bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship of Stress and Coping Methods to Adolescent Marijuana Use
Authors: Siqueira Lorena , Diab Marguerite , Bodian Carol , Rolnitzky Linda
Published: December 2009

As the use of marijuana among adolescents remains high, more effective interventions are needed. We conducted this cross–sectional survey at an outpatient, university–based, adolescent clinic to determine the prevalence of marijuana use in an inner–city adolescent population and to examine the relationship of stress and coping methods to marijuana user status (never user, experimenter, and frequent user). The subjects were 918 adolescents aged 12–21 years. Lifetime use in this population was 59% (n = 611) with 18.4% (n = 191) reporting frequent weekly use. Almost all (97%) marijuana users acknowledged marijuana use by friends. Stepwise logistic regression analysis showed that negative life events, greater use of the negative coping method of anger and less frequent use of the positive coping method of parental support were significantly and independently related to marijuana user status. In the presence of high peer use, exploring parent–child relationships and use of anger coping and intervening accordingly may decrease marijuana use.
The Prevalence of Cigarette Smoking in an Acute Inpatient Physical Medicine and Rehabilitation Population
Authors: Guilmette Thomas J. , Motta Sandra I. , Shadel William G. , Mukand Jon , Niaura Raymond
Published: December 2009

The purpose of this study was to determine the prevalence of cigarette smoking among patients before and after discharge from an acute inpatient physical medicine and rehabilitation unit and. to assess smokers’ interest in and desire for smoking cessation. A consecutive sample of inpatients (n = 233) admitted over a 5–month period to a regional rehabilitation inpatient center for acute rehabilitation treatment was surveyed for their smoking patterns. Ten percent of patients admitted to rehabilitation were active smokers prior to their hospitalization. In spite of reporting high motivation to stop smoking, half were not interested in participating in a smoking cessation program if one were offered to them. Following discharge from inpatient rehabilitation, 54% of a small sample of patients who could be contacted had resumed smoking (all within 4 weeks of being home). Given the prevalence of smoking in this population and its adverse consequences on health and quality of life, we suggest that rehabilitation professionals actively address this health problem during the patient's hospitalization.
The Effects on Facilitators of a Substance Abuse Education Program
Authors: Rhodes Sandra B. , Blondell Richard D. , Pfeifer Judie , Graham Antonnette V.
Published: December 2009

This retrospective–anecdotal study was conducted to determine if involvement in a learner–centered continuing education program in substance abuse prevention would influence the careers and work–related activities of the facilitators. A questionnaire was sent to 33 individuals who served as facilitators of a large substance abuse prevention education project. Of the 31 who responded, 21 (67.7%) indicated that serving as a facilitator resulted in either “major changes”; or “some changes”; to their careers, and 25 (80.6%) felt that they were “much more likely”; or “more likely”; to incorporate substance abuse prevention activities into their work. Teaching in substance abuse education programs may cause changes in the career paths and work–related activities of the facilitators. Investigators may need to incorporate evaluations of the effects of a particular program on the intended learners as well as the facilitators.
Active and Former Injection Drug users Report of HIV Risk Behaviors during Periods of Incarceration
Authors: Clarke Jennifer G. , Stein Michael D. , Hanna Lucy , Sobota Mindy , Rich Josiah D.
Published: December 2009

American prisons have increasing numbers of inmates incarcerated for drug offenses. This population is at high risk for HIV–infection and may continue HIV transmission risk behaviors while incarcerated. We find that 31 % of injection drug users with a history of imprisonment had used illicit drugs in prison, and nearly half of these persons had injected drugs while incarcerated. Male gender and number of times incarcerated were associated with drug use in prison. Interventions for drug–using prisoners that are advocated in some European prisons, such as needle exchange programs and methadone maintenance, need attention in the United States.
Factors Affecting the Short–Term Prognosis of Alcohol Dependent Patients Undergoing Inpatient Detoxification
Authors: Wicks S. , Hammar J. , Heilig M. , Wisén O.
Published: December 2009

