. The treatment was started 3 days previously with 10 mg/day because of regular...... suffering from obsessive and suicidal thoughts. An initial sign of overdose was excessive vomiting. Five days late she developed hyponatremia (serum sodium 112 mmol/l) with somnolence, confusion, muscle spasms, dehydration of arms and legs and slow reflexes. Ecchymoses and myxoedema were also observed...

Mental Health Among Jail and Prison Inmates

Science.gov (United States)

Yi, Youngmin; Turney, Kristin; Wildeman, Christopher

2016-01-01

Previous studies provide insight into the mental health of jail and prison inmates, but this research does not compare the two groups of inmates. Using data from the Fragile Families and Child Wellbeing Study, this article examines how the association between incarceration and self-reported mental health varies by facility type, net of an array of demographic and socioeconomic characteristics. Both jail and prison inmates report high rates of depression, life dissatisfaction, heavy drinking, and illicit drug use. In adjusted logistic regression models, those incarcerated in jails, compared with those not incarcerated, have higher odds of depression (odds ratio [OR] = 5.06, 90% confidence interval [CI; 1.96, 13.11]), life dissatisfaction (OR = 3.59, 90% CI [1.40, 9.24]), and recent illicit drug use (OR = 4.03, 90% CI [1.49, 10.58]). Those incarcerated in prisons have higher odds of life dissatisfaction (OR = 3.88, 90% CI [2.16, 6.94]) and lower odds of recent heavy drinking (OR = 0.32, 90% CI [0.13, 0.81]) compared with those not incarcerated. Furthermore, jail inmates report significantly more depression, heavy drinking, and illicit drug use than prison inmates. These results suggest the association between incarceration and mental health may vary substantially across facilities and highlight the importance of expanding research in this area beyond studies of prisons. The results also indicate that public health professionals in the correctional system should be especially attuned to the disproportionately high levels of poor mental health outcomes among jail inmates. PMID:27932588

Mental Health Among Jail and Prison Inmates.

Science.gov (United States)

Yi, Youngmin; Turney, Kristin; Wildeman, Christopher

2017-07-01

Previous studies provide insight into the mental health of jail and prison inmates, but this research does not compare the two groups of inmates. Using data from the Fragile Families and Child Wellbeing Study, this article examines how the association between incarceration and self-reported mental health varies by facility type, net of an array of demographic and socioeconomic characteristics. Both jail and prison inmates report high rates of depression, life dissatisfaction, heavy drinking, and illicit drug use. In adjusted logistic regression models, those incarcerated in jails, compared with those not incarcerated, have higher odds of depression (odds ratio [ OR] = 5.06, 90% confidence interval [CI; 1.96, 13.11]), life dissatisfaction ( OR = 3.59, 90% CI [1.40, 9.24]), and recent illicit drug use ( OR = 4.03, 90% CI [1.49, 10.58]). Those incarcerated in prisons have higher odds of life dissatisfaction ( OR = 3.88, 90% CI [2.16, 6.94]) and lower odds of recent heavy drinking ( OR = 0.32, 90% CI [0.13, 0.81]) compared with those not incarcerated. Furthermore, jail inmates report significantly more depression, heavy drinking, and illicit drug use than prison inmates. These results suggest the association between incarceration and mental health may vary substantially across facilities and highlight the importance of expanding research in this area beyond studies of prisons. The results also indicate that public health professionals in the correctional system should be especially attuned to the disproportionately high levels of poor mental health outcomes among jail inmates.

Sexual Health of Prison Inmates: A Case Study of Kano Central ...

African Journals Online (AJOL)

Sexual and reproductive health of prison inmates suffers from serious neglect in Nigeria. This mixed method study examined prison officials and 160 inmates on prison law and administration, and sexual health of inmates. Most of the inmates examined (82.5%) reported having frequent sexual desire. Wet dreams (46.2%) ...

Vital Signs-Preventing Prescription Drug Overdose

Centers for Disease Control (CDC) Podcasts

This podcast is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.

Nurses' experience of caring for inmate patients.

Science.gov (United States)

Weiskopf, Constance S

2005-02-01

The aim of this paper is to report the findings of a study of the experience of caring for prisoners through examining the everyday experience of nurses' delivering health care to inmate patients in a correctional setting. Prisons are most often viewed as places for punishment, while the goals of health and healing, and prevention of diseases in correctional facilities are often neglected. Nurses who deliver health care to prisoners are challenged to do so in a caring relationship that will facilitate their health and healing. The literature on the nature of prison nursing indicates that delivering health care to inmates must be carefully balanced against the need for security, and is affected by factors such as custody staff values, staff education, nursing management, and organizational practices. In-depth interviews were carried out with nine Registered Nurses who had been employed in a variety of correctional institutions throughout their careers, and analysed thematically using Colaizzi's phenomenological method. Findings. Nurses' caring was experienced as an attempt to negotiate the boundaries between the cultures of custody and caring. Facing complex challenges and a number of limitations on the nurse-patient relationship, nurses strived to find a way to care for their inmate patients. Environmental risk meant that caution and vigilance were essential and these nurses demonstrated courage and persevered for the sake of their inmate patients. The findings make clear the challenging and frustrating experience of nurses' caring for inmate patients in restrictive settings. As a result, there are implications for nursing practice, education, and research to assure the best possible health outcomes for inmate patients, the integrity of caring nursing practice, and the safety of both nurses and patients.

Preventing Prescription Drug Overdose PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.

Prescription Painkiller Overdoses PSA (:60)

Centers for Disease Control (CDC) Podcasts

2013-07-02

This 60 second public service announcement is based on the July 2013 CDC Vital Signs report. Prescription painkiller overdoses are an under-recognized and growing problem among women. This program includes things that women and health care providers can do to reduce the risk of overdose.  Created: 7/2/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/2/2013.

Association of elevated ambient temperature with death from cocaine overdose.

Science.gov (United States)

Auger, Nathalie; Bilodeau-Bertrand, Marianne; Labesse, Maud Emmanuelle; Kosatsky, Tom

2017-09-01

Ecologic data suggest that elevated outdoor temperature is correlated with mortality rates from cocaine overdose. Using non-aggregated death records, we studied the association of hot temperatures with risk of death from cocaine overdose. We carried out a case-crossover study of all deaths from cocaine or other drug overdose between the months of May and September, from 2000 through 2013 in Quebec, Canada. We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between maximum outdoor temperature and death from cocaine or other drug overdose. The main outcome measure was death from cocaine overdose as a function of maximum temperature the day of death and the days immediately preceding death. There were 316 deaths from cocaine overdose and 446 from other drug overdoses during the study. Elevated temperature the preceding week was associated with the likelihood of death from cocaine but not other drug overdose. Compared with 20°C, a maximum weekly temperature of 30°C was associated with an OR of 2.07 for death from cocaine overdose (95% CI 1.15-3.73), but an OR of 1.03 for other drug overdoses (95% CI 0.60-1.75). Associations for cocaine overdose were present with maximum daily temperature the day of and each of the three days preceding death. Elevated ambient temperature is associated with the risk of death from cocaine overdose. Public health practitioners and drug users should be aware of the added risk of mortality when cocaine is used during hot days. Copyright © 2017 Elsevier B.V. All rights reserved.

The opioid overdose epidemic: opportunities for pharmacists

Directory of Open Access Journals (Sweden)

Wu LT

2017-07-01

Full Text Available Li-Tzy Wu,1–4 Udi E Ghitza,5 Anne L Burns,6 Paolo Mannelli,1 1Department of Psychiatry and Behavioral Sciences, 2Department of Medicine, 3Duke Clinical Research Institute, Duke University School of Medicine, 4Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, NC, 5Center for Clinical Trials Network, National Institute on Drug Abuse, Bethesda, MD, 6American Pharmacists Association, Washington, DC, USA The USA is experiencing an opioid overdose epidemic. It has been driven largely by prescription opioids and intensified by a surge of illicit opioids (e.g., heroin and fentanyl.1,2 Drug-involved overdose, mainly opioids (e.g., prescription opioids and heroin, is a leading cause of accidental death in the USA. The opioid overdose epidemic has been escalating consistently for over a decade.2 Every day, an estimated 91 Americans die from opioid-related overdose.3 Opioid overdose appears to have disproportionally affected men, adults aged 25–64 years, and non-Hispanic whites.2

Socratic Pedagogy, Critical Thinking, and Inmate Education

Science.gov (United States)

Boghossian, Peter

2006-01-01

This article explains and analyzes the practical application of the Socratic method in the context of inmate education, and identifies core critical thinking elements that emerge from four transcribed Socratic discussions with prison inmates. The paper starts with a detailed examination of the stages of the Socratic method as practiced by the…

Tricyclic antidepressant overdose necessitating ICU admission ...

African Journals Online (AJOL)

Tricyclic antidepressant (TCA) overdose necessitating intensive care unit (ICU) admission remains a significant problem in the Western Cape. In this retrospective study, we reviewed the course of life-threatening TCA overdose in our centre to identify potential prognostic indicators. TCA levels >1 000 ng/ml were associated ...

The Special Needs of Prison Inmates with Handicaps: An Assessment.

Science.gov (United States)

Veneziano, Louis; And Others

1987-01-01

Surveyed 45 workers in correctional agencies to examine number of handicapped inmates and types of programs provided to them. Found that most prison systems had identified some handicapped inmates. Variety of programs were offered to inmates, many systems did not have specialized treatment for handicapped. Found need for evaluation and treatment…

Adrenaline overdose in pediatric anaphylaxis: a case report.

Science.gov (United States)

Liew, Pui Yi Lily; Craven, John Andrew

2017-05-08

Adrenaline is the standard treatment for anaphylaxis but appropriate administration remains challenging, and iatrogenic overdose is easily overlooked. Despite the established importance of pediatric blood pressure measurement, its use remains inconsistent in clinical practice. We report a case of adrenaline overdose in a 9-year-old white boy with anaphylaxis, where signs of adrenaline overdose were indistinguishable from progressive shock until blood pressure measurement was taken. The consequences of under-dosing adrenaline in anaphylaxis are well-recognized, but the converse is less so. Blood pressure measurement should be a routine part of pediatric assessment as it is key to differentiating adrenaline overdose from anaphylactic shock.

Adrenergic bronchodilator overdose

Science.gov (United States)

Adrenergic bronchodilators are inhaled medicines that help open up the airways. They are used to treat asthma and chronic bronchitis. Adrenergic bronchodilator overdose occurs when someone accidentally or intentionally ...

Reducing the Risk of Methadone Overdose

Centers for Disease Control (CDC) Podcasts

2012-07-03

This podcast is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

A Systematic Review on Insulin Overdose Cases

DEFF Research Database (Denmark)

Johansen, Nicklas Järvelä; Christensen, Mikkel Bring

2018-01-01

A large overdose of insulin is a serious health matter. Information concerning administration and duration of intravenous (IV) glucose, other treatment options or complications beside hypoglycaemia following large insulin overdoses is not readily apparent from the literature. This article...

28 CFR 541.12 - Inmate rights and responsibilities.

Science.gov (United States)

2010-07-01

....12 Section 541.12 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Inmate Discipline and Special Housing Units § 541.12..., and for assisting your family. 11. You have the responsibility to meet your financial and legal...

Naproxen sodium overdose

Science.gov (United States)

... page: //medlineplus.gov/ency/article/002507.htm Naproxen sodium overdose To use the sharing features on this page, please enable JavaScript. Naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID) used ...

Fenoprofen calcium overdose

Science.gov (United States)

... page: //medlineplus.gov/ency/article/002649.htm Fenoprofen calcium overdose To use the sharing features on this page, please enable JavaScript. Fenoprofen calcium is a type of medicine called a nonsteroidal ...

[Compliance of antituberculosis therapy among ex-inmates in the Madrid area].

Science.gov (United States)

Fernández De La Hoz, K; Fernández, S; Ordobás, M; Gómez, P; Fernández, M; Arce, A

2001-10-01

The inmate population is not a tight compartment without communication with the community but there is a flow of persons and thus of health problems. The high incidence of tuberculosis among inmates is therefore of concern for the Public Health System. The outcomes of antituberculosis treatment among ex-inmates released from prison in 1987 in the Madrid Area were evaluated and compared with those who remained in jail on treatment. Individuals who met the case definition of tuberculosis were included in the study. The outcome was defined as the individual status one year after the beginning of therapy. To determine the association between the study variables with outcome, odds ratios (OR) with their 95% confidence intervals were used. The Chi2 test was used to determine the statistical significance. Differences between outcomes of individuals in the two groups were observed: 69.7% of inmates had completed their therapy compared with 20.5% of ex-inmates. Treatment had to be prolonged in 15.2% of inmates compared with 46.2% in ex-inmates. The only predictor associated with therapy completion one year after the beginning was imprisonment, as OR for not having completed therapy for ex-inmates was almost 13 times higher (OR=12.94; 95% IC, 3.38-13.10) than those in jail. Special strategies should be developed that assure clinical cure of persons with factors related to non-compliance.

Drug overdose resulting in quadriplegia.

Science.gov (United States)

Wang, Teresa S; Grunch, Betsy H; Moreno, Jessica R; Bagley, Carlos A; Gottfried, Oren N

2012-06-01

To describe a case of cervical flexion myelopathy resulting from a drug overdose. A 56-year-old male presented to the emergency department unable to move his extremities following drug overdose. Neurological examination revealed him to be at C6 ASIA A spinal cord injury. The CT of his cervical spine revealed no fracture; however, an MRI revealed cord edema extending from C3 to C6 as well as posterior paraspinal signal abnormalities suggestive of ligamentous injury. The patient underwent a posterior cervical laminectomy and fusion from C3 to C7. Neurologically he regained 3/5 bilateral tricep function and 2/5 grip; otherwise, he remained at ASIA A spinal cord injury at 6 months. Our patient suffered a spinal cord injury likely due to existing cervical stenosis, and in addition to an overdose of sedating medications, he likely sat in flexed neck position for prolonged period of time with the inability to modify his position. This likely resulted in cervical spine vascular and/or neurological compromise producing an irreversible spinal cord injury. Spinal cord injury is a rare finding in patients presenting with drug overdose. The lack of physical exam findings suggestive of trauma may delay prompt diagnosis and treatment, and thus clinicians must have a high index of suspicion when evaluating patients in this setting.

Male Prison Inmates With Gender Dysphoria: When Is Sex Reassignment Surgery Appropriate?

Science.gov (United States)

Osborne, Cynthia S; Lawrence, Anne A

2016-10-01

Gender dysphoria (GD), a feeling of persistent discomfort with one's biologic sex or assigned gender, is estimated to be more prevalent in male prison inmates than in nonincarcerated males; there may be 3000-4000 male inmates with GD in prisons in the United States. An increasing number of U.S. prison systems now offer gender dysphoric inmates diagnostic evaluation, psychotherapy, cross-sex hormone therapy, and opportunities, albeit limited, to enact their preferred gender role. Sex reassignment surgery (SRS), however, has not been offered to inmates except in response to litigation. In the first case of its kind, the California Department of Corrections and Rehabilitation recently agreed to provide SRS to an inmate and developed policy guidelines for its future provision. In other recent cases, U.S. courts have ruled that male inmates with GD are entitled to SRS when it is medically necessary. Although these decisions may facilitate the provision of SRS to inmates in the future, many U.S. prison systems will probably remain reluctant to offer SRS unless legally compelled to do so. In this review, we address the medical necessity of SRS for male inmates with GD. We also discuss eligibility criteria and the practical considerations involved in providing SRS to inmates. We conclude by offering recommendations for physicians, mental health professionals, and prison administrators, designed to facilitate provision of SRS to inmates with GD in a manner that provides humane treatment, maximizes the likelihood of successful outcomes, minimizes risk of regret, and generates data that can help inform future decisions.

Sports cream overdose

Science.gov (United States)

Sports creams are creams or ointments used to treat aches and pains. Sports cream overdose can occur if someone uses this ... Two ingredients in sports creams that can be poisonous are: Menthol Methyl salicylate

Zinc oxide overdose

Science.gov (United States)

Zinc oxide is an ingredient in many products. Some of these are certain creams and ointments used ... prevent or treat minor skin burns and irritation. Zinc oxide overdose occurs when someone eats one of ...

Recovering from Opioid Overdose: Resources for Overdose Survivors & Family Members

Science.gov (United States)

... and gratitude, all accompanied by the discomfort of opioid withdrawal. Most need the support of family and friends to take the next steps toward recovery. While many factors can contribute to opioid overdose, it is al most always an accident. ...

Vital Signs-Preventing Prescription Drug Overdose

Centers for Disease Control (CDC) Podcasts

2014-07-01

This podcast is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.  Created: 7/1/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/1/2014.

The Impact of Correctional Officer Perceptions of Inmates on Job Stress

Directory of Open Access Journals (Sweden)

Marcos Misis

2013-05-01

Full Text Available Research suggests that job-related stress affects correctional officers’ attitudes toward their work environment, coworkers, and supervisors, as well as their physical and mental health; however, very few studies have examined the relationship between stress and attitudes toward inmates. This study examined the relationship between correctional officers’ levels of stress and their perceptions of inmates by surveying a sample of 501 correctional officers employed by a Southern prison system. Hierarchical multiple regression analysis was used to test the principal hypothesis of this study—that more negative perceptions of inmates would result in higher levels of stress for correctional officers. Independent variables were grouped into four groups (demographic variables, supervisory support, job characteristics, and attitudes toward inmates and were entered into the model in blocks. Lower supervisory support and perceptions of the job being dangerous were associated with higher levels of job stress. More importantly, correctional officers who saw inmates as intimidated (not arrogant and nonmanipulative reported lower levels of job stress, while officers who perceived inmates as being unfriendly, antisocial, and cold reported higher levels of stress.

Diclofenac sodium overdose

Science.gov (United States)

... will likely get better. In rare cases, a blood transfusion is needed. Passing a tube through the mouth into the stomach (endoscopy) may be required to stop internal bleeding. Alternative Names Voltaren overdose References Aronson JK. Non-steroidal ...

Preventing Prescription Drug Overdose PSA (:60)

Centers for Disease Control (CDC) Podcasts

2014-07-01

This 60 second public service announcement is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.  Created: 7/1/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/1/2014.

Cardiorespiratory Fitness of Inmates of a Maximum Security Prison ...

African Journals Online (AJOL)

USER

that prison inmates who are allowed to engage in sports on available playgrounds .... Differences in performance on 1 mile walk by gender. Variables. Mean. SD .... In many prisons in Nigeria, inmates sleep two to a bed or on the floor in filthy ...

28 CFR 540.103 - Inmate telephone calls to attorneys.

Science.gov (United States)

2010-07-01

... attorneys when the inmate demonstrates that communication with attorneys by correspondence, visiting, or... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmate telephone calls to attorneys. 540.103 Section 540.103 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL...

Opioid Overdoses Treated in Emergency Departments PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the March 2018 CDC Vital Signs report. Opioid overdoses continue to increase in the United States. Learn what can be done to help prevent opioid overdose and death.

Concomitant overdosing of other drugs in patients with paracetamol poisoning

DEFF Research Database (Denmark)

Schmidt, Lars E; Dalhoff, Kim

2002-01-01

AIMS: Paracetamol is frequently involved in intended self-poisoning, and concomitant overdosing of other drugs is commonly reported. The purpose of the study was to investigate further concomitant drug overdose in patients with paracetamol poisoning and to evaluate its effects on the outcome...... of the paracetamol intoxication. METHODS: Six hundred and seventy-one consecutive patients admitted with paracetamol poisoning were studied and concomitant drug intake was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, hepatic dysfunction, liver cell damage, and renal...... favourable outcome was observed in patients with concomitant NSAID overdose. CONCLUSIONS: Concomitant overdosing of benzodiazepines or analgesics is frequent in patients admitted with paracetamol poisoning. Concomitant benzodiazepine or acetylsalicylic acid overdose was associated with more severe toxicity...

Vital Signs – Prescription Painkiller Overdoses

Centers for Disease Control (CDC) Podcasts

This podcast is based on the July 2013 CDC Vital Signs report. Prescription painkiller overdoses are an under-recognized and growing problem among women. This program includes things that women and health care providers can do to reduce the risk of overdose.

Psychiatric needs of male prison inmates in Italy.

Science.gov (United States)

Piselli, Massimiliano; Attademo, Luigi; Garinella, Raffaele; Rella, Angelo; Antinarelli, Simonetta; Tamantini, Antonia; Quartesan, Roberto; Stracci, Fabrizio; Abram, Karen M

2015-01-01

This paper presents data on the mental health needs of men in an Italian prison and examines if mental health needs of inmates differ across key correctional subpopulations. Interviewers conducted semi-structured clinical interviews with 526 convicted males incarcerated in the Spoleto Prison from October 2010 through September 2011. Nearly two thirds (65.0%) of inmates had an Axis I or Axis II disorder. About half (52.7%) had an Axis I disorder. Personality disorders were the most common disorders (51.9%), followed by anxiety (25.3%) and substance use disorders (24.9%). Over one third of inmates (36.6%) had comorbid types of disorder. The most common comorbid types of disorders were substance use disorders plus personality disorders (20.1%) and anxiety disorders plus personality disorders (18.0%). Findings underscore a significant need for specialized mental health services for men in Italian prisons. Moreover, as inmates return to the community, their care becomes the responsibility of the community health system. Service systems must be equipped to provide integrated services for those with both psychiatric and substance use disorders and be prepared for challenges posed by patients with personality disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Non-communicable diseases among prison inmates in North-West ...

African Journals Online (AJOL)

Background: There is paucity of data on prevalence of non-communicable diseases in prison inmates. The aim of the study was to determine the prevalence and pattern of non-communicable diseases in inmates of Sokoto Central Prison, North-West Nigeria. Methodology: Cross-sectional descriptive study was carried out.

Sassafras oil overdose

Science.gov (United States)

Sassafras oil comes from the root bark of the sassafras tree. Sassafras oil overdose occurs when someone swallows more than the ... Safrole is the poisonous ingredient in sassafras oil. It is a clear or ... yellow oily liquid. It can be dangerous in large amounts.

77 FR 19932 - Inmate Communication With News Media: Removal of Byline Regulations

Science.gov (United States)

2012-04-03

... Communication With News Media: Removal of Byline Regulations AGENCY: Bureau of Prisons, Justice. ACTION: Final... media and the inmate, for which the inmate is compensated. But the scope of this lawsuit does not... because the inmate publishes a writing under a byline in the news media is much more remote. Id. at 1123...

Need Assessment of Inmates of Prisons through Distance Education

Science.gov (United States)

Aziz, Tahir; Chuadhry, Muhammad Asif; Liaquat, Sumaira; Ali, Asim

2014-01-01

To meet the educational needs of inmates, educational scholars of the world have attempted numerous strategies and interventions designs to facilitate learning and to improve achievement. The real function of a prison is to help develop better citizens, not just better inmates. Therefore, the present study was designed to investigate the…

Religiousness/Spirituality and Mental Health among Older Male Inmates

Science.gov (United States)

Allen, Rebecca S.; Phillips, Laura Lee; Roff, Lucinda Lee; Cavanaugh, Ronald; Day, Laura

2008-01-01

Purpose: With the rapid growth in the older inmate population, emerging issues regarding physical and mental health require greater research and clinical attention. We examined the relation of religiousness/spirituality; demographic characteristics such as age, race, and type of crime; and physical and mental health among 73 older male inmates in…

Comparison of toxicity of acute overdoses with citalopram and escitalopram.

Science.gov (United States)

Hayes, Bryan D; Klein-Schwartz, Wendy; Clark, Richard F; Muller, Allison A; Miloradovich, Jane E

2010-07-01

Seizures and QTc prolongation are associated with citalopram poisoning; however, overdose experience with escitalopram is more limited. The goals of this study were to compare citalopram's vs. escitalopram's clinical effects in overdose, including the incidence of seizures. A retrospective review was conducted for single-substance acute overdoses with citalopram and escitalopram, managed in hospitals, that were reported to six U.S. poison centers from 2002-2005. There were 374 citalopram and 421 escitalopram overdose cases. Gender and ages were similar between the two, with 68-70% females and a median age of 20 years for citalopram and 18 years for escitalopram. Median dose by history was 310 mg for citalopram and 130 mg for escitalopram. More serious outcomes were associated with citalopram overdoses (p escitalopram were tachycardia, drowsiness, hypertension, and vomiting. Seizures (30 vs. 1, respectively, p escitalopram cases (p = 0.109). There was an association between increasing dose and severity of outcome for citalopram (p escitalopram (p = 0.011). In children escitalopram cases experienced toxicity, such as drowsiness, nausea/vomiting, and tachycardia. There were no seizures in this age group. Escitalopram seems to be less toxic than citalopram after an acute overdose; seizures and tremors were more common with citalopram. Initial management of overdoses should include seizure precautions for citalopram and cardiac monitoring for both drugs. Copyright 2010 Elsevier Inc. All rights reserved.

Criminal justice continuum for opioid users at risk of overdose.

Science.gov (United States)

Brinkley-Rubinstein, Lauren; Zaller, Nickolas; Martino, Sarah; Cloud, David H; McCauley, Erin; Heise, Andrew; Seal, David

2018-02-24

The United States (US) is in the midst of an epidemic of opioid use; however, overdose mortality disproportionately affects certain subgroups. For example, more than half of state prisoners and approximately two-thirds of county jail detainees report issues with substance use. Overdose is one of the leading causes of mortality among individuals released from correctional settings. Even though the criminal justice (CJ) system interacts with a disproportionately high number of individuals at risk of opioid use and overdose, few CJ agencies screen for opioid use disorder (OUD). Even less provide access to medication assisted treatment (e.g. methadone, buprenorphine, and depot naltrexone), which is one of the most effective tools to combat addiction and lower overdose risk. However, there is an opportunity to implement programs across the CJ continuum in collaboration with law enforcement, courts, correctional facilities, community service providers, and probation and parole. In the current paper, we introduce the concept of a "CJ Continuum of Care for Opioid Users at Risk of Overdose", grounded by the Sequential Intercept Model. We present each step on the CJ Continuum and include a general overview and highlight opportunities for: 1) screening for OUD and overdose risk, 2) treatment and/or diversion, and 3) overdose prevention and naloxone provision. Copyright © 2018 Elsevier Ltd. All rights reserved.

Strategies for Coping with the Challenges of Incarceration among Nigerian Prison Inmates

Science.gov (United States)

Agbakwuru, Chikwe; Awujo, Grace C.

2016-01-01

This paper investigated the strategies for coping with the challenges of incarceration among inmates of Port Harcourt Prison, Nigeria. The population was 2,997 inmates of the prison while the sample was 250 inmates drawn through stratified random sampling technique from the same Port Harcourt prison. Six research questions were posed and data for…

PREP inside and out: marriage education for inmates.

Science.gov (United States)

Einhorn, Lindsey; Williams, Tamara; Stanley, Scott; Wunderlin, Nicole; Markman, Howard; Eason, Joanne

2008-09-01

Although research has demonstrated that marriage education has positive effects on relationship quality, little is known about how such services impact relationships where one partner is incarcerated. The current study implemented an adapted version of the Prevention and Relationship Enhancement Program (PREP Inside and Out) for inmates in Oklahoma correctional facilities. Inmates, with or without their partners, participated in the 12-hour program. The impact of the program was investigated on a range of relationship variables including satisfaction with relationship, dedication, confidence, communication skills, friendship, and negative interactions as reported by the inmate partner. Participants reported substantial gains in all variables and in overall satisfaction with their relationship after completing the program, regardless of their gender and racial/ethnic background. Implications for future marriage education programs and research in prisons are discussed.

Where "Old Heads" Prevail: Inmate Hierarchy in a Men's Prison Unit.

Science.gov (United States)

Kreager, Derek A; Young, Jacob T N; Haynie, Dana L; Bouchard, Martin; Schaefer, David R; Zajac, Gary

2017-01-01

Research of inmate social order is a once-vibrant area that receded just as American incarceration rates climbed and the country's carceral contexts dramatically changed. This study reengages inmate society with an abductive mixed methods investigation of informal status within a contemporary men's prison unit. The authors collect narrative and social network data from 133 male inmates housed in a unit of a Pennsylvania medium-security prison. Analyses of inmate narratives suggest that unit "old heads" provide collective goods in the form of mentoring and role modeling that foster a positive and stable peer environment. This hypothesis is then tested with Exponential Random Graph Models (ERGMs) of peer nomination data. The ERGM results complement the qualitative analysis and suggest that older inmates and those who have been on the unit longer are perceived by their peers as powerful and influential. Both analytical strategies point to the maturity of aging and the acquisition of local knowledge as important for attaining informal status in the unit. In sum, this mixed methods case study extends theoretical insights of classic prison ethnographies, adds quantifiable results capable of future replication, and points to a growing population of older inmates as important for contemporary prison social organization.

Lifespan Differences in the Social Networks of Prison Inmates

Science.gov (United States)

Bond, Gary D.; Thompson, Laura A.; Malloy, Daniel M.

2005-01-01

Socioemotional Selectivity Theory (SST) (Carstensen, 1992, 1993) accounts for lifespan changes in human social networks and for the motivations which underlie those changes. SST is applied in this research with 256 prison inmates and non-inmates, ages 18-84, from Mississippi, Kansas, and New Mexico. Two research questions sought to identify (a)…

Outcomes from massive paracetamol overdose: a retrospective observational study.

Science.gov (United States)

Marks, Daniel J B; Dargan, Paul I; Archer, John R H; Davies, Charlotte L; Dines, Alison M; Wood, David M; Greene, Shaun L

2017-06-01

This article is commented on by Bateman DN and Dear JW. Should we treat very large paracetamol overdose differently? Br J Clin Pharmacol 2017; 83: 1163-5. https://doi.org/10.1111/bcp.13279 AIMS: Treatment of paracetamol (acetaminophen) overdose with acetylcysteine is standardized, with dose determined only by patient weight. The validity of this approach for massive overdoses has been questioned. We systematically compared outcomes in massive and non-massive overdoses, to guide whether alternative treatment strategies should be considered, and whether the ratio between measured timed paracetamol concentrations (APAP pl ) and treatment nomogram thresholds at those time points (APAP t ) provides a useful assessment tool. This is a retrospective observational study of all patients (n = 545) between 2005 and 2013 admitted to a tertiary care toxicology service with acute non-staggered paracetamol overdose. Massive overdoses were defined as extrapolated 4-h plasma paracetamol concentrations >250 mg l -1 , or reported ingestions ≥30 g. Outcomes (liver injury, coagulopathy and kidney injury) were assessed in relation to reported dose and APAP pl :APAP t ratio (based on a treatment line through 100 mg l -1 at 4 h), and time to acetylcysteine. Ingestions of ≥30 g paracetamol correlated with higher peak serum aminotransferase (r = 0.212, P paracetamol overdose are at higher risk of organ injury, even when acetylcysteine is administered early. Enhanced therapeutic strategies should be considered in those who have an APAP pl :APAP t  ≥ 3. Novel biomarkers of incipient liver injury and abbreviated acetylcysteine regimens require validation in this patient cohort. © 2016 The British Pharmacological Society.

Calcium channel blocker overdose

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002580.htm Calcium-channel blocker overdose To use the sharing features on this page, please enable JavaScript. Calcium-channel blockers are a type of medicine used ...

28 CFR 541.63 - Hearing procedure.

Science.gov (United States)

2010-07-01

... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE... inmate is entitled to present documentary evidence and to have witnesses appear, provided that calling... to hear a witness or to receive documentary evidence. [54 FR 11323, Mar. 17, 1989, as amended at 63...

75 FR 76263 - Inmate Discipline Program/Special Housing Units: Subpart Revision and Clarification

Science.gov (United States)

2010-12-08

... staff will examine the inmate, including a personal interview. Emergency medical and mental health care.... Staff are currently aware that inmates are permitted limited opportunities to protect personal assets... allowed the same amount of personal property as permitted for inmates in general population,'' and ``AD...

Acetaminophen and codeine overdose

Science.gov (United States)

... and is not helped by other types of painkillers. Acetaminophen and codeine overdose occurs when someone takes ... a vein) A laxative Medicine to reverse the effects of the poison and treat symptoms Tube through ...

Birth control pills overdose

Science.gov (United States)

... page: //medlineplus.gov/ency/article/002599.htm Birth control pill overdose To use the sharing features on ... the medicine was prescribed for the person Poison Control Your local poison center can be reached directly ...

Collaborative research to prevent HIV among male prison inmates and their female partners.

Science.gov (United States)

Grinstead, O A; Zack, B; Faigeles, B

1999-04-01

Despite the need for targeted HIV prevention interventions for prison inmates, institutional and access barriers have impeded development and evaluation of such programs. Over the past 6 years, the authors have developed a unique collaborative relationship to develop and evaluate HIV prevention interventions for prison inmates. The collaboration includes an academic research institution (the Center for AIDS Prevention Studies at the University of California, San Francisco), a community-based organization (Centerforce), and the staff and inmate peer educators inside a state prison. In this ongoing collaboration, the authors have developed and evaluated a series of HIV prevention interventions for prison inmates and for women who visit prison inmates. Results of these studies support the feasibility and effectiveness of HIV prevention programs for inmates and their partners both in prison and in the community. Access and institutional barriers to HIV intervention research in prisons can be overcome through the development of collaborative research partnerships.

Sexual Health of Prison Inmates: A Case Study of Kano Central ...

African Journals Online (AJOL)

AJRH Managing Editor

Sexual and reproductive health of prison inmates suffers from serious neglect in Nigeria. This mixed method study .... inmates using a pretested semi structured self- administered ..... Lwanga SK, Lemeshow S. Sample Size Determination in.

[Tuberculosis among city jail inmates in Campinas, São Paulo, Brazil].

Science.gov (United States)

de Oliveira, Helenice Bosco; Cardoso, Janaina Corrêa

2004-03-01

To describe the incidence of tuberculosis among inmates of the municipal prison system in the city of Campinas, State of São Paulo, Brazil, from 1993 through 2000. A retrospective study was carried out of the number of cases of tuberculosis that were notified among inmates over the study period. This involved reviewing data from a total of 4,293 inmates who were held in the four prisons that comprise Campinas' municipal prison system. Data were obtained from the tuberculosis database belonging to the Department of Social and Preventive Medicine of the School of Medical Sciences at the State University of Campinas. The incidence of tuberculosis peaked in 1994 (1,397.62 cases per 100,000) and was lowest in 1999 (559.04 cases per 100,000). Most cases of tuberculosis occurred in inmates in the 25 to 34 year age group (62.6%). Acquired immunodeficiency syndrome (AIDS) was the disease most commonly associated with tuberculosis (49.9%), which was most often pulmonary in type (91.9%), with positive sputum smears in 70.3% of the inmates tested. Most inmates had not received treatment before (75.4%). The treatment dropout rate reached 49%, and a cure was achieved in only 20.8% of the cases notified over the study period. The incidence of tuberculosis observed in this study was moderate when compared to incidence rates found in other studies of prison inmates, but this could be due to underreporting. The frequency of treatment failure noted was low, since patients who were treated under supervision showed good adherence and were cured in the majority of cases. However, the high treatment dropout rate seen in the study is alarming because it could facilitate the spread of drug resistant strains of Mycobacterium tuberculosis to the community at large. Controlling tuberculosis among prison inmates should be part of routine interventions aimed at eliminating this disease from the community and at preventing resistance to antituberculosis therapy.

Opiate addiction and overdose: experiences, attitudes, and appetite for community naloxone provision.

LENUS (Irish Health Repository)

Barry, Tomás

2017-02-28

More than 200 opiate overdose deaths occur annually in Ireland. Overdose prevention and management, including naloxone prescription, should be a priority for healthcare services. Naloxone is an effective overdose treatment and is now being considered for wider lay use.

28 CFR 527.44 - Transfer of Bureau of Prisons inmates to other countries.

Science.gov (United States)

2010-07-01

... United States Court shall indicate his or her interest by completing and signing the appropriate form and... probability that the inmate will be given an interview with his or her nation's consular officials. (e) Upon... to document the inmate's voluntary consent for transfer. Counsel is provided the inmate for purpose...

Olanzapine Overdose in a Pin Point Pupil with Altered Sensorium

Directory of Open Access Journals (Sweden)

Naresh Midha

2017-09-01

Full Text Available Background:Olanzapine is a highly tolerable and easily affordable atypical antipsychotic drug which has been commonly prescribed in both inpatient and outpatient settings for several mental disorders. Olanzapine overdose is commonly seen in psychiatric patients, who attempt suicide by intoxicating themselves with their own prescribed medications. Increased olanzapine use is associated with increased incidence of overdosing. Case Presentation:We are reporting a case of olanzapine overdosage as a cause of pinpoint pupils and altered sensorium with exclusion of other differentials. The mainstay of managementof olanzapine overdose is general supportive and symptomatic measures. Discussion: Pinpoint pupils with altered sensorium and agitation are always an alarming situation for a clinician, because of differentials like organophosphorus poisoning, pontine hemorrhage and opium overdosing. Due to olanzapine overdosage, similar clinical picture can be confusing in the emergency department and early identification of such cases is helpful to decrease the risk of fatality. Conclusion: This case highlights the significance of olanzapine overdosing as a differential diagnosis for patients presented with altered sensorium and pinpoint pupils in the emergency department. Olanzapine overdosage is associated with high morbidity and mortality. Although there is no specific antidote for olanzapine overdose, appropriate history, assessment and early diagnosis are very useful for the better outcome.

Symmetry witnesses

Science.gov (United States)

Aniello, Paolo; Chruściński, Dariusz

2017-07-01

A symmetry witness is a suitable subset of the space of selfadjoint trace class operators that allows one to determine whether a linear map is a symmetry transformation, in the sense of Wigner. More precisely, such a set is invariant with respect to an injective densely defined linear operator in the Banach space of selfadjoint trace class operators (if and) only if this operator is a symmetry transformation. According to a linear version of Wigner’s theorem, the set of pure states—the rank-one projections—is a symmetry witness. We show that an analogous result holds for the set of projections with a fixed rank (with some mild constraint on this rank, in the finite-dimensional case). It turns out that this result provides a complete classification of the sets of projections with a fixed rank that are symmetry witnesses. These particular symmetry witnesses are projectable; i.e. reasoning in terms of quantum states, the sets of ‘uniform’ density operators of corresponding fixed rank are symmetry witnesses too.

Barbiturate intoxication and overdose

Science.gov (United States)

... users who do not know these combinations can lead to coma or death Experienced users who use them on purpose to alter their consciousness Symptoms Symptoms of barbiturate intoxication and overdose include: Altered level of consciousness Difficulty ...

Opioid Overdoses Treated in Emergency Departments PSA (:60)

Centers for Disease Control (CDC) Podcasts

2018-03-06

This 60 second public service announcement is based on the March 2018 CDC Vital Signs report. Opioid overdoses continue to increase in the United States. Learn what can be done to help prevent opioid overdose and death.  Created: 3/6/2018 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/6/2018.

Reducing the Risk of Methadone Overdose PSA (:60)

Centers for Disease Control (CDC) Podcasts

2012-07-03

This 60 second PSA is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

Prevalence of chronic medical conditions among inmates in the Texas prison system.

Science.gov (United States)

Harzke, Amy J; Baillargeon, Jacques G; Pruitt, Sandi L; Pulvino, John S; Paar, David P; Kelley, Michael F

2010-05-01

Given the rapid growth and aging of the US prison population in recent years, the disease profile and health care needs of inmates portend to have far-reaching public health implications. Although numerous studies have examined infectious disease prevalence and treatment in incarcerated populations, little is known about the prevalence of non-infectious chronic medical conditions in US prison populations. The purpose of this study was to estimate the prevalence of selected non-infectious chronic medical conditions among inmates in the Texas prison system. The study population consisted of the total census of inmates who were incarcerated in the Texas Department of Criminal Justice for any duration from September 1, 2006 through August 31, 2007 (N=234,031). Information on medical diagnoses was obtained from a system-wide electronic medical record system. Overall crude prevalence estimates for the selected conditions were as follows: hypertension, 18.8%; asthma, 5.4%; diabetes, 4.2%; ischemic heart disease, 1.7%; chronic obstructive pulmonary disease, 0.96%; and cerebrovascular disease, 0.23%. Nearly one quarter (24.5%) of the study population had at least one of the selected conditions. Except for asthma, crude prevalence estimates of the selected conditions increased monotonically with age. Nearly two thirds (64.6%) of inmates who were >or=55 years of age had at least one of the selected conditions. Except for diabetes, crude prevalence estimates for the selected conditions were lower among Hispanic inmates than among non-Hispanic White inmates and African American inmates. Although age-standardized prevalence estimates for the selected conditions did not appear to exceed age-standardized estimates from the US general population, a large number of inmates were affected by one or more of these conditions. As the prison population continues to grow and to age, the burden of these conditions on correctional and community health care systems can be expected to increase.

Performance Measures of Diagnostic Codes for Detecting Opioid Overdose in the Emergency Department.

Science.gov (United States)

Rowe, Christopher; Vittinghoff, Eric; Santos, Glenn-Milo; Behar, Emily; Turner, Caitlin; Coffin, Phillip O

2017-04-01

Opioid overdose mortality has tripled in the United States since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events. The present study aimed to validate the use of ICD, 9th revision, Clinical Modification (ICD-9-CM) codes in identifying opioid overdose events in the emergency department (ED) by examining multiple performance measures, including sensitivity and specificity. Data on ED visits from January 1, 2012, to December 31, 2014, including clinical determination of whether the visit constituted an opioid overdose event, were abstracted from electronic medical records for patients prescribed long-term opioids for pain from any of six safety net primary care clinics in San Francisco, California. Combinations of ICD-9-CM codes were validated in the detection of overdose events as determined by medical chart review. Both sensitivity and specificity of different combinations of ICD-9-CM codes were calculated. Unadjusted logistic regression models with robust standard errors and accounting for clustering by patient were used to explore whether overdose ED visits with certain characteristics were more or less likely to be assigned an opioid poisoning ICD-9-CM code by the documenting physician. Forty-four (1.4%) of 3,203 ED visits among 804 patients were determined to be opioid overdose events. Opioid-poisoning ICD-9-CM codes (E850.2-E850.2, 965.00-965.09) identified overdose ED visits with a sensitivity of 25.0% (95% confidence interval [CI] = 13.6% to 37.8%) and

Education for foreign inmates in Norwegian prisons: A legal and humanitarian perspective

Directory of Open Access Journals (Sweden)

Linda Gröning

2014-12-01

Full Text Available This article discusses the right to education for foreign inmates in Norwegian prisons, with a particular focus on the group of inmates who lack a residence permit in Norway and could be expelled once their sentence is served. The viewpoint of the Norwegian criminal justice policy is that all inmates should have the same right to education as other citizens and residents in Norway. For the group without residence permit, however, it seems not fully clear what that right to education should entail. National law only provides access to the education system for those with a residence permit. In addition, International law is not fully clear on the content of the right to education for inmates. On this background, the article clarifies the right to education for foreign inmates, as it follows from national and international law. It pays specific attention to the prison as a specific context for the provision of education, and explains how the right to education relates to the law of the execution of sentences. Drawing from the ethical considerations of the penal system, and from legal principles of non-discrimination, the article eventually concludes that all foreign inmates who serve sentences of certain duration must be ensured access to education on an equal basis with other prisoners.

Vital Signs – Prescription Painkiller Overdoses

Centers for Disease Control (CDC) Podcasts

2013-07-02

This podcast is based on the July 2013 CDC Vital Signs report. Prescription painkiller overdoses are an under-recognized and growing problem among women. This program includes things that women and health care providers can do to reduce the risk of overdose.  Created: 7/2/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/2/2013.

Intestinal helminth infections among inmates in Bedele prison with emphasis on soil-transmitted helminths.

Science.gov (United States)

Terefe, Bahiru; Zemene, Endalew; Mohammed, Abdurehman E

2015-12-14

Intestinal helminths infect more than two billion people worldwide. They are common in developing countries where sanitary facilities are inadequate. There is scarcity of documented data on the magnitude of intestinal helminths among inmates in Ethiopia. The aim of this study was to determine prevalence of intestinal helminth infections among inmates in Bedele prison, south-western Ethiopia. A cross-sectional study involving 234 inmates in Bedele prison was conducted in April 2012. Socio-demographic data was collected from each study participant using semi-structured questionnaire. Fresh stool specimens were collected and processed using modified McMaster technique. At least one species of intestinal helminth was identified in 111 (47.4 %) of the inmates. Ascaris lumbricoides was the most predominant parasite isolated, followed by the hookworms. Most of the cases of soil-transmitted helminths (STHs) were light infections. Untrimmed hand fingernails was significantly associated with A. lumbricoides infection (AOR 0.383, 95 % CI 0.200-0.731). Intestinal helminths are common among the inmates in Bedele prison. Health information should be given to the inmates on proper personal hygiene practices with emphasis on trimming of hand fingernails. Monitoring helminth infections in the inmate population is required.

Anesthetic propofol overdose causes endothelial cytotoxicity in vitro and endothelial barrier dysfunction in vivo

International Nuclear Information System (INIS)

Lin, Ming-Chung; Chen, Chia-Ling; Yang, Tsan-Tzu; Choi, Pui-Ching; Hsing, Chung-Hsi; Lin, Chiou-Feng

2012-01-01

An overdose and a prolonged treatment of propofol may cause cellular cytotoxicity in multiple organs and tissues such as brain, heart, kidney, skeletal muscle, and immune cells; however, the underlying mechanism remains undocumented, particularly in vascular endothelial cells. Our previous studies showed that the activation of glycogen synthase kinase (GSK)-3 is pro-apoptotic in phagocytes during overdose of propofol treatment. Regarding the intravascular administration of propofol, we therefore hypothesized that propofol overdose also induces endothelial cytotoxicity via GSK-3. Propofol overdose (100 μg/ml) inhibited growth in human arterial and microvascular endothelial cells. After treatment, most of the endothelial cells experienced caspase-independent necrosis-like cell death. The activation of cathepsin D following lysosomal membrane permeabilization (LMP) determined necrosis-like cell death. Furthermore, propofol overdose also induced caspase-dependent apoptosis, at least in part. Caspase-3 was activated and acted downstream of mitochondrial transmembrane potential (MTP) loss; however, lysosomal cathepsins were not required for endothelial cell apoptosis. Notably, activation of GSK-3 was essential for propofol overdose-induced mitochondrial damage and apoptosis, but not necrosis-like cell death. Intraperitoneal administration of a propofol overdose in BALB/c mice caused an increase in peritoneal vascular permeability. These results demonstrate the cytotoxic effects of propofol overdose, including cathepsin D-regulated necrosis-like cell death and GSK-3-regulated mitochondrial apoptosis, on endothelial cells in vitro and the endothelial barrier dysfunction by propofol in vivo. Highlights: ► Propofol overdose causes apoptosis and necrosis in endothelial cells. ► Propofol overdose triggers lysosomal dysfunction independent of autophagy. ► Glycogen synthase kinase-3 facilitates propofol overdose-induced apoptosis. ► Propofol overdose causes an increase

Anesthetic propofol overdose causes endothelial cytotoxicity in vitro and endothelial barrier dysfunction in vivo

Energy Technology Data Exchange (ETDEWEB)

Lin, Ming-Chung [Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan (China); Chen, Chia-Ling [Center of Infectious Disease and Signaling Research, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Yang, Tsan-Tzu; Choi, Pui-Ching [Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Hsing, Chung-Hsi [Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan (China); Department of Anesthesiology, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Lin, Chiou-Feng, E-mail: cflin@mail.ncku.edu.tw [Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Center of Infectious Disease and Signaling Research, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China)

2012-12-01

An overdose and a prolonged treatment of propofol may cause cellular cytotoxicity in multiple organs and tissues such as brain, heart, kidney, skeletal muscle, and immune cells; however, the underlying mechanism remains undocumented, particularly in vascular endothelial cells. Our previous studies showed that the activation of glycogen synthase kinase (GSK)-3 is pro-apoptotic in phagocytes during overdose of propofol treatment. Regarding the intravascular administration of propofol, we therefore hypothesized that propofol overdose also induces endothelial cytotoxicity via GSK-3. Propofol overdose (100 μg/ml) inhibited growth in human arterial and microvascular endothelial cells. After treatment, most of the endothelial cells experienced caspase-independent necrosis-like cell death. The activation of cathepsin D following lysosomal membrane permeabilization (LMP) determined necrosis-like cell death. Furthermore, propofol overdose also induced caspase-dependent apoptosis, at least in part. Caspase-3 was activated and acted downstream of mitochondrial transmembrane potential (MTP) loss; however, lysosomal cathepsins were not required for endothelial cell apoptosis. Notably, activation of GSK-3 was essential for propofol overdose-induced mitochondrial damage and apoptosis, but not necrosis-like cell death. Intraperitoneal administration of a propofol overdose in BALB/c mice caused an increase in peritoneal vascular permeability. These results demonstrate the cytotoxic effects of propofol overdose, including cathepsin D-regulated necrosis-like cell death and GSK-3-regulated mitochondrial apoptosis, on endothelial cells in vitro and the endothelial barrier dysfunction by propofol in vivo. Highlights: ► Propofol overdose causes apoptosis and necrosis in endothelial cells. ► Propofol overdose triggers lysosomal dysfunction independent of autophagy. ► Glycogen synthase kinase-3 facilitates propofol overdose-induced apoptosis. ► Propofol overdose causes an increase

Beware the yellow slimming pill: fatal 2,4-dinitrophenol overdose.

Science.gov (United States)

Holborow, Alexander; Purnell, Richard M; Wong, Jenny Frederina

2016-04-04

An industrial chemical, 2,4-dinitrophenol (DNP), has found use as a weight loss drug. It is extremely toxic in overdose and has a narrow therapeutic window with significant interindividual variability in metabolism. The rise in internet-based sales and distribution of this drug has seen an increased incidence of both accidental and intentional overdose presenting to emergency departments across the UK. No antidote currently exists and overdose is often fatal despite management based on current recommendations. We report a case of intentional overdose of DNP in a young man and discuss the current treatment guidelines. The case highlights the need for an increased awareness among frontline medical staff of the effects of DNP poisoning and questions the need for a more aggressive approach in the management of acute toxicity. 2016 BMJ Publishing Group Ltd.

A Nomogram to predict parotid gland overdose in head and neck IMRT

International Nuclear Information System (INIS)

Castelli, J.; Simon, A.; Rigaud, B.; Lafond, C.; Chajon, E.; Ospina, J. D.; Haigron, P.; Laguerre, B.; Loubière, A. Ruffier; Benezery, K.; Crevoisier, R. de

2016-01-01

To generate a nomogram to predict parotid gland (PG) overdose and to quantify the dosimetric benefit of weekly replanning based on its findings, in the context of intensity-modulated radiotherapy (IMRT) for locally-advanced head and neck carcinoma (LAHNC). Twenty LAHNC patients treated with radical IMRT underwent weekly computed tomography (CT) scans during IMRT. The cumulated PG dose was estimated by elastic registration. Early predictors of PG overdose (cumulated minus planned doses) were identified, enabling a nomogram to be generated from a linear regression model. Its performance was evaluated using a leave-one-out method. The benefit of weekly replanning was then estimated for the nomogram-identified PG overdose patients. Clinical target volume 70 (CTV70) and the mean PG dose calculated from the planning and first weekly CTs were early predictors of PG overdose, enabling a nomogram to be generated. A mean PG overdose of 2.5Gy was calculated for 16 patients, 14 identified by the nomogram. All patients with PG overdoses >1.5Gy were identified. Compared to the cumulated delivered dose, weekly replanning of these 14 targeted patients enabled a 3.3Gy decrease in the mean PG dose. Based on the planning and first week CTs, our nomogram allowed the identification of all patients with PG overdoses >2.5Gy to be identified, who then benefitted from a final 4Gy decrease in mean PG overdose by means of weekly replanning

The Nature, Function, and Impact of Inmate Communication Patterns in a Maximum Security Prison.

Science.gov (United States)

Van Voorhis, Patricia

To determine the areas in which communication affects prison environments and prison inmates, interviews were conducted with 21 adult male inmates shortly after their admission into a federal maximum security institution. The interviews were semistructured, addressing such issues as (1) perceptions of fellow inmates and staff; (2) additional…

Missed paracetamol (acetaminophen) overdose due to confusion regarding drug names.

Science.gov (United States)

Hewett, David G; Shields, Jennifer; Waring, W Stephen

2013-07-01

Immediate management of drug overdose relies upon the patient account of what was ingested and how much. Paracetamol (acetaminophen) is involved in around 40% of intentional overdose episodes, and remains the leading cause of acute liver failure in many countries including the United Kingdom. In recent years, consumers have had increasing access to medications supplied by international retailers via the internet, which may have different proprietary or generic names than in the country of purchase. We describe a patient that presented to hospital after intentional overdose involving 'acetaminophen' purchased via the internet. The patient had difficulty recalling the drug name, which was inadvertently attributed to 'Advil', a proprietary non-steroidal anti-inflammatory drug. The error was later recognised when the drug packaging became available, but the diagnosis of paracetamol overdose and initiation of acetylcysteine antidote were delayed. This case illustrates the benefit of routinely measuring paracetamol concentrations in all patients with suspected poisoning, although this is not universally accepted in practice. Moreover, it highlights the importance of the internet as a source of medications for intentional overdose, and emphasises the need for harmonisation of international drug names to improve patient safety.

Concomitant overdosing of other drugs in patients with paracetamol poisoning

DEFF Research Database (Denmark)

Schmidt, Lars E; Dalhoff, Kim

2002-01-01

of the paracetamol intoxication. METHODS: Six hundred and seventy-one consecutive patients admitted with paracetamol poisoning were studied and concomitant drug intake was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, hepatic dysfunction, liver cell damage, and renal...... was a protective factor in the development of hepatic encephalopathy (OR 0.26; CI 0.07, 0.96). Concomitant acetylsalicylic acid overdose was a risk factor in the development of hepatic encephalopathy (OR 4.87; CI 1.52, 15.7) and death or liver transplantation (OR 6.04; CI 1.69, 21.6). A tendency towards a more...... favourable outcome was observed in patients with concomitant NSAID overdose. CONCLUSIONS: Concomitant overdosing of benzodiazepines or analgesics is frequent in patients admitted with paracetamol poisoning. Concomitant benzodiazepine or acetylsalicylic acid overdose was associated with more severe toxicity...

Inmates' Cultural Beliefs about Sexual Violence and Their Relationship to Definitions of Sexual Assault

Science.gov (United States)

Fowler, Shannon K.; Blackburn, Ashley G.; Marquart, James W.; Mullings, Janet L.

2010-01-01

Effective strategies aimed at prison sexual assault require inmates to possess the same definition of sexual assault as prison administrations. This article argues that prison culture is rape-supportive and inmates may not define sexual assault as such. After analyzing questionnaire responses given by male and female inmates in a large Southern…

The relationship between US heroin market dynamics and heroin-related overdose, 1992-2008.

Science.gov (United States)

Unick, George; Rosenblum, Daniel; Mars, Sarah; Ciccarone, Daniel

2014-11-01

Heroin-related overdose is linked to polydrug use, changes in physiological tolerance and social factors. Individual risk can also be influenced by the structural risk environment including the illicit drug market. We hypothesized that components of the US illicit drug market, specifically heroin source/type, price and purity, will have independent effects on the number of heroin-related overdose hospital admissions. Yearly, from 1992 to 2008, Metropolitan Statistical Area (MSA) price and purity series were estimated from the US Drug Enforcement Administration data. Yearly heroin overdose hospitalizations were constructed from the Nationwide Inpatient Sample. Socio-demographic variables were constructed using several databases. Negative binomial models were used to estimate the effect of price, purity and source region of heroin on yearly hospital counts of heroin overdoses controlling for poverty, unemployment, crime, MSA socio-demographic characteristics and population size. Purity was not associated with heroin overdose, but each $100 decrease in the price per pure gram of heroin resulted in a 2.9% [95% confidence interval (CI) = 4.8%, 1.0%] increase in the number of heroin overdose hospitalizations (P = 0.003). Each 10% increase in the market share of Colombian-sourced heroin was associated with a 4.1% (95% CI = 1.7%, 6.6%) increase in number of overdoses reported in hospitals (P = 0.001) independent of heroin quality. Decreases in the price of pure heroin in the United States are associated with increased heroin-related overdose hospital admissions. Increases in market concentration of Colombian-source/type heroin is also associated with an increase in heroin-related overdose hospital admissions. Increases in US heroin-related overdose admissions appear to be related to structural changes in the US heroin market. © 2014 Society for the Study of Addiction.

Overdose Deaths Among Homeless Persons

Science.gov (United States)

... Twitter Overdose Deaths Among Homeless Persons January 2013 Homelessness is a persistent problem—nearly 690,000 people ... will ultimately help address the tragic problem of homelessness too, as many homeless people cite drug or ...

Rehabilitation in Principle and Practice: Perspectives of Inmates and Officers

Directory of Open Access Journals (Sweden)

Yanique A. Anderson

2017-01-01

Full Text Available This article addresses rehabilitation, its conceptualisation by officers and inmates, and its expression in practice within a select Norwegian prison. It reports on findings from a qualitative interview-based research project conducted as a pilot study, whereby semi-structured interviews were conducted with inmates and officers at the prison. Furthermore, the authors examine the principle of rehabilitation as it follows from Norwegian law and assess how it is implemented in practice in a Norwegian prison. The preliminary findings from the study reveal factors—such as inmate isolation and mental health challenges, drug use, unequal treatment, and limited capacity and resources—that are impacting the effectiveness of what the prison has intended to achieve and ask for further research and discussion in this area.

Mental Health Services to State Corrections Inmates. Staff Brief 86-10.

Science.gov (United States)

Henkel, Jane R.

This report was written for the Advisory Committee on Mentally Ill Inmates of the Wisconsin State Legislative Council's Special Committee on Mental Health Issues. It describes mental health services to inmates of Wisconsin's state prisons. Part I describes the organization of state level responsibilities for corrections, including the state…

Literacy, Information and Communication Technology as Tools for Empowerment of Inmates

Science.gov (United States)

Joseph, Tenibiaje Dele

2012-01-01

The study investigated the present position of literacy, information and communication technology (ICT) in prisons by examining the perception of inmates. The study adopted a descriptive survey using structured questionnaire and observation guides on a randomly and purposively drawn sample of 664 inmates out of a population of 47,628 inmates…

Allegheny County Fatal Accidental Overdoses

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Fatal accidental overdose incidents in Allegheny County, denoting age, gender, race, drugs present, zip code of incident and zip code of residence. Zip code of...

Evolving and Combining Facial Composites: Between-Witness and Within-Witness Morphs Compared

Science.gov (United States)

Valentine, Tim; Davis, Josh P.; Thorner, Kate; Solomon, Chris; Gibson, Stuart

2010-01-01

Student participant-witnesses produced 4 composites of unfamiliar faces with a system that uses a genetic algorithm to evolve appearance of artificial faces. Morphs of 4 composites produced by different witnesses (between-witness morphs) were judged better likenesses (Experiment 1) and were more frequently named (Experiment 2) by participants who…

Law enforcement attitudes towards naloxone following opioid overdose training.

Science.gov (United States)

Purviance, Donna; Ray, Bradley; Tracy, Abigail; Southard, Erik

2017-01-01

Opioid intoxication and overdoses are life-threatening emergencies requiring rapid treatment. One response to this has been to train law enforcement to detect the signs of an opioid overdose and train them to administer naloxone to reverse the effects. Although not a new concept, few studies have attempted to examine this policy. At 4 different locations in Indiana, law enforcement personnel were trained to detect the signs of an opioid-related overdose and how to administer naloxone to reverse the effects of the overdose. Pre and post surveys were administered at each location (N = 97). To examine changes in attitudes following training, the authors included items from the Opioid Overdose Attitudes Scale (OOAS), which measures respondents' competency, concerns, and readiness to administer naloxone. Among the full sample, naloxone training resulted in significant increases in competency, concerns, and readiness. Examining changes in attitudes by each location revealed that the training had the greatest effect on competency to administer naloxone and in easing concerns that law enforcement personal might have in administering naloxone. This study adds to others in showing that law enforcement personnel are receptive to naloxone training and that the OOAS is able to capture these attitudes. This study advances this literature by examining pre-post changes across multiple locations. As the distribution of naloxone continues to proliferate, this study and the OOAS may be valuable towards the development of an evidence-based training model for law enforcement.

Attitudes and knowledge about naloxone and overdose prevention among detained drug users in Ningbo, China

Directory of Open Access Journals (Sweden)

Liu Yu

2012-02-01

Full Text Available Abstract Background To date there has been limited research on both the prevalence of overdose and drug user knowledge about overdose prevention and response methods in China. In addition, there has been no effort to integrate naloxone information and distribution into pre-release services for drug users detained in isolated compulsory detoxification facilities in China. Methods The authors conducted a survey of 279 heroin users in isolated compulsory detoxification centers in Ningbo, China in an attempt to evaluate the possibility of conducting prelease peer naloxone programs in Ningbo isolated compulsory detoxification centers. Respondents' demographic background, history of heroin overdoses, and attitudes/knowledge about overdose prevention and response were collected. Results While drug users in Ningbo's compulsory detoxification centers have limited understandings of how to effectively respond to overdoses, they expressed concern about the possibility of overdose, interest in participating in overdose prevention and response programs, and a willingness to help their peers. In general, there was no significant difference in history and attitudes/knowledge of overdose between male and female participants. Conclusion Based on the findings of this research, our survey provides preliminary evidence that detained drug users have considerable interest in overdose prevention and response information and willingness to help peers. However, drug users in Ningbo isolated compulsory detoxification centers currently have limited understandings of effective ways of helping to prevent overdose deaths.

Speech Training for Inmate Rehabilitation.

Science.gov (United States)

Parkinson, Michael G.; Dobkins, David H.

1982-01-01

Using a computerized content analysis, the authors demonstrate changes in speech behaviors of prison inmates. They conclude that two to four hours of public speaking training can have only limited effect on students who live in a culture in which "prison speech" is the expected and rewarded form of behavior. (PD)

A study of drug use pattern among inmates of Jos prison, Nigeria ...

African Journals Online (AJOL)

A study of drug use pattern among inmates of Jos prison, Nigeria. ... A total of 3134 inmates who were admitted for drug use treatment in the ... children have been identified to abuse drugs should be co-opted into the rehabilitation process.

High Seroprevalence of Helicobacter Pylori Infection in Inmates: A Case Control Study in a Northern Mexican City

Science.gov (United States)

Alvarado-Esquivel, Cosme; Hernandez-Tinoco, Jesus; Sanchez-Anguiano, Luis Francisco; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Saenz-Soto, Leandro

2013-01-01

Background The epidemiology of Helicobacter pylori infection in inmates has not been previously studied. Therefore, we determine the seroepidemiology of H. pylori infection in inmates. Methods Through a case-control study, inmates from a state correctional facility in Durango, Mexico and subjects without incarceration of the same city were examined for the presence of anti-H. pylori IgG antibodies using enzyme-linked immunoassays. Seroprevalence association with socio-demographic, incarceration, clinical and behavioral characteristics of the inmates was also investigated. Results Antibodies to H. pylori were found in 140 (83.3%) of 168 inmates and in 101 (60.1%) of 168 controls. Seroprevalence of anti-H. pylori IgG antibodies was significantly higher in inmates than in controls (OR = 3.32; 95% CI: 1.93 - 5.71; P = 0.000002). The seroprevalence of H. pylori infection was not influenced by gender, age, or socioeconomic status of inmates. Seropositivity to H. pylori was found in 3 of 3 inmates with peptic ulcer and in 1 of 2 inmates with gastritis. The seroprevalence of H. pylori exposure was high regardless the jail section, duration (years) in incarceration and number of incarcerations. Multivariate analysis revealed that H. pylori exposure was positively associated with having tattoos (OR = 3.34; 95% CI: 1.14 - 9.70; P = 0.02), and negatively associated with drug abuse (OR = 0.28; 95% CI: 0.11 - 0.70; P = 0.007). Conclusions Seroprevalence of H. pylori exposure in inmates is higher than those found in non-incarcerated people and other populations in the region. Results indicate that inmates may represent a new risk group for H. pylori exposure. Results warrant for further research on the potential role of incarceration and behavioral features of inmates for H. pylori infection. PMID:27785257

Health conditions of inmates in Italy.

Science.gov (United States)

Voller, Fabio; Silvestri, Caterina; Martino, Gianrocco; Fanti, Eleonora; Bazzerla, Giorgio; Ferrari, Fabio; Grignani, Marco; Libianchi, Sandro; Pagano, Antonio Maria; Scarpa, Franco; Stasi, Cristina; Di Fiandra, Teresa

2016-11-16

Several studies have shown that prison is characterized by a higher prevalence of chronic diseases than unconfined settings. The aim of this study was to describe the characteristics and health of inmates, focusing on internal diseases. We designed a specific clinical record using the Python programming language. We considered all of the diagnoses according to the ICD-9-CM. Of a total of 17,086 inmates, 15,751 were enrolled in our study (M = 14,835; F = 869), corresponding to 92.2% of the entire inmate population (mean age of 39.6 years). The project involved a total of 57 detention facilities in six Italian regions (for a total of 28% of all detainees in Italy), as counted in a census taken on February 3, 2014. From the entire study sample, 32.5% of prisoners did not present any disorders, while 67.5% suffered from at least one disease. The most frequent pathologies were psychiatric (41.3%), digestive (14.5%), infectious (11.5%), cardiovascular (11.4%), endocrine, metabolic, and immune (8.6%), and respiratory (5.4%). The findings showed that a large number of detainees were affected by several chronic conditions such as hypertension, dyslipidemia and type 2 diabetes mellitus, with an unusually high prevalence for such a young population. Therefore, a series of preventive measures is recommended to strengthen the entire care process and improve the health and living conditions of prisoners.

Health conditions of inmates in Italy

Directory of Open Access Journals (Sweden)

Fabio Voller

2016-11-01

Full Text Available Abstract Background Several studies have shown that prison is characterized by a higher prevalence of chronic diseases than unconfined settings. The aim of this study was to describe the characteristics and health of inmates, focusing on internal diseases. Methods We designed a specific clinical record using the Python programming language. We considered all of the diagnoses according to the ICD-9-CM. Results Of a total of 17,086 inmates, 15,751 were enrolled in our study (M = 14,835; F = 869, corresponding to 92.2% of the entire inmate population (mean age of 39.6 years. The project involved a total of 57 detention facilities in six Italian regions (for a total of 28% of all detainees in Italy, as counted in a census taken on February 3, 2014. From the entire study sample, 32.5% of prisoners did not present any disorders, while 67.5% suffered from at least one disease. The most frequent pathologies were psychiatric (41.3%, digestive (14.5%, infectious (11.5%, cardiovascular (11.4%, endocrine, metabolic, and immune (8.6%, and respiratory (5.4%. Conclusion The findings showed that a large number of detainees were affected by several chronic conditions such as hypertension, dyslipidemia and type 2 diabetes mellitus, with an unusually high prevalence for such a young population. Therefore, a series of preventive measures is recommended to strengthen the entire care process and improve the health and living conditions of prisoners.

Incidence of Mycobacterium tuberculosis in the sputa of coughing inmates in selected Ghanaian prisons

International Nuclear Information System (INIS)

Gyamfi, O.K.; Bedzra, K.D.; Biney, E.; Marfo, K.; Khan, B.K.; Bonsu, F.A.; Addo, K. K.

2007-01-01

One hundred and ninety-five (195) inmates, from eight (8) selected prisons within Ghana's penal system, each with an active cough of at least one week (as the inclusion criterion) were made to submit two sputum samples each for screening for Mycobacterium tuberculosis (MTB) using culture and subsequent microscopy and biochemical speciation tests. This sampling population was made up of 111 convicts and 84 remand prisoners. Forty eight (48) or 24.6% of these sputum samples returned a positive growth of MTB on Loweinstein-Jensen (LJ) slants. All growths harvested were also acid-fast on Ziehl-Neelsen (ZN) microscopy. Out of the 111 convicted prisoners, 26 (or 23.4%) gave sputum samples which returned a positive growth on culture. On the other hand out of the 84 remanded inmates, 22 (or 26.2%) were positive on culture. Of all the total sputum samples returning a positive growth on culture, 54.2% (26/48) was from convicted inmates who made up 56.9% (111/195) of the sampling population whilst remanded inmates who made up only 39.3% (84/195) of our sampling population were responsible for 43.1% (22/54) of all positive culture growths. The percentage of MTB growths on culture in the sputa from coughing inmates domiciled in individual cells of selected prisons are interesting and instructive. The highest number of coughing inmates sampled in a single individual cell was 9 out of which 55.6% (5/9) had sputa giving a positive growth of MTB on culture. The percentage of positive growths of sputa obtained from coughing inmates in individual cells ranged from 20% (1/5) to 100% (1/1 and 2/2) for the selected prisons. A batch of samples (N=19) obtained from isolated inmates symptomatic for TB and at various stages of the DOTS chemotherapy were also analysed. Six (6) samples were positive on culture. Four (4) of these samples emanated from inmates on DOTS chemotherapy for periods between 69 and 290 days whilst the other 2 emanated from inmates on treatment for a period less than 60

Characterization and Management of Patients with Heroin versus Nonheroin Opioid Overdoses: Experience at an Academic Medical Center.

Science.gov (United States)

Morizio, Kate M; Baum, Regan A; Dugan, Adam; Martin, Julia E; Bailey, Abby M

2017-07-01

To characterize the differences between patients who had heroin and nonheroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. Retrospective cohort study. Large academic medical center. A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a nonheroin opioid overdose event, and 443 patients experienced a heroin overdose event. Patients presenting with heroin overdose tended to be younger and male, with higher rates of hepatitis C virus (HCV) infection compared with those presenting with nonheroin opioid overdose (pevent, history of injection drug use, and history of prescription opioid abuse compared with the nonheroin group (pevent with the same drug. The proportion of patients presenting with a heroin overdose steadily increased from 2010-2015; the number of patients presenting to the emergency department with nonheroin opioid overdoses steadily decreased. As rates of heroin overdose increased each year, the incidence of HCV infection increased dramatically. This study indicates that the incidence of heroin overdoses has significantly increased over the last several years, and the rates of HCV infection 4-fold since the start of the study period. Patients admitted for nonheroin opioid overdose were more likely to be admitted to the hospital and intensive care unit compared with those admitted for heroin overdose. The rise in overdose events only further illustrates a gap in our understanding of the cycle of addiction, drug abuse, and overdose events. © 2017 Pharmacotherapy Publications, Inc.

Minimal tomography with entanglement witnesses

International Nuclear Information System (INIS)

Zhu Huangjun; Teo Yong Siah; Englert, Berthold-Georg

2010-01-01

We introduce informationally complete measurements whose outcomes are entanglement witnesses and so answer the question of how many witnesses need to be measured to decide whether an arbitrary state is entangled or not: as many as the dimension of the state space. The witnesses can be measured successively; if all of them give an inconclusive result, one exploits their tomographic completeness for a reconstruction of the quantum state and can then determine its entanglement properties by data processing. There are witnesses that are optimal for this purpose. The optimized witness-based measurement can provide exponential improvement with respect to witness efficiency in high-dimensional Hilbert spaces, at the price of a reduction in the tomographic efficiency. We describe a systematic construction and illustrate the matter with the example of two qubits. For the case of two polarization qubits of photons, we show how existing technology can be used to implement the optimized witnesses in a very efficient way. Owing to the details of the implementation, which actually measures the eigenstate basis of the witness rather than solely determining the expectation value of the witness, one does not need to measure more than six witnesses in this example of a 16-dimensional state space.

Minimal tomography with entanglement witnesses

Science.gov (United States)

Zhu, Huangjun; Teo, Yong Siah; Englert, Berthold-Georg

2010-05-01

We introduce informationally complete measurements whose outcomes are entanglement witnesses and so answer the question of how many witnesses need to be measured to decide whether an arbitrary state is entangled or not: as many as the dimension of the state space. The witnesses can be measured successively; if all of them give an inconclusive result, one exploits their tomographic completeness for a reconstruction of the quantum state and can then determine its entanglement properties by data processing. There are witnesses that are optimal for this purpose. The optimized witness-based measurement can provide exponential improvement with respect to witness efficiency in high-dimensional Hilbert spaces, at the price of a reduction in the tomographic efficiency. We describe a systematic construction and illustrate the matter with the example of two qubits. For the case of two polarization qubits of photons, we show how existing technology can be used to implement the optimized witnesses in a very efficient way. Owing to the details of the implementation, which actually measures the eigenstate basis of the witness rather than solely determining the expectation value of the witness, one does not need to measure more than six witnesses in this example of a 16-dimensional state space.

28 CFR 541.43 - Hearing procedure.

Science.gov (United States)

2010-07-01

... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE... entitled to present documentary evidence and to have witnesses appear, provided that calling witnesses... witness or to receive documentary evidence. ...

Staggered overdose pattern and delay to hospital presentation are associated with adverse outcomes following paracetamol-induced hepatotoxicity

Science.gov (United States)

Craig, Darren G N; Bates, Caroline M; Davidson, Janice S; Martin, Kirsty G; Hayes, Peter C; Simpson, Kenneth J

2012-01-01

AIMS Paracetamol (acetaminophen) poisoning remains the major cause of severe acute hepatotoxicity in the UK. In this large single centre cohort study we examined the clinical impact of staggered overdoses and delayed presentation following paracetamol overdose. RESULTS Between 1992 and 2008, 663 patients were admitted with paracetamol-induced severe liver injury, of whom 161 (24.3%) had taken a staggered overdose. Staggered overdose patients were significantly older and more likely to abuse alcohol than single time point overdose patients. Relief of pain (58.2%) was the commonest rationale for repeated supratherapeutic ingestion. Despite lower total ingested paracetamol doses and lower admission serum alanine aminotransferase concentrations, staggered overdose patients were more likely to be encephalopathic on admission, require renal replacement therapy or mechanical ventilation and had higher mortality rates compared with single time point overdoses (37.3% vs. 27.8%, P = 0.025), although this overdose pattern did not independently predict death. The King's College poor prognostic criteria had reduced sensitivity (77.6, 95% CI 70.8, 81.5) for this pattern of overdose. Of the 396/450 (88.0%) single time point overdoses in whom accurate timings could be obtained, 178 (44.9%) presented to medical services >24 h following overdose. Delayed presentation beyond 24 h post overdose was independently associated with death/liver transplantation (OR 2.25, 95% CI 1.23, 4.12, P = 0.009). CONCLUSIONS Both delayed presentation and staggered overdose pattern are associated with adverse outcomes following paracetamol overdose. These patients are at increased risk of developing multi-organ failure and should be considered for early transfer to specialist liver centres. PMID:22106945

Psycho-pedagogical accompaniment as a condition for social adaptation of inmates of children's homes

OpenAIRE

Oksana Mishenko

2013-01-01

The research is devoted to the problem of pedagogic-psychological accompaniment of the process of social adaptation of inmates of children's homes. Essence of pedagogic-psychological support as a special kind of professional activity to create conditions conducive to the successful adaptation of the inmates of children's homes in the community. Describes the set of psycho-pedagogical conditions, optimizing the process of social adaptation of inmates of children's homes.

Factors Associated with Suicide Attempts in Female Inmates: The Hegemony of Hopelessness

Science.gov (United States)

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

2005-01-01

In this study factors associated with past suicide attempts in female inmates were examined. Female inmate participants (N = 105) were given structured diagnostic assessments of antisocial and borderline personality disorders and substance dependence, as well as measures of depression, hopelessness, problem-focused coping styles, and reasons for…

Neighborhood-Level and Spatial Characteristics Associated with Lay Naloxone Reversal Events and Opioid Overdose Deaths.

Science.gov (United States)

Rowe, Christopher; Santos, Glenn-Milo; Vittinghoff, Eric; Wheeler, Eliza; Davidson, Peter; Coffin, Philip O

2016-02-01

There were over 23,000 opioid overdose deaths in the USA in 2013, and opioid-related mortality is increasing. Increased access to naloxone, particularly through community-based lay naloxone distribution, is a widely supported strategy to reduce opioid overdose mortality; however, little is known about the ecological and spatial patterns of the distribution and utilization of lay naloxone. This study aims to investigate the neighborhood-level correlates and spatial relationships of lay naloxone distribution and utilization and opioid overdose deaths. We determined the locations of lay naloxone distribution sites and the number of unintentional opioid overdose deaths and reported reversal events in San Francisco census tracts (n = 195) from 2010 to 2012. We used Wilcoxon rank-sum tests to compare census tract characteristics across tracts adjacent and not adjacent to distribution sites and multivariable negative binomial regression models to assess the association between census tract characteristics, including distance to the nearest site, and counts of opioid overdose deaths and naloxone reversal events. Three hundred forty-two opioid overdose deaths and 316 overdose reversals with valid location data were included in our analysis. Census tracts including or adjacent to a distribution site had higher income inequality, lower percentage black or African American residents, more drug arrests, higher population density, more overdose deaths, and more reversal events (all p lay naloxone distribution sites in areas with high levels of substance use and overdose risk facilitates reversals of opioid overdoses in those immediate areas but suggests that alternative delivery methods may be necessary to reach individuals in other areas with less concentrated risk.

Rehabilitation in Principle and Practice: Perspectives of Inmates and Officers

OpenAIRE

Yanique A. Anderson; Linda Gröning

2017-01-01

This article addresses rehabilitation, its conceptualisation by officers and inmates, and its expression in practice within a select Norwegian prison. It reports on findings from a qualitative interview-based research project conducted as a pilot study, whereby semi-structured interviews were conducted with inmates and officers at the prison. Furthermore, the authors examine the principle of rehabilitation as it follows from Norwegian law and assess how it is implemented in practice in a Norw...

The Use of Metaphor to Overcome Inmate Resistance to Mental Health Counseling.

Science.gov (United States)

Romig, Charles A.; Gruenke, Carol

1991-01-01

Provides an overview of prison inmate resistance to mental health counseling and describes ways that indirect, metaphorical communication can be used to establish rapport with this client population. Establishing rapport is difficult because of the suspicion that inmate clients have toward mental health professionals and the correctional system…

75 FR 21163 - Inmate Communication With News Media: Removal of Byline Regulations

Science.gov (United States)

2010-04-23

... Communication With News Media: Removal of Byline Regulations AGENCY: Bureau of Prisons, Justice. ACTION: Interim... anything of value for correspondence with the news media. The inmate may not act as reporter or publish... correspondence with representatives of the news media. * * * * * (b) The inmate may not receive compensation or...

Witnessing the Future

DEFF Research Database (Denmark)

Elgaard Jensen, Torben

2007-01-01

and the problematic work life elsewhere. Finally, it notes that the manager's strategy enacts a timeworld characterised by dramatic epochal changes, which is radically different from the more stable and knowable time-world that is enacted in ordinary scientific discourses. Key words: actor-network theory, witnessing......Abstract: The paper explores the phenomenon of witnessing the future through a case study of how a Scandinavian new economy firm managed to persuade a number of business journalists that it was "the future". It describes the procedures and rhetorical strategies that the manager deployed to turn...... the journalists into witnesses. It compares the manager's strategy to other cases of effective witnessing in courtrooms and in science. It concludes that the manager's persuasiveness is derived from his ability to articulate a series of pointed contrasts between the attractive working life within the firm...

Brain Histamine -Methyltransferase as a Possible Target of Treatment for Methamphetamine Overdose

Directory of Open Access Journals (Sweden)

Junichi Kitanaka

2016-01-01

Full Text Available Stereotypical behaviors induced by methamphetamine (METH overdose are one of the overt symptoms of METH abuse, which can be easily assessed in animal models. Currently, there is no successful treatment for METH overdose. There is increasing evidence that elevated levels of brain histamine can attenuate METH-induced behavioral abnormalities, which might therefore constitute a novel therapeutic treatment for METH abuse and METH overdose. In mammals, histamine N -methyltransferase (HMT is the sole enzyme responsible for degrading histamine in the brain. Metoprine, one of the most potent HMT inhibitors, can cross the blood-brain barrier and increase brain histamine levels by inhibiting HMT. Consequently, this compound can be a candidate for a prototype of drugs for the treatment of METH overdose.

Coccidioidomycosis among Prison Inmates, California, USA, 2011

Centers for Disease Control (CDC) Podcasts

2015-02-26

Dr. Charlotte Wheeler discusses Coccidioidomycosis among Prison Inmates in California.  Created: 2/26/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/26/2015.

VSRR Provisional Drug Overdose Death Counts

Data.gov (United States)

U.S. Department of Health & Human Services — This data contains provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. National...

Development and implementation of intranasal naloxone opioid overdose response protocol at a homeless health clinic.

Science.gov (United States)

Dahlem, Chin Hwa Y; Horstman, Molly J; Williams, Brent C

2016-01-01

To describe the development, implementation, and preliminary evaluation of Opioid Overdose Response Protocol using intranasal (IN) naloxone in a homeless shelter. Opioid Overdose Response Protocol and training curriculum were developed using the Massachusetts Department of Public Health Opioid Overdose Education and Naloxone Distribution (OEND) flow chart, the American Heart Association (AHA) simplified adult basic life support algorithm, and resources through Harms Reduction Coalition. Intranasal naloxone offers a safe and effective method for opioid reversal. To combat the rising incidence of opioid overdose, IN naloxone should be made available at homeless shelters and other facilities with high frequency of opioid overdose, including the training of appropriate staff. This project has demonstrated the effective training and implementation of an Opioid Overdose Response Protocol, based on feedback received from cardiopulmonary resuscitation (CPR) trained nonhealthcare staff. Nurse practitioners (NPs), with our focus on patient care, prevention, and education, are well suited to the deployment of this life-saving protocol. NPs are in critical positions to integrate opioid overdose prevention education and provide naloxone rescue kits in clinical practices. ©2015 American Association of Nurse Practitioners.

Methadone-Related Overdose Deaths in a Liberal Opioid Maintenance Treatment Programme

DEFF Research Database (Denmark)

Tjagvad, C.; Skurtveit, Svetlana; Linnet, K.

2016-01-01

methadone-related overdose deaths in a liberal OMT programme. Methods: Drug-overdose deaths (n = 130) with detection of methadone in Copenhagen, Aarhus, and Odense Municipality, Denmark, during the period 2008-2011 were identified from a registry. Cases with and without prescribed methadone as OMT were...

Finding Boundaries Inside Prison Walls: Case Study of a Terminally Ill Inmate

Science.gov (United States)

O'Connor, Mary-Frances

2004-01-01

The number of terminally ill prison inmates rises each year. Mental health professionals are uniquely prepared to provide therapy during the end-of-life process with their assessment, training, empathy, and communication skills. This case study examines the six-month therapy of one terminally ill inmate, using a client-centered approach. Drawing…

Drug involvement in fatal overdoses

Directory of Open Access Journals (Sweden)

Christopher J. Ruhm

2017-12-01

Full Text Available Death certificate data from the Multiple Cause of Death (MCOD files were analyzed to better understand the drug categories most responsible for the increase in fatal overdoses occurring between 1999 and 2014. Statistical adjustment methods were used to account for the understatement in reported drug involvement occurring because death certificates frequently do not specify which drugs were involved in the deaths. The frequency of combination drug use introduced additional uncertainty and so a distinction was made between any versus exclusive drug involvement. Many results were sensitive to the starting and ending years chosen for examination. Opioid analgesics played a major role in the increased drug deaths for analysis windows starting in 1999 but other drugs, particularly heroin, became more significant for recent time periods. Combination drug use was important for all time periods and needs to be accounted for when designing policies to slow or reverse the increase in overdose deaths.

28 CFR 540.20 - Inmate correspondence with representatives of the news media.

Science.gov (United States)

2010-07-01

... representatives of the news media. 540.20 Section 540.20 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF... correspondence with representatives of the news media. (a) An inmate may write through “special mail” to representatives of the news media specified by name or title (see § 540.2(b)). (b) The inmate may not receive...

Pilot study of a brief dialectical behavior therapy skills group for jail inmates.

Science.gov (United States)

Moore, Kelly E; Folk, Johanna B; Boren, Emily A; Tangney, June P; Fischer, Sarah; Schrader, Shannon W

2018-02-01

Regulating emotions, refraining from impulsive, maladaptive behavior, and communicating effectively are considered primary treatment needs among jail inmates. Dialectical behavior therapy (DBT; Linehan, 1993a) skills address these deficits and have been implemented in long-term correctional settings, but have yet to be adapted for general population inmates in short-term jail settings. This study assessed the feasibility and acceptability of a DBT skills group in a jail setting, as well as its utility in improving coping skills and emotional/behavioral dysregulation. Male jail inmates participated in an 8-week DBT skills group and completed pre- and posttest assessments of coping skills, emotional/behavioral dysregulation, and measures of treatment acceptability. Out of 27 who started therapy, 16 completed it, primarily due to involuntary attrition such as transfer to another correctional facility. Although several logistical issues arose during this pilot study, preliminary results suggest that a brief DBT skills group is feasible and acceptable in a jail setting, and may improve coping skills and reduce externalization of blame among general population jail inmates. This study lays the groundwork for larger, controlled trials of abbreviated DBT skills groups for general population inmates in short-term jail settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Polyuria following an overdose

OpenAIRE

Collins, Angela; White, Nigel A

2013-01-01

Case report detailing the occurrence of diabetes insipidus in a 42-year-old man admitted to the intensive treatment unit (ITU) following an overdose. Whilst on ITU, he was sedated with propofol. Cessation of treatment with propofol coincided with resolution of the polyuria. Animal studies suggest a theoretical mechanism for propofol as the causative agent, but this phenomenon is not commonly seen in humans.

Tramadol Overdose Induced Transient Paresthesia and Decreased Muscle Strength: A Case Series

Directory of Open Access Journals (Sweden)

Khosrow Ghasempouri

2014-06-01

Conclusion: Transient paresthesia and transient symmetrical decline in muscle strength of upper and lower limbs are potential neurologic complications following tramadol abuse and overdose. Further studies are needed to fully clarify the pathogenesis and mechanism of these complications following tramadol overdose.

Determining Appropriate Criteria in the Evaluation of Correctional Mental Health Treatment for Inmates.

Science.gov (United States)

Alexander, Rudolph, Jr.

1992-01-01

Notes that, despite changed goals of mental health treatment for inmates, some prison treatment programs still evaluate effects in terms of adjustment indicators. Discusses and critiques proposals in Ohio to use adjustment indicators as outcome measures for new treatment program for mentally ill inmates. Discusses proper outcome measures for…

Minimal tomography with entanglement witnesses

OpenAIRE

Zhu, Huangjun; Teo, Yong Siah; Englert, Berthold-Georg

2009-01-01

We introduce informationally complete measurements whose outcomes are entanglement witnesses and so answer the question of how many witnesses need to be measured to decide whether an arbitrary state is entangled or not: as many as the dimension of the state space. The optimized witness-based measurement can provide exponential improvement with respect to witness efficiency in high-dimensional Hilbert spaces, at the price of a reduction in the tomographic efficiency. We describe a systematic c...

Waste Inspection Tomography (WIT)

International Nuclear Information System (INIS)

Bernardi, R.T.

1995-01-01

Waste Inspection Tomography (WIT) provides mobile semi-trailer mounted nondestructive examination (NDE) and assay (NDA) for nuclear waste drum characterization. WIT uses various computed tomography (CT) methods for both NDE and NDA of nuclear waste drums. Low level waste (LLW), transuranic (TRU), and mixed radioactive waste can be inspected and characterized without opening the drums. With externally transmitted x-ray NDE techniques, WIT has the ability to identify high density waste materials like heavy metals, define drum contents in two- and three-dimensional space, quantify free liquid volumes through density and x-ray attenuation coefficient discrimination, and measure drum wall thickness. With waste emitting gamma-ray NDA techniques, WIT can locate gamma emitting radioactive sources in two- and three-dimensional space, identify gamma emitting isotopic species, identify the external activity levels of emitting gamma-ray sources, correct for waste matrix attenuation, provide internal activity approximations, and provide the data needed for waste classification as LLW or TRU. The mobile feature of WIT allows inspection technologies to be brought to the nuclear waste drum storage site without the need to relocate drums for safe, rapid, and cost-effective characterization of regulated nuclear waste. The combination of these WIT characterization modalities provides the inspector with an unprecedented ability to non-invasively characterize the regulated contents of waste drums as large as 110 gallons, weighing up to 1,600 pounds. Any objects that fit within these size and weight restrictions can also be inspected on WIT, such as smaller waste bags and drums that are five and thirty-five gallons

Attention Deficit Hyperactivity Disorder (ADHD among longer-term prison inmates is a prevalent, persistent and disabling disorder

Directory of Open Access Journals (Sweden)

Hirvikoski Tatja

2010-12-01

Full Text Available Abstract Background ADHD is a common and disabling disorder, with an increased risk for coexisting disorders, substance abuse and delinquency. In the present study, we aimed at exploring ADHD and criminality. We estimated the prevalence of ADHD among longer-term prison inmates, described symptoms and cognitive functioning, and compared findings with ADHD among psychiatric outpatients and healthy controls. Methods At Norrtälje Prison, we approached 315 male inmates for screening of childhood ADHD by the Wender Utah Rating Scale (WURS-25 and for present ADHD by the Adult ADHD Self-Report Screener (ASRS-Screener. The response rate was 62%. Further, we assessed 34 inmates for ADHD and coexisting disorders. Finally, we compared findings with 20 adult males with ADHD, assessed at a psychiatric outpatient clinic and 18 healthy controls. Results The estimated prevalence of adult ADHD among longer-term inmates was 40%. Only 2 out of 30 prison inmates confirmed with ADHD had received a diagnosis of ADHD during childhood, despite most needed health services and educational support. All subjects reported lifetime substance use disorder (SUD where amphetamine was the most common drug. Mood and anxiety disorders were present among half of subjects; autism spectrum disorder (ASD among one fourth and psychopathy among one tenth. Personality disorders were common; almost all inmates presented conduct disorder (CD before antisocial personality disorder (APD. Prison inmates reported more ADHD symptoms during both childhood and adulthood, compared with ADHD psychiatric outpatients. Further, analysis of executive functions after controlling for IQ showed both ADHD groups performed poorer than controls on working memory tests. Besides, on a continuous performance test, the ADHD prison group displayed poorer results compared with both other groups. Conclusions This study suggested ADHD to be present among 40% of adult male longer-term prison inmates. Further, ADHD

Antidepressant or Antipsychotic Overdose in the Intensive Care Unit - Identification of Patients at Risk

DEFF Research Database (Denmark)

Borg, Linda; Julkunen, Anna; Madsen, Kristian Rørbaek

2016-01-01

It is often advised that patients who have ingested an overdose of antidepressants (AD) or antipsychotics (AP) are monitored with continuous ECG for minimum of 12-24 hr. These patients are often observed in an ICU. Our aim was to identify the number of patients with AD and/or AP overdose without...... adverse signs at hospital admission that turned out to need intensive care treatment. The effect of the antidepressants overdose risk assessment (ADORA) system was evaluated in patients with antidepressant as well as antipsychotic overdose. Our hypothesis was that patients with low ADORA do not need...... intensive care treatment. This retrospective study was conducted in adult patients admitted to the ICU at Odense University Hospital after an overdose with AP and/or AD between 1 January 2009 and 1 September 2014. Patients with predefined adverse signs in the emergency department were excluded due...

Escitalopram causes fewer seizures in human overdose than citalopram.

Science.gov (United States)

Yilmaz, Zeynep; Ceschi, Alessandro; Rauber-Lüthy, Christine; Sauer, Oliver; Stedtler, Uwe; Prasa, Dagmar; Seidel, Carola; Hackl, Elisabeth; Hoffmann-Walbeck, Petra; Gerber-Zupan, Gabriela; Bauer, Kathrin; Kupferschmidt, Hugo; Kullak-Ublick, Gerd-Achim; Wilks, Martin

2010-03-01

Seizures are a recognized complication of acute overdose with the racemic (1:1 ratio of R- and S-enantiomers) selective serotonin reuptake inhibitor antidepressant citalopram. We tested the hypothesis that escitalopram (the therapeutically active S-enantiomer of citalopram) causes fewer seizures in overdose than citalopram at comparable doses of the S-enantiomer. Multicenter retrospective review of cases with citalopram and escitalopram overdose reported to German, Austrian, and Swiss Poisons Centers between 1997 and 2006. 316 citalopram and 63 escitalopram cases were analyzed. Somnolence, nausea, vomiting, tachycardia, QT prolongation, and tremor occurred with similar frequency in both groups. There was a striking difference in the frequency of single and multiple seizures: 43 cases (13.5%) in the citalopram group and 1 case (1.6%) with a single seizure in the escitalopram group (p=0.0065). At comparable ingested doses of the S-enantiomer, the symptom profile for citalopram and escitalopram intoxications is similar except for seizures that occur more frequently in citalopram than in escitalopram poisoning.

Carbamazepine overdose after exposure to simethicone: a case report

Directory of Open Access Journals (Sweden)

Guneysel Ozlem

2008-07-01

Full Text Available Abstract Introduction Carbamazepine is an anticonvulsant drug and is also used as a treatment for patients with manic-depressive illness, post-herpetic neuralgia or phantom limb pain. The drug itself has many drug interactions. Simethicone is an antifoaming agent and is reported to be an inert material with no known drug interaction with carbamazepine. Case presentation We present a case of a patient who was routinely using carbamazepine 400 mg three times per day and levetiracetam 500 mg twice daily, and experienced carbamazepine overdose after exposure to simethicone. After cessation of simethicone therapy normal drug levels of carbamazepine were obtained again with the standard dose of the drug. The mechanism of interaction is unknown but the risk of overdose should be considered when prescribing simethicone to a patient who is using carbamazepine. Conclusion Simethicone and carbamazepine, when taken together, may be a cause of carbamazepine toxicity. The risk of carbamazepine overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.

Ischemic colitis complicating imipramine overdose and alcohol ingestion. Case report

DEFF Research Database (Denmark)

Basse, Peter Neimann; Rørdam, P

1992-01-01

Patients on antidepressant medication are instructed to avoid alcohol because of possible additive effects on cognitive function. An unusual case of colonic gangrene following overdose of imipramine and alcohol is presented. The patient recovered.......Patients on antidepressant medication are instructed to avoid alcohol because of possible additive effects on cognitive function. An unusual case of colonic gangrene following overdose of imipramine and alcohol is presented. The patient recovered....

A case of radiation overdose in radiotherapy

International Nuclear Information System (INIS)

Flatby, J.; Reitan, J.B.; Bjerke, H.; Olerud, H.

1985-01-01

The report describes a case of radiation overdose in the radiotherapeutic treatment of plantar warts. The treatment which caused necrosis and ostemyelitis in a big toe, implied a skin dose of 20 Gy to each of five partly overlapping treatment fields. A phantom test carried out by the National Institute of Radiation Hygiene, indicates doses to periosteum of appr. 70 Gy. It seems that the overdose mainly has been caused by high absorption in bone tissue and high photo emission from bone tissue. It is pointed out that most of the radiation treatment of benign diseases in Norway is carried out by roentgen diagnosticians. If the treatment of these diseases shall be maintained in the future, the educational consequenses should be thoroughly discussed

Hypothermic overdose, not all bad?

Directory of Open Access Journals (Sweden)

Timothy Petterson

2013-01-01

Full Text Available A 51-year-old woman was brought into the Emergency Department (ED following an intentional overdose of alcohol and her medication. Along with two bottles of wine it was estimated that she had taken 5800 mg of Quetiapine and 240 mg of Citalopram along with the wine. The ambient temperature in her flat was thought to be 10°C. On arrival to the ED her GCS was 8. She had agonal respirations with a pulse of 56/min, hypotensive 55/35 mmHg and a temperature 24°C. The patient was intubated and was given sodium bicarbonate, magnesium sulphate, calcium gluconate and an adrenaline infusion. She received active and passive rewarming measures. She had significant ECG findings related to her hypothermia and polypharmacy overdose which seemed to have been cumulative. The patient recovered and the only neurological deficit was numbness in her left leg which was thought to be related to prolonged immobility. Hypothermia may have contributed to her good outcome as hypothermia has been shown to improve both cardiac and neurological outcome.

Prescription drug overdose: between patients and their doctors

Directory of Open Access Journals (Sweden)

Ling W

2013-01-01

Full Text Available Walter Ling,1 Li-Tzy Wu21Department of Psychiatry and Biobehavioral Science, Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USAPrescription drug overdoses, mainly involving prescription opioids, have reached epidemic proportions in the United States over the past 20 years.1,2 Since 2003, prescription opioids have been involved in more drug-related overdose deaths than heroin and cocaine combined. Among patients who were prescribed opioids, an estimated 20% were prescribed high doses of opioids by either single or multiple physicians, and these patients appeared to account for the majority of prescription opioid-related overdoses.1,3,4 The increase in prescription overdose deaths has coincided with a major increase in prescription opioid sales.2 The prescribing practices of some physicians are often believed to have contributed in part to the increase in these overdose deaths. In a recently published perspective, Anna Lembke speculated on why doctors prescribe opioids to known prescription opioid abusers.5 Her article raises a timely and troubling issue for all of us interested in this area of medicine. Lembke identifies the root of the problem to lie in the changing societal attitude towards pain and suffering, the ever-growing availability of opioid medications, the regulatory requirements promulgated, and the perceived shift in the role of the medical professional in this context. Central to her argument is that physicians must now practice according to a set of externally imposed expectations of patients, payers, and regulators, putting the prescriber in the position of being "damned if you do and damned if you don’t". If Lembke is right, the physician now prescribes not according to what he or she wants to do, but according to what he or she must do. The result, at one extreme, is the patient acting as their

Prescription Painkiller Overdoses in the U.S. – What You Need to Know

Centers for Disease Control (CDC) Podcasts

This podcast is based on the November, 2011 CDC Vital Signs report. Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from these overdoses—more than those who die from heroin and cocaine combined. Learn the steps you can take to prevent an overdose.

28 CFR 570.43 - Inmates requiring a high degree of control and supervision.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmates requiring a high degree of control and supervision. 570.43 Section 570.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE COMMUNITY PROGRAMS AND RELEASE COMMUNITY PROGRAMS Escorted Trips § 570.43 Inmates requiring a high degree of control and supervision. Only the...

Successful use of haemodialysis to treat phenobarbital overdose.

Science.gov (United States)

Hoyland, Kimberley; Hoy, Michael; Austin, Richard; Wildman, Martyn

2013-11-21

A 50-year-old woman presented with coma caused by a phenobarbital overdose, requiring intubation and admission to critical care. She was an international visitor and had been prescribed the drug for night-sedation. Phenobarbital is a long-acting barbiturate, which in an overdose can cause central nervous system depression, respiratory failure and haemodynamic instability; these patients can remain obtunded for many days. After initial supportive therapy, she was dialysed to help in the elimination of the drug. Haemodialysis resulted in a markedly reduced plasma level of phenobarbital, which decreased the length of intubation and stay in the critical care unit and aided full recovery.

Acute thiopurine overdose: analysis of reports to a National Poison Centre 1995-2013.

Directory of Open Access Journals (Sweden)

Claudia Gregoriano

Full Text Available Literature regarding acute human toxicity of thiopurines is limited to a handful of case reports. Our objectives were to describe all cases of overdose with thiopurines reported to the Swiss Toxicological Information Centre between 1995-2013. A retrospective analysis was performed to determine circumstances, magnitude, management and outcome of overdose with these substances. A total of 40 cases (14 paediatric were reported (azathioprine, n = 35; 6-mercaptopurine, n = 5. Of these, 25 were with suicidal intent, 12 were accidental and 3 were iatrogenic errors. The magnitude of overdose ranged from 1.5 to 43 (median 8 times the usual dose in adults. Twelve cases (30% had attributable symptoms. The majority of these were minor and included gastrointestinal complaints and liver function test and blood count abnormalities. Symptoms were experienced by patients who took at least 1.5-times their usual daily thiopurine dose. Overdoses over two or more consecutive days, even if of modest size, were less well tolerated. One case of azathioprine and allopurinol co-ingestion over consecutive days led to agranulocytosis. Decontamination measures were undertaken in 11 cases (10 activated charcoal, 1 gastric lavage and these developed fewer symptoms than untreated patients. This study shows that acute overdoses with thiopurines have a favourable outcome in the majority of cases and provides preliminary evidence that gastrointestinal decontamination with activated charcoal may reduce symptom development after overdose of these substances if patients present to medical services soon after ingestion.

Making sense of differing overdose mortality: contributions to improved understanding of European patterns.

Science.gov (United States)

Waal, Helge; Gossop, Michael

2014-01-01

The European Monitoring Centre for Drugs and Drug Addiction, EMCDDA, publishes statistics for overdose deaths giving a European mean number, and ranking nations in a national 'league table' for overdose deaths. The interpretation of differing national levels of mortality is more problematic and more complex than is usually recognised. Different systems are used to compile mortality data and this causes problems for cross-national comparisons. Addiction behaviour can only be properly understood within its specific social and environmental ecology. Risk factors for overdose, such as the type of drug consumed, and the route of administration, are known to differ across countries. This paper describes problems associated with ranking and suggests how mortality data might be used in high-level countries aiming at reduction in the number of overdose deaths. Copyright © 2013 S. Karger AG, Basel.

Depression, anxiety, and history of substance abuse among Norwegian inmates in preventive detention: Reasons to worry?

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Værøy Henning

2011-03-01

Full Text Available Abstract Background Inmates on preventive detention are a small and select group sentenced to an indefinite term of imprisonment. Mood disorders and substance abuse are risk factors for inmate violence and recidivism, so the prevalence of depression, anxiety, and substance abuse was examined in this cohort using psychometric tests. Methods Completion of self-report questionnaires was followed by face-to-face clinical interviews with 26 of the 56 male inmates on preventive detention in Norway's Ila Prison. Substance abuse histories and information about the type of psychiatric treatment received were compiled. To assess anxiety and depression, the Hospital Anxiety and Depression Scale (HADS, the Clinical Anxiety Scale (CAS, and the Montgomery Asberg Depression Rating Scale (MADRS were used. Results Scores on the MADRS revealed that 46.1% of inmates had symptoms of mild depression. The HADS depression subscale showed that 19.2% scored above the cut-off for depression (κ = 0.57. The CAS anxiety score was above the cut-off for 30.7% of the subjects, while 34.6% also scored above the cut-off on the HADS anxiety subscale (κ = 0.61. Almost 70% of all these inmates, and more than 80% of those convicted of sex crimes, had a history of alcohol and/or drug abuse. Conclusions Mild anxiety and depression was found frequently among inmates on preventive detention. Likewise, the majority of the inmates had a history of alcohol and drug abuse. Mood disorders and substance abuse may enhance recidivism, so rehabilitation programs should be tailored to address these problems.

Corruption of Prison Staff in Inmate Discipline.

Science.gov (United States)

Glaser, Daniel; Fry, Lincoln J.

1987-01-01

Qualitative study of New Jersey State Prison (Sykes, 1956) concluded that authority of guards was corrupted by inmates. This study analyzed quantitative and qualitative research from three California prisons which supports Sykes' conclusion and agrees that reciprocity and default are factors in the corruption. (Author/NB)

The Portuguese adaptation of the Gudjonsson Suggestibility Scale (GSS1) in a sample of inmates.

Science.gov (United States)

Pires, Rute; Silva, Danilo R; Ferreira, Ana Sousa

2014-01-01

This paper comprises two studies which address the validity of the Portuguese adaptation of the Gudjonsson Suggestibility Scale, GSS1. In study 1, the means and standard deviations for the suggestibility results of a sample of Portuguese inmates (N=40, Mage=37.5 years, SD=8.1) were compared to those of a sample of Icelandic inmates (Gudjonsson, 1997; Gudjonsson & Sigurdsson, 1996). Portuguese inmates' results were in line with the original results. In study 2, the means and standard deviations for the suggestibility results of the sample of Portuguese inmates were compared to those of a general Portuguese population sample (N=57, Mage=36.1 years, SD=12.7). The forensic sample obtained significantly higher scores in suggestibility measures than the general population sample. ANOVA confirmed that the increased suggestibility in the inmates sample was due to the limited memory capacity of this latter group. Given that the results of both studies 1 and 2 are in keeping with the author's original results (Gudjonsson, 1997), this may be regarded as a confirmation of the validity of the Portuguese GSS1. Copyright © 2013 Elsevier Ltd. All rights reserved.

CDC Vital Signs: Prescription Painkiller Overdoses (Opioids): A Growing Epidemic, Especially Among Women

Science.gov (United States)

... health care providers and the public about prescription drug misuse, abuse, suicide, and overdose, and the risks for women. Developing and evaluating programs and policies that prevent and treat prescription drug abuse and overdose, while making sure patients have access ...