Stable measures of psychological functioning require a considerable period of abstinence. However, the duration of inpatient detoxification programs has decreased dramatically in most health care systems, posing a novel challenge for clinical evaluation of patients. The present study was carried out to examine whether factors predicting short–term prognosis can be identified in alcohol dependent subjects during early stages of inpatient detoxification. Self–reports of mood states were obtained, and executive cognitive functioning was examined. Outcome was studied at 2–3 months. No correlation was found between self–reported symptoms of depression, hopelessness, and anxiety, and percentage of nondrinking days. A significant positive correlation was found between Wisconsin Card Sorting Test (WCST) performance and short–term prognosis measured by this parameter. Thus, in addition to transient withdrawal–related effects, impairments of WCST performance in early stages of alcohol detoxification may reflect more long standing deficits in problem–solving strategies, of possible relevance for matching patients to treatment services.
Methadone Anonymous: A 12–Step Program for Methadone Maintained Heroin Addicts
Authors: Gilman Stephen M. , Galanter Marc , Dermatis Helen
Published: December 2009

Methadone Anonymous (MA) is a new 12–step fellowship developed for methadone maintained heroin addicts. A total of 53 MA members completed a survey assessing factors related to methadone maintenance treatment program (MMTP) entry, drug use, MA participation, beliefs concerning effectiveness of MMTP and MA, and level of social cohesiveness. Length of time in MA was associated with a decreased use of alcohol, cocaine, and marijuana. Clients rated components of MA to be significantly more helpful to recovery than MMTP treatment components. Affiliation to five MA members known best by the respondents was significantly greater than affiliation to non–MA members. Length of time in MA was positively associated with MA affiliation. Social affiliation and endorsement of 12–step principles were positively correlated. These findings suggest that MA participation has benefits not available in professionally driven MMTP, and should be further studied.
Faculty Rating of Learning Objectives for an Undergraduate Medical Curriculum in Substance Abuse
Authors: Kahan Meldon , Midmer Deana , Wilson Lynn , Liu Eleanor
Published: December 2009

The purpose of this study is to describe medical faculty's ratings of learning objectives related to substance abuse. A comprehensive set of learning objectives was drafted. The Associate Dean at each of Ontario's five medical schools was asked to select two faculty members from each clinical discipline who were involved in undergraduate medical education. The selected faculty were sent a survey asking them to rate 282 objectives according to their importance for undergraduate education in their discipline, using a 5–point scale. Sixty–eight out of 90 surveys were returned. For statistical analysis, disciplines were placed into two groups, Group 1 (internal medicine, surgery, emergency medicine, and anesthesia) and Group 2 (family medicine, psychiatry, and pediatrics). The mean ratings of Group 1 were significantly higher than Group 2 (p < 0.001) for five sets of objectives: attitudes, epidemiology, screening and assessment, nonmedical interventions, and specific populations (women, the elderly, and adolescents). Group 1 gave mean ratings above 4 to all themes except epidemiology, inpatient care, and medical complications. In contrast, Group 2 gave mean ratings above 4 to only three themes: physician substance abuse problems, withdrawal, and medical complications. The marked differences in learning objectives between disciplines suggest that a discipline–specific approach is needed for curricular development in substance abuse.
Benefit–Cost Analysis of Addiction Treatment in Arkansas: Specialty and Standard Residential Programs for Pregnant and Parenting Women
Authors: French Michael T. , McCollister Kathryn E. , Cacciola John , Durell Jack , Stephens Raymond L.
Published: December 2009

A benefit–cost analysis of specialty residential treatment (Specialty) and standard residential treatment (Standard) was conducted on a sample of pregnant and parenting substance abusers from Arkansas. Economic benefits were derived from client self–reported information at treatment entry and at 6–month postdischarge with the use of an augmented version of the Addiction Severity Index (ASI). The average cost of treatment in Specialty programs was $8,035 versus $1,467 for Standard residential treatment. Average net benefits (benefit–cost ratios) were estimated to be $17,144 (3.1) for Specialty and $8,090 (6.5) for Standard. The main policy implication of this research is that investment in Specialty residential treatment for pregnant and parenting substance–abusing women appears to be economically justified, but future evaluations should analyze larger and more comparable samples to improve power and precision in the benefit–cost statistics.
Making the Transition from High School to College: The Role of Alcohol–Related Social Influence Factors in Students’ Drinking
Authors: Read Jennifer P. , Wood Mark D. , Davidoff Orion J. , McLacken Julie , Campbell James F.
Published: December 2009