Targeted metabolomic profiling indicates structure-based perturbations in serum phospholipids in children with acetaminophen overdose

Directory of Open Access Journals (Sweden)

Sudeepa Bhattacharyya

Full Text Available Phospholipids are an important class of lipids that act as building blocks of biological cell membranes and participate in a variety of vital cellular functions including cell signaling. Previous studies have reported alterations in phosphatidylcholine (PC and lysophosphatidylcholine (lysoPC metabolism in acetaminophen (APAP-treated animals or cell cultures. However, little is known about phospholipid perturbations in humans with APAP toxicity. In the current study, targeted metabolomic analysis of 180 different metabolites including 14 lysoPCs and 73 PCs was performed in serum samples from children and adolescents hospitalized for APAP overdose. Metabolite profiles in the overdose group were compared to those of healthy controls and hospitalized children receiving low dose APAP for treatment of pain or fever (therapeutic group. PCs and lysoPCs with very long chain fatty acids (VLCFAs were significantly decreased in the overdose group, while those with comparatively shorter chain lengths were increased in the overdose group compared to the therapeutic and control groups. All ether linked PCs were decreased in the overdose group compared to the controls. LysoPC-C26:1 was highly reduced in the overdose group and could discriminate between the overdose and control groups with 100% sensitivity and specificity. The PCs and lysoPCs with VLCFAs showed significant associations with changes in clinical indicators of drug metabolism (APAP protein adducts and liver injury (alanine aminotransferase, or ALT. Thus, a structure-dependent reduction in PCs and lysoPCs was observed in the APAP-overdose group, which may suggest a structure-activity relationship in inhibition of enzymes involved in phospholipid metabolism in APAP toxicity. Keywords: Metabolomics, Phospholipids, Acetaminophen, Hepatotoxicity, Drug

Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.

Science.gov (United States)

Bachhuber, Marcus A; Saloner, Brendan; Cunningham, Chinazo O; Barry, Colleen L

2014-10-01

Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. Presence of a law establishing a medical cannabis program in the state. Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, -37.5% to -9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (-19.9%; 95% CI, -30.6% to -7.7%; P = .002), year 2 (-25.2%; 95% CI, -40.6% to -5.9%; P = .01), year 3 (-23.6%; 95% CI, -41.1% to -1.0%; P = .04), year 4 (-20.2%; 95% CI, -33.6% to -4.0%; P = .02), year 5 (-33.7%; 95% CI, -50.9% to -10.4%; P = .008), and year 6 (-33.3%; 95% CI, -44.7% to

Liver transplant associated with paracetamol overdose: Results from the seven-country SALT study

NARCIS (Netherlands)

S.E. Gulmez (Sinem Ezgi); D. Larrey (Dominique); G.P. Pageaux; J. Bernuau (Jacques); F. Bissoli (Franco); Y. Horsmans (Yves); D. Thorburn (Douglas); P.A. McCormick (P. Aiden); B.H.Ch. Stricker (Bruno); M. Toussi (Massoud); S. Lignot-Maleyran (Séverine); S. Micon (Sophie); F. Hamoud (Fatima); R. Lassalle (Régis); J. Jové (Jérémy); P. Blin (Patrick); N. Moore (Nicholas)

2015-01-01

textabstractAims Acute drug overdose, especially with paracetamol, may cause acute liver failure leading to registration for transplantation (ALFT). Population statistics and between-country differences for ALFT related to overdose have been poorly described. The aim of the present study was to

The Growth of Older Inmate Populations: How Population Aging Explains Rising Age at Admission.

Science.gov (United States)

Luallen, Jeremy; Cutler, Christopher

2017-09-01

Older inmates are the fastest growing segment of the prison population; however, the reasons for this are not well understood. One explanation is that the general population is aging, driving prison age distributions to change. For this article, we study the role of population aging in prison growth by investigating how the baby boom phenomenon of post-World War II has contributed to the growth of older inmate populations. We identify the impact of population aging using simulation methods that explain prison growth as the combination of criminal justice processes. Overall, we find evidence that population aging has played a significant role in explaining the growth of older inmate populations, in particular among inmates aged between 50 and 64 years, contributing to as much as half of the observed increase in these groups since 2000. This finding stands in contrast to the notion that population aging has little explanatory power in describing the growth of prison populations and implies that older inmate groups are more sensitive to compositional changes in the general population. We argue that prediction-based modeling of prison growth should more seriously consider the impacts and consequences of demographic shifts among older prisoner populations. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Self-identification of nonpharmaceutical fentanyl exposure following heroin overdose.

Science.gov (United States)

Griswold, Matthew K; Chai, Peter R; Krotulski, Alex J; Friscia, Melissa; Chapman, Brittany; Boyer, Edward W; Logan, Barry K; Babu, Kavita M

2018-01-01

To compare user self-identification of nonpharmaceutical fentanyl exposure with confirmatory urine drug testing in emergency department (ED) patients presenting after heroin overdose. This was a cross-sectional study of adult ED patients who presented after a heroin overdose requiring naloxone administration. Participants provided verbal consent after which they were asked a series of questions regarding their knowledge, attitudes and beliefs toward heroin and nonpharmaceutical fentanyl. Participants also provided urine samples, which were analyzed using liquid chromatography coupled to quadrupole time-of-flight mass spectrometry to identify the presence of fentanyl, heroin metabolites, other clandestine opioids, common pharmaceuticals and drugs of abuse. Thirty participants were enrolled in the study period. Ten participants (33%) had never required naloxone for an overdose in the past, 20 participants (67%) reported recent abstinence, and 12 participants (40%) reported concomitant cocaine use. Naloxone was detected in all urine drug screens. Heroin or its metabolites were detected in almost all samples (93.3%), as were fentanyl (96.7%) and its metabolite, norfentanyl (93.3%). Acetylfentanyl was identified in nine samples (30%) while U-47700 was present in two samples (6.7%). Sixteen participants self-identified fentanyl in their heroin (sensitivity 55%); participants were inconsistent in their qualitative ability to identify fentanyl in heroin. Heroin users presenting to the ED after heroin overdose requiring naloxone are unable to accurately identify the presence of nonpharmaceutical fentanyl in heroin. Additionally, cutting edge drug testing methodologies identified fentanyl exposures in 96.7% of our patients, as well as unexpected clandestine opioids (like acetylfentanyl and U-47700).

[Evaluation of Wits appraisal with superimposition method].

Science.gov (United States)

Xu, T; Ahn, J; Baumrind, S

1999-07-01

To compare the conventional Wits appraisal with superimposed Wits appraisal in evaluation of sagittal jaw relationship change between pre and post orthodontic treatment. The sample consists of 48-case pre and post treatment lateral head films. Computerized digitizing is used to get the cephalometric landmarks and measure conventional Wits value, superimposed Wits value and ANB angle. The correlation analysis among these three measures was done by SAS statistical package. The change of ANB angle has higher correlation with the change of superimposed Wits than that of the conventional Wits. The r-value is as high as 0.849 (P < 0.001). The superimposed Wits appraisal reflects the change of sagittal jaw relationship more objectively than the conventional one.

CDC Vital Signs–Opioid Overdoses Treated in Emergency Departments

Centers for Disease Control (CDC) Podcasts

2018-03-06

This podcast is based on the March 2018 CDC Vital Signs report. Opioid overdoses continue to increase in the United States. Learn what can be done to help prevent opioid overdose and death.  Created: 3/6/2018 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/6/2018.

28 CFR 522.15 - No good time credits for inmates serving only civil contempt commitments.

Science.gov (United States)

2010-07-01

... only civil contempt commitments. 522.15 Section 522.15 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INMATE ADMISSION, CLASSIFICATION, AND TRANSFER ADMISSION TO INSTITUTION Civil Contempt of Court Commitments § 522.15 No good time credits for inmates serving only civil contempt...

New York inmates' HIV risk behaviors: the implications for prevention policy and programs.

Science.gov (United States)

Mahon, N

1996-09-01

The median incidence rate of acquired immunodeficiency syndrome (AIDS) among prisoners is 7 times higher than for the general population. Yet high-risk sexual activity and drug use in US correctional facilities remain unexamined. This study explores inmate perceptions of high-risk behavior in New York state prisons and New York City jails and seeks to generate hypotheses to inform policies and future research. Participants were 22 former New York state prisoners and 28 current New York City inmates. Participants attended one of six focus groups and completed an anonymous questionnaire. Audiotapes of the groups were transcribed and evaluated. A range of consensual and nonconsensual sexual activity occurs among inmates and between inmates and staff. Without official access to latex barriers, prisoners use ineffective makeshift devices, like rubber gloves and used plastic wrap, in attempts to practice safer sex. Prisoners also shoot drugs intravenously with used syringes and pieces of pens and light bulbs. The absence of harm-reduction devices behind bars may create a greater risk of HIV transmission there than in the community. Officials should consider distributing risk-reduction devices to prisoners through anonymous methods.

Determining intestinal parasitic infections (IPIs) in inmates from Kajang Prison, Selangor, Malaysia for improved prison management.

Science.gov (United States)

Angal, Lorainne; Mahmud, Rohela; Samin, Sajideh; Yap, Nan-Jiun; Ngui, Romano; Amir, Amirah; Ithoi, Init; Kamarulzaman, Adeeba; Lim, Yvonne A L

2015-10-29

The prison management in Malaysia is proactively seeking to improve the health status of the prison inmates. Intestinal parasitic infections (IPIs) are widely distributed throughout the world and are still gaining great concern due to their significant morbidity and mortality among infected humans. In Malaysia, there is a paucity of information on IPIs among prison inmates. In order to further enhance the current health strategies employed, the present study aims to establish firm data on the prevalence and diversity of IPIs among HIV-infected and non-HIV-infected individuals in a prison, an area in which informed knowledge is still very limited. Samples were subjected to microscopy examination and serological test (only for Strongyloides). Speciation for parasites on microscopy-positive samples and seropositive samples for Strongyloides were further determined via polymerase chain reaction. SPSS was used for statistical analysis. A total of 294 stool and blood samples each were successfully collected, involving 131 HIV positive and 163 HIV negative adult male inmates whose age ranged from 21 to 69-years-old. Overall prevalence showed 26.5% was positive for various IPIs. The IPIs detected included Blastocystis sp., Strongyloides stercoralis, Entamoeba spp., Cryptosporidium spp., Giardia spp., and Trichuris trichiura. Comparatively, the rate of IPIs was slightly higher among the HIV positive inmates (27.5%) than HIV negative inmates (25.8%). Interestingly, seropositivity for S. stercoralis was more predominant in HIV negative inmates (10.4%) compared to HIV-infected inmates (6.9%), however these findings were not statistically significant. Polymerase chain reaction (PCR) confirmed the presence of Blastocystis, Strongyloides, Entamoeba histolytica and E. dispar. These data will enable the health care providers and prison management staff to understand the trend and epidemiological situations in HIV/parasitic co-infections in a prison. This information will further

Waste inspection tomography (WIT)

Energy Technology Data Exchange (ETDEWEB)

Bernardi, R.T. [Bio-Imaging Research, Inc., Lincolnshire, IL (United States)

1995-10-01

Waste Inspection Tomography (WIT) provides mobile semi-trailer mounted nondestructive examination (NDE) and assay (NDA) for nuclear waste drum characterization. WIT uses various computed tomography (CT) methods for both NDE and NDA of nuclear waste drums. Low level waste (LLW), transuranic (TRU), and mixed radioactive waste can be inspected and characterized without opening the drums. With externally transmitted x-ray NDE techniques, WIT has the ability to identify high density waste materials like heavy metals, define drum contents in two- and three-dimensional space, quantify free liquid volumes through density and x-ray attenuation coefficient discrimination, and measure drum wall thickness. With waste emitting gamma-ray NDA techniques, WIT can locate gamma emitting radioactive sources in two- and three-dimensional space, identify gamma emitting, isotopic species, identify the external activity levels of emitting gamma-ray sources, correct for waste matrix attenuation, provide internal activity approximations, and provide the data needed for waste classification as LLW or TRU.

Waste inspection tomography (WIT)

International Nuclear Information System (INIS)

Bernardi, R.T.

1995-01-01

Waste Inspection Tomography (WIT) provides mobile semi-trailer mounted nondestructive examination (NDE) and assay (NDA) for nuclear waste drum characterization. WIT uses various computed tomography (CT) methods for both NDE and NDA of nuclear waste drums. Low level waste (LLW), transuranic (TRU), and mixed radioactive waste can be inspected and characterized without opening the drums. With externally transmitted x-ray NDE techniques, WIT has the ability to identify high density waste materials like heavy metals, define drum contents in two- and three-dimensional space, quantify free liquid volumes through density and x-ray attenuation coefficient discrimination, and measure drum wall thickness. With waste emitting gamma-ray NDA techniques, WIT can locate gamma emitting radioactive sources in two- and three-dimensional space, identify gamma emitting, isotopic species, identify the external activity levels of emitting gamma-ray sources, correct for waste matrix attenuation, provide internal activity approximations, and provide the data needed for waste classification as LLW or TRU

Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial.

Directory of Open Access Journals (Sweden)

Phillip Oliver Coffin

Full Text Available The United States is amidst an opioid epidemic, including synthetic opioids that may result in rapid death, leaving minimal opportunity for bystander rescue. We pilot tested a behavioral intervention to reduce the occurrence of opioid overdose among opioid dependent persons at high-risk for subsequent overdose.We conducted a single-blinded randomized-controlled trial of a repeated dose motivational interviewing intervention (REBOOT to reduce overdose versus treatment as usual, defined as information and referrals, over 16 months at the San Francisco Department of Public Health from 2014-2016. Participants were 18-65 years of age, had opioid use disorder by Structured Clinical Interview, active opioid use, opioid overdose within 5 years, and prior receipt of naloxone kits. The intervention was administered at months 0, 4, 8, and 12, preceded by the assessment which was also administered at month 16. Dual primary outcomes were any overdose event and number of events, collected by computer-assisted personal interview, as well as any fatal overdose events per vital records.A total of 78 persons were screened and 63 enrolled. Mean age was 43 years, 67% were born male, 65% White, 17% African-American, and 14% Latino. Ninety-two percent of visits and 93% of counseling sessions were completed. At baseline, 33.3% of participants had experienced an overdose in the past four months, with a similar mean number of overdoses in both arms (p = 0.95; 29% overdosed during follow-up. By intention-to-treat, participants assigned to REBOOT were less likely to experience any overdose (incidence rate ratio [IRR] 0.62 [95%CI 0.41-0.92, p = 0.019 and experienced fewer overdose events (IRR 0.46, 95%CI 0.24-0.90, p = 0.023, findings that were robust to sensitivity analyses. There were no differences between arms in days of opioid use, substance use treatment, or naloxone carriage.REBOOT reduced the occurrence of any opioid overdose and the number of overdoses

28 CFR 551.101 - Definitions.

Science.gov (United States)

2010-07-01

... awaiting a verdict. (1) Civil contempt, deportable aliens, or material witnesses. For purpose of this rule, an inmate committed for civil contempt, or as a deportable alien, or as a material witness is...

'Brugada ECG' elicited by imipramine overdose

NARCIS (Netherlands)

van den Berg, M. P.; Tulleken, J. E.; Wilde, A. A. M.

2004-01-01

The ECG hallmark of the Brugada syndrome is ST-segment elevation in the right precordial leads. However, a 'Brugada ECG' may also occasionally be caused by other conditions. We report a case of a Brugada ECG due to an overdose of imipramine, a tricyclic antidepressant. The patient, a 66-year-old

Characteristics of Suicides Caused by Drug Overdose in the State of Maryland

Directory of Open Access Journals (Sweden)

Ling Li

2015-01-01

Full Text Available Suicidal drug overdose is a major public health issue. In the United States, every year more than 33,000 people commit suicides. Our study focused on the characteristics of suicide victims in the state of Maryland. Material and methods: This study was a retrospective review of autopsy cases of all suicide deaths caused by drug (s or drug (s with alcohol intoxication investigated by the OCME in Maryland over a 7-year period from January 2004 to December 2011. All deaths investigated by the OCME that require autopsy examination are subject to comprehensive toxicology testing for drugs and alcohol. The screen tests were performed using gas chromatography (GC and radioimmunoassay techniques. All detected drugs and/or metabolites were confirmed using GC-mass spectrometry (GC-MS. Results: From 2004 to 2011, 434 deaths were certified as suicide. Of the 434 suicidal overdose deaths, 84% were white, 11% were African-American, and about 5% were either Hispanic or Asian. The male and female ratio was almost equal. Their ages ranged 15-82 years. Of the 434 suicidal drug overdose deaths, 277 victims (63.8% consumed a single drug type and 157 (36.2% consumed more than one type of drug. Of the 277 single-drug overdose cases, 71.1% suicides were due to prescription drugs, 23.5% due to over-the-counter drugs, and 5.4% due to street/recreational drugs. Among single-type prescription drugs, analgesic (N = 76, antidepressant (N = 45, and neuroleptic (N = 35 classes were the three leading type of drugs used in suicidal deaths. Oxycodone, morphine, quetiapine, and amitriptyline were the most common prescription drugs in suicidal overdose. Diphenhydramine was the leading over-the-counter drug. Of the 157 victims who consumed more than one drug, combined prescription drugs were present in 54.1%, mixed prescription and over-the-counter drugs in 29.3%, and prescription drugs/over-the-counter drugs and street drugs in 16.6% of cases. Of the multiple-drug overdose suicides

Hazardous alcohol consumption in non-aboriginal male inmates in New South Wales.

Science.gov (United States)

Field, Courtney

2018-03-12

Purpose The purpose of this paper is to examine correlates and predictors of hazardous drinking behaviour, that may be considered evidence of generalised strain, in a sample of incarcerated non-Aboriginal males in New South Wales, Australia. Design/methodology/approach Data were collected from 283 non-Aboriginal male inmates as part of a larger epidemiological survey of inmates in NSW undertaken in 2015 by the Justice Health and Forensic Mental Health Network. Data relating to a range of social factors were selected with reference to relevant literature and assessed with regards their predictive value for scores from the Alcohol Use Disorders Identification Test (AUDIT). To facilitate regression analysis, variables were logically organised into historical factors or adult factors. Findings Almost all participants reported some history of alcohol consumption. Hazardous drinking was common among participants. While parental alcohol problems and adult drug use were the only correlates of AUDIT scores, parental misuse of alcohol was shown to be an important predictor of AUDIT scores in regression analysis. The role of parent gender was inconclusive. Previous incarceration as an adult, employment status, and drug use as an adult also predicted AUDIT scores. Originality/value Alcohol abuse is common among inmates and the use of alcohol is implicated in the commission of many offences. A better understanding of its genesis may inspire novel approaches to treatment, leading to improved health outcomes for inmates.

Intranasal naloxone administration by police first responders is associated with decreased opioid overdose deaths.

Science.gov (United States)

Rando, Jessica; Broering, Derek; Olson, James E; Marco, Catherine; Evans, Stephen B

2015-09-01

This study sought to answer the question, "Can police officers administer intranasal naloxone to drug overdose victims to decrease the opioid overdose death rate?" This prospective interventional study was conducted in Lorain County, OH, from January 2011 to October 2014. Starting October 2013, trained police officers administered naloxone to suspected opioid overdose victims through a police officer naloxone prescription program (NPP). Those found by the county coroner to be positive for opioids at the time of death and those who received naloxone from police officers were included in this study. The rate of change in the total number of opioid-related deaths in Lorain County per quarter year, before and after initiation of the NPP, and the trend in the survival rate of overdose victims who were given naloxone were analyzed by linear regression. Significance was established a priori at P police officer NPP with average deaths per quarter of 5.5 for 2011, 15.3 for 2012, and 16.3 for the first 9 months of 2013. After initiation of the police officer NPP, the number of opioid overdose deaths decreased each quarter with an overall average of 13.4. Of the 67 participants who received naloxone by police officers, 52 (77.6%) survived, and 8 (11.9%) were lost to follow-up. Intranasal naloxone administration by police first responders is associated with decreased deaths in opioid overdose victims. Copyright © 2015 Elsevier Inc. All rights reserved.

Islamic Educational Transformation through Inmate Social Interaction at Palu Correctional Facility Class II A, Central Sulawesi

Directory of Open Access Journals (Sweden)

Yusra

2017-06-01

Full Text Available Rehabilitation system adopted by correctional facility is based on Pancasila. All incarcerated men are rehabilitated there with the goal to make them repent, be law-abiding citizens, and uphold moral values. Correctional facility comes as a rehabilitation place to improve social interaction so that inmates can be received by their social environment once they are released from prison. At this point, the researcher focuses on Islamic educational transformation through inmate social interaction training program at Palu correctional facility class II A. This research uses descriptive quantitative design with social legal approach to observe patterns of inmate social interaction. The result of research points out that Islamic educational transformation which is packed into rehabilitation programs and correctional educational activities is remarkably emphasized in inmate social interaction. In this case, Islamic educational transformation applied in Palu correctional facility class II A is defined as ultimum remidium, correctional activities emphasizing on process-based approach. Rehabilitation process given to inmates is able to improve insight and awareness of ethical and moral values in their social interaction. Therefore, when returning to society they can be accepted by social environtment as good responsible people.

Acetaminophen-cysteine adducts during therapeutic dosing and following overdose

Directory of Open Access Journals (Sweden)

Judge Bryan S

2011-03-01

Full Text Available Abstract Background Acetaminophen-cysteine adducts (APAP-CYS are a specific biomarker of acetaminophen exposure. APAP-CYS concentrations have been described in the setting of acute overdose, and a concentration >1.1 nmol/ml has been suggested as a marker of hepatic injury from acetaminophen overdose in patients with an ALT >1000 IU/L. However, the concentrations of APAP-CYS during therapeutic dosing, in cases of acetaminophen toxicity from repeated dosing and in cases of hepatic injury from non-acetaminophen hepatotoxins have not been well characterized. The objective of this study is to describe APAP-CYS concentrations in these clinical settings as well as to further characterize the concentrations observed following acetaminophen overdose. Methods Samples were collected during three clinical trials in which subjects received 4 g/day of acetaminophen and during an observational study of acetaminophen overdose patients. Trial 1 consisted of non-drinkers who received APAP for 10 days, Trial 2 consisted of moderate drinkers dosed for 10 days and Trial 3 included subjects who chronically abuse alcohol dosed for 5 days. Patients in the observational study were categorized by type of acetaminophen exposure (single or repeated. Serum APAP-CYS was measured using high pressure liquid chromatography with electrochemical detection. Results Trial 1 included 144 samples from 24 subjects; Trial 2 included 182 samples from 91 subjects and Trial 3 included 200 samples from 40 subjects. In addition, we collected samples from 19 subjects with acute acetaminophen ingestion, 7 subjects with repeated acetaminophen exposure and 4 subjects who ingested another hepatotoxin. The mean (SD peak APAP-CYS concentrations for the Trials were: Trial 1- 0.4 (0.20 nmol/ml, Trial 2- 0.1 (0.09 nmol/ml and Trial 3- 0.3 (0.12 nmol/ml. APAP-CYS concentrations varied substantially among the patients with acetaminophen toxicity (0.10 to 27.3 nmol/ml. No subject had detectable APAP

Prescription Painkiller Overdoses in the U.S. – What You Need to Know

Centers for Disease Control (CDC) Podcasts

2011-11-01

This podcast is based on the November, 2011 CDC Vital Signs report. Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from these overdoses—more than those who die from heroin and cocaine combined. Learn the steps you can take to prevent an overdose.  Created: 11/1/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/1/2011.

41 CFR 105-70.033 - Witnesses.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Witnesses. 105-70.033 Section 105-70.033 Public Contracts and Property Management Federal Property Management Regulations System... may proceed by leading questions only if the witness is a hostile witness, an adverse party, or a...

Fentanyl and heroin contained in seized illicit drugs and overdose-related deaths in British Columbia, Canada: An observational analysis.

Science.gov (United States)

Baldwin, Nicholas; Gray, Roger; Goel, Anirudh; Wood, Evan; Buxton, Jane A; Rieb, Launette Marie

2018-04-01

Due to the alarming rise in opioid-related overdose deaths, a public health emergency was declared in British Columbia (BC). In this study, we examined the relationship between illicit fentanyl and heroin found in seized drugs and illicit overdose deaths in BC. An observational cross-sectional survey was conducted using BC data from Health Canada's Drug Analysis Service, which analyzes drug samples seized by law enforcement agencies, and non-intentional illicit overdoses from the BC Coroner's Service, from 2000 to 2016. Initial scatter plots and subsequent multivariate regression analysis were performed to describe the potential relationship between seized illicit fentanyl samples and overdose deaths and to determine if this differed from seized heroin and overdose deaths. Fentanyl samples were analyzed for other drug content. Fentanyl is increasingly being found combined with other opioid and non-opioid illicit drugs. Strong positive relationships were found between the number of seized fentanyl samples and total overdose deaths (R2 = 0.97) as well as between seized fentanyl and fentanyl-detected overdose deaths (R2 = 0.99). A positive association was found between the number of seized heroin samples and total overdose deaths (R2 = 0.78). This research contributes to the expanding body of evidence implicating illicit fentanyl use (often combined with heroin or other substances) in overdose deaths in BC. Policy makers and healthcare providers are urged to implement drug treatment and harm reduction strategies for people at risk of overdose associated with current trends in illicit opioid use. Copyright © 2018 Elsevier B.V. All rights reserved.

PROTECTION OF THREATENED WITNESSES

Directory of Open Access Journals (Sweden)

Nadia Claudia CANTEMIR-STOICA

2016-05-01

Full Text Available First, I wish to make a presentation of historically institution and subsequently parallels between past and current regulators to expose whether the legislature has reached desire - namely ensuring effective protection of witnesses threatened and vulnerable. Also, I decided to analyze the topic from the perspective of the criminal procedural provisions of Law 682/2002 and witness protection, which are republished to expose the conditions and criteria by which to ensure this status. I also want to present besides theoretical and practical ways in which the National Office for Witness Protection gives effective legal provisions. Not least, I will bring criticism of current regulation and not by law ferenda proposals.

Assessing Need for Medication-Assisted Treatment for Opiate-Dependent Prison Inmates

Science.gov (United States)

Albizu-García, Carmen E.; Caraballo, José Noel; Caraballo-Correa, Glorimar; Hernández-Viver, Adriana; Román-Badenas, Luis

2012-01-01

Individuals with a history of heroin dependence are overrepresented in American correctional facilities and 75% of inmates with a drug use disorder do not receive treatment during incarceration or after release. Medication-assisted treatment (MAT) with opiate agonists, such as methadone or buprenorphine, constitute standard of care; to guide planning for an expansion of drug treatment services in correctional facilities, a needs assessment was conducted at the Department of Correction and Rehabilitation (DCR) of Puerto Rico (PR). We report on the research process, the findings that informed our recommendations for the PCR to expand MAT for eligible inmates, and lessons learned. PMID:22263714

The sequential organ failure assessment (SOFA) score is an effective triage marker following staggered paracetamol (acetaminophen) overdose.

Science.gov (United States)

Craig, D G; Zafar, S; Reid, T W D J; Martin, K G; Davidson, J S; Hayes, P C; Simpson, K J

2012-06-01

The sequential organ failure assessment (SOFA) score is an effective triage marker following single time point paracetamol (acetaminophen) overdose, but has not been evaluated following staggered (multiple supratherapeutic doses over >8 h, resulting in cumulative dose of >4 g/day) overdoses. To evaluate the prognostic accuracy of the SOFA score following staggered paracetamol overdose. Time-course analysis of 50 staggered paracetamol overdoses admitted to a tertiary liver centre. Individual timed laboratory samples were correlated with corresponding clinical parameters and the daily SOFA scores were calculated. A total of 39/50 (78%) patients developed hepatic encephalopathy. The area under the SOFA receiver operator characteristic for death/liver transplantation was 87.4 (95% CI 73.2-95.7), 94.3 (95% CI 82.5-99.1), and 98.4 (95% CI 84.3-100.0) at 0, 24 and 48 h, respectively, postadmission. A SOFA score of paracetamol overdose, is associated with a good prognosis. Both the SOFA and APACHE II scores could improve triage of high-risk staggered paracetamol overdose patients. © 2012 Blackwell Publishing Ltd.

47 CFR 1.339 - Witness fees.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Witness fees. 1.339 Section 1.339....339 Witness fees. Witnesses who are subpenaed and respond thereto are entitled to the same fees, including mileage, as are paid for like service in the courts of the United States. Fees shall be paid by...

Prevalence, risk factors and social context of active pulmonary tuberculosis among prison inmates in Tajikistan.

Directory of Open Access Journals (Sweden)

Daniel E Winetsky

Full Text Available SETTING: Tuberculosis (TB is highly prevalent in prisons of the former Soviet Union. OBJECTIVE: To understand the behavioral, demographic and biological factors placing inmates in Tajikistan at risk for active TB. DESIGN: We administered a behavioral and demographic survey to 1317 inmates in two prison facilities in Sughd province, Tajikistan along with radiographic screening for pulmonary TB. Suspected cases were confirmed bacteriologically. Inmates undergoing TB treatment were also surveyed. In-depth interviews were conducted with former prisoners to elicit relevant social and behavioral characteristics. RESULTS: We identified 59 cases of active pulmonary TB (prevalence 4.5%. Factors independently associated with increased prevalence of active TB were: HIV-infection by self-report (PR 7.88; 95%CI 3.40-18.28, history of previous TB (PR 10.21; 95%CI 6.27-16.63 and infrequent supplemental nutrition beyond scheduled meals (PR 3.00; 95%CI 1.67-5.62. Access to supplemental nutrition was associated with frequency of visits from friends and family and ability to rely on other inmates for help. CONCLUSION: In prison facilities of Tajikistan, HIV-infection, injection drug use and low access to supplemental nutrition were associated with prevalent cases of active pulmonary TB. Policies that reduce HIV transmission among injection drug users and improve the nutritional status of socially isolated inmates may alleviate the TB burden in Tajikistan's prisons.

Severe Hypertension and Bradycardia Secondary to Midodrine Overdose.

Science.gov (United States)

Wong, L Y; Wong, A; Robertson, T; Burns, K; Roberts, M; Isbister, G K

2017-03-01

The objective of this case is to describe the pharmacokinetics and toxicity of midodrine in overdose. A 20 year old female ingested up to 350 mg midodrine while recovering in hospital from another overdose. She developed vomiting and severe hypertension (blood pressure [BP], 210/100 mmHg). Remarkable findings included a heart rate with a range of 43-60 beats/min, spontaneous respirations (20 breaths/min), and oxygen saturations of >95 % on FiO2 25 %, and a GS of 8. She was admitted to intensive care and had a normal non-contrast CT brain. She was treated with a glyceryl trinitrate patch (5 mg) and observed for 36 h with subsequent BP reduction to 124/81 mmHg and improved in conscious state. Midodrine and desglymidodrine concentrations were measured with liquid chromatography tandem mass spectrometry and were detected with 2-h post-ingestion at concentrations of 158.4 and 169.7 ng/mL, respectively. The parent drug concentrations rapidly decreased with an elimination of half-life of 1.6 h, and the metabolite initially increased and then decreased. The peak in blood pressure appeared to coincide with peak metabolite concentrations. Midodrine in overdose can potentially cause severe hypertension and reflex bradycardia but given its short half-life treatment with vasodilator agents and supportive care is sufficient.

Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management.

Science.gov (United States)

Spiller, Henry A; Hays, Hannah L; Aleguas, Alfred

2013-07-01

The prevalence of attention-deficit hyperactivity disorder (ADHD) in the USA is estimated at approximately 4-9% in children and 4% in adults. It is estimated that prescriptions for ADHD medications are written for more than 2.7 million children per year. In 2010, US poison centers reported 17,000 human exposures to ADHD medications, with 80% occurring in children cause an increase in extracellular concentrations of dopamine, norepinephrine, and serotonin in the neocortex. Overdose with modafinil is generally of moderate severity, with reported ingestions of doses up to 8 g. The most common neurological effects include increased anxiety, agitation, headache, dizziness, insomnia, tremors, and dystonia. The management of modafinil overdose is largely supportive, with a focus on sedation, and control of dyskinesias and blood pressure. Atomoxetine is a selective presynaptic norepinephrine transporter inhibitor. The clinical presentation after overdose with atomoxetine has generally been mild. The primary effects have been drowsiness, agitation, hyperactivity, GI upset, tremor, hyperreflexia, tachycardia hypertension, and seizure. The management of atomoxetine overdose is largely supportive, with a focus on sedation, and control of dyskinesias and seizures. Clonidine is a synthetic imidazole derivative with both central and peripheral alpha-adrenergic agonist actions. The primary clinical syndrome involves prominent neurological and cardiovascular effects, with the most commonly reported features of depressed sensorium, bradycardia, and hypotension. While clonidine is an anti-hypertensive medication, a paradoxical hypertension may occur early with overdose. The clinical syndrome after overdose of guanfacine may be mixed depending on central or peripheral alpha-adrenoreceptor effects. Initial clinical effects may be drowsiness, lethargy, dry mouth, and diaphoresis. Cardiovascular effects may depend on time post-ingestion and may present as hypotension or hypertension. The

Prescription Painkiller Overdoses in the U.S. – What You Need to Know PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second PSA is based on the November, 2011 CDC Vital Signs report. Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from these overdoses—more than those who die from heroin and cocaine combined. Learn the steps you can take to prevent an overdose.

Implementing an overdose education and naloxone distribution program in a health system.

Science.gov (United States)

Devries, Jennifer; Rafie, Sally; Polston, Gregory

To design and implement a health system-wide program increasing provision of take-home naloxone in patients at risk for opioid overdose, with the downstream aim of reducing fatalities. The program includes health care professional education and guidelines, development, and dissemination of patient education materials, electronic health record changes to promote naloxone prescriptions, and availability of naloxone in pharmacies. Academic health system, San Diego, California. University of California, San Diego Health (UCSDH), offers both inpatient and outpatient primary care and specialty services with 563 beds spanning 2 hospitals and 6 pharmacies. UCSDH is part of the University of California health system, and it serves as the county's safety net hospital. In January 2016, a multisite academic health system initiated a system-wide overdose education and naloxone distribution program to prevent opioid overdose and opioid overdose-related deaths. An interdisciplinary, interdepartmental team came together to develop and implement the program. To strengthen institutional support, naloxone prescribing guidelines were developed and approved for the health system. Education on naloxone for physicians, pharmacists, and nurses was provided through departmental trainings, bulletins, and e-mail notifications. Alerts in the electronic health record and preset naloxone orders facilitated co-prescribing of naloxone with opioid prescriptions. Electronic health record reports captured naloxone prescriptions ordered. Summary reports on the electronic health record measured naloxone reminder alerts and response rates. Since the start of the program, the health system has trained 252 physicians, pharmacists, and nurses in overdose education and take-home naloxone. There has been an increase in the number of prescriptions for naloxone from a baseline of 4.5 per month to an average of 46 per month during the 3 months following full implementation of the program including

Expanding access to naloxone for family members: The Massachusetts experience.

Science.gov (United States)

Bagley, Sarah M; Forman, Leah S; Ruiz, Sarah; Cranston, Kevin; Walley, Alexander Y

2018-05-01

The Massachusetts Department of Public Health Overdose Education and Naloxone Distribution Program provides overdose education and naloxone rescue kits to people at risk for overdose and bystanders, including family members. Using Massachusetts Department of Public Health data, the aims are to: (i) describe characteristics of family members who receive naloxone; (ii) identify where family members obtain naloxone; and (iii) describe characteristics of rescues by family members. We conducted a retrospective review using program enrollee information collected on a standardised form between 2008 and 2015. We calculated descriptive statistics, including demographics, current substance use, enrolment location, history of witnessed overdoses and rescue attempt characteristics. We conducted a stratified analysis comparing family members who used drugs with those who did not. Family members were 27% of total program enrollees (n = 10 883/40 801). Family members who reported substance use (n = 4679) were 35.6 years (mean), 50.6% female, 76.3% non-Hispanic white, 75.6% had witnessed an overdose, and they obtained naloxone most frequently at HIV prevention programs. Family members who did not report substance use (n = 6148) were 49.2 years (mean), 73.8% female, 87.9% non-Hispanic white, 35.3% had witnessed an overdose, and they obtained naloxone most frequently at community meetings. Family members were responsible for 20% (n = 860/4373) of the total rescue attempts. The Massachusetts experience demonstrates that family members can be active participants in responding to the overdose epidemic by rescuing family members and others. Targeted intervention strategies for families should be included in efforts to expand overdose education and naloxone in Massachusetts. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Overdose beliefs and management practices among ethnic Vietnamese heroin users in Sydney, Australia

Directory of Open Access Journals (Sweden)

Maher Lisa

2009-04-01

Full Text Available Abstract Background Ethnic Vietnamese injecting drug users (IDUs in Australia draw on a range of beliefs and etiologic models, sometimes simultaneously, in order to make sense of health and illness. These include understandings of illness as the result of internal imbalances and Western concepts of disease causation including germ/pollution theory. Methods Observational fieldwork and in-depth interviews were conducted between 2001 and 2006 in neighbourhoods characterised by high proportions of Asian background IDUs and street-based drug markets. Eligibility criteria for the study were: 1 ethnic Vietnamese cultural background; 2 aged 16 years and over and; 3 injected drugs in the last 6 months. Results Participants commonly attempted to treat heroin overdose by withdrawing blood (rút máu from the body. Central to this practice are cultural beliefs about the role and function of blood in the body and its relationship to illness and health. Participants' beliefs in blood were strongly influenced by understandings of blood expressed in traditional Chinese and Vietnamese medicine. Many participants perceived Western drugs, particularly heroin, as "hot" and "strong". In overdose situations, it was commonly believed that an excessive amount of drugs (particularly heroin entered the bloodstream and traveled to the heart, making the heart work too hard. Withdrawing blood was understood to reduce the amount of drugs in the body which in turn reduced the effects of drugs on the blood and the heart. Conclusion The explanatory model of overdose employed by ethnic Vietnamese IDUs privileges traditional beliefs about the circulatory, rather than the respiratory, system. This paper explores participants' beliefs about blood, the effects of drugs on blood and the causes of heroin overdose in order to document the explanatory model of overdose used by ethnic Vietnamese IDUs. Implications for overdose prevention, treatment and management are identified and

Inmate Prerelease Assessment (IPASS) Aftercare Placement Recommendation as a Predictor of Rural Inmate's 12-Step Attendance and Treatment Entry Postrelease

Science.gov (United States)

Oser, Carrie B.; Biebel, Elizabeth P.; Havens, Jennifer R.; Staton-Tindall, Michele; Knudsen, Hannah K.; Mooney, Jenny L.; Leukefeld, Carl G.

2009-01-01

The purpose of this study is to use the Criminal Justice Drug Abuse Treatment Studies' (CJ-DATS) Inmate Prerelease Assessment (IPASS), which recommends either intensive or nonintensive treatment after release, to predict rural offenders' 12-step attendance and treatment entry within six months of release from prison. IPASS scores indicated that…

ETHIOPIAN WITNESS PROTECTION SYSTEM: COMPARATIVE ...

African Journals Online (AJOL)

witness protection involves social cohesion of the protected person. Scholars ..... interests' need to balance an accused right to know and confront prosecution ..... was reduced to 2.5 years through the fast tracking of witness protection cases.

Intravenous paracetamol overdose in a paediatric patient

NARCIS (Netherlands)

Broeks, Ilse J.; Van Roon, Eric N.; Van Pinxteren-Nagler, Evelyn; De Vries, Tjalling W.

2013-01-01

BACKGROUND: Paracetamol is a widely used drug in children. In therapeutic doses, paracetamol has an excellent safety profile. Since the introduction of the intravenous form in 2004, only three reports of accidental overdose in children have been published. The low number probably is due to

Alcohol Overdose: The Dangers of Drinking Too Much

Science.gov (United States)

... The Dangers of Drinking Too Much Print version Alcohol Overdose: The Dangers of Drinking Too Much Celebrating ... excess. And the results can be deadly. Identifying Alcohol Poisoning Critical Signs and Symptoms of Alcohol Poisoning ...

Caring for the Jehovah's Witness Parturient.

Science.gov (United States)

Mason, C LaToya; Tran, Connie K

2015-12-01

Caring for the Jehovah's Witness parturient is a complex task that presents a number of ethical, medical, and legal concerns because many Jehovah's Witnesses refuse allogeneic blood transfusion. Childbirth and its surrounding events may be associated with significant blood loss. Given their significant role in the intraoperative administration of blood products, anesthesia providers should be familiar with factors that must be considered in the perioperative care of Jehovah's Witness parturients. Several pharmacologic therapies, anesthetic techniques, and operative interventions aimed at blood conservation may be useful in the care of such patients. Aside from their refusal of transfusion, each Witness makes a personal decision on the acceptability of derivatives of plasma or cellular blood components and autologous blood management. Therefore, the patient-physician relationship must ensure that the individual patient's desires are accurately communicated, respected, and documented in the patient's medical record. The Perioperative Surgical Home model is appropriate for use in caring for Jehovah's Witness patients because it allows for the early and continuing coordination of care and communication between the patient and a multidisciplinary team. In this article, we present a focused review of concepts important to the provision of anesthetic care of parturients who are Jehovah's Witnesses and introduce an algorithmic perioperative approach that may be applied to the care of the Jehovah's Witness parturient undergoing an operative procedure.

Patients Who Attend the Emergency Department Following Medication Overdose: Self-Reported Mental Health History and Intended Outcomes of Overdose

Science.gov (United States)

Buykx, Penny; Ritter, Alison; Loxley, Wendy; Dietze, Paul

2012-01-01

Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…

Adult clonidine overdose: prolonged bradycardia and central nervous system depression, but not severe toxicity.

Science.gov (United States)

Isbister, Geoffrey K; Heppell, Simon P; Page, Colin B; Ryan, Nicole M

2017-03-01

There are limited reports of adult clonidine overdose. We aimed to describe the clinical effects and treatment of clonidine overdose in adults. This was a retrospective review of a prospective cohort of poisoned patients who took clonidine overdoses (>200 μg). Demographic information, clinical effects, treatment, complications (central nervous system and cardiovascular effects) and length of stay (LOS) were extracted from a clinical database or medical records. From 133 admissions for clonidine poisoning (1988-2015), no medical record was available in 14 and 11 took staggered ingestions. Of 108 acute clonidine overdoses (median age 27 years; 14-65 years; 68 females), 40 were clonidine alone ingestions and 68 were clonidine with co-ingestants. Median dose taken was 2100 μg (interquartile range [IQR]: 400-15,000 μg). Median LOS was 21h (IQR: 14-35 h) and there were no deaths. Glasgow coma score [GCS] central nervous system depression and bradycardia. Naloxone was not associated with improved outcomes.

Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010

Science.gov (United States)

Bachhuber, Marcus A.; Saloner, Brendan; Cunningham, Chinazo O.; Barry, Colleen L.

2015-01-01

IMPORTANCE Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. OBJECTIVE To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. DESIGN, SETTING, AND PARTICIPANTS A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. EXPOSURES Presence of a law establishing a medical cannabis program in the state. MAIN OUTCOMES AND MEASURES Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. RESULTS Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (−19.9%; 95% CI, −30.6% to −7.7%; P = .002), year 2 (−25.2%; 95% CI, −40.6% to −5.9%; P = .01), year 3 (−23.6%; 95% CI, −41.1% to −1.0%; P = .04), year 4 (−20.2%; 95% CI, −33.6% to −4

Quality of Life Perception by Inmates in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Directory of Open Access Journals (Sweden)

Muasa Patoka Guillaume Kalonji

2017-12-01

Full Text Available Background: In developing countries, quality of prison life remains a challenge in public health. The present study aimed at determining the quality of life as perceived by inmates during their imprisonment at the Central Prison of Mbuji-Mayi, Democratic Republic of Congo. Methods: This cross-sectional study was carried out over a 3-month period (between December 2015 and February 2016 at the Central Prison of Mbuji-Mayi. Three hundred inmates participated to the survey. The World Health Organization Quality of Life Scale (WHOQOL-BREF was used to estimate health and problems affecting inmates’ everyday life. Results: Mean age of inmates was 33 ± 10 years (range: 18-70 years and most of them were male (88.7%. The quality of life score estimated was below 50, on the WHOQOL-BREF scale weighted over 100 points (average overall score: 26 ± 7. When considering each WHOQOLBREF domain, the lowest scores (0-100 normalized scale were registered for: perception of physical health (24 ± 11, psychological health (18 ± 8, social relationship (39 ± 15 and environmental relationships (24 ± 8. Overall, inmates aged over 30 years old presented an average score slightly lower than younger inmates (25 ± 6 vs. 27 ± 7; p=0.005. Depending on the length of incarceration, the average score was lower for inmates imprisoned for more than 6 months compared to others (26 ± 6 vs. 28 ± 8; p=0.015. Correlations between domain scores were low but statistically significant; no correlation was highlighted between environment and mental health domains. Conclusion: Most inmates considered their quality of life as negative, regardless of the WHOQOL-BREF domain. Efforts to improve quality of life should remain a priority for political authorities.

[Involuntary psychiatric care for inmates in France: Only for "dangerous" patients?

Science.gov (United States)

Fovet, T; Bertrand, M; Horn, M; Si Mohammed, W; Dandelot, D; Dalle, M-C; Thomas, P; Amad, A

2017-11-27

The unités hospitalières spécialement aménagées (UHSA) are full-time inpatient psychiatric units for inmates in France. Their creation has been associated with several advances in access to psychiatric care for inmates in recent years. However, there is still only one means of involuntary hospitalization for prisoners in France: care by decision of a representative of the state (les soins sur décision d'un représentant de l'état [SDRE]). Interestingly, for SDRE to be recognized as legal by the French judge, the patient must be "a danger to himself or to the others". Thus, there is a major difference with involuntary hospitalization outside the prison, and there are specific criteria for involuntary psychiatric hospitalization for inmates in France. This situation questions the general framework of involuntary psychiatric care and is very inconsistent with French law. Indeed, the goal of the loi n o  94-43 du 18 janvier 1994 relating to public health and social protection is to ensure equivalent care for all patients, incarcerated or not. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Documenting a best practice model for successful female inmate ...

African Journals Online (AJOL)

Documenting a best practice model for successful female inmate and female ex ... of men and women within the prison and correctional services as well as inform and ... and beyond, with scope for transforming it into a robust business model.

Cost-effectiveness of hepatitis B vaccination of prison inmates.

Science.gov (United States)

Pisu, Maria; Meltzer, Martin Isaac; Lyerla, Rob

2002-12-13

The purpose of this paper is to determine the cost-effectiveness of vaccinating inmates against hepatitis B. From the prison perspective, vaccinating inmates at intake is not cost-saving. It could be economically beneficial when the cost of a vaccine dose is US dollars 30 per dose, or there is no prevalence of infection upon intake, or the costs of treating acute or chronic disease are about 70% higher than baseline costs, or the incidence of infection during and after custody were >1.6 and 50%, respectively. The health care system realizes net savings even when there is no incidence in prison, or there is no cost of chronic liver disease, or when only one dose of vaccine is administered. Thus, while prisons might not have economic incentives to implement hepatitis B vaccination programs, the health care system would benefit from allocating resources to them.

Inmate must take HIV test if he wants to enroll in program.

Science.gov (United States)

1999-10-29

An inmate cannot sue the Taylorville Correctional Center in Illinois under the Americans with Disabilities Act (ADA) for requiring an HIV test for enrollment in a prison program. [Name removed] wanted to participate in the prison's culinary arts program, but did not want to take the HIV test. The 7th U.S. Circuit Court of Appeals ruled that [name removed] was not a "qualified individual with a disability" and therefore could not sue under ADA. The policy justification for the HIV test, which is required of all inmates enrolling in the program, was not addressed by the court.

Socio-demographic characteristics of the addicted inmates of Qom and Tabriz prisons in Iran

OpenAIRE

Sattari, Mohammadreza; Islambulchilar, Mina; Toluyi, Mohsen; Mashayekhi, Siminozar

2012-01-01

Purpose: The aim of this investigation was to study the factors responsible for drug addiction amongst the inmates of Tabriz and Qom prisons, to further understand the reasons for drug abuse particularly in the young and find improved methods for combating these widespread problems. Methods: A multi-choice questionnaire was provided to inmates to potentially assess the reasons for their drug addiction psychiatric, personal, social, economical, and political factors were thought to be implicat...

20 CFR 258.2 - Witnesses.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Witnesses. 258.2 Section 258.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT HEARINGS BEFORE THE BOARD... a delegation of authority to such examiner to require and compel the attendance of witnesses and the...

29 CFR 1921.18 - Witnesses and fees.

Science.gov (United States)

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Witnesses and fees. 1921.18 Section 1921.18 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... WORKERS' COMPENSATION ACT Miscellaneous § 1921.18 Witnesses and fees. Witnesses subpoenaed by any party...

Bleeding and asymptomatic overdose in patients under Vitamin K antagonist therapy: Frequency and risk factors

Directory of Open Access Journals (Sweden)

F. Ben Mbarka

2018-03-01

Full Text Available Background: Vitamin K antagonists are widely used in the treatment and prevention of thromboembolic disease. However, these drugs can cause serious side effects, especially bleeding. This study aims to evaluate frequency and risk factors of both bleeding and asymptomatic overdose in North African patients undergoing Vitamin K antagonist therapy. Methods: We performed a cross-sectional study in patients undergoing Vitamin K antagonist therapy. A statistical analysis has been conducted to identify overdose and bleeding risk factors by using chi-square test (p < .05. Results: One hundred and eleven patients were included. We recorded 14 cases of bleeding and 26 cases of asymptomatic overdose. Advanced age, poor adherence, concomitant use of paracetamol and history of previous bleeding are significant risk factors of over-anticoagulation. An INR value over 6 at admission, a high therapeutic target range for INR, concomitant use of acetylsalicylic acid, lack of information on overdose signs and measures to be taken in case of bleeding were identified as risk factors for bleeding. Conclusion: Most of the risk factors identified in our study seem to be related to patients lack of information and education. These results highlight the importance of creating a therapeutic patient education program. Keywords: Vitamin K antagonist, Bleeding, Risk factor, Overdose

Serotonin syndrome following overdose of a non-prescription slimming product containing sibutramine: a case report.

Science.gov (United States)

Lam, Pui Kin; Leung, K S; Wong, T W; Lee, H H C; Tang, M H Y; Mak, T W L

2012-04-01

Non-prescription slimming products are popular and can be easily purchased from the Internet. However, adulteration of these products with undeclared substances including prescription drugs is not uncommon. We report a case of serotonin syndrome after an overdose of a non-prescription product containing sibutramine. A 21-year-old woman presented with somnolence, sinus tachycardia, generalised increase in tone, hyper-reflexia and clonus more prominent in the lower limbs after an intentional overdose of a non-prescription slimming product obtained from the Internet. The product was later found to contain sibutramine and other substances such as animal thyroid tissues, caffeine and phenolphthalein. Quantitative analysis of patient's serum on presentation revealed a sibutramine concentration of 112 ng/mL, which far exceeded the reported peak serum concentration after a single oral dose of 15 mg (the maximum daily recommended dose). No other culpable agent was identified. The overall clinical presentation was compatible with serotonin syndrome associated with sibutramine overdose. The patient made a full recovery after supportive management. This case highlighted the health threat posed by non-prescription slimming products sold over the Internet. Sibutramine overdose can result in serotonin syndrome, as in overdose of other serotonergic agents. Early recognition and timely supportive treatment are essential to ensure a good clinical outcome.

Barriers to Helpseeking among New Zealand Prison Inmates

Science.gov (United States)

Skogstad, Philip; Deane, Frank P.; Spicer, John

2005-01-01

Treatment avoidance or help-negation has been described in clinical and non-clinical samples, in response to real or imagined suicidal scenarios (Carlton & Deane, 2000; Rudd, Joiner & Rajab, 1995). The aims of the present study were to describe the process of seeking psychological help in prison based on inmate interviews and to assess the…

32 CFR 724.213 - Attendance of witnesses.

Science.gov (United States)

2010-07-01

... BOARD Authority/Policy for Departmental Discharge Review § 724.213 Attendance of witnesses. Arrangement for attendance of witnesses testifying in behalf of the applicant at discharge review hearings is the... 32 National Defense 5 2010-07-01 2010-07-01 false Attendance of witnesses. 724.213 Section 724.213...

The Prescription Opioid Pain Medication Overdose Epidemic

Centers for Disease Control (CDC) Podcasts

2016-04-19

Overdose related to prescription opioids has become an epidemic. This podcast discusses the risks of this type of drug sometimes used to treat pain, and how to protect yourself. .  Created: 4/19/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/19/2016.

32 CFR 516.54 - Witnesses for the United States.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Witnesses for the United States. 516.54 Section..., Travel, and Expenses of Witnesses § 516.54 Witnesses for the United States. (a) Status of witness. A military member authorized to appear as a witness for the United States, including those authorized to...

Depression among inmates in a regional prison of eastern Nepal: a cross-sectional study.

Science.gov (United States)

Shrestha, Gambhir; Yadav, Deepak Kumar; Sapkota, Nidesh; Baral, Dharanidhar; Yadav, Birendra Kumar; Chakravartty, Avaniendra; Pokharel, Paras Kumar

2017-10-23

Depression is the most common form of mental disorder among inmates, with a prevalence much higher than in the general population. This study aims to estimate the prevalence of depression among inmates and identify factors associated with it. This cross-sectional study was conducted in Jhumka Regional Prison, the largest prison in eastern Nepal, from September 2014 to August 2015. A total of 434 randomly selected inmates were interviewed using a semi-structured questionnaire examining socio-demographic characteristics, detention status, self-reported health problems, substance use status, and suicidal ideation. Depression was screened using the Center for Epidemiologic Studies Depression scale. Chi-square tests and multiple logistic regression analysis were applied to determine the association between depression and related variables. The mean age of the participants was 35.7 years (SD 13.3). The prevalence of depression among the inmates was 35.3%. Approximately 2.3% reported suicidal ideation during imprisonment and 0.9% had attempted suicide inside the prison. In bivariate analysis, depression was significantly associated with previous incarceration (OR = 1.91, 95% CI = 1.05-3.47, p = 0.033), poor self-rated health (OR = 1.75, 95% CI = 1.16-2.64, p = 0.007), frequent appointments when encountering health problems (OR = 1.66, 95% CI = 1.06-2.61, p = 0.028), suicidal ideation (OR = 4.44, 95%CI = 1.13-17.44, p = 0.038) and loss of weight (OR = 1.49, 95% CI = 1.00-2.23, p = 0.049). However, only previous incarceration (AOR = 1.97, 95% CI = 1.04-3.74, p = 0.037) and frequent appointments when encountering health problems (AOR = 1.61, 95% CI = 1.01-2.57, p = 0.046) remained significant in a multivariate model. This study showed a high rate of depression among inmates in Nepal. The results suggest a need for psychiatric and rehabilitative care in correctional settings to improve the health status of the inmates.

Social learning and peer education in responding to opiate overdose among injection drug users in Ukraine

Directory of Open Access Journals (Sweden)

Anna Tokar

2014-06-01

Full Text Available BACKGROUND: Opiate overdoses (OD constitute one of the leading causes of avoidable deaths among people aged 20-40 years old. As peer-administered help in cases of overdose was found to be effective, we aimed to explore how much the subjects of the intervention are able to learn from one another and from their own experience. METHODS: Secondary data analysis was performed with the 2008 dataset of peer-driven intervention among IDUs who were not involved in harm reduction programs earlier; recruiting was performed with respondent driven sampling methodology combined with peer education covering overdose response. Subsample of 6667 opiate users was considered. Data on overdose response strategies experienced by respondents were considered predictors and data on intended response strategies as outcomes. To reveal relationships between the experienced and intended responses, binary logistic regression analysis was performed. RESULTS: With recommended strategies including calling ambulance, putting a person in recovery position, fixing the tongue, applying mouth-to-mouth resuscitation and cardiac massage, percentages of those planning to apply them was considerably higher (on average, 2.3 times higher than the percentage of those having experienced them. With other strategies including applying cold, pain, ammonia, percentages of those who experienced the strategy and those who planned to practice it were rather close and on average differed just by 1.1. With all the strategies, the intention to apply a particular response in future was strongly associated with personal experience of having had this applied when having an overdose episode. Peer-education to larger extent determines the intentions of those who have not experienced particular overdose responses themselves. On the other hand, social learning contributes to persisting of those experienced strategies which cannot be recommended. CONCLUSIONS: Social learning can impact intended overdose

Expert Witness

African Journals Online (AJOL)

Adele

formal rules of evidence apply) to help it understand the issues of a case and ... statements on medical expert witness by professional representative bodies in .... determining the size of the financial settlement that may have to be made to the.

To be truly alive: motivation among prison inmate hospice volunteers and the transformative process of end-of-life peer care service.

Science.gov (United States)

Cloyes, Kristin G; Rosenkranz, Susan J; Wold, Dawn; Berry, Patricia H; Supiano, Katherine P

2014-11-01

Some US prisons are meeting the growing need for end-of-life care through inmate volunteer programs, yet knowledge of the motivations of inmate caregivers is underdeveloped. This study explored the motivations of inmate hospice volunteers from across Louisiana State (n = 75) through an open-ended survey, a grounded theory approach to analysis, and comparison of responses by experience level and gender. Participants expressed complex motivations; Inter-related themes on personal growth, social responsibility and ethical service to vulnerable peers suggested that inmate caregivers experience an underlying process of personal and social transformation, from hospice as a source of positive self-identity to peer-caregiving as a foundation for community. Better understanding of inmate caregiver motivations and processes will help prisons devise effective and sustainable end of life peer-care programs. © The Author(s) 2013.

12 CFR 512.5 - Rights of witnesses.

Science.gov (United States)

2010-01-01

... has given. During the taking of the testimony of a witness, such attorney may make summary notes... before, during, and after the taking of his testimony and may briefly question the witness, on the record... permitted to be present during the taking of testimony of any other witness called in such proceeding...

Prescription Painkiller Overdoses in the U.S. – What You Need to Know PSA (:60)

Centers for Disease Control (CDC) Podcasts

2011-11-01

This 60 second PSA is based on the November, 2011 CDC Vital Signs report. Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from these overdoses—more than those who die from heroin and cocaine combined. Learn the steps you can take to prevent an overdose.  Created: 11/1/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/1/2011.

Assessment of prevalence of tobacco consumption among psychiatric inmates residing in Central Jail, Bhopal, Madhya Pradesh, India: A cross-sectional survey

Directory of Open Access Journals (Sweden)

Nilesh Arjun Torwane

2013-01-01

Full Text Available Aim: The aim of the current cross-sectional study was to assess the prevalence of tobacco consumption among psychiatric jail patients residing in Central Jail, Bhopal, Madhya Pradesh, India. Materials and Methods: The study subjects consisted of prediagnosed psychiatric patients residing in Central Jail, Bhopal, Madhya Pradesh, India. A matched control consisting of cross-section of the population, that is, jail inmates residing in the same Central Jail locality was also assessed to compare the psychiatric subjects. An 18 item questionnaire was used to assess the prevalence of tobacco consumption among study subjects. Results: The total number of subjects examined was 244, which comprised of 122 psychiatric inmates and 122 nonpsychiatric inmates. Among all psychiatric inmates, about 57.4% of inmates had a diagnosis of depression, 14.8% had psychotic disorders (such as schizophrenia, and 12.3% had anxiety disorder. A total of 77% study inmates, which comprised of 87.7% psychiatrics and 66.4% nonpsychiatrics had a habit of tobacco consumption (smokeless or smoking. Conclusion: The information presented in this study adds to our understanding of the common tobacco related practices among psychiatric inmate population. Efforts to increase patient awareness of the hazards of tobacco consumption and to eliminate the habit are needed to improve oral and general health of the prison population.

Overdosed paracetamol (acetaminophen) prescriptions and subsequent pharmacist interventions in French hospitals.

Science.gov (United States)

Charpiat, B; Bedouch, P; Rose, F X; Juste, M; Roubille, R; Conort, O; Allenet, B

2013-11-01

Little is known about the manner in which hospital pharmacists intervene for overdosed paracetamol prescriptions. The aim of this retrospective study was to describe the number and nature of pharmacists' interventions (PIs) for overdosed paracetamol adult prescriptions in hospitals. We studied PIs that had been documented by pharmacists on the French Society of Clinical Pharmacy website tool between 2007 and 2010. We identified PIs that were related to paracetamol-containing prescriptions of one brand name only (type 1) particularly for patients with body weight ≤ 50 kg who were prescribed 4 g/day, and PIs that concerned the co-prescription of two paracetamol-containing products (type 2). Among 60 hospitals, seven did not report any paracetamol overdose-related PIs. Of the 53 hospitals that had at least one PI, 16 did not report any type 1 PIs. Bodyweight, liver disease, cirrhosis and chronic alcoholism were absent recorded criterion by most of the hospitals included in this study. Previously published studies have highlighted that the most frequent PIs are type 1, especially for patients whose body weight is ≤ 50 kg. We observed a broad variability in the number or type of PI that were related to overdosed paracetamol prescriptions compared with the total of all recorded types of PI. These data suggest that a significant number of hospital pharmacists are unaware of the risks that adult patients with low body weight are exposed to when receiving four grams paracetamol/day over several days. Pharmacist educational programs are needed. Copyright © 2013. Published by Elsevier Masson SAS.

Two-Tiered Humanistic Pre-Release Interventions for Prison Inmates.

Science.gov (United States)

Bowman, Vicki E.; Lowrey, Louis; Purser, Jane

1997-01-01

Provides a rationale for a more humanistic approach to prerelease programming which focuses on the needs of inmates during this transitional period. A two-tiered educational and counseling-program model, which emphasizes education, information giving, and empowerment, is offered as an alternative to past prison programs. (RJM)

28 CFR 513.12 - Inmate request for record clarification.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmate request for record clarification. 513.12 Section 513.12 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL MANAGEMENT AND ADMINISTRATION ACCESS TO RECORDS Production or Disclosure of FBI/NCIC Information § 513.12...

Lack of respiratory depression in paracetamol-codeine combination overdoses.

Science.gov (United States)

Heppell, Simon P E; Isbister, Geoffrey K

2017-06-01

Codeine containing analgesics are commonly taken in overdose, but the frequency of respiratory depression is unknown. We investigated whether paracetamol-codeine combination overdoses caused respiratory depression more than paracetamol alone. We reviewed deliberate self-poisoning admissions with paracetamol (>2 g) and paracetamol-codeine combinations presenting to a tertiary toxicology unit (1987-2013). Demographic information, clinical effects, treatment (naloxone, length of stay [LOS], mechanical ventilation) were extracted from a prospective database. Primary outcome was naloxone requirement or ventilation for respiratory depression. From 4488 presentations, 1376 admissions were included with paracetamol alone (929), paracetamol-codeine combinations (346) or paracetamol-codeine-doxylamine combinations (101) without co-ingestants. Median age was 23 years (12-89 years); 1002 (73%) were female. Median dose was 12 g (interquartile range [IQR]: 7.5-20 g). Median LOS was 16 h (IQR: 6.5-27 h) and 564 (41%) were given acetylcysteine. Significantly larger paracetamol doses were ingested and more acetylcysteine given in paracetamol alone versus paracetamol combination overdoses. Seven out of 1376 patients were intubated or received naloxone (0.5%; 95% CI: 0.2-1.1%), three intubated, three given naloxone and one both. Three out of 929 patients ingesting paracetamol alone (0.3%; 95% CI: 0.1-1%) required intubation or naloxone, compared to two out of 346 ingesting paracetamol-codeine combinations (0.6%; 95% CI: 0.1-2.3%; absolute difference, 0.26%; 95% CI: -0.7-1.2%; P = 0.62). Two out of 101 patients ingesting paracetamol-codeine-doxylamine combinations (2%; 95% CI: 0.3-8%) required intubation or naloxone. Four patients were intubated for reasons other than respiratory depression: hepatotoxicity (2), retrieval (1), no data (1). Two out of 929 (0.2%) paracetamol alone overdoses had a Glasgow coma score depression, with only two given naloxone and none intubated for

Accidental hydroxychloroquine overdose resulting in neurotoxic vestibulopathy.

Science.gov (United States)

Chansky, Peter B; Werth, Victoria P

2017-04-12

Hydroxychloroquine is an oral antimalarial medication commonly used off-label for a variety of rheumatological conditions, including systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome and dermatomyositis. We present a case of a 64-year-old woman who presented with acute onset headache, bilateral tinnitus, and left-sided facial numbness and tingling in the setting of accidentally overdosing on hydroxychloroquine. By the next morning, the patient began to experience worsening in the tingling sensation and it eventually spread to her left arm, thigh and distal extremities. The patient also complained of new onset blurring of her peripheral vision and feeling 'off balance.' Despite a complete neurological and ophthalmological work-up with unremarkable imaging and blood work, the patient has had no improvement in her tinnitus, left-sided paresthesias, visual disturbance or ataxia. This is a unique case of hydroxychloroquine overdose resulting in permanent neurotoxic vestibulopathy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Zolpidem Overdose: A Dilemma in Mental Health.

Science.gov (United States)

Jung, Minsoo

Sleeping pills are one of the most common drugs taken by adults when afflicted by insomnia. Adverse effects of pharmacotherapy, however, should not be overlooked, and monitoring is needed to check for an overdose of sleeping pills. We reviewed zolpidem overdose and patient suicide with benefits and disadvantages of pharmacotherapy. Cases of adverse effects concerning the central nervous system, including delirium and hallucination, as well as abnormal behavior during sleep, are commonly reported among patients who have taken zolpidem for more than 1 year. The serious problem of long-term prescription to medication can lead to a higher mortality rate of insomniac patients. An alternative to medication for treating insomnia is cognitive behavioral therapy, which can improve sleeping habits. Cognitive behavioral therapy induces patients to recognize and change the negative thoughts that affect their sleep. Medical providers should be aware of the adverse effects of sleep inducers and provide sufficient information to their patients about them. When establishing treatment plans, they should encourage patients to make the proper decisions and try to reduce the adverse effects of any medication as much as possible.

Most drug overdose deaths from nonprescription opioids

Directory of Open Access Journals (Sweden)

Robbins RA

2016-12-01

Full Text Available No abstract available. Article truncated at 150 words. The Centers for Disease Control (CDC is reporting in Morbidity and Mortality Weekly that the number of people dying from an opioid overdose rose 15.5% from 2014 to 2015, but the increase had little to do with prescription painkillers such as oxycodone or hydrocodone (1. Roughly 52,000 people died from drug overdoses in 2015 and of those deaths 33,091 involved an opioid. The increases in “death rates were driven by synthetic opioids other than methadone (72.2%, most likely illicitly-manufactured fentanyl, and heroin (20.6%”. Deaths from methadone, which is usually prescribed by physicians, decreased 9.1%. The largest increase in deaths occurred in the South and Northeast with 3% and 24% increases in deaths from synthetic opioids from 2014 to 2015. In the Midwest and West, there were more modest 17% and 9% increases during the same period. States in the Southwest with “good” to “excellent” reporting included Colorado, Nevada, and New …

6 CFR 13.33 - Witnesses.

Science.gov (United States)

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Witnesses. 13.33 Section 13.33 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.33 Witnesses. (a) Except as provided in paragraph (b) of this section, testimony at the hearing will be given orally by...

Bearing witness: an existential position in caring.

Science.gov (United States)

Arman, Maria

2007-12-01

A basic assumption for the study is that perceiving a person's deepest needs and desires to be on hand for another person, and their attempt to do so, have, in an ontological sense, the power to bear witness of goodness and eternity. The study was based on a theoretical basis of a caring science view of suffering, as well as the ethics of the philosopher Lévinas. The aim was to explore and clinically validate nuances of witnessing as a caring act.A Socratic dialogue was performed and an interpretive (hermeneutic) method was employed in this study. The Socratic dialogue with four nurses in palliative care focused on and analysed one clinical example of witnessing in palliative care. As basis for the findings are the participating nurses jointly formulated assumptions on the subject: To be a witness you have to be with the patient and refer back to him or her what you have seen; but also to act in accordance with what you have perceived. In the moment you witness, a window is opened onto the unknown; you become vulnerable as a caregiver and require courage. Being a witness encompasses existential and spiritual aspects; being a fellow human being, having a heart to heart relationship is a wilful act on the part of the nurse. Our theoretical discussion focuses on the language of the body, courage as a bridge to an existential encounter and the alleviation of patients' suffering through caregivers' witnessing. A conclusive aspect is that being a witness may bring a new understanding of life in the face of death and suffering. The existential position of being a witness requires the caregiver to be courageous because of its transformative prospect, but may utterly enrich both parties' inner life of shared meaning.

Inmates perception of the living conditions in a medium security ...

African Journals Online (AJOL)

Inmates perception of the living conditions in a medium security prison in North ... and adopted a number of International legal instruments to protect and guarantee ... Data analysis was done with Statistical Package for Social Sciences version ...

78 FR 49470 - Adrian Jesus Reyna, Inmate Number #80629-280, FCI Bastrop, Federal Correctional Institution, P.O...

Science.gov (United States)

2013-08-14

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Adrian Jesus Reyna, Inmate Number 80629-280... Privileges On January 27, 2012, in the U.S. District Court, Western District of Texas, Adrian Jesus Reyna.... Until January 27, 2022, Adrian Jesus Reyna, with a last known address at: Inmate Number 80629-280, FCI...

Skin infections and infestations in prison inmates.

Science.gov (United States)

Oninla, Olumayowa A; Onayemi, Olaniyi

2012-02-01

Skin infections and infestations are common in a prison environment. The prison is in dynamic equilibrium with the larger society. Hence, it serves as a reservoir of infections which can spread to the larger society. The study sets out to find out how rampant these infections might be in the prison and the factors responsible. Inmates at a Nigerian prison in Ilesha, Osun State, were examined for skin infections. Personal hygiene and living conditions were critically examined. The overall prevalent rate of infectious dermatoses was 49.2% (150/305). There were 178 infections. Dermatophytes accounted for 64%, pityriasis versicolor 27%, bacterial infections 3.4%, and others 5.6%. Only frequency of soap use and accommodation arrangement significantly contributed to the overall prevalence. However, infectious dermatoses were significantly affected by prison status (PP = 0.04), frequency of bath (PP = 0.025), changing of clothing (PP = 0.05), accommodation arrangement (P = 0.0001), frequency of soap usage (P = 0.005), and toilet facility (P = 0.001). The HIV status of the inmates was unknown. Hence, effect of HIV infection cannot be ascertained. Skin infections and infestations are common in prison. A change in living conditions and personal hygiene will definitely help in reducing these infections. © 2012 The International Society of Dermatology.

Effects of Systematic Human Relations Training on Inmate Participants

Science.gov (United States)

Davis, E. Duane; And Others

1976-01-01

The present study was conducted to determine the applicability of human relations training in the rehabilitation of selected prisoners in a Southern prison. Inmates who participated in the study were able to learn discrimination between helpful and nonhelpful communication and to make positive gains in their work behavior. (Author)

An assessment of personality disorders with the Five-Factor Model among Belgian inmates.

Science.gov (United States)

Thiry, Benjamin

2012-01-01

Many international studies report a high prevalence of personality disorders among inmates on the basis of (semi)-structured diagnostic interviews. The present study proposes a self-reported evaluation of personality disorders using the NEO PI-R. The sample consists of 244 male and 18 female inmates (N=262) who were psychologically assessed. The analysis of the five psychological domains shows that the French-speaking Belgian inmates are as stable, as extroverted, more closed, more agreeable and more conscientious than the normative sample. The NEO PI-R facets are also analyzed. The mean Cohen's d (.26) is small. Two personality disorders have medium effect sizes: obsessive compulsive personality disorder (high) and histrionic personality (low). Small effect sizes exist for antisocial personality (low), psychopathy (low), narcissistic personality (low), schizoid personality (high) and borderline personality (low). In our view, the context of the assessment can partially explain these results but not entirely. The results do not confirm previous studies and question the high rates of psychiatric prevalence in prison. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Massive Overdose of Dalfampridine

Directory of Open Access Journals (Sweden)

Laura J. Fil

2015-12-01

Full Text Available Multiple sclerosis (MS is an immune mediated inflammatory disease that attacks myelinated axons in the central nervous system. Dalfampridine (4-aminopyridine was approved by the Food and Drug Administration in January 2010 for treatment of MS. Our patient was a 34-year-old male with a history of MS, who was brought to the emergency department after being found unresponsive. His current medications were valacyclovir, temazepam, dalfampridine (4-AP and a tysabri intravenous (IV infusion. Fifteen minutes after arrival the patient seized. The seizures were refractory to benzodiazepines, barbiturates and phenytoin. The 4-AP level was 530ng/mL (25ng/mL and 49ng/ mL. The patient stopped seizing on hospital day 3 and was discharged 14 days later with normal mental status and neurologic exam. 4-AP is a potassium channel blocker that blocks the potassium ion current of repolarization following an action potential. The blockade of the potassium channel at the level of the membrane widens the action potential and enhances the release of acetylcholine, thus increasing post-synaptic action potentials. The treatment of patients with 4-AP overdose is supportive. Animal data suggest that patients with toxic levels of 4-AP may respond to phenytoin. Our case illustrates the highest recorded level of 4-AP in an overdose. Our patient appeared to be refractory to a combination of high doses of anticonvulsants and only improved with time.

Study of coercive measures in prisons and secure psychiatric hospitals: the views of inmates and caregivers

Directory of Open Access Journals (Sweden)

A. Runte-Geidel

2014-06-01

Full Text Available Aim: The aim of the study was to ascertain the opinions of both inmates and staff of prison establishments about the use of coercive measures justified for clinical reasons for people with mental health problems and about the need to create protocols to regulate the application of these measures. Method: These opinions were gathered in a Qualitative Study with Focus Groups (prison inmates and prison staff from the Granada Penitentiary Centre and the Alicante Penitentiary Psychiatric Hospital, both in Spain. Results: The results showed that forced medication is the most commonly used coercive measure in these institutions. The inmates did not understand and rejected the use of this measure, above all because they were poorly informed about their illness and the medication required to treat it. The staff however defended the benefits of psychiatric medicine, even when administered without the patient's consent. Conclusions: Both inmates and staff agreed that it would be useful to have a protocol regulating the use of coercive measures. The study has also identified a number of important factors that could help to reduce the need for coercive measures or make their use unnecessary.

Entanglement witnesses arising from exposed positive linear maps

OpenAIRE

Ha, Kil-Chan; Kye, Seung-Hyeok

2011-01-01

We consider entanglement witnesses arising from positive linear maps which generate exposed extremal rays. We show that every entanglement can be detected by one of these witnesses, and this witness detects a unique set of entanglement among those. Therefore, they provide a minimal set of witnesses to detect all entanglement in a sense. Furthermore, if those maps are indecomposable then they detect large classes of entanglement with positive partial transposes which have nonempty relative int...

COMMUNICATING RISK IN THE CONTEXT OF METHADONE FORMULATION CHANGES: A QUALITATIVE STUDY OF OVERDOSE WARNING POSTERS IN VANCOUVER, CANADA

Science.gov (United States)

Markwick, Nicole; McNeil, Ryan; Anderson, Solanna; Small, Will; Kerr, Thomas

2015-01-01

BACKGROUND British Columbia, Canada’s provincial methadone program recently replaced their existing methadone formulation with a formulation ten times more concentrated. The transition raised concerns about heightened risk of accidental overdose, leading two organizations to disseminate methadone overdose warning posters during the transitional period. This study explores people who use drugs’ (PWUD) perceptions of these warning posters. METHODS Qualitative interviews were conducted with thirty-four PWUD enrolled in methadone maintenance treatment in Vancouver. Participants were recruited from ongoing cohort studies of drug-using individuals. Interview transcripts were analyzed thematically, focusing on participants’ perceptions of the warning posters and potential impacts on drug-related risks. RESULTS Overdose warning posters constituted a key source of information about the methadone formulation change, but did not provide adequate information for all participants. Participants articulated a preference for descriptive language, focusing on changes in concentration rather than “strength”, and universal hazard symbols to effectively communicate overdose risks. CONCLUSION Participants indicated that warnings employing descriptive language more effectively communicated risk of methadone overdose. Future overdose warnings for drug-using populations must provide adequate information for the intended audience, and be communicated to PWUD through multiple channels. PMID:26644025

Cognitive impairment in patients clinically recovered from central nervous system depressant drug overdose.

Science.gov (United States)

Dassanayake, Tharaka L; Michie, Patricia T; Jones, Alison; Carter, Gregory; Mallard, Trevor; Whyte, Ian

2012-08-01

Central nervous system depressant drugs (CNS-Ds) are known to impair cognitive functions. Overdose of these drugs is common, and most of the hospital-treated patients are discharged within 24 to 48 hours. No previous studies have examined whether they have residual impairment at the time of discharge. Our aim was to evaluate whether patients with CNS-D overdose are impaired in cognitive domains important in daily activities at that time. We compared visuomotor skills (Trail-Making Test A and Choice Reaction Time), executive functions (viz attentional set-shifting: Trail-Making Test B; and planning: Stockings of Cambridge Task from the Cambridge Neuropsychological Test Automated Battery), working memory (Letter-Number Sequencing), and impulsivity and decision making (Cambridge Neuropsychological Test Automated Battery Information Sampling) in 107 patients with CNS-D overdose (benzodiazepines, opioids, or antipsychotics) with a control group of 68 with non-CNS-D overdose (acetaminophen, selective serotonin reuptake inhibitors, and serotonin noradrenaline reuptake inhibitors) on discharge from hospital. Outcome measures were adjusted for demographic and clinical covariates in multivariate regression models. Compared with the controls, patients in the CNS-D group were significantly impaired in all domains: they had prolonged Trail-Making completion times and reaction times, poorer working memory and planning and were more impulsive in decision making. Their Stockings of Cambridge Task performance was comparable to that of the control group for simple problems but worsened with increasing task complexity. The results show that patients with CNS-D overdose could be impaired in multiple cognitive domains underlying everyday functioning even at the time they are deemed medically fit to be discharged. Such impairments could adversely affect social and professional lives of this relatively young population during the immediate postdischarge period.

Can naloxone prescription and overdose training for opioid users work in family practice?

Science.gov (United States)

Leece, Pamela; Orkin, Aaron; Shahin, Rita; Steele, Leah S.

2015-01-01

Abstract Objective To explore family physicians’ attitudes toward prescribing naloxone to at-risk opioid users, as well as to determine the opportunities and challenges for expanding naloxone access to patients in family practice settings. Design One-hour focus group session and SWOT (strengths, weaknesses, opportunities, and threats) analysis. Setting Workshop held at the 2012 Family Medicine Forum in Toronto, Ont. Participants Seventeen conference attendees from 3 Canadian cities who practised in various family practice settings and who agreed to participate in the workshop. Methods The workshop included an overview of information about naloxone distribution and overdose education programs, followed by group discussion in smaller focus groups. Participants were instructed to focus their discussion on the question, “Could this [overdose education and naloxone prescription] work in your practice?” and to record notes using a standardized discussion guide based on a SWOT analysis. Two investigators reviewed the forms, extracting themes using an open coding process. Main findings Some participants believed that naloxone could be used safely among family practice patients, that the intervention fit well with their clinical practice settings, and that its use in family practice could enhance engagement with at-risk individuals and create an opportunity to educate patients, providers, and the public about overdose. Participants also indicated that the current guidelines and support systems for prescribing or administering naloxone were inadequate, that medicolegal uncertainties existed for those who prescribed or administered naloxone, and that high-quality evidence about the intervention’s effectiveness in family practice was lacking. Conclusion Family physicians believe that overdose education and naloxone prescription might provide patients at risk of opioid overdose in their practices with broad access to a potentially lifesaving intervention. However, they

Epidemiology of tramadol overdose in Imam Khomeini hospital, Kermanshah, Iran (2008

Directory of Open Access Journals (Sweden)

Habib Ahmadi

2011-03-01

Full Text Available Background: Tramadol is an analgesic drug used for treatment of moderate to severe pain. According to side effects of Tramadol overdose, this study aimed to evaluate epidemiological characteristics of patients who admitted with Tramadol overdose in Imam Khomeini hospital - Kermanshah from March 2008 to March 2009.Methods: In this descriptive- analytical study, all profiles of poisoned subjects with Tramadol who have been referred to the hospital were reviewed. Considerable variables were extracted and data were analyzed using chi-square and Independent t test. Results: The result showed that majority of overdosed subjects was married (80.8% and aged 19 years old (11.2%. Suicide (98.7% was the most common cause of using Tramadol. 40% of cases showed a seizure symptom and seizure incidence in male subjects was higher than female (P<0.001. There was a significant correlation between Tramadol dosages and outbreak of a seizure symptoms. Conclusion: Abuse of Tramadol may leads to seizure and death, which threat young generation less than 30 years old committed to suicide. Increasing knowledge and restriction of Tramadol availability and distribution in community is necessary to prevent young generation from suicide commitment.

Overdose Deaths Related to Fentanyl and Its Analogs - Ohio, January-February 2017.

Science.gov (United States)

Daniulaityte, Raminta; Juhascik, Matthew P; Strayer, Kraig E; Sizemore, Ioana E; Harshbarger, Kent E; Antonides, Heather M; Carlson, Robert R

2017-09-01

Ohio is experiencing unprecedented loss of life caused by unintentional drug overdoses (1), with illicitly manufactured fentanyl (IMF) emerging as a significant threat to public health (2,3). IMF is structurally similar to pharmaceutical fentanyl, but is produced in clandestine laboratories and includes fentanyl analogs that display wide variability in potency (2); variations in chemical composition of these drugs make detection more difficult. During 2010-2015, unintentional drug overdose deaths in Ohio increased 98%, from 1,544 to 3,050.* In Montgomery County (county seat: Dayton), one of the epicenters of the opioid epidemic in the state, unintentional drug overdose deaths increased 40% in 1 year, from 249 in 2015 to 349 in 2016 (estimated unadjusted mortality rate = 57.7 per 100,000) (4). IMFs have not been part of routine toxicology testing at the coroner's offices and other types of medical and criminal justice settings across the country (2,3). Thus, data on IMF test results in the current outbreak have been limited. The Wright State University and the Montgomery County Coroner's Office/Miami Valley Regional Crime Laboratory (MCCO/MVRCL) collaborated on a National Institutes of Health study of fentanyl analogs and metabolites and other drugs identified in 281 unintentional overdose fatalities in 24 Ohio counties during January-February 2017. Approximately 90% of all decedents tested positive for fentanyl, 48% for acryl fentanyl, 31% for furanyl fentanyl, and 8% for carfentanil. Pharmaceutical opioids were identified in 23% of cases, and heroin in 6%, with higher proportions of heroin-related deaths in Appalachian counties. The majority of decedents tested positive for more than one type of fentanyl. Evidence suggests the growing role of IMFs, and the declining presence of heroin and pharmaceutical opioids in unintentional overdose fatalities, compared with 2014-2016 data from Ohio and other states (3-5). There is a need to include testing for IMFs as part

Celebrity witnessing

DEFF Research Database (Denmark)

Christiansen, Lene Bull; Frello, Birgitta

2016-01-01

This article deals with emotional address in the narrative modality of celebrity witnessing in the marketing of development aid. We analyse Danish celebrity narratives of global caring, drawing on Luc Boltanski’s work on a ‘politics of pity’, Lilie Chouliaraki’s notion of the ‘aspirational discou...

Risk factors for prevalent hepatitis C virus-infection among inmates in a state prison system in Mexico.

Directory of Open Access Journals (Sweden)

Pablo F Belaunzarán-Zamudio

Full Text Available To estimate the prevalence of HCV-infection and identify associated factors among inmates in the State Prison System of Guanajuato in Mexico (Sep-2011 to Feb-2012.Cross-sectional, observational study in 10 prisons in the State of Guanajuato in Mexico (2011-2012. We offered HCV-testing and applied audio computer-assisted self-interviews to all adults imprisoned in the State Prison System. We used a complex survey analysis to estimate the distribution of variables and its corresponding 95% confidence intervals, taking into consideration the expected cluster effect by common characteristics within prisons. Inverse probability weights were applied to correct potential biased estimates arising from non-participation in accrual activities and non-response rates. We fitted multivariate logistic regression models to identify risk-behaviors associated to HCV-infection.We included data of 2,519 participating inmates. Prevalence of HCV-infection was 4.9 (95%CI = 3.6-5.9. Most HCV-infected inmates were male (99%. Before being incarcerated, inmates with HCV-infection were more frequently tattooed, used and injected drugs more frequently, and were more likely to share materials for injecting, when compared with those non-infected. During incarceration, HCV-infected inmates got tattoos and used drugs more often than non-infected, including injecting-drugs and sharing materials. Injecting-drug use (OR = 7.6, 95%CI, 2.5-23.4, sharing materials for injecting-drugs (OR = 19.6, 95%CI, 4.7-81.7 and being tattooed at least once before incarceration (OR = 2.1, 95%CI, 1.1-3.9, but not during incarceration, were independently associated to HCV-infection.The prevalence of HCV-infection among inmates in the State of Guanajuato in Mexico is considerably higher than in the general population. The most important risk factors for HCV in this inmate population were injecting-drugs and sharing materials for injections before incarceration. High-risk behaviors during

The Antidotes to the Double Standard: Protecting the Healthcare Rights of Mentally Ill Inmates by Blurring the Line Between Estelle and Youngberg.

Science.gov (United States)

Goldberg, Rose Carmen

2016-01-01

This Note is an examination of mentally ill inmates' constitutional right to treatment. It has significant doctrinal and practical implications. In terms of doctrine, the Supreme Court has created distinct standards for the minimum levels of care for inmates (Estelle) and the civilly committed mentally ill (Youngberg). Under this framework mentally ill inmates are constitutionally equivalent to inmates generally, but are entitled to less care than the civilly committed even if they suffer the same illness. This Note explores this gap through the lens of equal protection and argues that mentally ill inmates are similarly situated to the civilly committed. It further contends that inmates constitute a "discrete and insular minority" and thus the standard establishing their right to care should be subject to strict scrutiny. This Note finds that Estelle fails this test. Practically, this Note brings visibility to a consequential area of the law neglected by scholarship. Over half of inmates are mentally ill and yet treatment in prisons is inadequate. The literature at the intersection of health, criminal justice, and constitutional rights has not constructively considered how doctrine should be changed to protect the wellbeing of this vulnerable population. Scholars have also provided little oversight of the judicial administration of justice in this field; there are few reviews of how judges actually apply treatment rights standards. This Note lessens this blind spot by exposing how courts fail to properly distinguish between different standards. This Note proposes that the most promising antidote to the Estelle-Youngberg double standard, counterintuitively, is not the creation of a uniform standard. A standard that puts mentally ill inmates on equal footing with the civilly committed would solve the doctrinal puzzle, but would be subject to Youngberg's inherent flaws and the judicial malpractice in this area. Recognizing the deficiencies of a purely judicial remedy

29 CFR 18.701 - Opinion testimony by lay witnesses.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Opinion testimony by lay witnesses. 18.701 Section 18.701 Labor Office of the Secretary of Labor RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS... Opinion testimony by lay witnesses. If the witness is not testifying as an expert, the witness' testimony...

Opioid overdose prevention training with naloxone, an adjunct to basic life support training for first-year medical students.

Science.gov (United States)

Berland, Noah; Fox, Aaron; Tofighi, Babak; Hanley, Kathleen

2017-01-01

Opioid overdose deaths have reached epidemic proportions in the United States. This problem stems from both licit and illicit opioid use. Prescribing opioids, recognizing risky use, and initiating prevention, including opioid overdose prevention training (OOPT), are key roles physicians play. The American Heart Association (AHA) modified their basic life support (BLS) algorithms to consider naloxone in high-risk populations and when a pulse is appreciated; however, the AHA did not provide OOPT. The authors' intervention filled this training deficiency by teaching medical students opioid overdose resuscitation with a Train-the-Trainer model as part of mandatory BLS training. The authors introduced OOPT, following a Train-the-Trainer model, into the required basic life support (BLS) training for first-year medical students at a single medical school in a large urban area. The authors administered pre- and post-evaluations to assess the effects of the training on opioid overdose knowledge, self-reported preparedness to respond to opioid overdoses, and attitudes towards patients with substance use disorders (SUDs). In the fall 2014, 120 first-year medical students received OOPT. Seventy-three students completed both pre- and posttraining evaluations. Improvements in knowledge about and preparedness to respond to opioid overdoses were statistically significant (P support dissemination of OOPT as a part of BLS training for all medical students, and potentially all BLS providers.

Do co-intoxicants increase adverse event rates in the first 24 hours in patients resuscitated from acute opioid overdose?

Science.gov (United States)

Mirakbari, Seyed Mostafa; Innes, Grant D; Christenson, Jim; Tilley, Jessica; Wong, Hubert

2003-01-01

Patients frequently arrive in emergency departments (EDs) after being resuscitated from opioid overdose. Autopsy studies suggest that multidrug intoxication is a major risk factor for adverse outcomes after acute heroin overdose in patients. If this is true, there may be high-risk drug combinations that identify patients who require more intensive monitoring and prolonged observation. Our objective was to determine the impact of co-intoxication with alcohol, cocaine, or CNS depressant drugs on short-term adverse event rates in patients resuscitated from acute opioid overdose. Data were extracted from the database of a prospective opioid overdose cohort study conducted between May 1997 and 1999. Patients were prospectively enrolled if they received naloxone for presumed opioid overdose. Investigators gathered clinical, demographic, and other predictor variables, including co-intoxicants used. Patients were followed to identify prespecified adverse outcome events occurring within 24 h, and multiple logistic regression was used to determine the association of concomitant drug use on short-term adverse event rates. Of 1155 patients studied, 58 (5%) had pure opioid overdose and 922 (80%) reported co-intoxicants, including alcohol, cocaine, and CNS depressants. Overall, out of 1056 patients with known outcome status there were 123 major adverse events (11.6%) and 194 minor adverse events (18.4%). After adjustment for age, gender, HIV status, cardiovascular disease, pulmonary disease and diabetes, we found that coadministration of alcohol, cocaine, or CNS depressants, alone or in combination, was not associated with increased risk of death or adverse events during the 24 h follow-up period. In patients resuscitated from acute opioid overdose, short-term outcomes are similar for patients with pure opioid overdose and multidrug intoxications. A history of cointoxication cannot be used to identify high-risk patients who require more intensive ED monitoring or prolonged

HIV seroprevalence among male prison inmates in the six countries of the Organization of Eastern Caribbean states in the Caribbean (OECS).

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Boisson, E V; Trotman, C

2009-03-01

To determine HIV prevalence among male prison inmates in the six OECS countries in the Caribbean. Six unlinked, anonymous point prevalence surveys of a total of 1288 male inmates were conducted during a one-year period, August 2004 - August 2005. An oral fluid sample was collected and an interviewer-administered questionnaire and consent form was completed for each survey participant. The overall HIV prevalence was 2.8% (range 2.0-4.1%). Only 39% of all inmates had previously been tested, compared to 67% of the HIV-positive inmates. Of all inmates who previously tested, 61% had their last test less than two years ago, 45% had done so while in prison and 39% had done so in a hospital. Most of those who had not previously been tested had no particular reason for not doing so (57%); 24% of them felt it was not necessary or they were not at risk. HIV prevalence among male prison inmates was three times higher than the estimated OECS population prevalence in 2003, slightly higher than the prevalence among incarcerated males in the United States of America and Canada, and lower than that in other Caribbean countries in earlier years. Health information on prison populations is important as this is a vulnerable group, with frequent movement in and out of the general population. Preventative services, voluntary counselling and testing, and appropriate care and treatment should be available to all inmates as this is an opportunity for many who may not otherwise access these services.

Safety Tips from the Expert Witness.

Science.gov (United States)

Gray, Gary R.

1995-01-01

Many physical educators and coaches use the potential for liability to guide their decisions about conducting activities. By understanding expert witnesses' roles in negligence actions, surer planning, teaching, and coaching are possible. The paper describes issues that expert witnesses examine in negligence actions against physical educators,…

Bilateral blindness secondary to optic nerve ischemia from severe amlodipine overdose: a case report.

Science.gov (United States)

Kao, Raymond; Landry, Yves; Chick, Genevieve; Leung, Andrew

2017-08-03

Calcium channel blockers are commonly prescribed medications; calcium channel blocker overdose is becoming increasingly prevalent. The typical presentation of a calcium channel blocker overdose is hypotension and decreased level of consciousness. We describe a case of a calcium channel blocker overdose that led to bilateral cortical blindness, a presentation that has not previously been reported. A 49-year-old white woman with known bilateral early optic atrophy presented to our hospital with hypotension and obtundation following a known ingestion of 150 mg of amlodipine. She was transferred to our intensive care unit where she was intubated, mechanically ventilated, and required maximal vasopressor support (norepinephrine 40 mcg/minute, epinephrine 40 mcg/minute, and vasopressin 2.4 units/hour) along with intravenously administered crystalloid boluses. Despite these measures, she continued to deteriorate with persistent hypotension and tachycardia, as well as anuria. Intralipid emulsion therapy was subsequently administered to which no initial response was observed. A chest X-ray revealed diffuse pulmonary edema; intravenous diuresis as well as continuous renal replacement therapy was initiated. Following the initiation of continuous renal replacement therapy, her oxygen requirements as well as urine output began to improve, and 3 days later she was liberated from mechanical ventilation. Following extubation, she complained of new onset visual impairment, specifically seeing only red-green colors, but no objects. An ophthalmologic examination revealed that this was due to bilateral optic atrophy from prolonged hypotension during the first 24 hours after the overdose. Persistent hypotension in the setting of a calcium channel blocker overdose can lead to worsening optic atrophy resulting in bilateral cortical blindness.

Supply-side response to declining heroin purity: fentanyl overdose episode in New Jersey.

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Hempstead, Katherine; Yildirim, Emel O

2014-06-01

The inelastic price demand observations characteristic of illegal drug markets have led to the conclusion that the burden of a negative supply shock would be completely reflected to consumers. This paper argues that the increasing availability of prescription opioids may threaten heroin sellers' profit margin and force them to find alternative methods to compensate buyers in the event of a supply shock. We investigate the 2006 fentanyl overdose episode in New Jersey and argue that the introduction of non-pharmaceutical fentanyl, its spatial distribution, and the timing of overdose deaths may have been related to trends in heroin purity. Using medical examiner data, as well as data from the Drug Enforcement Administration, Office of Diversion Control on retail sales of prescription opioids in a negative binomial specification, we show that month-to-month fluctuations in heroin purity have a significant effect on fentanyl-related overdoses, particularly in those areas where prescription opioids are highly available. Copyright © 2013 John Wiley & Sons, Ltd.

Prison Inmate Information System: The Case of Yola Central Pri son ...

African Journals Online (AJOL)

PROF. OLIVER OSUAGWA

inmates. There are two major types of convict ... This includes type of disposals like ..... Text. Table 1: Input Specification Guide. Detail Design. The designed system consist of different modules ... package: such as spread sheet, word processor.

Performance of a multi-disciplinary emergency department observation protocol for acetaminophen overdose.

Science.gov (United States)

Beauchamp, Gillian A; Hart, Kimberly W; Lindsell, Christopher J; Lyons, Michael S; Otten, Edward J; Smith, Carol L; Ward, Michael J; Wright, Stewart W

2013-09-01

The availability of 20-h N-acetylcysteine (NAC) infusion for low-risk acetaminophen (APAP) overdose enabled our center to implement an Emergency Department observation unit (OU) protocol as an alternative to hospitalization. Our objective was to evaluate our early experience with this protocol. This retrospective cohort study included all patients treated for low-risk APAP overdose in our academic hospital between 2006 and 2011. Cases were identified using OU and pharmacy records. Successful OU discharge was defined as disposition with no inpatient admission. Differences in medians with 95 % confidence intervals were used for comparisons. One hundred ninety-six patients received NAC for APAP overdose with a mean age of 35 years (SD 14); 73 % were white, and 43 % were male. Twenty (10 %) received care in the OU; 3/20(15 %) met criteria for inclusion in the OU protocol and 13/20(65 %) were discharged successfully. Out of the 196 patients, 10 met criteria for inclusion in the OU protocol but instead received care in the inpatient setting. The median total length of stay from presentation to ED discharge was 41 h for all patients treated in the OU, compared to 68 h for ten patients who met criteria for inclusion in the OU protocol but who were admitted (difference 27 h, 95 % CI 18-72 h). ED observation for APAP overdose can be a viable alternative to inpatient admission. Most patients were successfully discharged from the OU. This evaluation identified both over- and under-utilization of the OU. OU treatment resulted in shorter median length of stay than inpatient admission.

Social and economic inequalities in fatal opioid and cocaine related overdoses in Luxembourg: a case-control study.

Science.gov (United States)

Origer, Alain; Le Bihan, Etienne; Baumann, Michèle

2014-09-01

To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence in a nested case-control study design. Overdose cases were individually matched with four controls, when available, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs 1056 controls were analysed. Conditional logistic regression analysis was performed to assess the respective impact of a series of socioeconomic variables. Being professionally active [OR=0.66 (95% CI 0.45-0.99)], reporting salary as main legal income source [OR=0.42 (95% CI 0.26-0.67)] and education attainment higher than primary school [OR=0.50 (95% CI 0.34-0.73)] revealed to be protective factors, whereas the professional status of the father or legal guardian of victims was not significantly associated to fatal overdoses. Socioeconomic inequalities in drug users impact on the occurrence of fatal overdoses. Compared to their peers, users of illicit drugs with lower socioeconomic profiles show increased odds of dying from overdose. However, actual and self-referred socioeconomic characteristics of drug users, such as educational attainment and employment, may have a greater predictive value of overdose mortality than the parental socioeconomic status. Education, vocational training and socio-professional reintegration should be part of drug-related mortality prevention policies. Copyright © 2014 Elsevier B.V. All rights reserved.

Knowledge of Opioid Overdose and Attitudes to Supply of Take-Home Naloxone Among People with Chronic Noncancer Pain Prescribed Opioids.

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Nielsen, Suzanne; Peacock, Amy; Lintzeris, Nicholas; Bruno, Raimondo; Larance, Briony; Degenhardt, Louisa

2018-03-01

Take-home naloxone (THN) is recommended in response to pharmaceutical opioid-related mortality. Some health professionals are reluctant to discuss THN for fear of causing offense. The aims of this study were to assess knowledge of opioid overdose and attitudes toward THN for opioid overdose reversal in people with chronic noncancer pain (CNCP). Prospective cohort study. Australia, September to October 2015. A subset of participants (N = 208) from a cohort of people prescribed restricted opioids for CNCP. Questions added in the two-year telephone interviews examined knowledge of overdose symptoms and attitudes toward community supply of naloxone. Associations with overdose risk factors and naloxone supply eligibility criteria with attitudes toward naloxone were explored. Fourteen percent reported ever experiencing opioid overdose symptoms. Participants correctly identified fewer than half of the overdose signs and symptoms. After receiving information on naloxone, most participants (60%), thought it was a "good" or "very good" idea. Few participants reported that they would be "a little" (N = 21, 10%) or "very" offended (N = 7, 3%) if their opioid prescriber offered them naloxone. Positive attitudes toward THN were associated with male gender (odds ratio [OR] = 1.96, 95% confidence interval [CI] = 1.09-3.50), past year cannabis use (OR = 2.52, 95% CI = 1.03-6.16), and past year nicotine use (OR = 2.11, 95% CI = 1.14-3.91). Most participants had positive attitudes toward THN but low knowledge about opioid overdose symptoms. Strategies for educating patients and their caregivers on opioid toxicity are needed. THN may be best targeted toward those with risk factors in terms of overdose prevention and acceptability.

41 CFR 50-203.20 - Examination of witnesses.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Examination of witnesses... Under the Walsh-Healey Public Contracts Act § 50-203.20 Examination of witnesses. The administrative law... such examination or cross-examination of any witness as may be required for a full and true disclosure...

Children's Witnessing of Adult Domestic Violence.

Science.gov (United States)

Edleson, Jeffrey L.

1999-01-01

Expands common definitions of how children witness adult domestic violence through a review of 31 research articles. A variety of behavioral, emotional, and cognitive-functioning problems among children were found to be associated with exposure to domestic violence. Factors that appear to moderate the impact of witnessing violence (child abuse,…

14 CFR 406.161 - Witness fees.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Witness fees. 406.161 Section 406.161 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... the same fees and mileage expenses as are paid to a witness in a court of the United States in...

Does cytochrome P450 liver isoenzyme induction increase the risk of liver toxicity after paracetamol overdose?

Directory of Open Access Journals (Sweden)

Kalsi SS

2011-10-01

Full Text Available Sarbjeet S Kalsi1,2, David M Wood2–4, W Stephen Waring5, Paul I Dargan2–4 1Emergency Department, 2Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London; 3King's Health Partners, 4King's College London, London; 5York Teaching Hospital NHS Foundation Trust, York, UK Abstract: Paracetamol (acetaminophen, N-acetyl-p-aminophenol, 4-hydroxyacetanilide is the most common cause of acute liver failure in developed countries. There are a number of factors which potentially impact on the risk of an individual developing hepatotoxicity following an acute paracetamol overdose. These include the dose of paracetamol ingested, time to presentation, decreased liver glutathione, and induction of cytochrome P450 (CYP isoenzymes responsible for the metabolism of paracetamol to its toxic metabolite N-acetyl-p-benzoquinoneimine (NAPQI. In this paper, we review the currently published literature to determine whether induction of relevant CYP isoenzymes is a risk factor for hepatotoxicity in patients with acute paracetamol overdose. Animal and human in vitro studies have shown that the CYP isoenzyme responsible for the majority of human biotransformation of paracetamol to NAPQI is CYP2E1 at both therapeutic and toxic doses of paracetamol. Current UK treatment guidelines suggest that patients who use a number of drugs therapeutically should be treated as “high-risk” after paracetamol overdose. However, based on our review of the available literature, it appears that the only drugs for which there is evidence of the potential for an increased risk of hepatotoxicity associated with paracetamol overdose are phenobarbital, primidone, isoniazid, and perhaps St John's wort. There is no evidence that other drugs often quoted as increasing risk, such as carbamazepine, phenytoin, primidone, rifampicin, rifabutin, efavirenz, or nevirapine, should be considered risk factors for hepatotoxicity in patients presenting with acute paracetamol overdose. Keywords

Metabolic acidosis in a patient with metformin overdose

African Journals Online (AJOL)

gas findings taken at room temperature at this time are shown in Table 1. Calculation of the anion gap was not possible because ... Arterial blood gas findings on 30% oxygen at this time revealed a metabolic acidosis as shown in .... is ideal in acute overdose for effective removal of both metformin and circulating lactate.

Inmate Perceptions of Financial Education Needs: Suggestions for Financial Educators

Science.gov (United States)

Call, Lindsay Larson; Dyer, W. Justin; Wiley, Angela R.; Day, Randal D.

2013-01-01

Recently, national attention has turned to the need for increased financial education, particularly for low-income populations. Incarcerated individuals represent a growing low-income group with unique needs that could likely benefit from financial education. However, few studies have examined the specific financial education needs of inmates,…

Engagement in the Overdose RIsk InfOrmatioN (ORION) e-Health Tool for Opioid Overdose Prevention and Self-Efficacy: A Preliminary Study.

Science.gov (United States)

Carrà, Giuseppe; Crocamo, Cristina; Humphris, Gerald; Tabacchi, Tommaso; Bartoli, Francesco; Neufeind, Julia; Scherbaum, Norbert; Baldacchino, Alexander

2017-12-01

Increasing awareness of, and information about, overdose risk is an appropriate approach in risk reduction. e-Health technology in substance use disorders is an opportunity to support behavioral changes related to public health concerns. The present study aimed to evaluate the short-term impact of an innovative e-health psychoeducational software, the Overdose RIsk InfOrmatioN (ORION) tool. The ORION programme provided relevant information to opioid-dependent individuals about the risk of suffering a drug overdose as a result of high risky and dysfunctional behaviors. Seven aggregate risk factors were identified through a systematic review and their outputs included in a risk estimation model. We recruited 194 opioid-dependent treatment-seeking individuals from the United Kingdom, Germany, Italy, and Denmark. All participants were given at study entry, and after their use of the software, the General Self-Efficacy (GSE) Scale. We found comparable pre- and post-ORION administration mean GSE scores (SD), 28.49 (5.50) and 28.32 (5.90), respectively (p = 0.297). However, there was an inverse correlation between the number of risk factors and reported levels of self-efficacy (p ORION was able to identify individuals who are most in need of reducing their modifiable risk factors with appropriate interventions. However, a one-shot e-health tool cannot influence complex domains such as self-efficacy unless this is used with other effective interventions. Nonetheless, the ORION tool is unique in its style and content of delivery, that is translating risks combination into a clear estimation, and will need further development such as (a) integration in smartphone-based e-health apps and (b) testing in other high-risk populations.

An elevated neutrophil-lymphocyte ratio is associated with adverse outcomes following single time-point paracetamol (acetaminophen) overdose: a time-course analysis.

Science.gov (United States)

Craig, Darren G; Kitto, Laura; Zafar, Sara; Reid, Thomas W D J; Martin, Kirsty G; Davidson, Janice S; Hayes, Peter C; Simpson, Kenneth J

2014-09-01

The innate immune system is profoundly dysregulated in paracetamol (acetaminophen)-induced liver injury. The neutrophil-lymphocyte ratio (NLR) is a simple bedside index with prognostic value in a number of inflammatory conditions. To evaluate the prognostic accuracy of the NLR in patients with significant liver injury following single time-point and staggered paracetamol overdoses. Time-course analysis of 100 single time-point and 50 staggered paracetamol overdoses admitted to a tertiary liver centre. Timed laboratory samples were correlated with time elapsed after overdose or admission, respectively, and the NLR was calculated. A total of 49/100 single time-point patients developed hepatic encephalopathy (HE). Median NLRs were higher at both 72 (P=0.0047) and 96 h after overdose (P=0.0041) in single time-point patients who died or were transplanted. Maximum NLR values by 96 h were associated with increasing HE grade (P=0.0005). An NLR of more than 16.7 during the first 96 h following overdose was independently associated with the development of HE [odds ratio 5.65 (95% confidence interval 1.67-19.13), P=0.005]. Maximum NLR values by 96 h were strongly associated with the requirement for intracranial pressure monitoring (Pparacetamol overdoses. Future studies should assess the value of incorporating the NLR into existing prognostic and triage indices of single time-point paracetamol overdose.

Accidental Overdose Intoxication: A Hazard of Drug Smuggling

Science.gov (United States)

Arora, Sudhir; Tafreshi, Michael; Sobo, Steven; Krochmal, Paul; Alexander, Leslie L.

1982-01-01

Three patients involved in illicit drug smuggling via the swallowing of high dose, high purity drugs packed in multiple condoms are reported. Two of these patients experienced drug overdose symptoms due to leakage or rupture of the condoms in the GI tract. They were treated successfully. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:7120497

Correlates of HIV, HBV, HCV and syphilis infections among prison inmates and officers in Ghana: A national multicenter study

Directory of Open Access Journals (Sweden)

Asare Isaac

2008-03-01

Full Text Available Abstract Background Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana. Methods A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg. These data were analyzed using both univariate and multivariate techniques. Results Almost 18% (1336 of 7652 eligible inmates and 21% (445 of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84 and 38.1 years (range 25–59, respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis

Trends in drug overdose deaths in England and Wales 1993-98: methadone does not kill more people than heroin.

Science.gov (United States)

Hickman, Matthew; Madden, Peter; Henry, John; Baker, Allan; Wallace, Chris; Wakefield, Jon; Stimson, Gerry; Elliott, Paul

2003-04-01

To test the hypothesis that methadone is responsible for a greater increase in overdose deaths than heroin, and causes proportionally more overdose deaths than heroin at weekends. Multivariate analysis of 3961 death certificates mentioning heroin, morphine and/or methadone held on the Office for National Statistics drug-related poisoning mortality database from 1993 to 1998 in England and Wales. Percentage increase in deaths by year by drug, odds ratio (OR) of dying at the weekend from methadone-related overdose compared to dying from heroin/morphine overdose. From 1993 to 1998, annual opiate overdose deaths increased from 378 to 909. There was a 24.7% (95% confidence interval (CI) 22-28%) yearly increase in heroin deaths compared to 9.4% (95% CI 6-13%) for methadone only. This difference was significant (P < 0.001 by test of interaction) after adjustment for sex, age group, polydrug use, area of residence and underlying cause of death. The largest number of deaths occurred on Saturday (673). The OR of death from methadone overdose on Saturday and Sunday was 1.48 (95% CI 1.29-1.71) for methadone-only deaths compared to dying from heroin/morphine at the weekend after adjustment for other covariates, but the OR was not significant (1.09, 95% CI 0.95-1.25) if the weekend was defined as Friday and Saturday. There was no evidence that the threefold increase in deaths over time was due to methadone. There was equivocal support only for the hypothesis that there was an excess of deaths from methadone at weekends. Increased interventions to prevent overdose among injectors in England and Wales are long overdue.

Impact of different pack sizes of paracetamol in the United Kingdom and Ireland on intentional overdoses: a comparative study

LENUS (Irish Health Repository)

Hawton, Keith

2011-06-10

Abstract Background In order to reduce fatal self-poisoning legislation was introduced in the UK in 1998 to restrict pack sizes of paracetamol sold in pharmacies (maximum 32 tablets) and non-pharmacy outlets (maximum 16 tablets), and in Ireland in 2001, but with smaller maximum pack sizes (24 and 12 tablets). Our aim was to determine whether this resulted in smaller overdoses of paracetamol in Ireland compared with the UK. Methods We used data on general hospital presentations for non-fatal self-harm for 2002 - 2007 from the Multicentre Study of Self-harm in England (six hospitals), and from the National Registry of Deliberate Self-harm in Ireland. We compared sizes of overdoses of paracetamol in the two settings. Results There were clear peaks in numbers of non-fatal overdoses, associated with maximum pack sizes of paracetamol in pharmacy and non-pharmacy outlets in both England and Ireland. Significantly more pack equivalents (based on maximum non-pharmacy pack sizes) were used in overdoses in Ireland (mean 2.63, 95% CI 2.57-2.69) compared with England (2.07, 95% CI 2.03-2.10). The overall size of overdoses did not differ significantly between England (median 22, interquartile range (IQR) 15-32) and Ireland (median 24, IQR 12-36). Conclusions The difference in paracetamol pack size legislation between England and Ireland does not appear to have resulted in a major difference in sizes of overdoses. This is because more pack equivalents are taken in overdoses in Ireland, possibly reflecting differing enforcement of sales advice. Differences in access to clinical services may also be relevant.

College students' behavioral reactions upon witnessing relational peer aggression.

Science.gov (United States)

You, Ji-In; Bellmore, Amy

2014-01-01

With a sample of 228 college students (82.5% females) from the Midwestern United States, individual factors that contribute to emerging adults' behavioral responses when witnessing relational aggression among their peers were explored. The experience of witnessing relational aggression was found to be systematically associated with college students' behavioral responses to relational aggression through two social cognitive processes: normative beliefs about relational aggression and susceptibility to peer influence. The experience of witnessing relational aggression was associated with defending behavior through normative beliefs about relational aggression and both assisting and reinforcing behavior through normative beliefs about relational aggression and susceptibility to peer influence. The experience of witnessing relational aggression was also associated with onlooking behavior through normative beliefs about relational aggression. The findings indicate that exposure to relational aggression as a witness may influence witness responses because of the way such exposure may shape specific social cognitions. The potential for using the study findings for promoting effective witness interventions among college students is discussed. © 2014 Wiley Periodicals, Inc.

Anger as a predictor of psychological distress and self-harm ideation in inmates: a structured self-assessment diary study.

Science.gov (United States)

Humber, Naomi; Emsley, Richard; Pratt, Daniel; Tarrier, Nicholas

2013-11-30

Suicidal ideation and behaviour are common among inmates. Anger is found at exaggerated levels and has been associated with suicidal ideation and behaviour in inmate samples suggesting its possible salience in the prediction of suicide. The study investigated relationships between anger, psychological distress, and self-harm/suicidal ideation among inmates. The principles of Ecological Momentary Assessment were considered and a structured self-assessment diary was utilised to examine relationships between the variables of interest. Participants completed a structured self-assessment diary for six consecutive days which included momentary ratings of items describing psychological states of concurrent affects, thoughts, and appraisals related to anger, psychological distress, and self-harm/suicidal ideation. Psychometric assessment measures were also conducted. Temporal associations between predictors and outcomes were investigated. Multilevel modelling analyses were performed. Increased anger was significantly associated with concurrent high levels of self-harm ideation in inmates, when controlling for depression and hopelessness. Temporal analyses also revealed that anger at one time point did not predict suicidal ideation at the next time point. Elucidating the temporal nature of the relationship between anger, psychological distress, and self-harm/suicidal ideation has advanced understanding of the mechanisms of suicidal behaviour, by demonstrating an increased risk of suicide when a male inmate is angry. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Measuring a Crisis: Questioning the Use of Naloxone Administrations as a Marker for Opioid Overdoses in a Large U.S. EMS System.

Science.gov (United States)

Grover, Joseph M; Alabdrabalnabi, Taibah; Patel, Mehul D; Bachman, Michael W; Platts-Mills, Timothy F; Cabanas, Jose G; Williams, Jefferson G

2018-01-01

The United States is currently experiencing a public health crisis of opioid overdoses. To determine where resources may be most needed, many public health officials utilize naloxone administration by EMS as an easily-measured surrogate marker for opioid overdoses in a community. Our objective was to evaluate whether naloxone administration by EMS accurately represents EMS calls for opioid overdose. We hypothesize that naloxone administration underestimates opioid overdose. We conducted a chart review of suspected overdose patients and any patients administered naloxone in Wake County, North Carolina, from January 2013 to December 2015. Patient care report narratives and other relevant data were extracted from electronic patient care records and the resultant database was analyzed by two EMS physicians. Cases were divided into categories including "known opioid use," "presumed opioid use," "no known opioid," "altered mental status," "cardiac arrest with known opioid use," "cardiac arrest with no known opioid use," or "suspected alcohol intoxication," and then further separated based on whether naloxone was administered. Patient categories were compared by patient demographics and incident year. Using the chart review classification as the gold standard, we calculated the sensitivity and positive predictive value (PPV) of naloxone administration for opioid overdose. A total of 4,758 overdose cases from years 2013-15 were identified. During the same period, 1,351 patients were administered naloxone. Of the 1,431 patients with known or presumed opioid use, 57% (810 patients) received naloxone and 43% (621 patients) did not. The sensitivity of naloxone administration for the identification of patients with known or presumed opioid use was 57% (95% CI: 54%-59%) and the PPV was 60% (95% CI: 57%-63%). Among patients receiving care in this large urban EMS system in the United States, the overall sensitivity and positive predictive value for naloxone administration for

Oral hygiene profile of inmates in a correctional home | Braimoh ...

African Journals Online (AJOL)

Background: Prisoners are a vulnerable and socially deprived group requiring dental care intervention. They are often neglected with little or no access to health care and poor oral hygiene may be an additional burden. Objectives: To assess the oral hygiene status of prison inmates and investigate its relationship to ...

Sodium channel blockade with QRS widening after an escitalopram overdose.

Science.gov (United States)

Schreffler, Susan M; Marraffa, Jeanna M; Stork, Christine M; Mackey, Jennifer

2013-09-01

Escitalopram is rarely associated with prolongation of the QTc interval; however, there are no reported cases of QRS complex widening associated with escitalopram overdose. We report a case of a patient who presented with both QRS complex widening and QTc interval prolongation after an escitalopram overdose. A 16-year-old girl presented to the emergency department after ingestion of escitalopram, tramadol/acetaminophen, and hydrocodone/acetaminophen. Laboratory results were significant for 4-hour acetaminophen 21.1 μg/mL. Serum electrolytes including potassium, magnesium, and calcium were all normal. Initial electrocardiogram (ECG) revealed a widened QRS with an incomplete right bundle branch pattern. After administration of 100-mEq sodium bicarbonate, a repeat ECG revealed narrowing of the QRS complex and a prolonged QTc interval. Magnesium sulfate 2 g intravenous and sodium bicarbonate drip were initiated. A repeat ECG, 1 hour after the second, revealed normalization of the QRS complex and QTc interval. Prolongation of the QTc interval is an expected effect of escitalopram. Both escitalopram and citalopram are metabolized to the cardiotoxic metabolite S-didesmethylcitalopram and didesmethylcitalopram, respectively, which have been implicated in numerous cardiac abnormalities including widening of the QRS complex. Although never previously described with escitalopram, this mechanism provides a reasonable explanation for the QRS complex widening and incomplete right bundle branch block that occurred in our patient. Both QRS complex widening and QTc interval prolongation should be monitored in cases of escitalopram and citalopram overdoses.

Effect of an art brut therapy program called go beyond the schizophrenia (GBTS) on prison inmates with schizophrenia in mainland China-A randomized, longitudinal, and controlled trial.

Science.gov (United States)

Qiu, Hong-Zhong; Ye, Zeng-Jie; Liang, Mu-Zi; Huang, Yue-Qun; Liu, Wei; Lu, Zhi-Dong

2017-09-01

Creative arts therapies are proven to promote an interconnection between body and mind, but there are major obstacles for providing therapeutic services in prisons due to inmates' inherent mistrust for verbal disclosure and rigid self-defenses, especially among inmates with schizophrenia. Thus, we developed a structured and quantitative art brut therapy program called go beyond the schizophrenia to actually measure the benefits of art therapy on prison inmates in mainland China. Upon completion of the program, the intervention group reported a decrease in anxiety, depression, anger, and negative psychiatric symptoms and showed better compliance with rules, socialization with peers, compliance with medications, and regular sleeping patterns after 16 weekly sessions of go beyond the schizophrenia. This article concludes that the art brut therapy was effective for the inmates with schizophrenia in mainland China and provides encouraging data on how to enhance mental health for inmates with schizophrenia. Art brut therapy can reduce emotional distress and negative psychiatric symptoms among Chinese inmates. Arts brut therapy can enhance Chinese inmates' compliance with rules, socialization with peers, compliance with medicines, and regular sleeping patterns. Arts brut therapy in conjunction with medication is highly recommended for recovery of Chinese inmates with schizophrenia, especially for patients with negative symptoms. Copyright © 2017 John Wiley & Sons, Ltd.

Target biomarker profile for the clinical management of paracetamol overdose

Science.gov (United States)

Vliegenthart, A D Bastiaan; Antoine, Daniel J; Dear, James W

2015-01-01

Paracetamol (acetaminophen) overdose is one of the most common causes of acute liver injury in the Western world. To improve patient care and reduce pressure on already stretched health care providers new biomarkers are needed that identify or exclude liver injury soon after an overdose of paracetamol is ingested. This review highlights the current state of paracetamol poisoning management and how novel biomarkers could improve patient care and save healthcare providers money. Based on the widely used concept of defining a target product profile, a target biomarker profile is proposed that identifies desirable and acceptable key properties for a biomarker in development to enable the improved treatment of this patient population. The current biomarker candidates, with improved hepatic specificity and based on the fundamental mechanistic basis of paracetamol-induced liver injury, are reviewed and their performance compared with our target profile. PMID:26076366

Impact of Horticultural Therapy on Psychosocial Functioning among Urban Jail Inmates.

Science.gov (United States)

Rice, Jay Stone; Remy, Linda L.

1998-01-01

Investigates the impact of a horticultural therapy program on 48 county jail inmates. Examines the changes in psychosocial functioning of the participants while in treatment and in post-release. Explores the clinical relevance of horticultural therapy in cultivating healthy self-development. (MKA)

Expert witness and Jungian archetypes.

Science.gov (United States)

Lallave, Juan Antonio; Gutheil, Thomas Gordon

2012-01-01

Jung's theories of archetype, shadow, and the personal and collective unconscious provide a postmodern framework in which to consider the role of the expert witness in judicial proceedings. Archetypal themes, motifs, and influences help to illuminate the shadow of the judicial system and projections and behaviors among the cast of the court in pursuing justice. This article speaks to archetypal influences and dialectical tensions encountered by the expert witness in this judicial drama. The archetype of Justice is born from the human need for order and relational fairness in a world of chaos. The persona of justice is the promise of truth in the drama. The shadow of justice is untruth, the need to win by any means. The dynamics of the trickster archetype serve and promote injustice. These influences are examined by means of a case example. This approach will deepen understanding of court proceedings and the role of the expert witness in the heroic quest for justice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Young Adult's Immediate Reaction to a Personal Alcohol Overdose

Science.gov (United States)

Reis, Janet; Harned, Ilene; Riley, William

2004-01-01

Following an emergency medical transport for alcohol overdose, first-year college students were asked to complete a survey assessing their reactions to the transport experience, their assessment of why they required this emergency response, and plans for future personal alcohol consumption. Transported students who responded to a baseline survey…

Accuracy of the paracetamol-aminotransferase multiplication product to predict hepatotoxicity in modified-release paracetamol overdose.

Science.gov (United States)

Wong, Anselm; Sivilotti, Marco L A; Graudins, Andis

2017-06-01

The paracetamol-aminotransferase multiplication product (APAP × ALT) is a risk predictor of hepatotoxicity that is somewhat independent of time and type of ingestion. However, its accuracy following ingestion of modified-release formulations is not known, as the product has been derived and validated after immediate-release paracetamol overdoses. The aim of this retrospective cohort study was to evaluate the accuracy of the multiplication product to predict hepatotoxicity in a cohort of patients with modified-release paracetamol overdose. We assessed all patients with modified-release paracetamol overdose presenting to our hospital network from October 2009 to July 2016. Ingestion of a modified-release formulation was identified by patient self-report or retrieval of the original container. Hepatotoxicity was defined as peak alanine aminotransferase ≥1000 IU/L, and acute liver injury (ALI) as a doubling of baseline ALT to more than 50 IU/L. Of 1989 paracetamol overdose presentations, we identified 73 modified-release paracetamol exposures treated with acetylcysteine. Five patients developed hepatotoxicity, including one who received acetylcysteine within eight hours of an acute ingestion. No patient with an initial multiplication product paracetamol overdose treated with acetylcysteine, the paracetamol-aminotransferase multiplication product demonstrated similar accuracy and temporal profile to previous reports involving mostly immediate-release formulations. Above a cut-point of 10,000 mg/L × IU/L, it was very strongly associated with the development of acute liver injury and hepatotoxicity, especially when calculated more than eight hours post-ingestion. When below 1500 mg/L × IU/L the likelihood of developing hepatotoxicity was very low. Persistently high serial multiplication product calculations were associated with the greatest risk of hepatotoxicity.

Condom acceptability for prevention of HIV infection amongst male inmates in a convict prison in north western Nigeria: A Qualitative Research Report

Directory of Open Access Journals (Sweden)

Audu Onyemocho

2014-01-01

Full Text Available There is a general recognition of homosexuality being responsible for the high prevalence of HIV/AIDS among inmates in Nigerian prisons. However, the use of condoms which is an evidenced-based preventive measure is critical in the prison setting because of socio-cultural reasons. Due to the dynamic nature of the prison population, interventions targeting the prisons will have a significant effect on the general population. This study assessed condom acceptability for the prevention of HIV infection among male inmates in a convict prison in north-western, Nigeria in order to provide supplementary information that will corroborate some findings from quantitative methods. A qualitative study was conducted in Zaria prison between 18th December, 2012 and 8th January, 2013. Purposive sampling identified 48 inmates who had Focused Group Discussions (FGDs and In-depth Interviews (IDIs. Common trends and variations in the responses were identified and reflected as appropriate and presented as narratives with relevant quotations. Majority of the respondents agreed that homosexuality exists among the inmates, but all the inmates scowled at the distribution of condoms to inmates in prison. Majority were of the opinion that condom distribution will promote homosexuality which is prohibited by Nigerian laws and controlling HIV transmissions in Nigeria prisons can be effectively done through behavioral modifications that are geared towards total abstinence.

Condom acceptability for prevention of HIV infection amongst male inmates in a convict prison in north western Nigeria: A Qualitative Research Report

Directory of Open Access Journals (Sweden)

Audu Onyemocho

2014-09-01

Full Text Available There is a general recognition of homosexuality being responsible for the high prevalence of HIV/AIDS among inmates in Nigerian prisons. However, the use of condoms which is an evidenced-based preventive measure is critical in the prison setting because of socio-cultural reasons. Due to the dynamic nature of the prison population, interventions targeting the prisons will have a significant effect on the general population. This study assessed condom acceptability for the prevention of HIV infection among male inmates in a convict prison in north-western, Nigeria in order to provide supplementary information that will corroborate some findings from quantitative methods. A qualitative study was conducted in Zaria prison between 18th December, 2012 and 8th January, 2013. Purposive sampling identified 48 inmates who had Focused Group Discussions (FGDs and In‐depth Interviews (IDIs. Common trends and variations in the responses were identified and reflected as appropriate and presented as narratives with relevant quotations. Majority of the respondents agreed that homosexuality exists among the inmates, but all the inmates scowled at the distribution of condoms to inmates in prison. Majority were of the opinion that condom distribution will promote homosexuality which is prohibited by Nigerian laws and controlling HIV transmissions in Nigeria prisons can be effectively done through behavioral modifications that are geared towards total abstinence.

Overdosed prescription of paracetamol (acetaminophen) in a teaching hospital.

Science.gov (United States)

Charpiat, B; Henry, A; Leboucher, G; Tod, M; Allenet, B

2012-07-01

Paracetamol is the most commonly used analgesic and antipyretic. Reviews of hospital use of paracetamol are scarce. Little is known about the appropriateness of the dose of paracetamol prescribed for hospitalized adults. The aim of this study was to report on the nature and the frequency of the overdosed prescription of paracetamol observed in adult patients over a 4.5-year period in a teaching hospital. Prescription analysis by pharmacists was performed once a week in six medical and three surgical departments and daily in a post-emergency unit. In cases of prescription error, the pharmacist notified the physician through an electronic alert when a computerized prescription order entry system was available or otherwise by face-to-face discussion. For each drug-related problem detected, the pharmacists recorded relevant details in a database. From October 2006 to April 2011, 44,404 prescriptions were reviewed and 480 alerts related to the overdosed prescription of paracetamol were made (1% of analyzed prescriptions). The extent of errors of dosage was within the intervals [90-120 mg/kg/d] and greater than 120 mg/kg/d for 87 and 11 patients respectively, who were prescribed a single non-combination paracetamol containing product. Sixty alerts concerned co-prescription of at least two paracetamol containing products with similar frequency for computerized (1.4/1000) or handwritten (1.2/1000) prescriptions. Prescriptions of paracetamol for hospitalized adults frequently exceed the recommended dosage. These results highlight the need for increased awareness of unintentional paracetamol overdose and support the initiation of an educational program aimed at physicians and nurses. Copyright © 2012. Published by Elsevier Masson SAS.

Molecular epidemiology of HIV, HBV, HCV, and HTLV-1/2 in drug abuser inmates in central Javan prisons, Indonesia.

Science.gov (United States)

Prasetyo, Afiono Agung; Dirgahayu, Paramasari; Sari, Yulia; Hudiyono, Hudiyono; Kageyama, Seiji

2013-06-15

This study was conducted to determine the current molecular prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and human T lymphotropic virus-1/2 (HTLV-1/2) circulating among drug abuser inmates incarcerated in prisons located in Central Java, Indonesia. Socio-epidemiological data and blood specimens were collected from 375 drug abuser inmates in four prisons. The blood samples were analyzed with serological and molecular testing for HIV, HBV, HCV, HDV, and HTLV-1/2. The seroprevalence of HIV, HBsAg, HCV, HDV, and HTLV-1/2 in drug abuser inmates was 4.8% (18/375), 3.2% (12/375), 34.1% (128/375), 0% (0/375), and 3.7% (14/375), respectively. No co-infections of HIV and HBV were found. Co-infections of HIV/HCV, HIV/HTLV-1/2, HBV/HCV, HBV/HTLV-1/2, and HCV/HTLV-1/2 were prevalent at rates of 4% (15/375), 1.3% (5/375), 1.1% (4/375), 0.3% (1/375), and 2.1% (8/375), respectively. The HIV/HCV co-infection rate was significantly higher in injection drug users (IDUs) compared to non-IDUs. Triple co-infection of HIV/HCV/HTLV-1/2 was found only in three IDUs (0.8%). HIV CRF01_AE was found to be circulating in the inmates. HBV genotype B3 predominated, followed by C1. Subtypes adw and adr were found. HCV genotype 1a predominated among HCV-infected inmates, followed by 1c, 3k, 3a, 4a, and 1b. All HTLV-1 isolates shared 100% homology with HTLV-1 isolated in Japan, while all of the HTLV-2 isolates were subtype 2a. Drug abuser inmates in prisons may offer a unique community to bridge prevention and control of human blood-borne virus infection to the general community.

Connectivity, prison environment and mental health among first-time male inmates in Mexico City.

Science.gov (United States)

Albertie, Ariel; Bourey, Christine; Stephenson, Rob; Bautista-Arredondo, Sergio

2017-02-01

Research from high-income countries suggests that prison populations are affected disproportionately by mental illness. However, little research has examined mental health among prisoners in low- and middle-income countries or associations between mental health and contextual factors surrounding the prison experience among susceptible first-time inmates in these settings. The current study examines associations between connectivity, prison environment and mental health (major depression and substance use) among novice male inmates (n = 593) in three Mexico City prisons. Severe depression (46.2%), any substance use (53.8%) and heavy substance use (45.7%) were prevalent. Among key co-variates, recent visitors were protective for severe depression, conjugal visits for any substance use and prison employment for heavy substance use. Physical attacks were associated with increased prevalence of depression, sentence time served with both any and heavy substance use and overcrowding with any substance use. These findings suggest the need for routine health assessments to improve identification and treatment programmes to minimise mental health burden. Addressing demographic risk factors as well as contextual determinants, by decreasing physical violence and overcrowding and supporting outside connections for prisoners, may help improve inmate mental health.

Temporal differences in gamma-hydroxybutyrate overdoses involving injecting drug users versus recreational drug users in Helsinki: a retrospective study

Directory of Open Access Journals (Sweden)

Boyd James J

2012-02-01

Full Text Available Abstract Background Gamma-hydroxybutyrate (GHB and gamma-butyrolactone (GBL have been profiled as 'party drugs' used mainly at dance parties and in nightclubs on weekend nights. The purpose of this study was to examine the frequency of injecting drug use among GHB/GBL overdose patients and whether there are temporal differences in the occurrence of GHB/GBL overdoses of injecting drug and recreational drug users. Methods In this retrospective study, the ambulance and hospital records of suspected GHB- and GBL overdose patients treated by the Helsinki Emergency Medical Service from January 1st 2006 to December 31st 2007 were reviewed. According to the temporal occurrence of the overdose, patients were divided in two groups. In group A, the overdose occurred on a Friday-Saturday or Saturday-Sunday night between 11 pm-6 am. Group B consisted of overdoses occurring on outside this time frame. Results Group A consisted of 39 patient contacts and the remaining 61 patient contacts were in group B. There were statistically significant differences between the two groups in (group A vs. B, respectively: history of injecting drug abuse (33% vs. 59%, p = 0.012, reported polydrug and ethanol use (80% vs. 62%, p = 0.028, the location where the patients were encountered (private or public indoors or outdoors, 10%, 41%, 41% vs. 25%, 18%, 53%, p = 0.019 and how the knowledge of GHB/GBL use was obtained (reported by patient/bystanders or clinical suspicion, 72%, 28% vs. 85%, 10%, p = 0.023. Practically all (99% patients were transported to emergency department after prehospital care. Conclusion There appears to be at least two distinct groups of GHB/GBL users. Injecting drug users represent the majority of GHB/GBL overdose patients outside weekend nights.

THE CODE OF THE STREET AND INMATE VIOLENCE: INVESTIGATING THE SALIENCE OF IMPORTED BELIEF SYSTEMS*

Science.gov (United States)

MEARS, DANIEL P.; STEWART, ERIC A.; SIENNICK, SONJA E.; SIMONS, RONALD L.

2013-01-01

Scholars have long argued that inmate behaviors stem in part from cultural belief systems that they “import” with them into incarcerative settings. Even so, few empirical assessments have tested this argument directly. Drawing on theoretical accounts of one such set of beliefs—the code of the street—and on importation theory, we hypothesize that individuals who adhere more strongly to the street code will be more likely, once incarcerated, to engage in violent behavior and that this effect will be amplified by such incarceration experiences as disciplinary sanctions and gang involvement, as well as the lack of educational programming, religious programming, and family support. We test these hypotheses using unique data that include measures of the street code belief system and incarceration experiences. The results support the argument that the code of the street belief system affects inmate violence and that the effect is more pronounced among inmates who lack family support, experience disciplinary sanctions, and are gang involved. Implications of these findings are discussed. PMID:24068837

Witness memory and alcohol: The effects of state-dependent recall.

Science.gov (United States)

Schreiber Compo, Nadja; Carol, Rolando N; Evans, Jacqueline R; Pimentel, Pamela; Holness, Howard; Nichols-Lopez, Kristin; Rose, Stefan; Furton, Kenneth G

2017-04-01

Many real-world eyewitnesses are under the influence of alcohol either at the time of the crime, the interview, or both. Only recently has empirical research begun to examine the effects of alcohol on witness memory, yielding mixed results. The present study tested the importance of state-dependent memory in the context of alcohol's effects on encoding versus retrieval of a witnessed event, while simultaneously informing real-world investigative practices: Should witnesses sober up before an interview? Participants (N = 249) were randomized to a control, placebo, or alcohol condition at encoding and to either an immediate retrieval condition (in the same state) or a 1-week delay control, placebo, or alcohol retrieval condition. They recalled a witnessed mock crime using open ended and cued recall formats. After a delay, witnesses intoxicated at both encoding and retrieval provided less accurate information than witnesses in sober or placebo groups at both times. There was no advantage of state-dependent memory but intoxicated witnesses were best when recalling immediately compared to 1 week later (sober, placebo, or reintoxicated). Findings have direct implications for the timing of intoxicated witnesses' interviews such that moderately intoxicated witnesses may not benefit from a sobering delay but rather, should be interviewed immediately. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Illicit use of opioid substitution drugs: prevalence, user characteristics, and the association with non-fatal overdoses.

Science.gov (United States)

Bretteville-Jensen, Anne Line; Lillehagen, Mats; Gjersing, Linn; Andreas, Jasmina Burdzovic

2015-02-01

Diversion of opioid substitution drugs (OSD) is of public concern. This study examined the prevalence, frequency, and predictors of illicit OSD use in a group of injecting drug users (IDUs) and assessed if such use was associated with non-fatal overdoses. Semi-annual cross-sectional interviews conducted in Oslo, Norway (2006-2013), from 1355 street-recruited IDUs. Hurdle, logistic, and multinomial regression models were employed. Overall, 27% reported illicit OSD use in the past four weeks; 16.8% methadone, 12.5% buprenorphine, and 2.9% both drugs. Almost 1/10 reported at least one non-fatal overdose in the past four weeks, and roughly 1/3 reported such experience in the past year. Use of additional drugs tended to be equally, or more prevalent among illicit OSD users than other IDUs. In terms of illicit OSD use being a risk factor for non-lethal overdoses, our results showed significant associations only for infrequent buprenorphine use (using once or less than once per week). Other factors associated with non-fatal overdoses included age, education, homelessness, as well as the benzodiazepines, stimulants, and heroin use. Users of diverted OSD may represent a high-risk population, as they used more additional drugs and used them more frequently than other IDUs. However, illicit OSD use may be less harmful than previously assumed. After accounting for an extensive set of covariates, only infrequent illicit buprenorphine use, but not methadone use, was associated with non-fatal overdoses. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Neurosurgical Procedures in Jehovah's Witnesses: The Tema ...

African Journals Online (AJOL)

BACKGROUND: On account of religious reasons, Jehovah Witnesses do not accept blood or blood products; occasionally, they accept reinfusion of autologous blood via a cell saver during surgery. OBJECTIVE: The aim of this study was to document the demographics of Jehovah Witnesses undergoing neurosurgical ...

Lay responder naloxone access and Good Samaritan law compliance: postcard survey results from 20 Indiana counties.

Science.gov (United States)

Watson, Dennis P; Ray, Bradley; Robison, Lisa; Huynh, Philip; Sightes, Emily; Walker, La Shea; Brucker, Krista; Duwve, Joan

2018-04-06

To reduce fatal drug overdoses, two approaches many states have followed is to pass laws expanding naloxone access and Good Samaritan protections for lay persons with high likelihood to respond to an opioid overdose. Most prior research has examined attitudes and knowledge among lay responders in large metropolitan areas who actively use illicit substances. The present study addresses current gaps in knowledge related to this issue through an analysis of data collected from a broader group of lay responders who received naloxone kits from 20 local health departments across Indiana. Postcard surveys were included inside naloxone kits distributed in 20 Indiana counties, for which 217 returned cards indicated the person completing it was a lay responder. The survey captured demographic information and experiences with overdose, including the use of 911 and knowledge about Good Samaritan protections. Few respondents had administered naloxone before, but approximately one third had witnessed a prior overdose and the majority knew someone who had died from one. Those who knew someone who had overdosed were more likely to have obtained naloxone for someone other than themselves. Also, persons with knowledge of Good Samaritan protections or who had previously used naloxone were significantly more likely to have indicated calling 911 at the scene of a previously witnessed overdose. Primary reasons for not calling 911 included fear of the police and the person who overdosed waking up on their own. Knowing someone who has had a fatal or non-fatal overdose appears to be a strong motivating factor for obtaining naloxone. Clarifying and strengthening Good Samaritan protections, educating lay persons about these protections, and working to improve police interactions with the public when they are called to an overdose scene are likely to improve implementation and outcomes of naloxone distribution and opioid-related Good Samaritan laws.

HIV counselling and testing utilisation and attitudes of male inmates ...

African Journals Online (AJOL)

Lelaka C Motshabi MPH , Professor Supa Pengpid MSc DrPH MBA a & Professor Karl Peltzer PhD DrHabil b kpeltzer@hsrc.ac.za

2011-09-03

Sep 3, 2011 ... literature as one of the many strategies that can prevent, detect and .... the mental wellbeing of inmates and the Department is thus obliged to provide for these special ... for HIV will be given health education on issues of healthy sex practices so ... (REPC) of the National School of Public Health (NSPH) at.

Dental pain as a risk factor for accidental acetaminophen overdose: a case-control study.

Science.gov (United States)

Vogel, Jody; Heard, Kennon J; Carlson, Catherine; Lange, Chad; Mitchell, Garrett

2011-11-01

Patients frequent take acetaminophen to treat dental pain. One previous study found a high rate of overuse of nonprescription analgesics in an emergency dental clinic. The purpose of this study is to determine if patients with dental pain are more likely to be treated for accidental acetaminophen poisoning than patients with other types of pain. We conducted a case-control study at 2 urban hospitals. Cases were identified by chart review of patients who required treatment for accidental acetaminophen poisoning. Controls were self-reported acetaminophen users taking therapeutic doses identified during a survey of emergency department patients. For our primary analysis, the reason for taking acetaminophen was categorized as dental pain or not dental pain. Our primary outcome was the odds ratio of accidental overdose to therapeutic users after adjustment for age, sex, alcoholism, and use of combination products using logistic regression. We identified 73 cases of accidental acetaminophen poisoning and 201 therapeutic users. Fourteen accidental overdose patients and 4 therapeutic users reported using acetaminophen for dental pain. The adjusted odds ratio for accidental overdose due to dental pain compared with other reasons for use was 12.8 (95% confidence interval, 4.2-47.6). We found that patients with dental pain are at increased risk to accidentally overdose on acetaminophen compared with patients taking acetaminophen for other reasons. Emergency physicians should carefully question patients with dental pain about overuse of analgesics. Copyright © 2011 Elsevier Inc. All rights reserved.

An Appraisal of Library Services Provision to Prison Inmates in Nigeria

African Journals Online (AJOL)

Prisons like other correctional institutions deserve organized information provision centers like a library. This study examined library services provision in the south-western part of Nigeria. It was found out that despite their incarceration, inmates desires variety of information; whereas the library stock is grossly inadequate ...

Five Year Review of Disease Profile of Inmates in Three Prison ...

African Journals Online (AJOL)

Psychiatric cases (24.1%) constituted the most prevalent disease category among inmates. This was followed by gastrointestinal diseases (22.6%), diseases of the respiratory tract (10.9%), dermatology/allergy (5.4%) and cardiovascular diseases (2.4%). Among the specific conditions examined malaria (21.6%) was found ...

Atipamezole in the management of detomidine overdose in a pony.

Science.gov (United States)

Di Concetto, Stefano; Michael Archer, R; Sigurdsson, Sigurdur F; Clarke, Kw

2007-01-01

A pony undergoing elective castration accidentally received an overdose of IV detomidine (200 microg kg(-1)) before anaesthesia was induced with ketamine and midazolam. A further 100 microg kg(-1) IV dose of detomidine was administered during anaesthesia. The mistake was recognized only when the animal failed to recover from anaesthesia in the expected time. The overdose (300 microg kg(-1) in total) was treated successfully with atipamezole, initially given IV and subsequently IM and titrated to effect to a total dose of 1100 microg kg(-1). The pony regained the standing position. A further injection of atipamezole (76 microg kg(-1) IM) was given 5 hours later to counteract slight signs of re-sedation. Atipamezole proved an effective antagonist for detomidine in a pony at an initial dose 3.65 x and a final total dose 3.9 x greater than the alpha2 agonist.

Effects of group prosocial skills training on anger control in prison inmates.

Science.gov (United States)

Forbes, M R; Pratsinak, G J; Fagan, T J; Ax, R K

1992-02-01

A prosocial skills training program did not significantly affect the abilities of 48 adult male prison inmates to manage anger. Eight group treatment sessions did not influence their emotions, thoughts, and behaviors developed over years of experiential learning.

Correlates of Mandrax use and condom beliefs in preventing sexually transmitted infections among a cohort of South African prison inmates.

Science.gov (United States)

Stephens, Torrance T; Gardner, Darius; Jones, Keena; Sifunda, Sibusiso; Braithwaite, Ronald; Smith, Selina E

2016-03-01

This study was designed to identify the extent to which self-reported Mandrax use impacts condom-use beliefs amongst South African prison inmates. Participants were inmates from four prisons in the provinces of KwaZulu-Natal and Mpumalanga. In total, 357 inmates participated in the parent study of which 121 are included in this analysis based on their self-reported use of Mandrax. The questionnaire was developed in English, translated into Zulu, and back translated into English. Age significantly predicted the use of Mandrax: younger prison inmates reported higher use. Linear regression analysis was conducted to determine whether the use of Mandrax was associated with length of incarceration and other demographic variables, as well as participants' self-reported condom use beliefs behavior. Regression results indicated that two factors operationalizing condom-use beliefs were impacted by Mandrax use: 1) it is important to use condoms every time you have sex (pcondoms work well to prevent the spread of HIV (puse. STI prevention programs among prison inmates that seek to promote safer sex behaviors among men must address attitudes to condom use, specifically consistent and correct use of latex condoms and reducing substance misuse. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[HIVAb, HCVAb and HBsAg seroprevalence among inmates of the prison of Bologna and the effect of counselling on the compliance of proposed tests].

Science.gov (United States)

Sabbatani, Sergio; Giuliani, Ruggero; Fulgaro, Ciro; Paolillo, Pasquale; Baldi, Elena; Chiodo, Francesco

2004-01-01

The aims of the study were to evaluate the HIVAb, HCVAb and HBsAg seroprevalence among Italian and foreign inmates of the prison of Bologna, to evaluate if the extensive counselling of "new" inmates has significantly enhanced adherence to laboratory tests. The serological status was determined by a blood withdraw following the informed consent. Before asking their consent, patients were informed by cultural mediators who had been instructed about the aims of the study/exam during introductory meetings. The initial step managed by mediators was followed by further individual counselling interventions, carried out by hospital infective disease unit, prison and prison drug abuse service physicians. The laboratory tests were performed in an external structure. Prison of Bologna. The study was conducted on 433 subjects among a whole population of 900 inmates in the local prison: 390 subjects were males (90.1%) and 43 were females (9.9%). The median age of the whole population was 34.86 years (+/- 9.9). The studied population counted 147 (33.9%) intravenous drug users (IDU) and 286 not addicts (66.1%). As regards nationality, 212 subjects were Italian (48.9%) and 221 (51.1%) foreigners. Among the total 433 inmates considered, 78 (18%) were known as previous IDU with conviction history or condemned to long term sentences, while 59 (13.6%) were inmates recently convicted active IDU assisted by the internal drug abusers service. The third group was composed by 296 inmates imprisoned during the summer (103 Italians and 193 foreigners) self declared not IDU. A. 12.5% of inmates were HIV positive, 8.1% HBV positive and 31.1% HCV positive. 25 subjects were found positive both to HIV and HCV; 1 both to HIV and HBV and 5 to HIV, HBV and HCV. HIV positivity is more common among Italian vs. foreigners inmates, among IDU vs. not IDU. HCV positivity is more common among Italian vs. foreigners inmates, and among IDU vs. not IDU. The distribution of HBV seropositivity among the

Dealing with the inevitable: Strategies of self-presentation and meaning construction in the final statements of inmates on Texas death row

NARCIS (Netherlands)

Schuck, A.R.T.; Ward, J.

2008-01-01

Last statements of death row inmates represent a genre of discourse characterized by an acute situation in which to express final reflections. This article describes how Texas death row inmates give meaning to their situation by examining their last statements. Between December 1982 and November

Safety of a Brief Emergency Department Observation Protocol for Patients With Presumed Fentanyl Overdose.

Science.gov (United States)

Scheuermeyer, Frank X; DeWitt, Christopher; Christenson, Jim; Grunau, Brian; Kestler, Andrew; Grafstein, Eric; Buxton, Jane; Barbic, David; Milanovic, Stefan; Torkjari, Reza; Sahota, Indy; Innes, Grant

2018-03-09

Fentanyl overdoses are increasing and few data guide emergency department (ED) management. We evaluate the safety of an ED protocol for patients with presumed fentanyl overdose. At an urban ED, we used administrative data and explicit chart review to identify and describe consecutive patients with uncomplicated presumed fentanyl overdose (no concurrent acute medical issues) from September to December 2016. We linked regional ED and provincial vital statistics databases to ascertain admissions, revisits, and mortality. Primary outcome was a composite of admission and death within 24 hours. Other outcomes included treatment with additional ED naloxone, development of a new medical issue while in the ED, and length of stay. A prespecified subgroup analysis assessed low-risk patients with normal triage vital signs. There were 1,009 uncomplicated presumed fentanyl overdose, mainly by injection. Median age was 34 years, 85% were men, and 82% received out-of-hospital naloxone. One patient was hospitalized and one discharged patient died within 24 hours (combined outcome 0.2%; 95% confidence interval [CI] 0.04% to 0.8%). Sixteen patients received additional ED naloxone (1.6%; 95% CI 1.0% to 2.6%), none developed a new medical issue (0%; 95% CI 0% to 0.5%), and median length of stay was 173 minutes (interquartile range 101 to 267). For 752 low-risk patients, no patients were admitted or developed a new issue, and one died postdischarge; 3 (0.4%; 95% CI 0.01% to 1.3%) received ED naloxone. In our cohort of ED patients with uncomplicated presumed fentanyl overdose-typically after injection-deterioration, admission, mortality, and postdischarge complications appear low; the majority can be discharged after brief observation. Patients with normal triage vital signs are unlikely to require ED naloxone. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Cardiorespiratory fitness of inmates of a maximum security prison in ...

African Journals Online (AJOL)

Prisoners are a special population group who have limited freedom and are subjected to restrictions. They may not be able to enjoy health enhancing leisure and recreational activities or exercise of their choice or at a time they desire. The aim of this study is to determine the level of cardiorespiratory fitness (CRF) of inmates ...

Rates of opioid dispensing and overdose after introduction of abuse-deterrent extended-release oxycodone and withdrawal of propoxyphene.

Science.gov (United States)

Larochelle, Marc R; Zhang, Fang; Ross-Degnan, Dennis; Wharam, J Frank

2015-06-01

In the second half of 2010, abuse-deterrent extended-release oxycodone hydrochloride (OxyContin; Purdue Pharma) was introduced and propoxyphene was withdrawn from the US market. The effect of these pharmaceutical market changes on opioid dispensing and overdose rates is unknown. To evaluate the association between 2 temporally proximate changes in the opioid market and opioid dispensing and overdose rates. Claims from a large national US health insurer were analyzed, using an interrupted time series study design. Participants included an open cohort of 31.3 million commercially insured members aged 18 to 64 years between January 1, 2003, and December 31, 2012, with median follow-up of 20 months (last follow-up, December 31, 2012). Introduction of abuse-deterrent OxyContin (resistant to crushing or dissolving) on August 9, 2010, and market withdrawal of propoxyphene on November 19, 2010. Standardized opioid dispensing rates and prescription opioid and heroin overdose rates were the primary outcomes. We used segmented regression to analyze changes in outcomes from 30 quarters before to 8 quarters after the 2 interventions. Two years after the opioid market changes, total opioid dispensing decreased by 19% from the expected rate (absolute change, -32.2 mg morphine-equivalent dose per member per quarter [95% CI, -38.1 to -26.3]). By opioid subtype, the absolute change in dispensing by milligrams of morphine-equivalent dose per member per quarter at 2 years was -11.3 (95% CI, -12.4 to -10.1) for extended-release oxycodone, 3.26 (95% CI, 1.40 to 5.12) for other long-acting opioids, -8.19 (95% CI, -9.30 to -7.08) for propoxyphene, and -16.2 (95% CI, -18.8 to -13.5) for other immediate-release opioids. Two years after the market changes, the estimated overdose rate attributed to prescription opioids decreased by 20% (absolute change, -1.10 per 100,000 members per quarter [95% CI, -1.47 to -0.74]), but heroin overdose increased by 23% (absolute change, 0.26 per 100

Ethiopian witness protection system: comparative analysis with ...

African Journals Online (AJOL)

Witnesses are the eyes and the ears of justice.” They assist the court in deciding the guilt or otherwise of the accused person. They are crucial in a criminal proceeding; from reporting of crime to its trial. The evidence by a witness is crucial for the ...

Bad Luck or Bad Decisions: College Students' Perceptions of the Reasons for and Consequences of Their Alcohol Overdose

Science.gov (United States)

Reis, Janet

2007-01-01

Reasons for and immediate consequences of an alcohol overdose were explored for 217 undergraduate students requiring a medical emergency transport because of excessive alcohol consumption. The sample was categorized into 26 students attributing their overdose solely to bad luck and 191 students citing bad decision making as an explanation. A…

75 FR 25110 - Inmate Communication With News Media: Removal of Byline Regulations

Science.gov (United States)

2010-05-07

... DEPARTMENT OF JUSTICE Bureau of Prisons 28 CFR Part 540 [BOP-1149] RIN 1120-AB49 Inmate Communication With News Media: Removal of Byline Regulations AGENCY: Bureau of Prisons, Justice Department. ACTION: Interim final rule; technical correction. [[Page 25111

Experience in working with volunteers as providers of support to victims and witnesses in victim and witness support departments at the courts

Directory of Open Access Journals (Sweden)

Hamer-Vidmar Nikica

2015-01-01

Full Text Available The aim of this paper is to present the results of a survey on the experience of engaging volunteers as providers of support for victims and witnesses in Victim and Witness Support Departments at the courts. The Independent Service for Victim and Witness Support in Ministry of Justice is responsible for the development of the victim and witness support system in Croatia. The Independent Service also coordinates the work of Victim and Witness Support Departments and develops and provides training programs and supervision for support officers and volunteers. A survey was conducted in order to determine volunteer motivation, assess the volunteers’ required qualities, their educational needs, the emotional impact arising from the work with victims and witnesses and the volunteers‘ assessment of the level of acceptance by court officials. In order to improve the level of safety of volunteers and the organization itself, the selection and educational processes for volunteers have been improved, according to both the experience achieved by working with volunteers and the results of the aforementioned survey. Engaging volunteers in the judicial system is a large step forward in the field of co-operation between the judiciary and the community.

HIV/AIDS, STIs and condom use beliefs among male prison inmates in two South African provinces: Mpumalanga and KwaZulu-Natal.

Science.gov (United States)

Stephens, T; Conerly, R; Braithwaite, R L; Sifunda, S; Ogbuawa, N; Bhengu, S; Reddy, P

2009-01-01

The purpose of this study was to describe the characteristics of a random sample of prison inmates from two provinces in South Africa with respect to correct knowledge regarding HIV/AIDS and sexual transmitted infection (STI) risk and beliefs about condom use. This cross-sectional descriptive study of 357 prison inmates formed part of a larger longitudinal investigation designed to implement a health education intervention for prison inmates in the KwaZulu-Natal (KZN) and Mpumalanga (MP) provinces of South Africa. Mean differences for groups were compared across sites using Analysis of Variance (ANOVA). Inmates from KZN were less likely to agree that 'It is important to use condoms every time you have sex' F (1355) = 25.8, pCondoms work well to prevent the spread of HIV' F (1355) = 11.7, pCondoms also prevent pregnancy' F (1355) = 5.1, pcondom use behaviour suggested that future prevention efforts focus on the importance of using condoms to prevent the spread of HIV/AIDS and other STIs.

Prevalence of Pulmonary Tuberculosis among Prison Inmates in Ethiopia, a Cross-Sectional Study.

Science.gov (United States)

Ali, Solomon; Haileamlak, Abraham; Wieser, Andreas; Pritsch, Michael; Heinrich, Norbert; Loscher, Thomas; Hoelscher, Michael; Rachow, Andrea

2015-01-01

Tuberculosis (TB) is one of the major health problems in prisons. This study was done to assess the prevalence and determinants of active tuberculosis in Ethiopian prisons. A cross-sectional study was conducted from January 2013 to December 2013 in 13 zonal prisons. All incarcerated inmates underwent TB symptom screening according to WHO criteria. From identified TB-suspects two sputum samples were analyzed using smear microscopy and solid culture. A standardized questionnaire assessing TB risk factors was completed for each TB suspect. 765 (4.9%) TB suspects were identified among 15,495 inmates. 51 suspects were already on anti-TB treatment (6.67%) and 20 (2.8%) new culture-confirmed TB cases were identified in the study, resulting in an overall TB prevalence of 458.1/100,000 (95%CI: 350-560/100,000). Risk factors for active TB were alcohol consumption, contact with a TB case before incarceration and no window in prison cell. HIV prevalence was not different between TB suspects and active TB cases. Further, the TB burden in prisons increased with advancing distance from the capital Addis Ababa. The overall TB prevalence in Ethiopian prisons was high and extremely variable among different prisons. TB risk factors related to conditions of prison facilities and the impact of implemented TB control measures need to be further studied in order to improve TB control among inmates.

Jehovah's Witness patients within the German medical landscape.

Science.gov (United States)

Rajtar, Małgorzata

2016-08-01

Blood transfusions belong to standard and commonly utilised biomedical procedures. Jehovah's Witnesses' transfusion refusals are often referred to in bioethical and medical textbooks. Members of this globally active religious organisation do not, however, challenge biomedical diagnosis and treatment as such. A result of both their trust in and their interpretation of the Bible, they question only this medical treatment. In spite of the global presence of this religious community and its uniformly practised teachings, including those pertaining to blood, experiences and choices of Jehovah's Witness patients have been understudied. Drawing on a nine-month fieldwork with Jehovah's Witnesses and physicians in Germany (mainly in Berlin) between 2010 and 2012, the paper addresses treatment choices made by Witness patients and their relationship with physicians. In light of the long tradition of 'medical heterodoxy' established in German culture and society, Germany constitutes an ideal point of departure for such a study. By utilising the concept of 'medical landscape' it is argued that Jehovah's Witnesses in my field site find themselves at the intersection of different medical landscapes: in the 'immediate' surroundings of the German healthcare system that is open to different 'treatment modalities', and that of the United States, which favours biomedicine. The paper also argues that Jehovah's Witnesses' position towards blood transfusions can further be used as a lens to shed light on the German (bio)medical landscape itself.

[Acetaminophen: Knowledge, use and overdose risk in urban patients consulting their general practitioner. A prospective, descriptive and transversal study].

Science.gov (United States)

Cipolat, Lauriane; Loeb, Ouriel; Latarche, Clotilde; Pape, Elise; Gillet, Pierre; Petitpain, Nadine

2017-09-01

Acetaminophen is the most involved active substance in both unintentional and intentional drug poisoning. However, its availability outside community pharmacies is being debated in France. We made, via a self-administered questionnaire, a prospective assessment of knowledge, use and acetaminophen overdose risk in patients consulting their general practitioner, in the Metz Métropole urban area, between May 2015 and February 2016. We estimated the prevalence of potential unintentional overdosage by capture-recapture method. Among 819 responding patients, only 17.9 % had a sufficient knowledge and 20.3 % were at risk for potential unintentional overdose. The risk was higher for patients aged over 55 years or belonging to socioprofessional categories of laborers and inactive. A good knowledge score was a protective factor for overdose risk (P<0.0001). The liver toxicity of acetaminophen was particularly unknown. The prevalence of potential unintentional acetaminophen overdose was estimated at 1 to2 % of the population. Proposing acetaminophen outside of pharmacies cannot be recommended in France in such conditions. Information campaigns are needed to limit the risk of unintentional overdose and its consequences on liver toxicity. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Detecting quantum entanglement. Entanglement witnesses and uncertainty relations

International Nuclear Information System (INIS)

Guehne, O.

2004-01-01

This thesis deals with methods of the detection of entanglement. After recalling some facts and definitions concerning entanglement and separability, we investigate two methods of the detection of entanglement. In the first part of this thesis we consider so-called entanglement witnesses, mainly in view of the detection of multipartite entanglement. Entanglement witnesses are observables for which a negative expectation value indicates entanglement. We first present a simple method to construct these witnesses. Since witnesses are nonlocal observables, they are not easy to measure in a real experiment. However, as we will show, one can circumvent this problem by decomposing the witness into several local observables which can be measured separately. We calculate the local decompositions for several interesting witnesses for two, three and four qubits. Local decompositions can be optimized in the number of measurement settings which are needed for an experimental implementation. We present a method to prove that a given local decomposition is optimal and discuss with this the optimality of our decompositions. Then we present another method of designing witnesses which are by construction measurable with local measurements. Finally, we shortly report on experiments where some of the witnesses derived in this part have been used to detect three- and four-partite entanglement of polarized photons. The second part of this thesis deals with separability criteria which are written in terms of uncertainty relations. There are two different formulations of uncertainty relations since one can measure the uncertainty of an observable by its variance as well as by entropic quantities. We show that both formulations are useful tools for the derivation of separability criteria for finite-dimensional systems and investigate the resulting criteria. Our results in this part exhibit also some more fundamental properties of entanglement: We show how known separability criteria for

High grade squamous intraepithelial lesion in inmates from Ohio: cervical screening and biopsy follow-up

Directory of Open Access Journals (Sweden)

Rofagha Soraya

2006-01-01

Full Text Available Abstract Background Cervical carcinoma remains the second leading cause of cancer death in women worldwide and sexual behavior is regarded as the main contributing factor. We studied cervical cytology screening with surgical biopsy follow-up in women prisoners and compared the findings to those in the general population. Methods We reviewed 1024 conventional cervical smears, 73 cervical biopsies and 2 loop electrosurgical excision procedure (LEEP specimens referred to us from the Correctional Center in Columbus, Ohio during a 12-month period. The results were compared to 40,993 Pap smears from the general population for the same 12-month period. Results High grade squamous intraepithelial lesion (HGSIL was diagnosed in 1.3% of the cervical smears from the inmate population versus 0.6% in the general population (p < 0.01. The unsatisfactory rate was 1.6% compared to 0.3% in the general population (p < 0.01. Among the study population, follow-up tissue diagnosis was obtained in 24.3% of the abnormal cytology results (ASCUS, LGSIL, and HGSIL. Of the HGSIL Pap smears, 61.5% had a subsequent tissue diagnosis. Thirty-nine biopsies (52% of the all inmate biopsies and LEEP showed CIN II/III (cervical intraepithelial neoplasia II/III. Eight of these thirty-nine follow-up biopsies diagnosed as CIN II/III had a previous cervical cytology diagnosis of ASCUS. The average age for HGSIL was 30.5 years (S.D. = 5.7 and for low grade squamous intraepithelial lesion (LGSIL was 27.2 years (S.D. = 6.1. Conclusion A significantly higher prevalence of HGSIL cervical cytology and unsatisfactory smears was encountered in female inmates, with tissue follow-up performed in less than two thirds of the patients with HGSIL. These results are in keeping with data available in the literature suggesting that the inmate population is high-risk and may be subject to less screening and tissue follow-up than the general population. Clinicians should proceed with urgency to improve

Evaluation of a Life Skills Program for Women Inmates in Michigan.

Science.gov (United States)

Schram, Pamela J.; Morash, Merry

2002-01-01

Describes and evaluates a life skills program that focuses on addressing the special needs of female inmates. Analyses of pre- and post-test scores of program participants compared emotional empathy, self-esteem, coping resources, problem solving, parenting stress, employability, and well-being. Results suggest tat the program does address some of…

Rapid identification of drugs in the overdosed patient.

Science.gov (United States)

Hackett, L P; Dusci, L J

1977-01-01

A rapid analytical procedure is described for a variety of drugs that could be present in the overdosed patient. The technique used gives quantitative results for most of the drugs analyzed in serum using gas chromatography and incorporates thin-layer chromatography and spot tests for drug confirmation. The procedure is novel for it relies on the initial extraction of acidics, basics, and neutrals from serum acidified with hydroxhloric acid.

From expert witness to defendant: abolition of expert witness protection and its implications.

Science.gov (United States)

Mendelson, Danuta

2012-12-01

In Jones v Kaney [2011] 2 AC 398, the United Kingdom Supreme Court held that in England and Wales (but not in Scotland), clients can sue expert witnesses in negligence and/or contract for work performed under their retainer, whether in civil or criminal trials. The duties of expert witnesses in England are regulated by the Civil Procedure Rules and Protocols; the former also regulate the conduct of cases involving expert opinions. The legal context that led to the litigation is examined in the light of these rules, in particular, the nature of the allegations against Dr Kaney, a psychologist retained to provide psychiatric opinion. Jones v Kaney, as a decision of the United Kingdom Supreme Court, is not a binding precedent in Australia. However, unlike statutory enactments, common law judgments are retrospective in their operation, which means that health care practitioners who follow a generally accepted practice today may still be sued for damages by their patients or clients in the future. By definition, the future, including the refusal by the Australian High Court to follow Kaney's abolition of expert witnesses' immunity from suit for breach of duty to their clients, cannot be predicted with certainty. Consequently, health care practitioners in Australia and other countries should be aware of the case, its jurisprudential and practical ramifications.

12 CFR 308.148 - Rights of witnesses.

Science.gov (United States)

2010-01-01

... meets the requirements of § 308.6 of the Uniform Rules. That counsel may be present and may: (1) Advise... conflict of interest arising out of an attorney's or law firm's representation of multiple witnesses, the... the Uniform Rules; and (e) Witness fees shall be paid in accordance with § 308.14 of the Uniform Rules...

Evaluation of CHANGE, an Involuntary Cognitive Program for High-Risk Inmates

Science.gov (United States)

Hogan, Nancy L.; Lambert, Eric G.; Barton-Bellessa, Shannon M.

2012-01-01

Prison violence is a major concern in most correctional institutions. One intervention frequently used to reduce violent behavior is cognitive therapy. An involuntary cognitive program at a Midwestern state prison was evaluated for its impact on official misconduct. A total of 213 inmates were randomly assigned to the treatment (CHANGE) group (n =…

The Effect of Prisonization and Self-Esteem on Inmates' Career Maturity.

Science.gov (United States)

Homant, Robert J.; Dean, Douglas G.

1988-01-01

Tested model of offender career maturity by dividing 211 inmates into groups based on self-esteem and prisonization (taking on of prison culture). Compared groups on job planning, job attitudes, and stigmatization. Contrary to model, high self-esteem and low prisonization were both correlated significantly with higher scores on job planning and…

Acetaminophen overdose associated with double serum concentration peaks

Directory of Open Access Journals (Sweden)

Cristian Papazoglu

2015-12-01

Full Text Available Acetaminophen is the most commonly used analgesic–antipyretic medication in the United States. Acetaminophen overdose, a frequent cause of drug toxicity, has been recognized as the leading cause of fatal and non-fatal hepatic necrosis. N-Acetylcysteine is the recommended antidote for acetaminophen poisoning. Despite evidence on the efficacy of N-acetylcysteine for prevention of hepatic injury, controversy persists about the optimal duration of the therapy. Here, we describe the case of a 65-year-old male with acetaminophen overdose and opioid co-ingestion who developed a second peak in acetaminophen serum levels after completing the recommended 21-hour intravenous N-acetylcysteine protocol and when the standard criteria for monitoring drug levels was achieved. Prolongation of N-acetylcysteine infusion beyond the standard protocol, despite a significant gap in treatment, was critical for successful avoidance of hepatotoxicity. Delay in acetaminophen absorption may be associated with a second peak in serum concentration following an initial declining trend, especially in cases of concomitant ingestion of opioids. In patients with acetaminophen toxicity who co-ingest other medications that may potentially delay gastric emptying or in those with risk factors for delayed absorption of acetaminophen, we recommend close monitoring of aminotransferase enzyme levels, as well as trending acetaminophen concentrations until undetectable before discontinuing the antidote therapy.

Zolpidem Overdose: A Medical and Ethical Dilemma.

Science.gov (United States)

Shuaib, Waqas; Beatrice, Cristina; Abazid, Ahmad G

Acute altered mental status can be caused by a broad range of etiologies, including cerebrovascular, neurologic, traumatic, metabolic, infectious, psychiatric, medications, etc. We present a case of a 53-year-old healthcare professional with an acute altered mental status after a trip to Africa. The patient was extensively worked up for infectious, cardiovascular, and neurologic etiologies, and all results were within normal limits. Further history revealed an overdose of a self-medicated hypnotic (zolpidem) for insomnia. The patient was conservatively managed and discharged on trazadone for insomnia.

On Witnessed Models in Fuzzy Logic III - Witnessed Gödel Logics

Czech Academy of Sciences Publication Activity Database

Hájek, Petr

2010-01-01

Roč. 56, č. 2 (2010), s. 171-174 ISSN 0942-5616 R&D Projects: GA MŠk(CZ) 1M0545 Institutional research plan: CEZ:AV0Z10300504 Keywords : mathematical fuzzy logic * Gödel logic * witnessed models * arithmetical complexity Subject RIV: BA - General Mathematics Impact factor: 0.361, year: 2010

Death Anxiety and Pain Catastrophizing Among Male Inmates With Nonsuicidal Self-Injury Behavior: A Comparative Study.

Science.gov (United States)

Enea, Violeta; Dafinoiu, Ion; Bogdan, Georgiana; Matei, Carmen

2017-07-01

Most of the studies concerning nonsuicidal self-injury behaviors of persons deprived of liberty were on female participants. This cross-sectional comparative study compared the levels of death anxiety, pain catastrophizing, dissociative experiences, and state-trait anger among male inmates with nonsuicidal self-injury behaviors and noninjuring controls. The results indicated high levels of death anxiety, dissociation, and pain catastrophizing in both groups of participants and the absence of significant differences between the groups. The implications of the results suggest the need of taking into consideration these variables in the behavior management plans used with inmates who engage in self-injurious behavior.

ASPECTS OF CRIMINALISTICS TACTICS RELATED TO WITNESS HEARING

Directory of Open Access Journals (Sweden)

Nicolae Mărgărit

2017-12-01

Full Text Available The article analyses some aspects related to witness statements, with regard to the actual tactics of hearing witnesses and the hearing of child witnesses. Judicial practice has well shown that giving evidence is the most important phase in the course of the activity carried out by judicial bodies, being the way for determining the facts, for finding the truth in the case referred for settlement. Giving the evidence in a correct and complete way, the value of the administered evidence and its correct and lawful evaluation are decisive for the judicial bodies to come to an intimate belief with regard to the factual reality on which the solution they pronounce should be based, the lawfulness itself of court rulings and other solutions given by the judicial bodies being dependant on these elements. In order to obtain the evidence and make the most of it in a criminal trial, legal activities or operations are necessary to discover it and to present it in a form which is perceptible for the judicial bodies, an aspect which is accomplished by legal means of evidence. Criminal doctrine and judicial practice alike have determined that for finding the truth in a criminal trial, besides the statements made by the suspect or the accused, the statements of the other parties in the trial have an appreciable contribution too. In this context, the contribution of Criminalistics – the science of crime investigation – to establishing the facts in a criminal trial is especially noticeable with the conclusions of forensic examinations and findings. The study put forward reveals some aspects of criminalistics tactics related to witness hearing in a criminal trial, as well as that the result of the investigation depends on how the activity of witness hearing is prepared and the compliance with all procedural rules. At the same time, as Criminalistics supports the witness hearing activity, it develops a particular tactical hearing procedure, starting precisely

The Effect of Drug Treatment on Inmate Misconduct in Federal Prisons.

Science.gov (United States)

Langan, Neal P.; Pelissier, Bernadette M. M.

2001-01-01

Evaluates the Federal Bureau of Prisons' substance abuse treatment program's effectiveness in reducing prisoner misconduct. Results show that program graduates are 74 percent less likely to engage in misconduct over a 14-month period than a comparison group. This benefit is shared by male and female inmates alike. (Contains 25 references and 2…

Introducing Inmates to Extension through Financial Education and Experiential Learning Tools

Science.gov (United States)

Richel, Karen

2013-01-01

Research shows that in order to reduce recidivism rates in prisons, financial education and other life skills should be a mandatory topic in our prison systems. By creating a learning environment conducive to the specialized needs of this audience, an inmate's ability to set goals, recognize wants and needs, maintain bank accounts, create a…

Witnessing entanglement by proxy

International Nuclear Information System (INIS)

Bäuml, Stefan; Bruß, Dagmar; Kampermann, Hermann; Huber, Marcus; Winter, Andreas

2016-01-01

Entanglement is a ubiquitous feature of low temperature systems and believed to be highly relevant for the dynamics of condensed matter properties and quantum computation even at higher temperatures. The experimental certification of this paradigmatic quantum effect in macroscopic high temperature systems is constrained by the limited access to the quantum state of the system. In this paper we show how macroscopic observables beyond the mean energy of the system can be exploited as proxy witnesses for entanglement detection. Using linear and semi-definite relaxations we show that all previous approaches to this problem can be outperformed by our proxies, i.e. entanglement can be certified at higher temperatures without access to any local observable. For an efficient computation of proxy witnesses one can resort to a generalised grand canonical ensemble, enabling entanglement certification even in complex systems with macroscopic particle numbers. (paper)

Factors associated with syphilis seropositive and Human Immunodeficiency Virus (HIV) infection among inmates at Lubuk Pakam prison, Indonesia

Science.gov (United States)

Sembiring, E.; Ginting, Y.; Saragih, R. H.

2018-03-01

Syphilis has been known to increase the risk of acquiring or transmitting HIV infection. Epidemiologic studies showed that HIV transmission is 3-5 times higher in people with syphilis.Hence, in this current study, the factors associated with syphilis-seropositive and HIV infection were evaluated.This study used cross-sectional study. This study included inmates at Lubuk Pakam prison in November 2016. After interviewing participants’ demographics and risk behaviors, blood samples were obtained to be tested for HIV and syphilis, using the Rapid Test tool of HIV 3 methods and One STEP Syphilis Anti TP-Test. A total number of 1,114 inmates were included in this study, consisted of 1,081 male (97%) and 33female (3%). Ten inmates were HIV-positive (0.9%), whereas 70 inmates were syphilis-seropositive (6.3%).Based on multivariate-analyses, high-risk sexual behaviors associated with the increased risk of syphilis-seropositive of up to 8.31 times (p=0.002). HIV status also portrayed higher risk of syphilis-seropositive compared to non-HIV participants (3.98 fold, p=0.019). In HIV incidence, found that high-risk sexual behaviors also significantly increased the risk of HIV (7.69 fold, p=0.003). Syphilis-seropositive was also highly associated with HIV risk (5.09 fold, p=0.019).Syphilis and HIV showed a close association with several shared contributing factors.

Interventions for paracetamol (acetaminophen) overdose

DEFF Research Database (Denmark)

Chiew, Angela L; Gluud, Christian; Brok, Jesper

2018-01-01

BACKGROUND: Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various...... of paracetamol. Acetylcysteine should be given to people at risk of toxicity including people presenting with liver failure. Further randomised clinical trials with low risk of bias and adequate number of participants are required to determine which regimen results in the fewest adverse effects with the best...... was abandoned due to low numbers recruited), assessing several different interventions in 700 participants. The variety of interventions studied included decontamination, extracorporeal measures, and antidotes to detoxify paracetamol's toxic metabolite; which included methionine, cysteamine, dimercaprol...

Entanglement witness via quantum-memory-assisted entropic uncertainty relation

Science.gov (United States)

Shi, Jiadong; Ding, Zhiyong; Wu, Tao; He, Juan; Yu, Lizhi; Sun, Wenyang; Wang, Dong; Ye, Liu

2017-12-01

By virtue of the quantum-memory-assisted entropic uncertainty relation (EUR), we analyze entanglement witness via the efficiencies of the estimates proposed by Berta (2010 Nat. Phys. 6 659) and Pati (2012 Phys. Rev. A 86 042105). The results show that, without a structured reservoir, the entanglement regions witnessed by these EUR estimates are only determined by the chosen estimated setup, and have no correlation with the explicit form of the initial state. On the other hand, with the structured reservoirs, the time regions during which the entanglement can be witnessed, and the corresponding entanglement regions closely depend on the choice of the estimated setup, the initial state and the state purity p . Concretely, for a pure state with p=1 , the entanglement can be witnessed by both estimates, while for mixed states with p=0.78 , it can only be witnessed using the Pati estimate. What is more, we find that the time regions incorporating the Pati estimate become discontinuous for the initial state with ≤ft| {{φ }\\prime } \\right> ={≤ft(≤ft| 01 \\right> +≤ft| 10 \\right> \\right)}/{\\sqrt{2}} , and the corresponding entanglement regions remain the same; however the entanglement can only be witnessed once by utilizing the Berta estimate.

28 CFR 513.62 - Freedom of Information Act requests by former inmates.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Freedom of Information Act requests by... GENERAL MANAGEMENT AND ADMINISTRATION ACCESS TO RECORDS Release of Information Freedom of Information Act Requests for Information § 513.62 Freedom of Information Act requests by former inmates. Former federal...

Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas - United States.

Science.gov (United States)

Mack, Karin A; Jones, Christopher M; Ballesteros, Michael F

2017-10-20

Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015. The National Survey of Drug Use and Health (NSDUH) collects information through face-to-face household interviews about the use of illicit drugs, alcohol, and tobacco among the U.S. noninstitutionalized civilian population aged ≥12 years. Respondents include residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories, migratory workers' camps, and halfway houses) and civilians living on military bases. NSDUH variables include sex, age, race/ethnicity, residence (metropolitan/nonmetropolitan), annual household income, self-reported drug use, and drug use disorders. National Vital Statistics System Mortality (NVSS-M) data for U.S. residents include information from death certificates filed in the 50 states and the District of Columbia. Cases were selected with an underlying cause of death based on the ICD-10 codes for drug overdoses (X40-X44, X60-X64, X85, and Y10-Y14). NVSS-M variables include decedent characteristics (sex, age, and race/ethnicity) and information on intent (unintentional, suicide, homicide, or undetermined), location of death (medical facility, in a home, or other [including nursing homes, hospices, unknown, and other locations]) and county of residence (metropolitan/nonmetropolitan). Metropolitan/nonmetropolitan status is assigned independently in each data system. NSDUH uses a three-category system: Core Based Statistical Area (CBSA) of ≥1 million persons; CBSA of illicit drugs, the prevalence was highest for the large metropolitan areas compared with

An Acute Ibuprofen Overdose Masking a Severe Staphylococcus aureus Meningitis: A Case Report

Directory of Open Access Journals (Sweden)

Matthew Smetana

2013-01-01

Full Text Available Acute bacterial meningitis has a low incidence (3/100,000 in the United States and yet high fatality rate (approximately 14–16% and classically presents as a triad of fever, neck stiffness, and altered mental status. However, less than half of patients with meningitis present with this classic triad. We present the clinical course of a patient who initially presented to the emergency department after overdosing on ibuprofen for what he described as back pain secondary to mechanical injury. However, the patient's condition quickly deteriorated: he developed tachycardia, mental status changes, was intubated due to respiratory distress, and then suffered an 8-minute PEA arrest before return of spontaneous circulation was achieved. After the patient was stabilized, in addition to the nonsteroidal anti-inflammatory drug (NSAID overdose Staphylococcus aureus meningitis, bacteremia, and pneumonia were diagnosed. We report this case to illustrate that the initial presentation of meningitis may be extremely unusual especially in the setting of NSAID overdose and the acutely decompensating patient. As the risk of adverse clinical outcomes increases with delays in appropriate antibiotic therapy, it is therefore crucial to recognize the many signs and symptoms of meningitis, typical and atypical, and quickly begin appropriate treatment.

Prolonged QRS Widening After Aripiprazole Overdose.

Science.gov (United States)

Mazer-Amirshahi, Maryann; Porter, Robert; Dewey, Kayla

2018-05-05

Aripiprazole is an atypical antipsychotic with a long half-life. Overdose can result in protracted somnolence and cardiac disturbances, particularly QT interval prolongation. This is a single case report of a 14-year-old boy who took an overdose of aripiprazole and developed QRS widening. A 14-year-old boy intentionally ingested 20 tablets of aripiprazole (5 mg). He was brought to the emergency department when his ingestion was discovered. The patient's vital signs were as follows: temperature, 37.7°C; heart rate, 108 beats/min; blood pressure, 138/98 mm Hg; and respirations, 16 breaths/min. Activated charcoal was administered within 90 minutes of ingestion. Initial electrocardiogram (EKG) showed sinus tachycardia, with a QRS of 138 ms and QT interval of 444 ms. QRS duration was 90 ms on an EKG performed 3 months earlier. A bolus of sodium bicarbonate was administered, and the patient was transferred to the pediatric intensive care unit. Repeat EKG demonstrated a QRS of 156 ms, and a sodium bicarbonate infusion was initiated. The patient continued to have QRS prolongation for the next 8 days, reaching a peak of 172 ms 3 days postingestion. Despite aggressive treatment with sodium bicarbonate, there was persistent QRS prolongation; however, the patient did not have any dysrhythmias and remained hemodynamically stable. The patient was discharged 9 days postingestion when the QRS duration normalized to 82 ms. Genetic testing revealed that the patient was a CYP2D6 poor metabolizer. This case suggests that aripiprazole toxicity may possibly be associated with QRS prolongation without associated dysrhythmias or cardiovascular compromise. In addition, toxicity may be prolonged in patients who are CYP2D6 poor metabolizers.

Working at the social-clinical-community-criminology interface: The GMU Inmate Study.

Science.gov (United States)

Tangney, June Price; Mashek, Debra; Stuewig, Jeffrey

2007-01-01

This paper describes our attempt to import social-personality theory and research on moral emotions and moral cognitions to applied problems of crime, substance abuse, and HIV risk behavior. Thus far, in an inmate sample, we have evidence that criminogenic beliefs and proneness to guilt are each predictive of re-offense after release from jail. In addition, we have evidence that jail programs and services may reduce criminogenic beliefs and enhance adaptive feelings of guilt. As our sample size increases, our next step is to test the full mediational model, examining the degree to which programs and services impact post-release desistance via their effect on moral emotions and cognitions. In addition to highlighting some of the key findings from our longitudinal study of jail inmates over the period of incarceration and post-release, we describe the origins and development of this interdisciplinary project, highlighting the challenges and rewards of such endeavors.

Innovative alcohol- and drug-user treatment of inmates in New Zealand prisons.

Science.gov (United States)

Huriwai, Terry

2002-01-01

The Kowhai Alcohol and Drug Treatment Unit at Rolleston Prison offers an innovative treatment approach for New Zealand inmates. The development of the program has involved local staff from Public Prisons, Psychological Services, and the Community Probation Service (CPS). This presentation outlines the author's impression of this bold innovation. The primary aim of the program is to reduce recidivism. This is achieved by assisting inmates to recognize the thoughts, emotions, and behaviours that are present in the period preceding and/or during the commission of criminal activity--particularly those that are precipitated and/or maintained by alcohol and drug use. This insight, coupled with the learning of specific coping skills and intensive lifestyle and reintegration planning, leads naturally to the follow-up phase that is conducted in the community. The functional relationship between offending and substance use is far more explicitly addressed in this new program compared with past programs that focused more on substance use.

Demographic, criminal and psychiatric factors related to inmate suicide

OpenAIRE

Blaauw, E.; Kerkhof, A.J.F.M.; Hayes, L.M.

2005-01-01

A review of 19 studies suggests that it may be feasible to identify prisoners with suicide risk on the basis of demographic, psychiatric, and criminal characteristics. The present study aimed to identify combinations of characteristics that are capable of identifying potential suicide victims. Characteristics of 95 suicide victims in the Dutch prison system were compared with those of a random sample of 247 inmates in ten jails. Combinations of indicators for suicide risk were also tested for...

A Psycholinguistic Approach to Inmate Argot in Romanian Prisons

OpenAIRE

Nădrag, Lavinia; Stroescu, Manuela

2010-01-01

The lexis and structure of prison argot reflect the personalities of inmates who employ them, as well as the conflicts and tensions inherent in prison settings. It is shown in this article that the distinctiveness of prison argot is largely a product of the character of penal context. Its extent of use varies with the extent of penal discipline. Appreciation of this complex relationship might facilitate improved communication between prisoners and custodial authorities. In addition, knowledge...

Analyzing Counsel/Witness Discourse in Nnewi, Anambra State ...

African Journals Online (AJOL)

This paper analyzed counsel/witness discourse using the High Court in. Nnewi Municipal Council. Specifically, it described the structure and organization of counsel/witness discourse in the courtroom context highlighting some discourse features inherent in them, and observed the communication strategies and motivation ...

The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions.

Science.gov (United States)

Perlman, David C; Jordan, Ashly E

2018-04-01

This article reviews the case for recognizing (1) the epidemics of opioid misuse, overdose, hepatitis C virus, and HIV as a syndemic and (2) the importance of examining and addressing structural factors in responses to this syndemic. We focus on the current syndemic in the US, but also consider data from other locations to highlight the issues existing and arising in various contexts. Advances in multi-level theory and statistical methods allow sound ecologic and multi-level analyses of the impact of structural factors on the syndemic. Studies of opioid misuse, overdoses, hepatitis C virus, and HIV demonstrate that area-level access to healthcare, medication-assisted treatment of opioid use disorders, sterile injection equipment, and overdose prevention with naloxone, as well as factors such as opioid marketing, income inequality, intensity of policing activities, and health care policies, are related to the prevalence of substance misuse, overdoses, infection risk, and morbidity. Structural variables can predict area-level vulnerability to the syndemic. The implementation of combined prevention and treatment interventions can control and reverse components of the syndemic. Recognizing and monitoring potent structural factors can facilitate the identification of areas at risk of vulnerability to the syndemic. Further, many structural factors are modifiable through intervention and policy to reduce structural vulnerability and create health-enabling environments. Evidence supports the immediate implementation of broader HCV and HIV testing and substance use screening, medication-assisted treatment, needle/syringe exchange programs, naloxone programs, increased population-level implementation of HCV treatment, and further attention to structural-level factors predicting, and contributing to, area-level vulnerability, such as degrees of opioid marketing, distribution, and prescribing.

A novel approach for estimating ingested dose associated with paracetamol overdose.

Science.gov (United States)

Zurlinden, Todd J; Heard, Kennon; Reisfeld, Brad

2016-04-01

In cases of paracetamol (acetaminophen, APAP) overdose, an accurate estimate of tissue-specific paracetamol pharmacokinetics (PK) and ingested dose can offer health care providers important information for the individualized treatment and follow-up of affected patients. Here a novel methodology is presented to make such estimates using a standard serum paracetamol measurement and a computational framework. The core component of the computational framework was a physiologically-based pharmacokinetic (PBPK) model developed and evaluated using an extensive set of human PK data. Bayesian inference was used for parameter and dose estimation, allowing the incorporation of inter-study variability, and facilitating the calculation of uncertainty in model outputs. Simulations of paracetamol time course concentrations in the blood were in close agreement with experimental data under a wide range of dosing conditions. Also, predictions of administered dose showed good agreement with a large collection of clinical and emergency setting PK data over a broad dose range. In addition to dose estimation, the platform was applied for the determination of optimal blood sampling times for dose reconstruction and quantitation of the potential role of paracetamol conjugate measurement on dose estimation. Current therapies for paracetamol overdose rely on a generic methodology involving the use of a clinical nomogram. By using the computational framework developed in this study, serum sample data, and the individual patient's anthropometric and physiological information, personalized serum and liver pharmacokinetic profiles and dose estimate could be generated to help inform an individualized overdose treatment and follow-up plan. © 2015 The British Pharmacological Society.

Bupropion Overdose Presenting as Status Epilepticus in an Infant.

Science.gov (United States)

Rivas-Coppola, Marianna S; Patterson, Amy L; Morgan, Robin; Wheless, James W

2015-09-01

Bupropion is a monocyclic antidepressant in the aminoketone class, structurally related to amphetamines. The Food and Drug Administration withdrew this product from the market in 1986 after seizures were reported in bulimic patients. It was later reintroduced in 1989 when the incidence of seizures was shown to be dose-related in the immediate release preparation. Massive bupropion ingestion has been associated with status epilepticus and cardiogenic shock in adults. Seizures have been reported in children, but not status epilepticus. This report highlights a patient who presented with status epilepticus and developed cardiopulmonary arrest after bupropion ingestion. False-positive amphetamine diagnosis from urine drug screen on presentation was reported. We review the presentation, clinical course, diagnostic studies, and outcome of this patient. We then review the literature regarding bupropion overdose in children. Symptoms of bupropion toxicity and risk for seizures are dose-dependent and fatalities have been reported. Our patient developed status epilepticus and cardiopulmonary arrest and then progressed to have a hypoxic ischemic encephalopathy and refractory symptomatic partial seizures. Our report highlights the need to keep this medication away from children in order to prevent accidental overdose. Copyright © 2015 Elsevier Inc. All rights reserved.

Metallic witness packs for behind-armour debris characterization

NARCIS (Netherlands)

Verolme, J.L.; Szymczak, M.; Broos, J.P.F.

1999-01-01

For the experimental characterization of behind-armour debris so-called metallic witness packs can be used. A metallic witness pack consists of an array of metallic plates interspaced by polystyrene foam sheets. To quantify the fragment mass and velocity from the corresponding hole area and position

Caring to learn, learning to care: Inmate Hospice Volunteers and the Delivery of Prison End-of-Life Care

Science.gov (United States)

Cloyes, Kristin G.; Rosenkranz, Susan J.; Supiano, Katherine P.; Berry, Patricia H.; Routt, Meghan; Llanque, Sarah M.; Shannon-Dorcy, Kathleen

2017-01-01

The increasing numbers of aging and chronically ill prisoners incarcerated in Western nations is well documented, as is the growing need for prison-based palliative and end-of-life care. Less often discussed is specifically how end-of-life care can and should be provided, by whom, and with what resources. One strategy incorporates prisoner volunteers into end-of-life services within a peer care program. This article reports on one such program based on focused ethnographic study including in-depth interviews with inmate hospice volunteers, nursing staff, and corrections officers working in the hospice program. We describe how inmate volunteers learn hospice care through formal education and training, supervised practice, guidance from more experienced inmates, and support from correctional staff. We discuss how emergent values of mentorship and stewardship are seen by volunteers and staff as integral to prison hospice sustainability and discuss implications of this volunteer-centric model for response-ability for the end-of-life care of prisoners. PMID:28100141

Health Care Needs of Prison Inmates: Treating a population that has special needs

OpenAIRE

Wachsmuth, Anne

1991-01-01

Prisoners in correctional facilities constitute a unique population requiring specialized medical care. Drug withdrawal, self-destructive behavior, infectious diseases (including AIDS), and serious mental disorders are some of the challenges to the physician who provides medical services to these inmates.

Identifying Witness Accounts from Social Media Using Imagery

Directory of Open Access Journals (Sweden)

Marie Truelove

2017-04-01

Full Text Available This research investigates the use of image category classification to distinguish images posted to social media that are Witness Accounts of an event. Only images depicting observations of the event, captured by micro-bloggers at the event, are considered Witness Accounts. Identifying Witness Accounts from social media is important for services such as news, marketing and emergency response. Automated image category classification is essential due to the large number of images on social media and interest in identifying witnesses in near real time. This paper begins research of this emerging problem with an established procedure, using a bag-of-words method to create a vocabulary of visual words and classifier trained to categorize the encoded images. In order to test the procedure, a set of images were collected for case study events, Australian Football League matches, from Twitter. Evaluation shows an overall accuracy of 90% and precision and recall for both classes exceeding 83%.

Perspectives on Inmate Communication and Interpersonal Relations in the Maximum Security Prison.

Science.gov (United States)

Van Voorhis, Patricia; Meussling, Vonne

In recent years, scholarly and applied inquiry has addressed the importance of interpersonal communication patterns and problems in maximum security institutions for males. As a result of this research, the number of programs designed to improve the interpersonal effectiveness of prison inmates has increased dramatically. Research suggests that…

28 CFR 540.50 - Visits to inmates not in regular population status.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visits to inmates not in regular population status. 540.50 Section 540.50 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE... not in regular population status. (a) Admission and holdover status. The Warden may limit to the...

Exploring the sequential lineup advantage using WITNESS.

Science.gov (United States)

Goodsell, Charles A; Gronlund, Scott D; Carlson, Curt A

2010-12-01

Advocates claim that the sequential lineup is an improvement over simultaneous lineup procedures, but no formal (quantitatively specified) explanation exists for why it is better. The computational model WITNESS (Clark, Appl Cogn Psychol 17:629-654, 2003) was used to develop theoretical explanations for the sequential lineup advantage. In its current form, WITNESS produced a sequential advantage only by pairing conservative sequential choosing with liberal simultaneous choosing. However, this combination failed to approximate four extant experiments that exhibited large sequential advantages. Two of these experiments became the focus of our efforts because the data were uncontaminated by likely suspect position effects. Decision-based and memory-based modifications to WITNESS approximated the data and produced a sequential advantage. The next step is to evaluate the proposed explanations and modify public policy recommendations accordingly.

Sociodemographic and health profile of inmates of old age homes in and around Belgaum city, Karnataka.

Science.gov (United States)

Viveki, R G; Halappanavar, A B; Joshi, A V; Pujar, Kirankumar; Patil, Sandhya

2013-10-01

A new trend of admitting more and more senior citizens hailing from the Indian middle class background to old age homes is being observed in recent times. The objectives of this study were to study sociodemographic dimensions and common health problems of inmates of old age homes and to know various reasons for their admissions and their leisure time activities in old age homes. The present cross-sectional study was conducted during March and April 2010 in 4 different old age homes in and around Belgaum city, North Karnataka, by interviewing the inmates of old age homes using predesigned, pretested, structured questionnaire followed by thorough clinical examination and haemoglobin estimation by Sahli's method. The collected data was compiled and analysed using SPSS software version 14. Out of 73 elderly, 54 were females (74.0%). Majority were in the age group of 61-70 years (50.7%) and 56 were belonging to nuclear family (76.7%). Thirty-nine inmates were widow/widower (53.4%) and 42 were having no children (57.5%). Forty-seven inmates were admitted as there was nobody to take care of them (64.4%). Common health problems observed were locomotive/joint and muscle disorders (35.6%), hypertension (34.2%), diabetes mellitus (26.0%), respiratory disorders (23.3%), hearing loss (21.9%) etc. Forty-nine were having normal body mass index (67.1%) while 19.2% were underweight. Majority were having haemoglobin levels between 10-12 g/dl (58.9%). Old age homes definitely will enable the elderly to remain sociopsychologically healthy and lead active lives if effective medical and emotional support is given.

Psychiatric morbidity among inmates of center for destitutes: A cross-sectional study

Directory of Open Access Journals (Sweden)

Raghavendra B Nayak

2015-01-01

Full Text Available Context: One percent of the population in India is homeless (destitutes which include beggars, commercial sex workers, homeless mentally ill, elderly women with dependent children, street children, and persons with disability. Psychiatric disorders are generally seen to be common among homeless individuals. The data are limited regarding psychiatric morbidity and its prevalence in this populace in Indian context. Aim: The aim was to study the prevalence of psychiatric morbidity among the inmates of a center for destitutes. Settings and Design: Cross-sectional study. Materials and Methods: The study included all the residents (n = 50 of a center of destitutes. Psychiatric evaluation was done by qualified practicing psychiatrist. Brief Psychiatric Rating Scale and Global Assessment of Functioning instruments were used to assess the severity of psychiatric symptoms and general functioning of the individuals with mental disorders. Statistical Analysis Used: SPSS version 13 was used for statistical analysis. Results: All residents (n = 50 of center of destitutes were evaluated for psychiatric co-morbidity. 42 (84% inmates were suffering from psychiatric disorders. Most common psychiatric disorder among them was psychotic disorders in 19 (38%, followed by affective disorders, mainly depression in 16 (32%, somatoform disorders in 5 (10%, and anxiety disorders in 2 (4%. No significant gender differences were noted (P = 0.335. Substance abuse was present in 22 (44% of the inmates. A significant negative correlation between psychiatric symptoms and functioning of the subject was seen, (P < 0.001. Conclusion: Psychiatric disorders and in particular substance abuse, are common among the homeless people who stay in the center of destitutes. Psychiatric disorders are likely to be the cause significant functional impairment.

A behavioral typology of opioid overdose risk behaviors among recent veterans in New York City.

Directory of Open Access Journals (Sweden)

Alex S Bennett

Full Text Available To identify meaningful classes of opioid-using military veterans in terms of self-reported opioid overdose risk behaviors.The study recruited a sample of 218 military veterans in the NYC area who were discharged from active duty service after September 11, 2001 and reported past-month opioid use. Survey data including measures of mental health, social stressors, substance use, and opioid-related overdose risk behaviors were analyzed using Latent Class Analysis (LCA.A five group solution had excellent fit scores and interpretability. Factor analysis confirmed the existence of two major dimensions of variation: non-adherence and heroin use. The five groups included lower-risk prescription opioid users, non-adherent prescription opioid users and heroin users. The non-adherent prescription opioid users and heroin user classes were both further subdivided into "occasional" and "regular" use categories. In addition to endorsing a greater number of overdose risk behaviors, users in the regular use classes were more likely to screen positive for alcohol and substance use disorders, reported greater self-medicating opioid use to relieve anxiety, reported greater problems with physical pain, were more likely to have had mental health, alcohol and drug treatment, and were less likely to be employed or in school. Heroin users also were less likely to report stable housing.Findings indicate that opioid overdose risk classes are grounded in contextual factors related to experiences of psychological, physiological, and social adjustment pain and distress which should be addressed in tailored interventions targeting opioid users' unique constellations of risk behaviors and comorbid conditions.

Longitudinal Associations in Youth Involvement as Victimized, Bullying, or Witnessing Cyberbullying.

Science.gov (United States)

Holfeld, Brett; Mishna, Faye

2018-04-01

Although cyberbullying has been linked to cyber victimization, it is unknown whether witnessing cyberbullying impacts and is impacted by experiences of cyberbullying and victimization. In the current study, we examine the frequency of youth involved as victimized, bullying, and witnessing cyberbullying and how these experiences are associated across three academic years. Participants comprised 670 Canadian students who began the longitudinal study in grades 4, 7, or 10 at Time 1 (T1). Cyber witnessing represented the largest role of youth involvement in cyberbullying. Cyber witnessing was positively associated with both cyberbullying and victimization. Cyber victimization at T1 was positively associated with cyber witnessing at T2, which was positively related to both cyberbullying and victimization at T3. Findings highlight the significance of addressing the role of cyber witnesses in cyberbullying prevention and intervention efforts.

Group Therapy Goals: A Comparison of Group Therapy Providers and Male Inmates

Science.gov (United States)

Morgan, Robert D.; Garland, J. Travis; Rozycki, Alicia T.; Reich, Darcy A.; Wilson, Scott

2005-01-01

This study was designed to identify important process and content goals from the perspective of inmates and compare these goals to the goals identified by group therapists in a previous study conducted by Winterowd, Morgan, and Ferrell (2001). Utilizing survey data from 156 incarcerated adult males, an initial confirmatory factor analysis…

Tricyclic antidepressant overdose: emergency department findings as predictors of clinical course.

Science.gov (United States)

Foulke, G E; Albertson, T E; Walby, W F

1986-11-01

There is controversy regarding the appropriate utilization of health care resources in the management of tricyclic antidepressant overdosage. Antidepressant overdose patients presenting to the emergency department (ED) are routinely admitted to intensive care units, but only a small proportion develop cardiac arrhythmias or other complications requiring such an environment. The authors reviewed the findings in 165 patients presenting to an ED with antidepressant overdose. They found that major manifestations of toxicity on ED evaluation (altered mental status, seizures, arrhythmias, and conduction defects) were commonly associated with a complicated hospital course. Patients with the isolated findings of sinus tachycardia or QTc prolongation had no complications. No patient experienced a serious toxic event without major evidence of toxicity on ED evaluation and continued evidence of toxicity during the hospital course. These data support the concept that proper ED evaluation can identify a large body of patients with trivial ingestions who may not require hospital observation.

Ceramic waste form qualification using results from witness tubes

International Nuclear Information System (INIS)

O'Holleran, T.P.; Johnson, S.G.; Bateman, K.J.

2002-01-01

A ceramic waste form has been developed to immobilize the salt waste stream from electrometallurgical treatment of spent nuclear fuel. The ceramic waste form is prepared in a hot isostatic press (HIP). The use of small, easily fabricated HIP capsules called witness tubes has been proposed as a practical way to obtain representative samples of ceramic waste form material for process monitoring, waste form qualification, and archiving. Witness tubes are filled with the same material used to fill the corresponding HIP can, and are HIPed along with the HIP can. Relevant physical, chemical, and performance (leach test) data are analyzed and compared. Differences between witness tube and HIP can materials are shown to be statistically insignificant, demonstrating that witness tubes do provide ceramic waste form material representative of the material in the corresponding HIP can.

Neurosurgical procedures in Jehovah's Witnesses: the Tema experience.

Science.gov (United States)

Andrews, N B

2009-05-01

On account of religious reasons, Jehovah Witnesses do not accept blood or blood products; occasionally, they accept reinfusion of autologous blood via a cell saver during surgery. The aim of this study was to document the demographics of Jehovah Witnesses undergoing neurosurgical procedures, the neurosurgical procedures undertaken in Jehovah Witnesses and to evaluate the complications of the procedures. A retrospective audit of the medical records of all Jehovah's Witnesses who underwent neurosurgical procedures at our institution, from January 1st 2000 to December 31st 2006, was carried out. The parameters investigated included demographics, pre and post operative diagnosis, type of neurosurgical procedure and complications. Nineteen patients (fifteen male, four female; male/female 3.8:1) constituted the series. The mean age was 45.8 (range: 20-65) years. A total of 21 procedures were performed; intracranial surgery (33%), spinal surgery (67%). No autotransfusion of blood was given. Lumbar laminectomy for stenosis was the commonest spine procedure, ten (71.4%); craniotomy for tumor excision was the commonest intracranial procedure, six (85.7%). With respect to the whole series, the morbidity rate was 4.7% and the mortality rate was 4.7%; both were from intracranial surgery. It is possible to perform certain types of neurosurgical procedures in Jehovah's Witnesses without increasing the mortality and morbidity rate.

Recombinant human erythropoietin therapy in critically ill Jehovah's Witnesses.

Science.gov (United States)

Ball, Amanda M; Winstead, P Shane

2008-11-01

Blood transfusions and blood products are often given as a life-saving measure in patients with critical illness. However, some patients, such as Jehovah's Witnesses, may refuse their administration due to religious beliefs. Jehovah's Witnesses accept most available medical treatments, but not blood transfusions or blood products due to their religion's interpretation of several passages from the Bible. Since recombinant human erythropoietin (rHuEPO) became available, several cases have been reported in which rHuEPO was successfully administered to critically ill Jehovah's Witnesses. Administration of rHuEPO in combination with other blood conservation techniques has been shown to increase hemoglobin levels and survival in patients who experienced trauma, burns, general surgery, or gastrointestinal hemorrhage. We performed a literature search of the MEDLINE and International Pharmaceutical Abstracts databases of rHuEPO therapy in the Jehovah's Witness population. Fourteen cases were identified in which rHuEPO was administered to Jehovah's Witnesses who required the drug for critical care resuscitation as an alternative to blood products. In each clinical situation, rHuEPO enhanced erythropoiesis; however, time to the start of treatment, dosages, route of administration, and treatment duration varied widely. Supplementation with adjunctive agents, such as iron, folic acid, and vitamin B12, was also beneficial. Use of rHuEPO in Jehovah's Witnesses may provide an alternative to blood transfusions or blood products. Other alternatives, such as hemoglobin-based oxygen carriers and perfluorocarbons, are also being explored.

Glucose-6-phosphate dehydrogenase deficiency: an unusual cause of acute jaundice after paracetamol overdose.

Science.gov (United States)

Phillpotts, Simon; Tash, Elliot; Sen, Sambit

2014-11-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the commonest human enzyme defect causing haemolytic anaemia after exposure to specific triggers. Paracetamol-induced haemolysis in G6PD deficiency is a rare complication and mostly reported in children. We report the first case (to the best of our knowledge) of acute jaundice without overt clinical features of a haemolytic crisis, in an otherwise healthy adult female following paracetamol overdose, due to previously undiagnosed G6PD deficiency. It is important that clinicians consider this condition when a patient presents following a paracetamol overdose with significant and disproportionate jaundice, without transaminitis or coagulopathy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Pharmacists' role in opioid overdose: Kentucky pharmacists' willingness to participate in naloxone dispensing.

Science.gov (United States)

Freeman, Patricia R; Goodin, Amie; Troske, SuZanne; Strahl, Audra; Fallin, Amanda; Green, Traci C

To assess pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified pharmacists to dispense naloxone under a physician-approved protocol. Electronic survey (e-mail) gauging perception of pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing. All Kentucky pharmacists with active licenses in 2015. Ordinal logistic regression was used to estimate the impact of pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community pharmacists reported barriers to naloxone access at higher rates than pharmacists from other practice settings. Kentucky pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing pharmacist confidence through appropriately designed education programs could facilitate pharmacist participation in naloxone

Preventing deaths from rising opioid overdose in the US – the promise of naloxone antidote in community-based naloxone take-home programs

Directory of Open Access Journals (Sweden)

Straus MM

2013-09-01

Full Text Available Michele M Straus, Udi E Ghitza, Betty Tai Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, USA Abstract: The opioid overdose epidemic is an alarming and serious public health problem in the United States (US that has been escalating for 11 years. The 2011 National Survey on Drug Use and Health (NSDUH demonstrated that 1 in 20 persons in the US aged 12 or older reported nonmedical use of prescription painkillers in the past year. Prescription drug overdose is now the leading cause of accidental death in the United States – surpassing motor vehicle accidents. Great efforts have been initiated to curb the overdose crisis. Notable examples of these efforts are (1 the Drug Enforcement Administration’s (DEA National Take-Back Initiative instituted in 2010; (2 the Prescription Drug Monitoring Programs (PDMPs implemented in most US states to provide practitioners with point-of-care information regarding a patient's controlled substance use; (3 the naloxone rescue programs initiated in the community to avert mortality resulting from overdose. The use of naloxone rescue strategies has gained traction as an effective measure to prevent fatal opioid overdose. Many US federal-government agencies are working to make these strategies more accessible to first responders and community participants. This new approach faces many challenges, such as accessibility to naloxone and the equipment and training needed to administer it, but none is more challenging than the fear of legal repercussions. US federal-government agencies, local governments, health care institutions, and community-based organizations have begun to tackle these barriers, and naloxone take-home programs have gained recognition as a feasible and sensible preventive strategy to avoid a fatal result from opioid overdose. Although many challenges still need to be overcome

On the importance of considering heterogeneity in witnesses' competence levels when reconstructing crimes from multiple witness testimonies.

Science.gov (United States)

Waubert de Puiseau, Berenike; Greving, Sven; Aßfalg, André; Musch, Jochen

2017-09-01

Aggregating information across multiple testimonies may improve crime reconstructions. However, different aggregation methods are available, and research on which method is best suited for aggregating multiple observations is lacking. Furthermore, little is known about how variance in the accuracy of individual testimonies impacts the performance of competing aggregation procedures. We investigated the superiority of aggregation-based crime reconstructions involving multiple individual testimonies and whether this superiority varied as a function of the number of witnesses and the degree of heterogeneity in witnesses' ability to accurately report their observations. Moreover, we examined whether heterogeneity in competence levels differentially affected the relative accuracy of two aggregation procedures: a simple majority rule, which ignores individual differences, and the more complex general Condorcet model (Romney et al., Am Anthropol 88(2):313-338, 1986; Batchelder and Romney, Psychometrika 53(1):71-92, 1988), which takes into account differences in competence between individuals. 121 participants viewed a simulated crime and subsequently answered 128 true/false questions about the crime. We experimentally generated groups of witnesses with homogeneous or heterogeneous competences. Both the majority rule and the general Condorcet model provided more accurate reconstructions of the observed crime than individual testimonies. The superiority of aggregated crime reconstructions involving multiple individual testimonies increased with an increasing number of witnesses. Crime reconstructions were most accurate when competences were heterogeneous and aggregation was based on the general Condorcet model. We argue that a formal aggregation should be considered more often when eyewitness testimonies have to be assessed and that the general Condorcet model provides a good framework for such aggregations.

Altered intensity coding in the salicylate-overdose animal model of tinnitus

Czech Academy of Sciences Publication Activity Database

Wan, I.; Pokora, O.; Chiu, T.; Lánský, Petr; Poon, P. W.

2015-01-01

Roč. 136, Oct 2015 (2015), s. 113-119 ISSN 0303-2647 R&D Projects: GA ČR(CZ) GA15-08066S Institutional support: RVO:67985823 Keywords : auditory evoked potential * electrocorticogram * Fisher information * salicylate-overdose * tinnitus * rat Subject RIV: BD - Theory of Information Impact factor: 1.495, year: 2015

Optimal Entanglement Witnesses for Qubits and Qutrits

International Nuclear Information System (INIS)

Bertlmann, R.A.; Durstberger, K.; Hiesmayr, B.C.; Krammer, P.

2005-01-01

Full text: We give a review of the connection between an optimal entanglement witness and the Hilbert-Schmidt measure of entanglement (that is the minimal distance of an entangled state to the set of separable states): a generalized Bell inequality is derived within the concept of entanglement witnesses, in the sense that a violation of the inequality detects entanglement and not non-locality liKEX usual Bell inequalities do. It can be seen that the maximal violation equals the Hilbert-Schmidt measure. Furthermore, since finding the nearest separable state to a given entangled state is rather difficult, a method for checking an estimated nearest separable state is presented. This is illustrated with isotropic qubit and qutrit states; the Hilbert-Schmidt measure, the optimal entanglement witness and the maximal violation of the GBI are calculated for those cases. Possible generalizations for arbitrary dimensions are discussed. (author)

Cross-Validation of Levenson's Psychopathy Scale in a Sample of Federal Female Inmates

Science.gov (United States)

Brinkley, Chad A.; Diamond, Pamela M.; Magaletta, Philip R.; Heigel, Caron P.

2008-01-01

Levenson, Kiehl, and Fitzpatrick's Self-Report Psychopathy Scale (LSRPS) is evaluated to determine the factor structure and concurrent validity of the instrument among 430 federal female inmates. Confirmatory factor analysis fails to validate the expected 2-factor structure. Subsequent exploratory factor analysis reveals a 3-factor structure…

Do the presence of Barr bodies in male jail inmates indicates criminality: A pilot study.

Science.gov (United States)

Kulkarni, Mayuri K; Somannavar, Pradeep D; Kotrashetti, Vijayalakshmi; Nayak, Ramakant; Hosmani, Jagadish; Babji, Deepa

2016-01-01

Cytogenetic studies from past decades have shown that interphase cells of female cats contain a densely stained chromatin mass in their nuclei called as Barr bodies (BBs) named after the scientist Murray Barr. BBs are unique chromatin structures formed due to the condensation of the X-chromosome. Many psychopathic disorders originate from defective genes including the multiple X syndromes. Males with extra X-chromosome generally present with severe personality disorder. The present study was conducted to determine the presence of extra X-chromosome in male jail inmates through the detection of BB in peripheral blood and buccal smear. Study included 100 male subjects (fifty jail inmates and fifty controls), after obtaining the consent, peripheral blood smears (PBS) and buccal smears (BS) were prepared and stained using Leishman's and cresyl violet stain respectively. One hundred neutrophils in PBS and epithelial cells in BS were screened for detection of the BB; accumulated data were tabulated and statistically analyzed using t-test and Chi-square test. 60% of cases in PBS and 36% in BS showed positivity for the presence of BB in jail inmates as compared to 14% of cases in PBS and none in BS were positive for BB in controls. Presence of BB in male suggests increased likelihood of criminal tendencies. Further studies are to be carried out to compare the results with karyotyping.

Witnessing Partner Violence: Exploring the Role of Partner Preferences on Dating Violence.

Science.gov (United States)

Gonzalez-Mendez, Rosaura; Yanes, José M; Ramírez-Santana, Gustavo

2015-06-02

Research has shown that witnessing partner violence (WPV) increases the likelihood of experiencing or perpetrating violence in later romantic relationships, but little is known about the mechanisms underlying this process. This study examines the relationships between preference for unsuitable partners and teen dating violence (TDV) among adolescents who have witnessed parental violence or not. Attachment was also considered. Participants were 356 adolescents, both witnesses and non-witnesses of partner violence. Results showed no difference in preferences (for good, risky, or loving partners) between the two groups. However, preference for unsuitable partners did significantly predict TDV perpetration and victimization, but only among witnesses. Also, loving-partner preference moderates the relationship between WPV and TDV perpetration among highly avoidant witnesses. Findings indicate a new avenue for prevention through targeting partner preferences. © The Author(s) 2015.

29 CFR 18.614 - Calling and interrogation of witnesses by judge.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Calling and interrogation of witnesses by judge. 18.614... interrogation of witnesses by judge. (a) Calling by the judge. The judge may, on the judge's own motion or at... thus called. (b) Interrogation by the judge. The judge may interrogate witnesses, whether called by the...

Dose-dependent adsorptive capacity of activated charcoal for gastrointestinal decontamination of a simulated paracetamol overdose in human volunteers

DEFF Research Database (Denmark)

Gude, Anne-Bolette Jill; Hoegberg, Lotte Christine Groth; Riis Angelo, Helle

2010-01-01

The amount of activated charcoal needed to treat drug overdoses has arbitrarily been set at a charcoal-drug ratio of 10:1. Recent in vitro studies have shown a larger adsorptive capacity for activated charcoal when used in a model of paracetamol overdose. In the present study, we investigated...... whether this reserve capacity exists in vivo. This is clinically relevant in cases of large overdoses or if the full standard dose of 50 g activated charcoal cannot be administered. We performed a randomized, cross-over study (n = 16). One hour after a standard breakfast, 50 mg/kg paracetamol...... was administered, followed 1 hr later by an activated charcoal-Water slurry containing 50 (control), 25 or 5 g activated charcoal. The areas under the serum concentration-time curve (AUC) for paracetamol were used to estimate the efficacy of each activated charcoal dose. The AUC of the 25-g dose was found...

Bush vs. Obama Detainee Policy Post-9/11: An Assessment

Science.gov (United States)

2010-01-01

total darkness; • deliberate exposure to extremes of heat and cold; • threats of attack from unmuzzled dogs ; • forced nakedness; • short...witness was not available as a practical matter or the production of the witness would have an adverse impact on military or intelligence operations...foreign inmates absent a formal agreement. Lithuania began talks with the United States about accepting prisoners from Guantanamo, and the European

Driver-witness electron beam acceleration in dielectric mm-scale capillaries

Science.gov (United States)

Lekomtsev, K.; Aryshev, A.; Tishchenko, A. A.; Shevelev, M.; Lyapin, A.; Boogert, S.; Karataev, P.; Terunuma, N.; Urakawa, J.

2018-05-01

We investigated a corrugated mm-scale capillary as a compact accelerating structure in the driver-witness acceleration scheme, and suggested a methodology to measure the acceleration of the witness bunch. The accelerating fields produced by the driver bunch and the energy spread of the witness bunch in a corrugated capillary and in a capillary with a constant inner radius were measured and simulated for both on-axis and off-axis beam propagation. Our simulations predicted a change in the accelerating field structure for the corrugated capillary. Also, an approximately twofold increase of the witness bunch energy gain on the first accelerating cycle was expected for both capillaries for the off-axis beam propagation. These results were confirmed in the experiment, and the maximum measured acceleration of 170 keV /m at 20 pC driver beam charge was achieved for off-axis beam propagation. The driver bunch showed an increase in energy spread of up to 11%, depending on the capillary geometry and beam propagation, with a suppression of the longitudinal energy spread in the witness bunch of up to 15%.

Housing for the "Worst of the Worst" Inmates: Public Support for Supermax Prisons

Science.gov (United States)

Mears, Daniel P.; Mancini, Christina; Beaver, Kevin M.; Gertz, Marc

2013-01-01

Despite concerns whether supermaximum security prisons violate human rights or prove effective, these facilities have proliferated in America over the past 25 years. This punishment--aimed at the "worst of the worst" inmates and involving 23-hr-per-day single-cell confinement with few privileges or services--has emerged despite little…

Accuracy of the paracetamol-aminotransferase product to predict hepatotoxicity in paracetamol overdose treated with a 2-bag acetylcysteine regimen.

Science.gov (United States)

Wong, Anselm; Sivilotti, Marco L A; Gunja, Naren; McNulty, Richard; Graudins, Andis

2018-03-01

Paracetamol concentration is a highly accurate risk predictor for hepatotoxicity following overdose with known time of ingestion. However, the paracetamol-aminotransferase multiplication product can be used as a risk predictor independent of timing or ingestion type. Validated in patients treated with the traditional, "three-bag" intravenous acetylcysteine regimen, we evaluated the accuracy of the multiplication product in paracetamol overdose treated with a two-bag acetylcysteine regimen. We examined consecutive patients treated with the two-bag regimen from five emergency departments over a two-year period. We assessed the predictive accuracy of initial multiplication product for the primary outcome of hepatotoxicity (peak alanine aminotransferase ≥1000IU/L), as well as for acute liver injury (ALI), defined peak alanine aminotransferase ≥2× baseline and above 50IU/L). Of 447 paracetamol overdoses treated with the two-bag acetylcysteine regimen, 32 (7%) developed hepatotoxicity and 73 (16%) ALI. The pre-specified cut-off points of 1500 mg/L × IU/L (sensitivity 100% [95% CI 82%, 100%], specificity 62% [56%, 67%]) and 10,000 mg/L × IU/L (sensitivity 70% [47%, 87%], specificity of 97% [95%, 99%]) were highly accurate for predicting hepatotoxicity. There were few cases of hepatotoxicity irrespective of the product when acetylcysteine was administered within eight hours of overdose, when the product was largely determined by a high paracetamol concentration but normal aminotransferase. The multiplication product accurately predicts hepatotoxicity when using a two-bag acetylcysteine regimen, especially in patients treated more than eight hours post-overdose. Further studies are needed to assess the product as a method to adjust for exposure severity when testing efficacy of modified acetylcysteine regimens.

Perceived stress, external locus of control, and social support as predictors of psychological adjustment among female inmates with or without a history of sexual abuse.

Science.gov (United States)

Asberg, Kia; Renk, Kimberly

2014-01-01

Given the growing number of women who are incarcerated across the United States, the current study investigated the relationships among female inmates' perceptions of their own stress, external locus of control (LOC), social support adequacy, and various aspects of psychological functioning. Generally, female inmates with a self-reported history of childhood sexual abuse did not differ from their nonabused counterparts on the variables of interest. Results suggested that female inmates' perceptions of higher stress, a higher degree of external LOC, and inadequate social support correlated with greater symptoms of depression and hopelessness as well as lower self-esteem. In regression analyses, stress and social support were significant predictors for depression and anxiety. In contrast, stress was the only significant predictor of hopelessness and self-esteem. Finally, none of the predictors examined here was significant in the prediction of traumatic stress. Overall, findings suggested the importance of stress and social support in the prediction of female inmates' adjustment, specifically their symptoms of depression and anxiety.

Medicine, religion and faith: issues in Jehovah's Witnesses and ...

African Journals Online (AJOL)

Background: Major surgical treatment in Jehovah's Witnesses (JW) presents complex ethical and legal issues to the physician. The Jehovah's Witness is willing to accept all medical treatment except blood transfusion; and so, the physician is often confronted with a difficult task especially in emergency settings and among ...

Risk of overdose and death following codeine prescription among immigrants.

Science.gov (United States)

Ray, Joel G; Hollands, Simon; Gomes, Tara; Urquia, Marcelo L; Macdonald, Erin M; Li, Ping; Mamdani, Muhammad M; Juurlink, David N

2014-11-01

Immigrants may be at a higher risk of adverse drug reactions, in that poor language proficiency reduces individuals understanding of drug label instructions. Additionally, there are reports of severe or fatal toxicity due to CYP2D6 ultrarapid hepatic metabolism of codeine to morphine among some ethnic groups, especially those from Eastern Africa. Between 2002 and 2012 we conducted a population-based cohort study among residents of Ontario, Canada. We used administrative health databases that linked immigrants and Canadian-born individuals to both prescription medication use and emergency department visits and hospital admissions. The primary composite outcome was the risk of drug overdose or all-cause mortality within 30 days of codeine prescription, comparing patients from various world regions to Canadian-born individuals. A secondary analysis stratified by codeine dose and ability to speak English and/or French. There were 553 504 individuals exclusively prescribed codeine. Relative to an incidence rate of 57.1/100 000 person-days among Canadian-born codeine recipients, those who migrated from various world regions were at a lower risk of drug overdose or death. For example, Eastern Africans had an adjusted HR of 0.60 (95% CI 0.31 to 1.17) on controlling for potential confounders such as age, sex, income and physician visits. Patients unable to speak English or French who were prescribed codeine were at a lower risk of the composite outcome relative to those proficient in either language (adjusted HR 0.63, 95% CI 0.54 to 0.74). Overdose and death following the institution of codeine therapy are not more commonly observed among immigrants from world regions with a high prevalence of ultrarapid CYP2D6 status relative to those born in Canada. Lower proficiency in English or French also did not appear to heighten the risk. 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.

Chloroquine is grossly overdosed and overused but well tolerated in Guinea-Bissau

DEFF Research Database (Denmark)

Ursing, Johan; Kofoed, Poul-Erik; Rodrigues, Amabelia

2009-01-01

High chloroquine doses are commonly prescribed in Guinea-Bissau. Double dose chloroquine has been shown to be more efficacious (92% efficacy) than the standard dose (80% efficacy). However, chloroquine is toxic when overdosed and it is not known if the high doses prescribed in Guinea-Bissau are t...... prescribed to children without parasitaemia. Use of high dose CQ is concurrent with an exceptionally low prevalence of chloroquine resistant P. falciparum.......High chloroquine doses are commonly prescribed in Guinea-Bissau. Double dose chloroquine has been shown to be more efficacious (92% efficacy) than the standard dose (80% efficacy). However, chloroquine is toxic when overdosed and it is not known if the high doses prescribed in Guinea......-Bissau are taken or whether they cause adverse effects. We aimed to determine the dosage of chloroquine commonly prescribed, the doses commonly taken and if there were concentration dependent adverse events in routine practice. Chloroquine prescriptions by 8 physicians and chloroquine intake by 102 children were...

Deadly heroin or the death of heroin -- overdoses caused by illicit drugs of abuse in Budapest, Hungary between 1994 and 2012.

Science.gov (United States)

Horváth, Mónika; Dunay, György; Csonka, Renata; Keller, Éva

2013-12-01

Rates of illicit drug use and drug-related deaths have continuously increased in developed countries since the 1960s even though the patterns of use and thus the related mortality differ from region to region. In Europe heroin is the drug most often implicated in overdoses. The decedents are most often male, between 20 and 30 years of age and have a long history of drug use. According to the majority of available studies a concomitant use of alcohol and benzodiazepines is one of the risk factors of heroin overdose. In our study we have examined the basic demographic and toxicological features of illicit drug related death cases in Budapest, Hungary between 1994 and 2012. Drug overdose death cases have been divided into two subgroups according to the substances responsible for the death of the subjects: an opioid group and a non-opioid group. The huge majority (87.9%) of decedents died due to heroin overdose and were male (87%). There has been a significant increase in the mean age of the opioid group for the past 19 years. The majority of heroin overdose cases (58%) has had no other psychofarmacons present at the toxicological examination. We have found a slight but significant positive correlation (p=0.0204, r=0.349) between the number of heroin overdose death cases and the mean concentration of street level purity heroin. Most of the examined demographic and toxicological features of the population studied have been in concordance with data previously reported. However, in contrast to other studies we report a strikingly high proportion of "pure" heroin overdose cases where no other psychoactive substances were found. The reason for this is currently unknown; we can only speculate that it can be related to the fact that heroin is used and abused differently from other countries. The remarkable phenomenon of the "ageing" of heroin users may also support a change in the drug use habits of the youngest population. The emergence and spread of new designer drugs also

Nonlinear entanglement witnesses, covariance matrices and the geometry of separable states

Energy Technology Data Exchange (ETDEWEB)

Guehne, Otfried [Institut fuer Quantenoptik und Quanteninformation, Oesterreichische Akademie der Wissenschaften, A-6020 Innsbruck (Austria); Luetkenhaus, Norbert [Institute for Quantum Computing and Department of Physics and Astronomy, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1 (Canada)

2007-05-15

Entanglement witnesses provide a standard tool for the analysis of entanglement in experiments. We investigate possible nonlinear entanglement witnesses from several perspectives. First, we demonstrate that they can be used to show that the set of separable states has no facets. Second, we give a new derivation of nonlinear witnesses based on covariance matrices. Finally, we investigate extensions to the multipartite case.

Learning to be cruel?: exploring the onset and frequency of animal cruelty.

Science.gov (United States)

Hensley, Christopher; Tallichet, Suzanne E

2005-02-01

Few studies have examined how animal cruelty is learned within a specific social context among incarcerated individuals. Using data from 261 inmates, this study specifically addressed how demographic characteristics and childhood experiences with animal abuse may have affected the recurrence and onset of childhood and adolescent cruelty as a learned behavior. Multiple regression analyses revealed that inmates who experienced animal cruelty at a younger age were more likely to demonstrate recurrent animal cruelty themselves. In addition, respondents who observed a friend abuse animals were more likely to hurt or kill animals more frequently. Finally, inmates who were younger when they first witnessed animal cruelty also hurt or killed animals at a younger age.

43 CFR 45.47 - What are the requirements for subpoenas and witness fees?

Science.gov (United States)

2010-10-01

... and witness fees? 45.47 Section 45.47 Public Lands: Interior Office of the Secretary of the Interior... § 45.47 What are the requirements for subpoenas and witness fees? (a) Request for subpoena. (1) Except...) Witness fees. (1) A party who subpoenas a witness who is not a party must pay him or her the same fees and...

Minimal Entanglement Witness from Electrical Current Correlations.

Science.gov (United States)

Brange, F; Malkoc, O; Samuelsson, P

2017-01-20

Despite great efforts, an unambiguous demonstration of entanglement of mobile electrons in solid state conductors is still lacking. Investigating theoretically a generic entangler-detector setup, we here show that a witness of entanglement between two flying electron qubits can be constructed from only two current cross correlation measurements, for any nonzero detector efficiencies and noncollinear polarization vectors. We find that all entangled pure states, but not all mixed ones, can be detected with only two measurements, except the maximally entangled states, which require three. Moreover, detector settings for optimal entanglement witnessing are presented.

Optimal entanglement witnesses for qubits and qutrits

Science.gov (United States)

Bertlmann, Reinhold A.; Durstberger, Katharina; Hiesmayr, Beatrix C.; Krammer, Philipp

2005-11-01

We study the connection between the Hilbert-Schmidt measure of entanglement (that is the minimal distance of an entangled state to the set of separable states) and entanglement witness in terms of a generalized Bell inequality which distinguishes between entangled and separable states. A method for checking the nearest separable state to a given entangled one is presented. We illustrate the general results by considering isotropic states, in particular two-qubit and two-qutrit states—and their generalizations to arbitrary dimensions—where we calculate the optimal entanglement witnesses explicitly.

Optimal entanglement witnesses for qubits and qutrits

International Nuclear Information System (INIS)

Bertlmann, Reinhold A.; Durstberger, Katharina; Hiesmayr, Beatrix C.; Krammer, Philipp

2005-01-01

We study the connection between the Hilbert-Schmidt measure of entanglement (that is the minimal distance of an entangled state to the set of separable states) and entanglement witness in terms of a generalized Bell inequality which distinguishes between entangled and separable states. A method for checking the nearest separable state to a given entangled one is presented. We illustrate the general results by considering isotropic states, in particular two-qubit and two-qutrit states--and their generalizations to arbitrary dimensions--where we calculate the optimal entanglement witnesses explicitly

Minimal Entanglement Witness from Electrical Current Correlations

Science.gov (United States)

Brange, F.; Malkoc, O.; Samuelsson, P.

2017-01-01

Despite great efforts, an unambiguous demonstration of entanglement of mobile electrons in solid state conductors is still lacking. Investigating theoretically a generic entangler-detector setup, we here show that a witness of entanglement between two flying electron qubits can be constructed from only two current cross correlation measurements, for any nonzero detector efficiencies and noncollinear polarization vectors. We find that all entangled pure states, but not all mixed ones, can be detected with only two measurements, except the maximally entangled states, which require three. Moreover, detector settings for optimal entanglement witnessing are presented.

Optimized entanglement witnesses for Dicke states

Energy Technology Data Exchange (ETDEWEB)

Bergmann, Marcel; Guehne, Otfried [Naturwissenschaftlich-Technische Fakultaet, Universitaet Siegen, Department Physik, Walter-Flex-Strasse 3, D-57068 Siegen (Germany)

2013-07-01

Quantum entanglement is an important resource for applications in quantum information processing like quantum teleportation and cryptography. Moreover, the number of particles that can be entangled experimentally using polarized photons or ion traps has been significantly enlarged. Therefore, criteria to decide the question whether a given multi-particle state is entangled or not have to be improved. Our approach to this problem uses the notion of PPT mixtures which form an approximation to the set of bi-separable states. With this method, entanglement witnesses can be obtained in a natural manner via linear semi-definite programming. In our contribution, we will present analytical results for entanglement witnesses for Dicke states. This allows to overcome the limitations of convex optimization.

Will "no blood" kill Jehovah Witnesses?

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Chua, R; Tham, K F

2006-11-01

A 46-year-old Indonesian woman presented with signs and symptoms suggestive of an ovarian tumour and was advised to have surgery with exploratory laparotomy and removal of the mass. She agreed but refused blood transfusion any time in the course of her treatment or procedure, as she was a Jehovah Witness. As there was a high risk of intraoperative haemorrhage, steps were taken to reduce any consequent complications due to the surgery. The ethical conflict is between respecting patient autonomy and compromising standards of care, arising from the refusal of a standard therapy. The latest developments in the blood transfusion doctrine policy for the Jehovah Witnesses are also discussed in this case study.

Heroin-related overdose: The unexplored influences of markets, marketing and source-types in the United States.

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Mars, Sarah G; Fessel, Jason N; Bourgois, Philippe; Montero, Fernando; Karandinos, George; Ciccarone, Daniel

2015-09-01

Heroin overdose, more accurately termed 'heroin-related overdose' due to the frequent involvement of other drugs, is the leading cause of mortality among regular heroin users. (Degenhardt et al., 2010) Heroin injectors are at greater risk of hospital admission for heroin-related overdose (HOD) in the eastern United States where Colombian-sourced powder heroin is sold than in the western US where black 'tar' heroin predominates. (Unick et al., 2014) This paper examines under-researched influences on HOD, both fatal and non-fatal, using data from a qualitative study of injecting drug users of black tar heroin in San Francisco and powder heroin in Philadelphia Data were collected through in-depth, semi-structured interviews carried out in 2012 that were conducted against a background of longer-term participant-observation, ethnographic studies of drug users and dealers in Philadelphia (2007-12) and of users in San Francisco (1994-2007, 2012). Our findings suggest three types of previously unconsidered influences on overdose risk that arise both from structural socio-economic factors and from the physical properties of the heroin source-types: 1) retail market structure including information flow between users; 2) marketing techniques such as branding, free samples and pricing and 3) differences in the physical characteristics of the two major heroin source forms and how they affect injecting techniques and vascular health. Although chosen for their contrasting source-forms, we found that the two cities have contrasting dominant models of drug retailing: San Francisco respondents tended to buy through private dealers and Philadelphia respondents frequented an open-air street market where heroin is branded and free samples are distributed, although each city included both types of drug sales. These market structures and marketing techniques shape the availability of information regarding heroin potency and its dissemination among users who tend to seek out the

Disciplinary responses to misconduct among female prison inmates with mental illness, substance use disorders, and co-occurring disorders.

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Houser, Kimberly; Belenko, Steven

2015-03-01

Most female inmates have mental health, substance use, or co-occurring disorders (CODs), which can create greater difficulty adjusting to incarceration and higher rates of prison misconduct. The response of prison officials to institutional misbehaviors has important implications for female inmates' experiences while incarcerated, their likelihood of parole, and the clinical course of their condition. This article examined whether disciplinary actions are more severe for women with CODs. Data were provided by the Pennsylvania Department of Corrections for all female state prison inmates incarcerated between January 1, 2007, and July 30, 2009 (N = 2,279). The final sample of 211 women included those who had committed a minor misconduct during their incarceration. Disorder categories were created based on intake assessments, and multivariate models were estimated to determine the effect of disorder category on whether the prison imposed a severe or minor disciplinary response to the misconduct. The odds of receiving severe disciplinary responses to minor misconduct was significantly greater for women with CODs than those with the singular disorders of mental illness or substance abuse disorders, or those with no disorders. Findings suggest correctional institutions are responding in a punitive manner to the symptomatic manifestations of CODs in female inmates. These findings suggest the importance of screening instruments in correctional settings that assess for the presence of dual disorders. In addition, correctional administrators must implement training protocols for correctional officers and staff on the complexity of CODs and the ability to identify behavioral and emotional symptoms associated with this vulnerable subset of the offender population. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

The Emotional Child Witness Effect Survives Presentation Mode.

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Melinder, Annika; Burrell, Lisa; Eriksen, Maria Olaussen; Magnussen, Svein; Wessel, Ellen

2016-01-01

The emotional witness effect - the phenomenon whereby people are affected by the emotional manner in which a witness presents testimony - constitutes a possible source of wrongful decisions in legal contexts. One stereotypical view of abused children is that they should be sad when talking about their experiences of maltreatment, whereas children may in fact express a variety of emotional expressions when talking about abusive events. This raises the question as to whether there is an optimal mode in which to present child victim testimony that could reduce the possible influence of displayed emotions. In the present study, mock police interviews were carried out with female child actors, role-playing the victims of physical abuse by their stepfather, telling the same story with four emotional expressions (neutral, sad, angry, or positive). Laypersons (N = 465) were presented with the interviews as transcripts with the emotional reactions of the child witness noted, audio recordings, or videotaped recordings. Participants then rated the credibility of the victim witness. Replicating previous results, the "sad" expression elicited the highest credibility ratings across all modes of presentations. Presentation mode affected ratings of credibility, with the transcript versions resulting in the highest ratings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Seropositivity of hepatitis C in prison inmates of Pakistan--a cross sectional study in prisons of Sindh.

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Gorar, Zulfikar Ali; Zulfikar, Imrana

2010-06-01

To assess the proportion of seropositivity of Hepatitis C amongst the prison inmates in the jails of Sindh. A cross sectional HCV seroprevalence survey was done at 14 out of 19 prisons in the Sindh province from November 2008 to January 2009. A team of Pathologist, phlebotomist and laboratory technician took the blood sample of the inmates inside the correctional facility; the blood was centrifuged at the spot and brought back to the pathology laboratory on same day in cold chain i.e. a temperature-controlled supply chain. Serum was analyzed on 3rd generation ELISA for HCV antibodies. Standard ethical considerations were properly followed. Atotal of 9508 prison inmates were approached. Refusal rate was 20%. Remaining, 7539 prisoners were screened at 14 out of 19 jails in Sindh. HCV antibody positive were 965 making the proportion of seropositivity 12.8% (95% C.I. 8.92% - 12.92%). Higher seropositivity in the jails of northern Sindh jails was identified. Hepatitis C prevalence in the prison population of Sindh is higher than the national prevalence of 4.9% amongst general population. However it is lower than that reported from correctional facilities of developed countries. Hepatitis prevention and control activities in the correctional facilities of Pakistan need to be institutionalized (JPMA 60:476; 2010).

Reducing Depression, Anxiety, and Trauma of Male Inmates: An HIV/AIDS Psychoeducational Group Intervention.

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Pomeroy, Elizabeth C.; Kiam, Risa; Green, Diane L.

2000-01-01

Reports on a quasi-experimental research study that found that a 10-session psychoeducational group intervention was effective in increasing knowledge of AIDS and decreasing depression, anxiety, and trauma symptoms among male inmates. The intervention consisted of both AIDS education topics and psychological support. Results indicate significant…

A new device-independent dimension witness and its experimental implementation

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Cai, Yu; Bancal, Jean-Daniel; Romero, Jacquiline; Scarani, Valerio

2016-07-01

A dimension witness is a criterion that sets a lower bound on the dimension needed to reproduce the observed data. Three types of dimension witnesses can be found in the literature: device-dependent ones, in which the bound is obtained assuming some knowledge on the state and the measurements; device-independent prepare-and-measure ones, that can be applied to any system including classical ones; and device-independent Bell-based ones, that certify the minimal dimension of some entangled systems. Here we consider the Collins-Gisin-Linden-Massar-Popescu Bell-type inequality for four outcomes. We show that a sufficiently high violation of this inequality witnesses d≥slant 4 and present a proof-of-principle experimental observation of such a violation. This presents a first experimental violation of the third type of dimension witness beyond qutrits.

Technical Note: A novel leaf sequencing optimization algorithm which considers previous underdose and overdose events for MLC tracking radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Wisotzky, Eric, E-mail: eric.wisotzky@charite.de, E-mail: eric.wisotzky@ipk.fraunhofer.de; O’Brien, Ricky; Keall, Paul J., E-mail: paul.keall@sydney.edu.au [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney, NSW 2006 (Australia)

2016-01-15

Purpose: Multileaf collimator (MLC) tracking radiotherapy is complex as the beam pattern needs to be modified due to the planned intensity modulation as well as the real-time target motion. The target motion cannot be planned; therefore, the modified beam pattern differs from the original plan and the MLC sequence needs to be recomputed online. Current MLC tracking algorithms use a greedy heuristic in that they optimize for a given time, but ignore past errors. To overcome this problem, the authors have developed and improved an algorithm that minimizes large underdose and overdose regions. Additionally, previous underdose and overdose events are taken into account to avoid regions with high quantity of dose events. Methods: The authors improved the existing MLC motion control algorithm by introducing a cumulative underdose/overdose map. This map represents the actual projection of the planned tumor shape and logs occurring dose events at each specific regions. These events have an impact on the dose cost calculation and reduce recurrence of dose events at each region. The authors studied the improvement of the new temporal optimization algorithm in terms of the L1-norm minimization of the sum of overdose and underdose compared to not accounting for previous dose events. For evaluation, the authors simulated the delivery of 5 conformal and 14 intensity-modulated radiotherapy (IMRT)-plans with 7 3D patient measured tumor motion traces. Results: Simulations with conformal shapes showed an improvement of L1-norm up to 8.5% after 100 MLC modification steps. Experiments showed comparable improvements with the same type of treatment plans. Conclusions: A novel leaf sequencing optimization algorithm which considers previous dose events for MLC tracking radiotherapy has been developed and investigated. Reductions in underdose/overdose are observed for conformal and IMRT delivery.

The Acquisition of Standard English Speech Habits Using Second-Language Techniques: An Experiment in Speech Modification and Generalization in the Verbal Behavior of Prison Inmates.

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McKee, John M.; And Others

Many people take for granted the use of language as a tool for coping with everyday occupational and social problems. However, there are those, such as prison inmates, who have difficulty using language in this manner. Realizing that prison inmates are not always able to communicate effectively through standard patterns of speech and thus are…

78 FR 49469 - Stephen Glen Guerra, Inmate #98595-279, FCI Yazoo City Medium, Federal Correctional Institution...

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2013-08-14

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Stephen Glen Guerra, Inmate 98595-279, FCI... Export Privileges On February 6, 2012, in the U.S. District Court, Western District of Texas, Stephen... conviction. [[Page 49470

Validation of the Portuguese Version of Impulsive–Premeditated Aggression Scale in an Inmate Population

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Jacinto Costa Azevedo

2018-02-01

Full Text Available Aggression is one of the core symptoms of antisocial personality disorder (ASPD with therapeutic and prognostic relevance. ASPD is highly prevalent among inmates, being responsible for adverse events and elevated direct and indirect economic costs for the criminal justice system. The Impulsive/Premeditated Aggression Scale (IPAS is a self-report instrument that characterizes aggression as either predominately impulsive or premeditated. This study aims to determine the validity and reliability of the IPAS in a sample of Portuguese inmates. A total of 240 inmates were included in the study. A principal component factor analysis was performed so as to obtain the construct validity of the IPAS impulsive aggression (IA and premeditated aggression (PM subscales; internal consistency was determined by Cronbach’s alpha coefficient; convergent and divergent validity of the subscales were determined analyzing correlations with the Barratt Impulsiveness scale, 11th version (BIS-11, and the Psychopathic Checklist Revised (PCL-R. The rotated matrix with two factors accounted for 49.9% of total variance. IA subscale had 11 items and PM subscale had 10 items. The IA and PM subscales had a good Cronbach’s alpha values of 0.89 and 0.88, respectively. The IA subscale is correlated with BIS-11 attentional, motor, and non-planning impulsiveness dimensions (p < 0.05. The PM subscale is correlated with BIS-11 attentional, motor impulsiveness dimensions (p < 0.05. The PM subscale is correlated with PCL-R interpersonal, lifestyle, and antisocial dimensions (p < 0.05. The IA subscale is not correlated with PCL-R. The Portuguese translated version of IPAS has adequate psychometric properties, allowing the measurement of impulsive and premeditated dimensions of aggression.

Epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge in Japan: An exploratory descriptive study using a nationwide claims database.

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Okumura, Yasuyuki; Sakata, Nobuo; Takahashi, Kunihiko; Nishi, Daisuke; Tachimori, Hisateru

2017-08-01

Little is known about the nationwide epidemiology of the annual rate, causative substance, and clinical course of overdose-related admission. We aimed to describe the epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge to home. We assessed all cases of admission due to overdose (21,663 episodes) in Japan from October 2012 through September 2013 using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. The annual rate of overdose admission was 17.0 per 100,000 population. Women exhibited two peaks in admission rates at 19-34 years (40.9 per 100,000) and ≥75 years (27.8 per 100,000). Men exhibited one peak in the admission rate at ≥75 years (23.7 per 100,000). Within 90 days prior to overdose, ≥60% and ≥9% of patients aged 19-49 years received a prescription for benzodiazepines and barbiturates, respectively. In addition, 59% of patients aged ≥75 years received a prescription for benzodiazepines prior to overdose, 47% had a history of congestive heart failure, and 24% had a diagnosis of poisoning by cardiovascular drugs. The proportion of patients with recent psychiatric treatments decreased with age (65.1% in those aged 35-49 years and 13.9% in those aged ≥75 years). The findings emphasize the need for overdose prevention programs that focus on psychiatric patients aged 19-49 years who are prescribed benzodiazepines or barbiturates and on non-psychiatric patients aged ≥75 years who are prescribed benzodiazepines or digitalis. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

20 CFR 725.457 - Witnesses.

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2010-04-01

...' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT... days before the hearing. The failure to give notice of the appearance of an expert witness in... relevant to the physical condition of the miner, such physician must have prepared a medical report...

Determinants of witnessed parental physical violence among university students in transitional Albania.

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Burazeri, Genc; Qirjako, Gentiana; Roshi, Enver; Brand, Helmut

2011-03-01

We aimed to assess the extent and the socioeconomic correlates of witnessed parental physical violence among university students in Albania, a country in transition from rigidly structured socialism to a market-oriented system. 2797 students (93% of all students) at the Medical Faculty, Tirana, filled out an anonymous structured questionnaire in April-June 2009. Information on witnessed father-to-mother physical violence during childhood and/or adolescence and sociodemographic and socioeconomic data were collected. The association of witnessed parental violence with socioeconomic factors was assessed with multivariable-adjusted logistic regression. 736 (26.7%) of students witnessed father-to-mother physical violence, and 36 (1.3%) reported 'very often' witnessing episodes. In multivariable-adjusted models, independent predictors of witnessed violence were: low family income [odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.7-3.2], rural origin (OR = 1.9, 95% CI = 1.5-2.5), father's lower education and unemployment (OR = 5.4, 95% CI = 4.1-7.1 and OR = 2.5, 95% CI = 1.9-3.2, respectively) and mother's educational and employment advantage compared with the spouse (OR = 2.7, 95% CI = 1.9-3.8 and OR = 2.2, 95% CI = 1.6-2.8, respectively). Father's socioeconomic disadvantage and mother's socioeconomic empowerment were each independently related to increased risk for witnessed father-to-mother physical violence among university students in this transitional patriarchal society. Health professionals in post-communist Albania should be aware of the ways in which witnessed domestic violence influences physical and psychological health of young adults.

Overdose effect of aconite containing Ayurvedic Medicine ('Mahashankha Vati').

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Panda, Ashok Kumar; Debnath, Saroj Kumar

2010-07-01

There are chances that the use of larger than recommended dose of Ayurvedic medicines containing aconite can produce drug reactions. Vatsanabha (Aconitum ferox Wall.) is a very well-known ingredient of Ayurvedic formulations and is prescribed as an antipyretic, analgesic, anti-rheumatic, appetizer and digestive. The recommended dose of purified Vatsanabha (A. ferox Wall.) root is 15 mg. We present a case of hypotension and bradycardia due to aconite poisoning caused by overdosing of an Ayurvedic medicine (Mahashankha Vati), which was primarily managed by Ayurvedic treatment.

Knowledge, Attitude, and Practice (KAP Regarding HIV/AIDS Transmission and Prevention Among Inmates in Bushehr Prison, 2009 – 2010

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Bagherzadeh

2015-10-01

Full Text Available Background HIV has been recognized as an important problem in prisons because of the common practice of needle sharing and unsafe sex. Assessment of knowledge, attitude, and practice (KAP apropos HIV/AIDS in prisons is needed to devise educational programs. Objectives This research was performed to assess KAP regarding HIV/AIDS transmission and prevention among Bushehr Prison inmates. Patients and Methods This analytical cross-sectional study was conducted between 2009 and 2010 among 800 inmates in Bushehr Prison. Convenience sampling was utilized, and the inclusion criteria comprised Iranian nationality, ability to speak or read and write in Farsi, and a prison stay for at least 2 months before entering the study. The data collection tool was a self-designed questionnaire, consisting of close-ended questions in 4 sections: demographic information, 36 questions on knowledge (total score ranging from 0 to 36, 20 questions on attitude (total score ranging from 0 to 40, and 7 questions on practice. Content validity was confirmed by using subject matter experts. Reliability was confirmed via a pilot study and Cronbach’s α method. The α coefficients were between 0.75 and 0.95 for the different sections. The data were analyzed using descriptive and inferential statistics. Results The mean score of HIV/AIDS knowledge in the male and female inmates was 23.84 ± 4.70 and 21.35 ± 6.28, respectively (P < 0.001. The mean score of HIV/AIDS attitude among the men and women was 26.6 ± 5.4 and 24.48 ± 7.6, correspondingly (P < 0.001. Additionally, 63.3% of the male and 57.3% of the female inmates had read about HIV/AIDS (P = 0.20, 4% of the men and 11.3% of the women had tattooing in prison, and 28.5% of the men and 32.5% of the women had participated in HIV/AIDS prevention classes (P = 0.29. Conclusions Comprehensive programs on HIV/AIDS education and counseling are needed to improve KAP apropos HIV risk factors and reduce risk behavior among prison

Relationships and sexuality of imprisoned men in the German penal system--a survey of inmates in a Berlin prison.

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Barth, Thomas

2012-01-01

The lack of concrete scientific data on the sexual behavior of inmates in German prisons is surprising, especially given the extant international scholarship on prison culture and sexual violence. Historically, the most influential publications were Clemmer's "The Prison Community", and Sykes's "The Society of Captives", which both addressed the importance of sexual deprivation and analyzed the impact of sexual victimization on prisoners. Different forms of homosexual contact between inmates include prostitution and "protective pairing", both characterized as "dark" issues--nonconsensual sexual acts--which still have not been scientifically researched. The United States enacted the Prison Rape Elimination Act, 2003, revealing nationwide data on the prevalence of sexual assault within correctional facilities. Prison inmates suffer not only from separation from their spouses or partners, but also from sexual harassment, extortion, and the threat of rape, which has multiple implications for their mental and physical health. This article presents the first German study to record data about the relationships and sexuality of imprisoned men, and was conducted in an adult correctional facility for long-term prisoners in Berlin-Tegel. The survey, which is based on results from a questionnaire taken by voluntary study participants, had a special focus on the occurrence of consensual homoerotic contacts between heterosexual inmates. The emphasis was on the potential impact of such contact on role behavior during confinement, as well as the impact on sexual identity after release. The survey revealed the first data on the incidence and prevalence of sexual violence and coercion within correctional facilities. This article presents the results of this survey for the first time. Copyright © 2012 Elsevier Ltd. All rights reserved.

Accidental alfaxalone overdose in a mature cat undergoing anaesthesia for magnetic resonance imaging

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Wendy Bayldon

2016-04-01

Full Text Available Case summary This case report describes the clinical signs and treatment of an alfaxalone 10 times overdose in a 12-year-old cat undergoing anaesthesia for MRI. The cat was discharged from hospital following a prolonged recovery including obtunded mentation and cardiorespiratory depression for several hours following cessation of anaesthesia. The cat received supportive therapy that included supplemental oxygen via a face mask, intravenous crystalloid fluids and active rewarming. The benefits of using alfaxalone for maintenance of anaesthesia, its pharmacokinetics and previously reported lethal doses are discussed. Strategies for reducing the incidence of medication errors are presented. Relevance and novel information An unintentional overdose of alfaxalone by continuous rate infusion has not been reported previously in a cat. Treatment is supportive and directed towards maintenance of the cardiorespiratory systems. Whenever possible, smart pumps that have been designed to reduce human error should be used to help prevent medication errors associated with continuous rate infusions.

Citizen Camera-Witnessing: A Case Study of the Umbrella Movement

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Wai Han Lo

2016-08-01

Full Text Available Citizen camera-witness is a new concept by which to describe using mobile camera phone to engage in civic expression. I argue that the meaning of this concept should not be limited to painful testimony; instead, it is a mode of civic camera-mediated mass self-testimony to brutality. The use of mobile phone recordings in Hong Kong’s Umbrella Movement is examined to understand how mobile cameras are employed as personal witnessing devices to provide recordings to indict unjust events and engage others in the civic movement. This study has examined the Facebook posts and You Tube videos of the Umbrella Movement between September 22, 2014 and December 22, 2014. The results suggest that the camera phone not only contributes to witnessing the brutal repression of the state, but also witnesses the beauty of the movement, and provides a testimony that allows for rituals to develop and semi-codes to be transformed.

Student-selected component in the medical curriculum: investigations and psychiatric referral for paracetamol overdose in an accident and emergency department

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Cowman JG

2017-08-01

Full Text Available James G Cowman, Manuel Bakheet Royal College of Surgeons in Ireland – Medical University of Bahrain, Manama, Bahrain Background: A student-selected component (SSC of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit.Materials and methods: An audit approach was applied. The aim of the project study was to investigate the level of compliance with best-practice guidelines for investigations and psychiatric referral in paracetamol overdose.Results: A total of 40 cases meeting the inclusion criteria were randomly selected. The sample had a mean age of 27 years, of whom 70.5% were female, and the ingested dose of paracetamol ranged from 0.864 to 80 g. Paracetamol abuse may present as intentional and unintentional overdose. In our study, 85% of cases were identified as intentional overdose and 76% had a history of psychiatric illness. Generally, medical management was compliant with guidelines, with some minor irregularities. The international normalized ratio was the most underperformed test.Conclusion: Our choice of topic, paracetamol overdose, contributed to our understanding of the breadth of factors to be considered in the emergency medical management of a patient. In this regard, we had the benefit of understanding how the diagnostic and therapeutic factors, when applied in accordance with best-practice guidelines, work very effectively. The SSC impacted positively on our cognitive, personal, and professional development. In facilitating the student with

Plasmapheresis reverses all side-effects of a cisplatin overdose – a case report and treatment recommendation

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Ploner Ferdinand

2006-01-01

Full Text Available Abstract Background Cisplatin is widely used as an antineoplastic agent since it is effective against a broad spectrum of different tumours. Nevertheless, it has several potential side effects affecting different organ systems and an overdose may lead to life-threatening complications and even death. Case presentation We report on a 46-year old woman with non-small cell lung cancer who accidentally received 225 mg/m2 of cisplatin, which was threefold the dose as scheduled, within a 3-day period. Two days later, the patient presented with hearing loss, severe nausea and vomiting, acute renal failure as well as elevated liver enzymes. In addition, she developed a severe myelodepression. After plasmapheresis on two consecutive days and vigorous supportive treatment, the toxicity-related symptoms improved and the patient recovered without any sequelae. Conclusion To date, no general accepted guidelines for the treatment of cisplatin overdoses are available. Along with the experience from other published cases, our report shows that plasmapheresis is capable of lowering cisplatin plasma and serum levels efficiently. Therefore, plasma exchange performed as soon as possible can ameliorate all side effects of a cisplatin overdose and be a potential tool for clinicians for treatment. However, additional intensive supportive treatment-modalities are necessary to control all occurring side effects.

Evaluation of childhood trauma with respect to criminal behavior, dissociative experiences, adverse family experiences and psychiatric backgrounds among prison inmates.

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Altintas, Merih; Bilici, Mustafa

2018-04-01

To evaluate childhood trauma in relation to criminal behavior, dissociative experiences, adverse family experiences during childhood and psychiatric backgrounds among prison inmates. In total, 200 prison inmates were included in this questionnaire-based study. Data on demographic characteristics, adverse family experiences during childhood and psychiatric backgrounds were collected via face-to-face interviews, and a psychometric evaluation was conducted using the Childhood Trauma Questionnaire (CTQ-28) and Dissociative Experiences Scale (DES). Several historical items were more common in females than in males including family history of psychiatric disease (23.0% vs. 13.0%, p = 0.048), a personal history of psychiatric disease (51.0% vs. 29.0%, p first crime (24.9 ± 8.9 years vs. 30.3 ± 9.2 years, p first offense (β = 0.772, p first offense. In conclusion, our findings revealed a high prevalence of and significant associations among childhood trauma, dissociative experiences, adverse family experiences and psychiatric problems in a cohort of incarcerated females and males. A psychiatric background, childhood trauma characterized by sexual abuse and violent crimes were found to be predominant in female prison inmates, whereas a criminal background with a younger age at first offense and frequent previous convictions, substance use and sexual crimes were more prevalent among male prison inmates. Our findings indicate a potential link between childhood traumatization and criminal behavior in terms of subsequent offending but not in terms of severity of the subsequent offense. Copyright © 2018. Published by Elsevier Inc.

[Gynaecological surgery of Jehovah´s Witnesses].

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Kudela, M; Pilka, R; Hansmanová, L

2013-06-01

To present experience with surgical treatment of various gynaecological diseases in patients belonging to the Church of Jehova´s Witness. DESIGNE: Retrospective study. Department of Obstetrics and Gynaecology, Palacky University Olomouc, Institute of Health Care Studies, Faculty of Humanity Studies, Thomas Bata University, Zlín. The study included 24 patients belonging to the Church of Jehova´s Witness who reject blood tranfusion. The operations in these patients were performed for malignant as well as nonmalignant gynaecological disorders which could not be treated by conservative therapeutic procedures. The operation records were analysed and evaluated according to a set of criteria including the type of surgical procedure, estimated amount of blood loss, postoperative complications and the outcome of surgical treatment. Jehovas´s Witnesses represent a risk group of patients considering their refusal of blood transfusion. The indication for the operation and its performing is responsible decision which always inherits a certain degrese of risk. On the other hand, when adhering to the principles of bloodless surgery, the therapeutic results are very good and in the properly indicated cases the scope of risk is acceptable.

Seropositivity of hepatitis C in prison inmates of Pakistan - a cross sectional study in prisons of Sindh

International Nuclear Information System (INIS)

Gorar, Z.A.; Zulfikar, I.

2010-01-01

Objective: To assess the proportion of sero positivity of Hepatitis C amongst the prison inmates in the jails of Sindh. Methods: A cross sectional HCV sero prevalence survey was done at 14 out of 19 prisons in the Sindh province from November 2008 to January 2009. A team of Pathologist, phlebotomist and laboratory technician took the blood sample of the inmates inside the correctional facility; the blood was centrifuged at the spot and brought back to the pathology laboratory on same day in cold chain i.e. a temperature-controlled supply chain. Serum was analyzed on third generation ELISA for HCV antibodies. Standard ethical considerations were properly followed. Results: A total of 9508 prison inmates were approached. Refusal rate was 20%. Remaining, 7539 prisoners were screened at 14 out of 19 jails in Sindh. HCV antibody positive were 965 making the proportion of sero positivity 12.8% (95% C.I. 8.92% - 12.92%). Higher sero positivity in the jails of northern Sindh jails was identified. Conclusions: Hepatitis C prevalence in the prison population of Sindh is higher than the national prevalence of 4.9% amongst general population. However it is lower than that reported from correctional facilities of developed countries. Hepatitis prevention and control activities in the correctional facilities of Pakistan need to be institutionalized. (author)

Clinical Effects of Synthetic Cannabinoid Receptor Agonists Compared with Marijuana in Emergency Department Patients with Acute Drug Overdose.

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Zaurova, Milana; Hoffman, Robert S; Vlahov, David; Manini, Alex F

2016-12-01

Synthetic cannabinoid receptor agonists (SCRAs) are heterogeneous compounds originally intended as probes of the endogenous cannabinoid system or as potential therapeutic agents. We assessed the clinical toxicity associated with recent SCRA use in a large cohort of drug overdose patients. This subgroup analysis of a large (n = 3739) drug overdose cohort study involved consecutive ED patients at two urban teaching hospitals collected between 2009 and 2013. Clinical characteristics of patients with the exposure to SCRAs (SRCA subgroup) were compared with those from patients who smoked traditional cannabinoids (marijuana subgroup). Data included demographics, exposure details, vital signs, mental status, and basic chemistries gathered as part of routine clinical care. Study outcomes included altered mental status and cardiotoxicity. Eighty-seven patients reported exposure to any cannabinoid, of whom 17 reported SCRAs (17 cases, 70 controls, mean age 38.9 years, 77 % males, 31 % Hispanic). There were no significant differences between SRCA and marijuana with respect to demographics (age, gender, and race/ethnicity), exposure history (suicidality, misuse, and intent), vital signs, or serum chemistries. Mental status varied between SRCA and marijuana, with agitation significantly more likely in SCRA subgroup (OR = 3.8, CI = 1.2-11.9). Cardiotoxicity was more pronounced in the SCRA subgroup with dysrhythmia significantly more likely (OR = 9.2, CI = 1.0-108). In the first clinical study comparing the adverse effects of SCRA overdose vs. marijuana controls in an ED population, we found that SCRA overdoses had significantly pronounced neurotoxicity and cardiotoxicity compared with marijuana.

Neurobehavioral disorders locked in Alcatraz: case reports on three famous inmates

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Hélio A. G. Teive

2015-08-01

Full Text Available The Alcatraz prison, with its picturesque surroundings and fascinating life stories of its inmates, has been the subject of a number of films and publications. The authors take a closer look at the biographies of “Al Capone”, Robert “Birdman” Stroud and “Mickey” Cohen. These legendary American mobsters shared not only a history at “The Rock”, but also a history of neuropsychiatric diseases, ranging from neurosyphilis to anti-social, borderline and obsessive-compulsive personality disorders.

Drug-Induced QT Prolongation as a Result of an Escitalopram Overdose in a Patient with Previously Undiagnosed Congenital Long QT Syndrome

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Paul Singh

2014-01-01

Full Text Available We present a case of drug-induced QT prolongation caused by an escitalopram overdose in a patient with previously undiagnosed congenital LQTS. A 15-year-old Caucasian female presented following a suicide attempt via an escitalopram overdose. The patient was found to have a prolonged QT interval with episodes of torsades de pointes. The patient was admitted to the telemetry unit and treated. Despite the resolution of the torsades de pointes, she continued to demonstrate a persistently prolonged QT interval. She was seen by the cardiology service and diagnosed with congenital long QT syndrome. This case illustrates the potential for an escitalopram overdose to cause an acute QT prolongation in a patient with congenital LQTS and suggests the importance of a screening electrocardiogram prior to the initiation of SSRIs, especially in patients at high risk for QT prolongation.

21 CFR 17.37 - Witnesses.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Witnesses. 17.37 Section 17.37 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL CIVIL MONEY PENALTIES... pay for his or her travel to the hearing. The sponsoring party is responsible for producing the...

26 CFR 301.7610-1 - Fees and costs for witnesses.

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2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Fees and costs for witnesses. 301.7610-1... Examination and Inspection § 301.7610-1 Fees and costs for witnesses. (a) Introduction. Section 7610 provides..., these fees are considered to be directly incurred by the summoned third party. (2) Reproduction cost...

50 CFR 221.47 - What are the requirements for subpoenas and witness fees?

Science.gov (United States)

2010-10-01

... and witness fees? 221.47 Section 221.47 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE... requirements for subpoenas and witness fees? (a) Request for subpoena. (1) Except as provided in paragraph (a... return it to the party on whose behalf the subpoena was served. (c) Witness fees. (1) A party who...

Witnesses' memory for events and faces under elevated levels of intoxication.

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Altman, Christopher M; Schreiber Compo, Nadja; McQuiston, Dawn; Hagsand, Angelica V; Cervera, Jiselle

2018-08-01

Research on alcohol and witness memory has burgeoned over the last decade. However, most studies have tested participants at relatively low breath alcohol concentration (BAC) levels, unrepresentative of those encountered by officers in the field. To examine how higher intoxication levels might impair witness memory for events and faces, the current research tested participants' ability to recall a mock crime at elevated BAC levels (>.08%). The BAC levels of bar patrons (N = 138) were recorded before witnessing a video-taped mock crime. Participants were then interviewed using free recall and cued questions and shown a six-person target-present or target-absent lineup. Results show that alcohol negatively affected both the quantity and quality of recall. Regardless of question format, alcohol also reduced the percentage of accurate information elicited from witnesses; however, only cued questions increased the percentage of inaccurate information reported. Intoxication had no effect on identification accuracy. These findings suggest that the encoding and storage systems for faces and events may be impacted differently by alcohol. Our results also highlight the importance of including higher BAC levels when examining the effects of alcohol on witness memory.

Noncardiogenic Pulmonary Edema after Amlodipine Overdose without Refractory Hypotension and Bradycardia

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M. Hedaiaty

2015-01-01

Full Text Available Amlodipine overdose can be life-threatening when manifesting as noncardiogenic pulmonary edema. Treatment remains challenging. We describe a case of noncardiogenic pulmonary edema without refractory hypotension and bradycardia after ingestion of 500 milligram amlodipine with suicidal intent. Mechanical ventilation, dexamethasone, atrovent HFA (ipratropium, pulmicort inhalation, and antibiotic therapy were used for the management. Length of hospital stay was 11 days. The patient was discharged with full recovery.

Prophylactic use of factor IX concentrate in a Jehovah's Witness patient.

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Bolliger, Daniel; Sreeram, Gautam; Duncan, Alexander; Molinaro, Ross J; Szlam, Fania; Chen, Edward P; Tanaka, Kenichi A

2009-11-01

In Jehovah's Witness patients, the use of red blood cells, platelets, and fresh frozen plasma is not optional. Various blood conservation techniques are available, but complex cardiac surgery remains a major challenge. The feasibility of fractions of "primary components" has not been fully considered in published case reports. For Jehovah's Witness patients who preoperatively give consent, factor IX concentrates may be acceptable for hemostatic therapy. We hereby describe a combination of "secondary components" to prevent excessive bleeding in a Jehovah's Witness patient undergoing complex replacement of the aortic arch.

CHILD WITNESSES AND THE CONFRONTATION CLAUSE.

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Lyon, Thomas D; Dente, Julia A

2012-01-01

After the Supreme Court's ruling in Crawford v. Washington that a criminal defendant's right to confront the witnesses against him is violated by the admission of testimonial hearsay that has not been cross-examined, lower courts have overturned convictions in which hearsay from children was admitted after child witnesses were either unwilling or unable to testify. A review of social scientific evidence regarding the dynamics of child sexual abuse suggests a means for facilitating the fair receipt of children's evidence. Courts should hold that defendants have forfeited their confrontation rights if they exploited a child's vulnerabilities such that they could reasonably anticipate that the child would be unavailable to testify. Exploitation includes choosing victims on the basis of their filial dependency, their vulnerability, or their immaturity, as well as taking actions that create or accentuate those vulnerabilities.

26 CFR 301.7602-1 - Examination of books and witnesses.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Examination of books and witnesses. 301.7602-1... Examination and Inspection § 301.7602-1 Examination of books and witnesses. (a) In general. For the purpose of... officer or employee of the Internal Revenue Service may examine any books, papers, records or other data...

28 CFR 541.23 - Protection cases.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Protection cases. 541.23 Section 541.23 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE... present documentary evidence, to request witnesses, to be present throughout the hearing, and advance...

Witness response at acute onset of stroke: a qualitative theory-guided study.

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Stephan U Dombrowski

Full Text Available Delay in calling emergency medical services following stroke limits access to early treatment that can reduce disability. Emergency medical services contact is mostly initiated by stroke witnesses (often relatives, rather than stroke patients. This study explored appraisal and behavioural factors that are potentially important in influencing witness behaviour in response to stroke.Semi-structured interviews with 26 stroke witnesses were transcribed and theory-guided content analysed was undertaken based on the Common Sense Self-Regulation Model (appraisal processes and Theory Domains Framework (behavioural determinants. Response behaviours were often influenced by heuristics-guided appraisal (i.e. mental rules of thumb. Some witnesses described their responses to the situation as 'automatic' and 'instinctive', rather than products of deliberation. Potential behavioural influences included: environmental context and resources (e.g. time of day, social influence (e.g. prompts from patients and beliefs about consequences (e.g. 999 accesses rapid help. Findings are based on retrospective accounts and need further verification in prospective studies.Witnesses play a key role in patient access to emergency medical services. Factors that potentially influence witnesses' responses to stroke were identified and could inform behavioural interventions and future research. Interventions might benefit from linking automatic/instinctive threat perceptions with deliberate appraisal of stroke symptoms, prompting action to call emergency medical services.

Federal Prisons. Inmate and Staff Views on Education and Work Training Programs. Report to the Chairman, Select Committee on Narcotics Abuse and Control, House of Representatives.

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General Accounting Office, Washington, DC. General Government Div.

The purpose of this study was to determine the uses and usefulness of prison literacy and vocational education programs to the 65,000 inmates of federal prisons. Data were collected in two ways: (1) a survey of prison staff and review of selected inmate case files and other data to determine if the Federal Bureau of Prisons (BOP) had reliable…

Implementation of a hepatitis A/B vaccination program using an accelerated schedule among high-risk inmates, Los Angeles County Jail, 2007-2010.

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Costumbrado, John; Stirland, Ali; Cox, Garrett; El-Amin, Alvin Nelson; Miranda, Armidia; Carter, Ann; Malek, Mark

2012-11-06

The Centers for Disease Control and Prevention recommend vaccination for men who have sex with men (MSM) and injection drug users against hepatitis A and B. This study is the first report of a hepatitis vaccination program in a United States jail with a combined vaccine using an accelerated schedule. Los Angeles County has the largest jail system in the nation and Men's Central Jail (MCJ) is the largest facility within that system. MCJ includes a unit for self-identified MSM, where approximately 2700 inmates are housed per year. Starting in August 2007, a combined hepatitis A and B vaccine was offered to all inmates housed in this special unit. Using an accelerated schedule (0-, 7-, 21-30 days, 12-month booster), a total of 3931 doses were administered to 1633 inmates as of June 2010. Of those, 77% received 2 doses, 58% received 3 doses, and 11% received the booster dose. Inmates who screened positive for a sexually transmitted infection in this unit were 1.3 times more likely to be vaccinated (95% CI 1.2-1.4) compared to others in the same housing unit who screened negative. Hepatitis vaccination initiatives can be successfully implemented in an urban jail among an extremely high-risk population using the accelerated, combined hepatitis A/B vaccine. Ours may be a useful model for other programs to vaccinate incarcerated populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Serotonin Syndrome after Sertraline Overdose in a Child: A Case Report

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Joana Grenha

2013-01-01

Full Text Available Serotonin syndrome is a potentially life-threatening drug effect. It may be misdiagnosed because it has mostly been reported in adults. Case Report. An 8-year-old girl with behavioral problems and medicated with risperidone and sertraline was admitted in the emergency department after she had taken voluntarily 1500 mg of sertraline (50 mg/kg. At admission, she had marked agitation, visual hallucinations, diaphoresis, flushing, and tremor. She had fever and periods of hypertension. She also showed generalized rigidity and involuntary movements. She was treated with fluids and iv diazepam, midazolam, clemastine, and biperiden. As the patient presented a severe insomnia and a progressive rhabdomyolysis, she was transferred to pediatric intensive care unit (ICU, where she was under treatment with cyproheptadine, mechanical ventilation, and muscular paralysis for 11 days. She was discharged from hospital a few days later with no neurological sequelae. Conclusions. Serotonin syndrome is still not well recognized by physicians. In our patient, the diagnosis was made early due to the history of overdose with serotonin reuptake inhibitors and the triad of mental, neurological, and autonomic signs. Parents must be educated to prevent children from having free access to drugs, avoiding self-medication or overdose.

Bearing Witness to the Inhuman at M? Lai: Museum, Ritual, Pilgrimage

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Roy Tamashiro

2018-05-01

Full Text Available This article explores how the Son M? Memorial and Museum and its associated community activities and programs commemorate and memorialize the 1968 M? Lai Massacre and its aftermath. The museum provides space for reflection and bearing witness to the profound suffering in the Massacre. B'earing witness' means reliving or remembering and coming to know an experience, especially a traumatic one like M? Lai. Witness bearers are both those reporting first-hand experiences and memories, and those listening to and learning about the experiences. When locals and visitors alike participate in the activities and rituals at Son M?, in pilgrimages to M? Lai, or in touring the memorial and museum, an opportunity is available to recognize the “existential legitimacy” of the events, experiences, and memories. Bearing witness can open pathways to individual and societal healing as well as identity redefinition.

Association between witnessing traumatic events and psychopathology in the South African Stress and Health Study.

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Atwoli, Lukoye; Platt, Jonathan; Williams, David R; Stein, Dan J; Koenen, Karestan C

2015-08-01

The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders. Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders. Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders. Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected.

Socio-economic status and health in a marginalized group: the role of subjective social status among prison inmates.

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Friestad, Christine

2010-12-01

One problem in studies of social inequality in health is that traditional socio-economic indicators are unsuitable for groups finding themselves on the outside of those societal arenas from which measures of education, income and occupation are generated. A measure of subjective social position has accordingly been proposed as an addition to the traditional objective socio-economic measures. The present study investigates this concepts' usefulness as an addition to objective SES markers in a sample of prison inmates, known for their marginalized position in society as well as their poor health. Analyses are based on the male part (n = 225) of a nationally representative sample of prison inmates in Norway. Outcome measures are self-rated health, long-standing illness or disability, mental health problems, perceived change in health status and drug use. Analyses of correlation as well as multivariate logistic regression analyses were performed. Subjective social status was bivariately related to all of the health outcomes, except long-standing illness. Multivariate analyses indicated that subjective social status influenced the odds of experiencing mental health problems, but not any of the other health outcomes when controlling for the other independent variables. Subjective social status may add important information to our understanding of the relationship between social disadvantage and mental health in a marginalized social group such as prison inmates.

Comprehensive personal witness: a model to enlarge missional involvement of the local church

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Hancke, Frans

2013-06-01

Full Text Available In the The Split-Level Fellowship, Wesley Baker analysed the role of individual members in the Church. He gave a name to a tragic phenomenon with which Church leaders are familiar. Although true of society in general it is especially true of the church. Baker called the difference between the committed few and the uninvolved many, Factor Beta. This reality triggers the question: Why are the majority of Christians in the world not missionally involved through personal witness and which factors consequently influence personal witness and missional involvement? This article explains how the range of personal witness and missional involvement found in local churches are rooted in certain fundamental factors and conditions which are mutually influencing each other and ultimately contribute towards forming a certain paradigm. This paradigm acts as the basis from which certain behavioural patterns (witness will manifest. The factors influencing witness are either described as accelerators or decelerators and their relativity and mutual relationships are considered. Factors acting as decelerators can severely hamper or even annul witness, while accelerators on the other hand, can have an immensely positive effect to enlarge the transformational influence of witness. In conclusion a transformational model is developed through which paradigms can be influenced and eventually changed. This model fulfils a diagnostic and remedial function and will support local churches to enlarge the individual and corporate missional involvement of believers.

Escalation with Overdose Control Using Ordinal Toxicity Grades for Cancer Phase I Clinical Trials

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Mourad Tighiouart

2012-01-01

Full Text Available We extend a Bayesian adaptive phase I clinical trial design known as escalation with overdose control (EWOC by introducing an intermediate grade 2 toxicity when assessing dose-limiting toxicity (DLT. Under the proportional odds model assumption of dose-toxicity relationship, we prove that in the absence of DLT, the dose allocated to the next patient given that the previously treated patient had a maximum of grade 2 toxicity is lower than the dose given to the next patient had the previously treated patient exhibited a grade 0 or 1 toxicity at the most. Further, we prove that the coherence properties of EWOC are preserved. Simulation results show that the safety of the trial is not compromised and the efficiency of the estimate of the maximum tolerated dose (MTD is maintained relative to EWOC treating DLT as a binary outcome and that fewer patients are overdosed using this design when the true MTD is close to the minimum dose.

Carbamazepine and carbamazepine-10,11-epoxide clearance measurements during continuous venovenous hemofiltration in a massive overdose.

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Smollin, Craig Geoffrey; Petrie, Matthew S; Kearney, Thomas

2016-06-01

Carbamazepine (CBZ) overdose can result in significant neurologic and cardiovascular toxicity, and is compounded by the presence of an active metabolite, carbamazepine-10,11-epoxide (CBZE). Existing publications describing continuous venovenous hemofiltration (CVVH) in CBZ overdose are limited in their ability to calculate accurate clearances. We report a case of CBZ overdose treated with CVVH with detailed measurement of CBZ, CBZE and their respective clearances calculated utilizing serial effluent measurements. This was coupled with serum level determinations comparing two analytical methodologies, time-of-flight mass spectroscopy and an immunoassay. A 41-year-old woman presented unresponsive after an overdose of CBZ. Initial CBZ serum levels were markedly elevated (57.8 μg/mL) and continued to rise. Due to continued hemodynamic instability, extracorporeal removal was initiated using CVVH. During the first 30 h of CVVH, interval serum samples and all ultrafiltrate bags were collected and analyzed. Serum and effluent levels of CBZ and CBZE were measured using an Agilent 6230 time-of-flight high-resolution mass spectrometer (TOF-MS). CBZ levels were also obtained utilizing the Microgenics CEDIA Carbamazepine Immunoassay (Thermo Fisher, Waltham, MA) for serum and effluent samples. Immunoassay analysis was performed using Siemens ADVIA 1800 instrument. The clearances achieved for CBZE (mean = 25.2, range 17.7-42.6 mL/min) exceeded that for CBZ (mean = 18.1, range 12.7-28.7 mL/min). CVVH removed a total of 1293 and 1261 mg of CBZ and CBZE, respectively. Serum levels of CBZ measured by immunoassay when compared with TOF-MS indicated cross reactivity of CBZE with the immunoassay. CVVH removed CBZE with higher clearances than CBZ. However, CVVH clearance rates for both CBZ and CBZE were lower than published clearances of CBZ and CBZE by intermittent hemodialysis. Our methodology allowed for a precise pharmacokinetic assessment of clearance based on

Risk stratification after paracetamol overdose using mechanistic biomarkers: results from two prospective cohort studies.

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Dear, James W; Clarke, Joanna I; Francis, Ben; Allen, Lowri; Wraight, Jonathan; Shen, Jasmine; Dargan, Paul I; Wood, David; Cooper, Jamie; Thomas, Simon H L; Jorgensen, Andrea L; Pirmohamed, Munir; Park, B Kevin; Antoine, Daniel J

2018-02-01

Paracetamol overdose is common but patient stratification is suboptimal. We investigated the usefulness of new biomarkers that have either enhanced liver specificity (microRNA-122 [miR-122]) or provide mechanistic insights (keratin-18 [K18], high mobility group box-1 [HMGB1], and glutamate dehydrogenase [GLDH]). The use of these biomarkers could help stratify patients for their risk of liver injury at hospital presentation. Using data from two prospective cohort studies, we assessed the potential for biomarkers to stratify patients who overdose with paracetamol. We completed two independent prospective studies: a derivation study (MAPP) in eight UK hospitals and a validation study (BIOPAR) in ten UK hospitals. Patients in both cohorts were adults (≥18 years in England, ≥16 years in Scotland), were diagnosed with paracetamol overdose, and gave written informed consent. Patients who needed intravenous acetylcysteine treatment for paracetamol overdose had circulating biomarkers measured at hospital presentation. The primary endpoint was acute liver injury indicating need for continued acetylcysteine treatment beyond the standard course (alanine aminotransferase [ALT] activity >100 U/L). Receiver operating characteristic (ROC) curves, category-free net reclassification index (cfNRI), and integrated discrimination index (IDI) were applied to assess endpoint prediction. Between June 2, 2010, and May 29, 2014, 1187 patients who required acetylcysteine treatment for paracetamol overdose were recruited (985 in the MAPP cohort; 202 in the BIOPAR cohort). In the derivation and validation cohorts, acute liver injury was predicted at hospital presentation by miR-122 (derivation cohort ROC-area under the curve [AUC] 0·97 [95% CI 0·95-0·98]), HMGB1 (0·95 [0·93-0·98]), and full-length K18 (0·95 [0·92-0·97]). Results were similar in the validation cohort (miR-122 AUC 0·97 [95% CI 0·95-0·99], HMGB1 0·98 [0·96-0·99], and full-length K18 0·93 [0·86-0·99]). A

I see so I feel: Coping with workplace violence among victims and witnesses.

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Zhou, Biru; Marchand, Alain; Guay, Stéphane

2017-01-01

Workplace violence is a serious concern for workers' mental health and well-being in high risk work sectors. This study examined victims' and witnesses' experiences after exposure to workplace violence, and the types of help they used to cope with the violent event. Workers (n = 211) from five different work sectors participated in our study. Multiple mediation analysis was used to investigate the indirect effects through psychological and work consequences on victims' versus witnesses' differential likelihood of using formal, paraformal and informal helping. Results showed that workplace violence has detrimental effects on both victims and witnesses. Direct victims were more negatively affected psychologically and at work than witnesses. The indirect effect through psychological difficulty after experiencing workplace violence was significant in predicting formal helping. The indirect effect through reduced work functioning in predicting paraformal helping was also significant. No significant indirect effect was found in predicting informal helping. Both victims and witnesses used multiple types of helping to cope with the violent event. This study has practical implications on management and clinical practices for better organizations of resources in helping victims and witnesses to cope with workplace violence.

Population pharmacokinetics and pharmacodynamics of escitalopram in overdose and the effect of activated charcoal

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van Gorp, Freek; Duffull, Stephen; Hackett, L Peter; Isbister, Geoffrey K

2012-01-01

AIMS To describe the pharmacokinetics and pharmacodynamics (PKPD) of escitalopram in overdose and its effect on QT prolongation, including the effectiveness of single dose activated charcoal (SDAC). METHODS The data set included 78 escitalopram overdose events (median dose, 140 mg [10–560 mg]). SDAC was administered 1.0 to 2.6 h after 12 overdoses (15%). A fully Bayesian analysis was undertaken in WinBUGS 1.4.3, first for a population pharmacokinetic (PK) analysis followed by a PKPD analysis. The developed PKPD model was used to predict the probability of having an abnormal QT as a surrogate for torsade de pointes. RESULTS A one compartment model with first order input and first-order elimination described the PK data, including uncertainty in dose and a baseline concentration for patients taking escitalopram therapeutically. SDAC reduced the fraction absorbed by 31% and reduced the individual predicted area under the curve adjusted for dose (AUCi/dose). The absolute QT interval was related to the observed heart rate with an estimated individual heart rate correction factor (α = 0.35). The heart rate corrected QT interval (QTc) was linearly dependent on predicted escitalopram concentration [slope = 87 ms/(mg l–1)], using a hypothetical effect-compartment (half-life of effect-delay, 1.0h). Administration of SDAC significantly reduced QT prolongation and was shown to reduce the risk of having an abnormal QT by approximately 35% for escitalopram doses above 200 mg. CONCLUSIONS There was a dose-related lengthening of the QT interval that lagged the increase in drug concentration. SDAC resulted in a moderate reduction in fraction of escitalopram absorbed and reduced the risk of the QT interval being abnormal. PMID:21883384

Treatment of opioid overdose in a physician-based prehospital EMS: frequency and long-term prognosis

DEFF Research Database (Denmark)

Nielsen, Karina Skafte; Nielsen, Søren Louman; Siersma, Volkert Dirk

2011-01-01

Prehospital treatment of opioid overdose accounts for a significant proportion of the workload of the emergency system in most major cities. Treatment consists of basic life support and administering naloxone. In our physician-manned mobile emergency care unit (MECU), most patients are released...

Obesity in French Inmates: Gender Differences and Relationship with Mood, Eating Behavior and Physical Activity.

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Lagarrigue, Aude; Ajana, Soufiane; Capuron, Lucile; Féart, Catherine; Moisan, Marie-Pierre

2017-01-01

Inmates, notably women, are at greater risk for obesity and metabolic complications than the general population according to several studies from high income countries. Data regarding French correctional institutions are lacking so far. To fill this gap, we have assessed in a sample from a French prison (33 females and 18 males) the gender-specific effect of incarceration on weight and body mass index (BMI) and examined their current metabolic status. Furthermore, to reveal the possible determinants of increased obesity, we analyzed emotional vulnerability, eating behavior and physical activity using self-reported questionnaires. In this sample, obesity (BMI≥30 kg/m2) was already frequent in women (18.2%) but rather scarce for men (11%) at prison entry. Incarceration worsened the rate of obesity in both genders (21.2% and 16.7% respectively). At the time of study, abdominal obesity estimated through waist circumference was particularly prevalent in women (69.7%) versus men (27.8%) and metabolic syndrome was detected in 33% of female against none in male inmates. Abdominal obesity was associated with female sex (pobesity in multivariate analysis. A marked difference between genders was found for practice of physical activity with a higher proportion of women compared to men being inactive (37.9% vs. 11.8%) and fewer women being very active (17.2% vs. 41.2%). This study revealed that a significant proportion of women of this correctional institution combined established obesity, a metabolic syndrome and very little practice of physical activity which put them at high risk of cardiovascular disease. Thus, obesity should be better surveyed and treated in prison, especially for female inmates. Increased physical activity, adapted to obese women, would be the first mean to decrease obesity and gender differences.

Associations between witnessing parental violence and ...

African Journals Online (AJOL)

information concerning witnessing parental violence as a child, symptoms of depression during the current academic year. Logistic regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Results: Approximately 22.7% female students and 27.1% of the male students reported ...

Narratives of four Māori ex-inmates about their experiences and perspectives of rehabilitation programmes.

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Nakhid, Camille; Shorter, Lily Tairiri

2014-06-01

Māori are overrepresented in the criminal justice system in Aotearoa New Zealand. Māori offenders comprise 53% of those serving custodial sentences and 48% serving community-based sentences. The majority of Māori offenders reoffended within 2 years of serving their sentence. A number of programmes aimed at reducing recidivism among Māori have been implemented, and there is considerable debate around the effectiveness of these programmes. This qualitative study focuses on the narratives of four Māori male ex-inmates about their reoffending and their experiences of the rehabilitation programmes during their incarceration. Using a narrative approach, the study sought to hear the shared stories from the men and to determine what they believe would have reduced their reoffending. The stories revealed that a lack of financial resources and gang connections influenced reoffending; the value of prison rehabilitation programmes varied depending on their appropriateness to the inmate and to their intended outcomes; and healing programmes incorporating kaupapa Māori principles and practices assisted the participants in understanding their cultural heritage and communicating with society in more acceptable ways.

6 CFR 13.22 - Exchange of witness lists, Statements, and exhibits.

Science.gov (United States)

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Exchange of witness lists, Statements, and exhibits. 13.22 Section 13.22 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.22 Exchange of witness lists, Statements, and exhibits. (a) At least 15...

Overdose prevention for injection drug users: lessons learned from naloxone training and distribution programs in New York City.

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Piper, Tinka Markham; Rudenstine, Sasha; Stancliff, Sharon; Sherman, Susan; Nandi, Vijay; Clear, Allan; Galea, Sandro

2007-01-25

Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention) and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP) in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a) political climate surrounding naloxone distribution; b) extant prescription drug laws; c) initial low levels of recruitment into the program; d) development of participant appropriate training methodology; e) challenges in the design of a suitable formal evaluation; and f) evolution of program response to naloxone. Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in program planning and implementation, developing evaluation

Overdose effect of aconite containing Ayurvedic Medicine (‘Mahashankha Vati’)

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Panda, Ashok Kumar; Debnath, Saroj Kumar

2010-01-01

There are chances that the use of larger than recommended dose of Ayurvedic medicines containing aconite can produce drug reactions. Vatsanabha (Aconitum ferox Wall.) is a very well-known ingredient of Ayurvedic formulations and is prescribed as an antipyretic, analgesic, anti-rheumatic, appetizer and digestive. The recommended dose of purified Vatsanabha (A. ferox Wall.) root is 15 mg. We present a case of hypotension and bradycardia due to aconite poisoning caused by overdosing of an Ayurvedic medicine (Mahashankha Vati), which was primarily managed by Ayurvedic treatment. PMID:21170213

'Uninterested in anything except food': the work of nurses feeding the liberated inmates of Bergen-Belsen.

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Brooks, Jane

2012-10-01

The aim of this article is to explore the work of nurses feeding and helping liberate the inmates of Bergen-Belsen concentration camp in the spring of 1945. A considerable amount has been published on the relief of Belsen, but the majority of the research has focused on the medical staff and the army in general. The exception to this is an article published by Ellen Ben-Sefer, but its analysis of the actual work of the nurses is limited. The data are explored through the medium of nurses' work, especially feeding work and its place in the historiography. This article will offer an analysis of archival material, including official reports and personal testimony and published primary sources. Nurses were very much hidden from the liberation picture, partly through government policy, partly because of gendered ideologies and partly because of the desire of many to hide their memories. However, the data identify the pivotal role of nurses in the saving of lives and rehabilitation of inmates. This article demonstrates this role through the work of feeding. The nurses had to continually negotiate and renegotiate their place in the liberation. As women, their place at Belsen was problematic and often thwarted by the ideologies of the day. Nevertheless, the services of registered nurses during the war had proved indispensible. The Allied governments and Royal Army Medical Corps were ultimately to rely on their professional expertise. The nurses' work in the feeding of starving inmates demonstrates their value. This article demonstrates the importance of nurses' feeding work and their role in the caring of people's humanity. © 2012 Blackwell Publishing Ltd.

The Phase of Aggressive Behavior, Deprivation among the Inmates Age Group of Nigerian Prisons: A Survey of Sokoto Central Prison.

Directory of Open Access Journals (Sweden)

Ibrahim Yusuf

2016-08-01

Full Text Available The article examines the phase of aggressive behavior, deprivation, among the inmate's age group of Nigerian prison. However, the study elaborated the meaning of aggressive behavior; factors contributed to aggressive behavior, theory of aggressive behavior, literature review, method of information collection and data analysis. Therefore, prison setting can instigate aggressive behaviors, especially in Nigeria, where inmates are deprived of their particular right and are treated brutality in some instances studies shows, that Nigerian prisons are not adequately organized and made do as such, inmates are exposed to all kinds of atrocity. It should be noted that a condition of privation and lack of societal well-being especially among people being in an isolated environment as in the case with most prisons in Nigeria can degenerate to frustration and aggression which in turn can result in dangerous situations such as riots/ violence in the prisons. Aggression can lead to violence that may be adaptive under certain conditions regarding natural selection. That is most obviously the case regarding attacking prey to obtain food, or in anti-predator defense. The results showed that there is significant difference between the levels of aggressiveness with respect to the classes of age groups. Recommendation will be discussed further.

Tuberculose no sistema prisional de Campinas, São Paulo, Brasil Tuberculosis among city jail inmates in Campinas, São Paulo, Brazil

Directory of Open Access Journals (Sweden)

Helenice Bosco de Oliveira

2004-03-01

Full Text Available OBJETIVO: Descrever a situação da tuberculose nas prisões da Cidade de Campinas, Estado de São Paulo, Brasil. MÉTODOS: Realizou-se um estudo retrospectivo dos casos notificados de tuberculose em presidiários no período de 1993 a 2000. Foram avaliados dados de 4 293 detentos dos quatro presídios que constituem o complexo penitenciário da região. Foram utilizadas informações do banco de dados em tuberculose do Departamento de Medicina Preventiva e Social da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP. RESULTADOS: Observou-se um pico de incidência da tuberculose em 1994 (1 397,62 notificações em 100 000 indivíduos. A menor taxa foi observada em 1999 (559,04. Predominou a faixa etária de 25 a 34 anos (62,6% e a AIDS como doença associada (49,9%. A forma preponderante de tuberculose foi a pulmonar (91,9%, com baciloscopia de escarro positiva em 70,3%. A maioria dos presidiários não tinha realizado tratamentos prévios (75,4%. O abandono de tratamento chegou a 49%. Houve cura em apenas 20,8% dos casos no período estudado. CONCLUSÕES: A incidência intermediária de tuberculose observada neste estudo pode estar relacionada à subnotificação. A freqüência de falência do tratamento ainda é baixa. No entanto, o abandono, como fator que facilita a propagação de micobactérias resistentes na comunidade, causa preocupação. O controle da tuberculose nas prisões deveria ser parte rotineira das intervenções direcionadas a eliminar a doença na comunidade e a prevenir a resistência às drogas antituberculose.OBJECTIVE: To describe the incidence of tuberculosis among inmates of the municipal prison system in the city of Campinas, State of São Paulo, Brazil, from 1993 through 2000. METHODS: A retrospective study was carried out of the number of cases of tuberculosis that were notified among inmates over the study period. This involved reviewing data from a total of 4 293 inmates who were held

"Signs of honor" among Russian inmates in Israel's prisons.

Science.gov (United States)

Shoham, Efrat

2010-12-01

The unique nature of Israeli society as an immigrant society has also affected the prison population in Israel. This article focuses on a social and cultural phenomenon that particularly characterizes the prisoners of Russian origin, the phenomenon of tattoos. Using postmodernist theories, the article examines the function of the tattoo among Russian prisoners and the role it plays in constructing the criminal self-identity of these inmates in Israeli prisons. The tattoos observed during 2005-2006 among the Russian prisoners in four major Israeli prisons reflect the values of the Russian criminal subculture from which they evolved and were imported. This subculture is characterized by a hierarchical class structure and manifestations of machismo, domination, defiance, rebellion, and open antagonism against the Establishment and its representatives.

29 CFR 4003.55 - Opportunity to appear and to present witnesses.

Science.gov (United States)

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Opportunity to appear and to present witnesses. 4003.55 Section 4003.55 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION GENERAL RULES FOR ADMINISTRATIVE REVIEW OF AGENCY DECISIONS Administrative Appeals § 4003.55 Opportunity to appear and to present witnesses. (a) At the...

Dental witness seminars: dentistry in the UK since 1948.

Science.gov (United States)

Wilson, N H F; Gelbier, S

2016-02-12

Witness seminars attempt to get behind the scenes of advances and developments to find out what really happened at certain times; they are not intended to provide a detailed history of events. This paper presents highlights from the five John McLean Archive witness seminars, providing an instructional collection of memories and insights into the world of dentistry in the UK since the late 1940s. It is concluded that future change will be seen as a welcome constant to be used for the benefit of the profession and the patients and communities it serves.

Child-Witnesses of Domestic Violence: The Evolution of a Counseling Group

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Thompson, Elizabeth Heather

2009-01-01

A qualitative research design was used to explore the processes by which four child-witnesses of domestic violence made meaning of their experiences in a counseling group. A specific aim of this study was to determine if there were stages of group development that occurred in the counseling group with four young child-witnesses of domestic…

Reflexive awareness, transcendence and witnessing - in contemplative awareness cultures in school

DEFF Research Database (Denmark)

Nielsen, Anne Maj

The paper presents reflections about contemplative education as a way to learn openness and witnessing phenomena of the mind and of lived experiences of oneself and others. The reflections include concepts of transcendence and witnessing and results from a qualitative study of contemplative educa...... and to adopt an open and reflective self-perception and understanding of others....

Relationship proximity to victims of witnessed community violence: associations with adolescent internalizing and externalizing behaviors.

Science.gov (United States)

Lambert, Sharon F; Boyd, Rhonda C; Cammack, Nicole L; Ialongo, Nicholas S

2012-01-01

Witnessing community violence has been linked with several adverse outcomes for adolescents, including emotional and behavioral problems. Among youth who have witnessed community violence, proximity to the victim of community violence is one factor that may determine, in part, the nature of adolescents' responses to community violence exposure. The present study examines whether relationship proximity to the victim of community violence is associated with internalizing and externalizing behaviors among a sample of urban and predominantly African American adolescents (N = 501) who have witnessed community violence. In 10th grade, participants reported whether they had witnessed 10 community violence events during the past year, and, if so, whether the victim of the violence was a family member, close friend, acquaintance, or stranger. Witnessed community violence against a family member or close friend was associated with depressive symptoms, and witnessed community violence against known individuals was associated with anxiety symptoms. Witnessing community violence against familiar persons and strangers was linked with aggressive behavior. Gender differences in these associations and implications for assessment and intervention with community violence-exposed youth are discussed. © 2012 American Orthopsychiatric Association.

78 FR 37792 - Mario Julian Martinez-Bernache, Inmate Number #95749-279, CI Big Spring, Corrections Institution...

Science.gov (United States)

2013-06-24

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Mario Julian Martinez-Bernache, Inmate... Order with the Under Secretary of Commerce for Industry and Security. The appeal must be filed within 45... the Internal Security Act of 1950 (50 U.S.C. 783(b)), or section 38 of the Arms Export Control Act (22...

78 FR 37789 - Juan Narcizo Oyervides-Campos, Inmate Number #86526-279, Correctional Institution Reeves I & II...

Science.gov (United States)

2013-06-24

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Juan Narcizo Oyervides-Campos, Inmate... Order with the Under Secretary of Commerce for Industry and Security. The appeal must be filed within 45... the Internal Security Act of 1950 (50 U.S.C. 783(b)), or section 38 of the Arms Export Control Act (22...

Interventions for paracetamol (acetaminophen) overdose.

Science.gov (United States)

Chiew, Angela L; Gluud, Christian; Brok, Jesper; Buckley, Nick A

2018-02-23

Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various interventions to treat paracetamol poisoning, depending on the clinical status of the person. These interventions include inhibiting the absorption of paracetamol from the gastrointestinal tract (decontamination), removal of paracetamol from the vascular system, and antidotes to prevent the formation of, or to detoxify, metabolites. To assess the benefits and harms of interventions for paracetamol overdosage irrespective of the cause of the overdose. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (January 2017), CENTRAL (2016, Issue 11), MEDLINE (1946 to January 2017), Embase (1974 to January 2017), and Science Citation Index Expanded (1900 to January 2017). We also searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov database (US National Institute of Health) for any ongoing or completed trials (January 2017). We examined the reference lists of relevant papers identified by the search and other published reviews. Randomised clinical trials assessing benefits and harms of interventions in people who have ingested a paracetamol overdose. The interventions could have been gastric lavage, ipecacuanha, or activated charcoal, or various extracorporeal treatments, or antidotes. The interventions could have been compared with placebo, no intervention, or to each other in differing regimens. Two review authors independently extracted data from the included trials. We used fixed-effect and random-effects Peto odds ratios (OR) with 95% confidence intervals (CI) for analysis of the review outcomes. We used the Cochrane 'Risk of bias' tool to assess the risks of bias (i.e. systematic errors leading to overestimation of

78 FR 76813 - Igor Bobel, Inmate #-67253-066, FCI Loretto, Federal Correctional Institution, P.O. Box 1000...

Science.gov (United States)

2013-12-19

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Igor Bobel, Inmate -67253-066, FCI Loretto, Federal Correctional Institution, P.O. Box 1000, Loretto, PA 15940; Order Denying Export Privileges On May... 1000, Loretto, PA 15940, and when acting for or on behalf of Bobel, his representatives, assigns...

[Reliability of iWitness photogrammetry in maxillofacial application].

Science.gov (United States)

Jiang, Chengcheng; Song, Qinggao; He, Wei; Chen, Shang; Hong, Tao

2015-06-01

This study aims to test the accuracy and precision of iWitness photogrammetry for measuring the facial tissues of mannequin head. Under ideal circumstances, the 3D landmark coordinates were repeatedly obtained from a mannequin head using iWitness photogrammetric system with different parameters, to examine the precision of this system. The differences between the 3D data and their true distance values of mannequin head were computed. Operator error of 3D system in non-zoom and zoom status were 0.20 mm and 0.09 mm, and the difference was significant (P 0.05). Image captured error of 3D system was 0.283 mm, and there was no significant difference compared with the same group of images (P>0.05). Error of 3D systen with recalibration was 0.251 mm, and the difference was not statistically significant compared with image captured error (P>0.05). Good congruence was observed between means derived from the 3D photos and direct anthropometry, with difference ranging from -0.4 mm to +0.4 mm. This study provides further evidence of the high reliability of iWitness photogrammetry for several craniofacial measurements, including landmarks and inter-landmark distances. The evaluated system can be recommended for the evaluation and documentation of the facial surface.

Heroin-related overdose: The unexplored influences of markets, marketing and source-types in the United States

Science.gov (United States)

Mars, Sarah G.; Fessel, Jason N.; Bourgois, Philippe; Montero, Fernando; Karandinos, George; Ciccarone, Daniel

2015-01-01

Heroin overdose, more accurately termed ‘heroin-related overdose’ due to the frequent involvement of other drugs, is the leading cause of mortality among regular heroin users. (Degenhardt et al., 2010) Heroin injectors are at greater risk of hospital admission for heroin-related overdose (HOD) in the eastern United States where Colombian-sourced powder heroin is sold than in the western US where black ‘tar’ heroin predominates. (Unick et al., 2014) This paper examines under-researched influences on HOD, both fatal and non-fatal, using data from a qualitative study of injecting drug users of black tar heroin in San Francisco and powder heroin in Philadelphia Data were collected through in-depth, semi-structured interviews carried out in 2012 that were conducted against a background of longer-term participant-observation, ethnographic studies of drug users and dealers in Philadelphia (2007–12) and of users in San Francisco (1994–2007, 2012). Our findings suggest three types of previously unconsidered influences on overdose risk that arise both from structural socio-economic factors and from the physical properties of the heroin source-types: 1) retail market structure including information flow between users; 2) marketing techniques such as branding, free samples and pricing and 3) differences in the physical characteristics of the two major heroin source forms and how they affect injecting techniques and vascular health. Although chosen for their contrasting source-forms, we found that the two cities have contrasting dominant models of drug retailing: San Francisco respondents tended to buy through private dealers and Philadelphia respondents frequented an open-air street market where heroin is branded and free samples are distributed, although each city included both types of drug sales. These market structures and marketing techniques shape the availability of information regarding heroin potency and its dissemination among users who tend to seek out

An evaluation of a heroin overdose prevention and education campaign.

Science.gov (United States)

Horyniak, Danielle; Higgs, Peter; Lewis, Jennifer; Winter, Rebecca; Dietze, Paul; Aitken, Campbell

2010-01-01

Following detection of an upward trend in the frequency of fatal heroin overdoses in Victoria between 2001 and 2003, Victoria's Department of Human Services planned a campaign aimed at increasing injecting drug users' (IDU) awareness of overdose risks and prevention strategies. Stickers, wallet cards and posters featuring five key messages were distributed via needle and syringe programs (NSP) and other drug and alcohol services between November 2005 and April 2006. An evaluation of the campaign was commissioned to be conducted in late 2006. The evaluation consisted of analysis of three independent data sets--quantitative data collected from IDU during the campaign period (n = 855 at baseline; and a range of 146-656 at follow up); qualitative interviews with IDU who were NSP clients during the campaign period (n = 16) and qualitative interviews with NSP staff and other key stakeholders (n = 9). While key experts felt that the campaign messages had engendered lasting impact for at least some IDU, these positive impressions were not borne out by the NSP client data, with less than one quarter of all campaign messages being mentioned by a significantly higher proportion of clients during the post-campaign period compared with baseline. Key experts perceived the greatest weakness of the campaign to be the delay between issue identification and the introduction of campaign materials. While IDU are generally responsive to health promotion campaigns, future initiatives in this domain should be designed and implemented rapidly and in ways that are sufficiently flexible to cope with shifts in drug markets which could influence the reception of key messages.

Assessment of the safety and ease of use of the naloxone auto-injector for the reversal of opioid overdose

Directory of Open Access Journals (Sweden)

Merlin MA

2015-06-01

Full Text Available Mark A Merlin,1,2 Navin Ariyaprakai,1 Faizan H Arshad1,2 1Newark Beth Israel Medical Center, Newark, NJ, USA; 2Monmouth Ocean Hospital Service Corporation (MONOC, Wall Township, NJ, USA Abstract: Over the last decade, opioid-related deaths in the United States have increased at an alarming rate. The use of naloxone by laypersons is a newer concept and its utilization can benefit patients by rapid administration due to it being readily available immediately after an opioid overdose. The US Food and Drug Administration approved a naloxone auto-injector on April 3, 2014 for adults and pediatrics, designed for use by anyone including patients, family members, bystanders, and medical professionals. This device (EZVIO™ is the first device of its kind available on the market. The auto-injector is a battery-operated disposable 0.4 mg/0.4 mL prefilled device for use in the lateral thigh by patients, bystanders, or health care professionals. It utilizes auditory and visual commands for ease of administration and instructs patients to seek further medical care after injection. EVZIO costs about $600 for two auto-injectors and a trainer. Additionally, in August 2013, the Substance Abuse and Mental Health Services Administration introduced the Opioid Overdose Toolkit, a federal resource promoting safety and prevention information. This extensive document provides information for medical professionals, first responders, patients, caregivers, and overdose survivors. It outlines many strategies for dealing with this health care crisis. Most importantly, it highlights the importance of rapid recognition and treatment of opioid overdoses as well as routine conversations with patients assessing the need for naloxone prescriptions. The auto-injector is a safe, portable device with limited instruction needed and should routinely be made available to anyone who has contact with an opioid user. Keywords: narcotics, abuse, heroin, EZVIO

Fidelity Witnesses for Fermionic Quantum Simulations

Science.gov (United States)

Gluza, M.; Kliesch, M.; Eisert, J.; Aolita, L.

2018-05-01

The experimental interest and developments in quantum spin-1 /2 chains has increased uninterruptedly over the past decade. In many instances, the target quantum simulation belongs to the broader class of noninteracting fermionic models, constituting an important benchmark. In spite of this class being analytically efficiently tractable, no direct certification tool has yet been reported for it. In fact, in experiments, certification has almost exclusively relied on notions of quantum state tomography scaling very unfavorably with the system size. Here, we develop experimentally friendly fidelity witnesses for all pure fermionic Gaussian target states. Their expectation value yields a tight lower bound to the fidelity and can be measured efficiently. We derive witnesses in full generality in the Majorana-fermion representation and apply them to experimentally relevant spin-1 /2 chains. Among others, we show how to efficiently certify strongly out-of-equilibrium dynamics in critical Ising chains. At the heart of the measurement scheme is a variant of importance sampling specially tailored to overlaps between covariance matrices. The method is shown to be robust against finite experimental-state infidelities.

Taxometric Analysis of the Antisocial Features Scale of the Personality Assessment Inventory in Federal Prison Inmates

Science.gov (United States)

Walters, Glenn D.; Diamond, Pamela M.; Magaletta, Philip R.; Geyer, Matthew D.; Duncan, Scott A.

2007-01-01

The Antisocial Features (ANT) scale of the Personality Assessment Inventory (PAI) was subjected to taxometric analysis in a group of 2,135 federal prison inmates. Scores on the three ANT subscales--Antisocial Behaviors (ANT-A), Egocentricity (ANT-E), and Stimulus Seeking (ANT-S)--served as indicators in this study and were evaluated using the…

Psychosocial Functioning Among Inmates in Prison-Based Drug Treatment: Results from Project BRITE.

Science.gov (United States)

Burdon, William M; St De Lore, Jef; Dang, Jeff; Warda, Umma S; Prendergast, Michael L

2013-03-01

To assess the impact of a positive behavioral reinforcement intervention on psychosocial functioning of inmates over the course of treatment and on post-treatment self-reported measures of treatment participation, progress, and satisfaction. Male ( n = 187) and female ( n = 143) inmates participating in 12-week prison-based Intensive Outpatient (IOP) drug treatment were randomly assigned to receive standard treatment (ST) or standard treatment plus positive behavioral reinforcement (BR) for engaging in targeted activities and behaviors. Participants were assessed for psychosocial functioning at baseline and at the conclusion of treatment (post-treatment). Self-reported measures of treatment participation, treatment progress, and treatment satisfaction were also captured at post-treatment. The intervention affected female and male subjects differently and not always in a way that favored BR subjects, as compared to the ST subjects, most notably on measures of depression and criminal thinking. Possible explanations for the results include differences in the male and female custody environments combined with the procedures that study participants had to follow to earn and/or receive positive reinforcement at the two study sites, as well as baseline differences between the genders and a possible floor effect among females on measures of criminality. Limitations of the study included the inability to make study participants blind to the study conditions and the possible over-branding of the study, which may have influenced the results.

WITS - WASTE DATA COLLECTION WITH OUR PALMS AT OUR FINGERTIPS

International Nuclear Information System (INIS)

Martinez, B.

2000-01-01

The waste management and environmental compliance group (NMT-7) at the Los Alamos National Laboratory (LANL) has initiated a project to build a computer-based system for tracking inventory, storage and disposal information for hazardous and radioactive waste and contaminated byproducts. This project, the Waste Inventory Tracking System (WITS), will initially be used in TA-55 (which includes the Los Alamos National Laboratory Plutonium Facility) and the Chemical and Metallurgy Research (CMR) building where wastes are generated. The system handles numerous waste types with variation in size, disposal method, and hazard classification including: low level waste such as room trash (compactable waste), SEG waste (non-compactable), and over-sized waste, mixed waste, hazardous and chemical waste, universal waste, and waste containing asbestos and PCB's. WITS is designed to provide up-to-date location, status, content information, radioactivity analyses, and other inventory information for every waste item and container managed by NMT-7. The system will support comprehensive reporting capabilities and cradle-to-grave audit trails. WITS is intended to facilitate handling of waste by NMT-7 staff to help minimize waste disposal costs, ensure compliance with applicable regulations, and standardize waste management methodologies and practices. This paper compares current management practices with revised methodologies supported by WITS. It shows how automating inventory tracking helps achieve these goals

Witnesses to hunger: participation through photovoice to ensure the right to food.

Science.gov (United States)

Chilton, Mariana; Rabinowich, Jenny; Council, Christina; Breaux, Jennifer

2009-01-01

Currently 30.2% of female-headed households with children in the United States experience food insecurity, defined as the lack of access to enough food for an active and healthy life. In 2007, approximately 12.4 million children were at risk for hunger. When female-headed households and households with children have the highest prevalence of food insecurity and hunger in the US, the participation of low-income mothers in the development and administration of policies and programs related to nutrition and poverty are fundamental to the process of ending hunger and improving child well-being. In this article, we describe the Witnesses to Hunger program, a participatory advocacy project that uses the "photovoice" technique to engage mothers to take photos and record their stories about poverty and hunger with the intent to inform social welfare policy in the US. Witnesses to Hunger is grounded in the human rights framework that is supported by international conventions on the rights of women, the rights of the child, and economic, social, and cultural rights. The Witnesses to Hunger program works to increase civic participation of low-income women and to maintain a strategic public awareness campaign. After introducing the Witnesses to Hunger program, this article describes the past decade of unchanging food insecurity disparities, demonstrates the lack of participatory dialogue in health and welfare programs, and provides examples of how Witnesses to Hunger counters the conventional dialogue about welfare. Throughout, this paper demonstrates how the participatory approach of the Witnesses to Hunger program improves our understanding of basic human needs and the social determinants of health, and informs legislators on how to improve health and welfare policy.

[Thoughts on the Witnessed Audit in Medical Device Single Audit Program].

Science.gov (United States)

Wen, Jing; Xiao, Jiangyi; Wang, Aijun

2018-02-08

Medical Device Single Audit Program is one of the key projects in International Medical Device Regulators Forum, which has much experience to be used for reference. This paper briefly describes the procedures and contents of the Witnessed Audit in Medical Device Single Audit Program. Some revelations about the work of Witnessed Audit have been discussed, for reference by the Regulatory Authorities and the Auditing Organizations.

13 CFR 142.25 - Can a party or witness object to discovery?

Science.gov (United States)

2010-01-01

... discovery? 142.25 Section 142.25 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 142.25 Can a party or witness object to discovery? Any party or prospective witness may file a motion to quash a subpoena or to limit discovery or the...

Witnessing traumatic events and post-traumatic stress disorder: Insights from an animal model.

Science.gov (United States)

Patki, Gaurav; Salvi, Ankita; Liu, Hesong; Salim, Samina

2015-07-23

It is becoming increasingly recognized that post-traumatic stress disorder (PTSD) can be acquired vicariously from witnessing traumatic events. Recently, we published an animal model called the "Trauma witness model" (TWM) which mimics PTSD-like symptoms in rats from witnessing daily traumatic events (social defeat of cage mate) [14]. Our TWM does not result in any physical injury. This is a major procedural advantage over the typical intruder paradigm in which it is difficult to delineate the inflammatory response of tissue injury and the response elicited from emotional distress. Using TWM paradigm, we examined behavioral and cognitive effects in rats [14] however, the long-term persistence of PTSD-like symptoms or a time-course of these events (anxiety and depression-like behaviors and cognitive deficits) and the contribution of olfactory and auditory stress vs visual reinforcement were not examined. This study demonstrates that some of the features of PTSD-like symptoms in rats are reversible after a significant time lapse of the witnessing of traumatic events. We also have established that witnessing is critical to the PTSD-like phenotype and cannot be acquired solely due to auditory or olfactory stresses. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Tobacco use and oral health of inmates in a Nigerian prison.

Science.gov (United States)

Akaji, E A; Folaranmi, N

2013-01-01

To determine the effect of tobacco use on oral health status of inmates of a federal prison in Enugu, Nigeria. The study involved 230 inmates of the Nigerian Prison in Enugu. An interviewer-administered questionnaire was used to collect data on the demographic characteristics of the participants, oral hygiene methods, and smoking habits. An intra-oral examination to determine their oral health status was done using simplified oral hygiene index (OHI-S) for the oral hygiene status, the modified decayed missing and filled teeth (DMFT) index for caries status, and community periodontal index of treatment needs (CPITN) for the periodontal needs. Statistical Package for Social Sciences software, version 15 was used to analyze data. One hundred and twenty participants (52.2%) were current smokers. Mean DMFT of smokers and nonsmokers were 2.38 ± 0.71 and 2.25 ± 0.83 respectively ( P = 0.508) while mean Community Periodontal Index (CPI) scores of smokers and nonsmokers were 4.71 ± 1.26 and 2.27 ± 0.86, respectively ( P = 0.276). Oral soft tissue lesions such as mucosal burn, oral leukoplakia-like lesions were found mainly in the tobacco users. Tobacco use had a negative effect on the oral health of the participants as smokers had worse oral health profile than non-smokers. They may benefit from counseling programs with the view to educate them on the effect of tobacco use on oral health and by extension, the general health. The full implementation of the Framework Convention on Tobacco Control (FCTC) treaty in Nigeria could help in curtailing these unwanted consequences of tobacco use.

Traumatic experiences and re-victimization of female inmates undergoing treatment for substance abuse.

Science.gov (United States)

Mejía, Bertha; Zea, Paloma; Romero, Martha; Saldívar, Gabriela

2015-02-09

In the past decade, several studies have focused on the treatment needs of female inmates with substance abuse problems. An important finding has been that these women are more likely to report histories of sexual, physical, and emotional abuse-at rates varying from 77% to 90%. The trauma resulting from this kind of abuse is a key contributing factor in behavioral problems in adolescence and subsequent delinquency, substance abuse, and criminality in adulthood. This was a retrospective clinical study. A convenience sample of 112 women who entered the program's treatment groups consecutively for one year form part of the study. Information on traumatic events was obtained using some questions from the Initial Trauma Review. It explores whether the participant experienced physical abuse, sexual abuse, disasters, automobile accidents, or witnessed violence under the age of 18. It also examines experiences as an adult, including sexual and physical abuse, attacks by others who are not intimate partners, and abuse by authorities. Revictimization in sexual abuse was found in 78.1% of participants. Significant differences were identified between women who had experienced a traumatic sexual event from a person five years their senior before the age of 18 and then suffered from sexual violence as an adult, and women who had never undergone either of these events (x(2) = 11.3, df 112/1, p = abuse, the figure was 82.17%. Differences were observed between women who were revictimized through physical abuse before and after the age of 18 (x(2) = 5.91, df 112/1, p = child and subsequently physical violence from their parents, and women who had not undergone either of these events (x(2) = 3.48, df 112/1, p = <.05). Investment in treatment in these areas during the prison sentence and after release may contribute to preventing these women from become repeat offenders. Creating sources of work and halfway houses that continue the program to prevent relapses

Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015.

Science.gov (United States)

Stopka, Thomas J; Donahue, Ashley; Hutcheson, Marguerite; Green, Traci C

To determine the prevalence of nonprescription naloxone and sterile syringe sales, factors associated with nonprescription sales, geospatial access to nonprescription naloxone and syringe-selling pharmacies, and targets for potential interventions. Cross-sectional study. Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to nonprescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease hepatitis C virus transmission, respectively. We completed brief telephone surveys with 809 of 1042 retail pharmacies across Massachusetts (response rate = 77.6%) during 2015 to assess experience with nonprescription sales of naloxone and sterile syringes. Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes or no) for nonprescription sales and nonprescription syringe sales (yes or no). We conducted multivariable regression analyses and created maps using a geographic information system to identify factors associated with nonprescription sales of naloxone and sterile syringes, and to improve our understanding of geospatial access to pharmacy-based naloxone and syringe sales. More than 97% of pharmacies reported selling sterile syringes without requiring a prescription, and 45% of pharmacies reported stocking and selling naloxone. Factors associated with nonprescription sales included hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to nonprescription sale of sterile syringes is widespread, whereas geospatial access to naloxone is limited. Training to understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Access to sterile syringes through nonprescription sales is strong across Massachusetts, and although more than 350

Overdose prevention for injection drug users: Lessons learned from naloxone training and distribution programs in New York City

Directory of Open Access Journals (Sweden)

Nandi Vijay

2007-01-01

Full Text Available Abstract Background Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs. Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. Methods During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. Results There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a political climate surrounding naloxone distribution; b extant prescription drug laws; c initial low levels of recruitment into the program; d development of participant appropriate training methodology; e challenges in the design of a suitable formal evaluation; and f evolution of program response to naloxone. Conclusion Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in

Basic and Advanced EMS Providers Are Equally Effective in Naloxone Administration for Opioid Overdose in Northern New England.

Science.gov (United States)

Gulec, Nazey; Lahey, Joseph; Suozzi, James C; Sholl, Matthew; MacLean, Charles D; Wolfson, Daniel L

2018-01-01

Overdose mortality from illicit and prescription opioids has reached epidemic proportions in the United States, especially in rural areas. Naloxone is a safe and effective agent that has been shown to successfully reverse the effects of opioid overdose in the prehospital setting. The National EMS Scope of Practice Model currently only recommends advanced life support (ALS) providers to administer naloxone; however, some individual states have expanded this scope of practice to include intranasal (IN) administration of naloxone by basic life support (BLS) providers, including the Northern New England states. This study compares the effectiveness and appropriateness of naloxone administration between BLS and ALS providers. All Vermont, New Hampshire, and Maine EMS patient encounters between April 1, 2014 and December 31, 2016 where naloxone was administered were examined and 3,219 patients were identified. The proportion of successful reversals of opioid overdose, based on improvement in the Glasgow Coma Scale (GCS), respiratory rate (RR), and provider global assessment (GA) of response to medication was compared between BLS and ALS providers using a Chi-Squared statistic, Fisher's exact or Wilcoxon rank-sum test. There was no significant difference in the percent improvement in GCS between BLS and ALS (64% and 64% P = 0.94). There was no significant difference in the percentage of improvement in RR between BLS and ALS (45% and 48% P = 0.43). There was a significant difference in the percentage of improvement of GA between BLS and ALS (80% and 67% P < 0.001). There was no significant difference in determining appropriate cases to administer naloxone where RR < 12 and GCS < 15 between BLS and ALS (42% and 43% P = 0.94). BLS providers were as effective as ALS providers in improving patient outcome measures after naloxone administration and in identifying patients for whom administration of naloxone is appropriate. These findings support expanding the National EMS Scope

'Het gaat niet over zwart en wit'

NARCIS (Netherlands)

Drs. Kennedy Aquilino Tielman; prof dr Douwe Beijaard; Dr. Perry den Brok; Dr. S. Bolhuis

2009-01-01

'Het gaat niet over zwart en wit' De meeste mbo-scholen hebben samenwerking tussen de leerlingen hoog in het vaandel. Kunnen samenwerken is belangrijk voor de latere beroepsuitoefening en het functioneren van de leerlingen in de samenleving. De grote culturele diversiteit binnen de leerlingpopulatie