Using a sample of entering college freshmen (N = 311), the purposes of this study were to examine 1) whether perceived norms for college student alcohol use and problems differed by gender and level of intended Greek involvement (Greek intent); 2) associations between perceived norms, Greek intent, and alcohol use and problems; and 3) whether relations between perceived norms, Greek intent, and alcohol use and problems were moderated by gender. Results revealed no differences in levels of perceived norms for alcohol use and problems as a function of gender or intention to affiliate with a Greek letter organization. Perceived norms demonstrated consistent, significant associations with both alcohol use and problems, while Greek intent demonstrated significant associations only with alcohol problems. Examination of gender effects in associations between perceived norms, Greek intent, and alcohol use and problems revealed a number of differences in these relations. Specifically, Greek intent was significantly associated with measures of alcohol use and problems for men, but not for women. Likewise, the association between perceived norms and alcohol use and problems were significant for men, but not for women. Finally, although perceived norms were a significant predictor of heavy drinking for both men and women, the association was much stronger among male students. These findings suggest that alcohol prevention interventions may benefit from specifically targeting perceived norms among incoming students who are at highest risk (i.e., male pledges).
Substance Abuse Integration in Nursing Education: An Innovative Collaborative Model
Authors: Hayes Patricia D.
Published: December 2009

This paper reports the outcomes of a 3–year faculty development project, the Nursing School Education Collaborative (NSEC), implemented in four baccalaureate schools of nursing. The focus of the NSEC was to strengthen educational programs through faculty development and curriculum integration in the area of substance abuse and addictions education. A comprehensive needs assessment process is outlined, and faculty development and curriculum integration activities are detailed. Faculty development has resulted in significant improvements in each school's substance abuse curriculum. Outcomes at each participating school have included continuing education activities, acquisition of additional teaching resources, the development of an integration model, and increased curriculum and clinical contact hours. With the increasing recognition of substance abuse as a number one public health problem and nursing as a major health workforce, this project serves as a model for replication.
Detection of Substance Use Disorders in Patients Presenting with Depression
Authors: Mallin Robert , Slott Kathryn , Tumblin Martha , Hunter Melissa
Published: December 2009

Comorbidity between substance use disorders and major depression may complicate the treatment and adversely affect the outcome of either disorder. This study examines the frequency with which patients presenting with depression are evaluated for a substance use disorder in a university–based family medicine residency program. A retrospective chart review was performed to identify 200 patients age 18 and older, seen between June 1, 1989, and June 1, 1999, who were diagnosed with depression ( DSM IV code 300.4 or 311.0). The records were divided into two strata based on whether they were seen by resident or faculty physicians. The records were then reviewed for evidence of substance use screening. The overall percentage of patients with depression and evaluated for substance use disorders was calculated, and further stratified as to gender, age, previous psychiatric diagnosis, and previous substance use disorder diagnosis. Family physicians evaluated outpatients with a diagnosis of depression for substance use disorders only 24.5% of the time. Faculty evaluated depressed patients 18%, compared to residents doing so in 31 % of patients. Male patients were evaluated 34.7% as compared to 21.2 % of females. Patients over age 70 were screened at a rate of only 10.7%. Given the observed prevalence of substance use disorders in patients with a diagnosis of depression is between 40 and 50%, our finding that our depressed patients were evaluated for substance use disorders only 24.5% of the time, suggests that family physicians may be missing a significant number of patients with comorbid disease.
The Parental Influence of Betel–Chewing Behavior among Junior High School Students in Taiwan
Authors: Ho Ching–Sung , Gee Mei–Jih
Published: December 2009

A cross–sectional study with stratification sampling was conducted to explore the parental influence of betel–chewing behavior among junior high school students in Taichung County in 1998. The sample consisted of 2244 students in three different districts in Taichung County: the mountain line area, the seashore area; and the satellite cities area (near Taichung City). A self–reported questionnaire was filled out anonymously by the sampled students. Fifty percent of the students’ fathers and 2.5% of the students’ mothers are betel chewers. A higher prevalence of betel chewing is found among students whose parents are betel chewers. Also the lower the father's educational level, the higher the prevalence of betel chewing among the students. Compared with students whose fathers have more than 12 years of education, the odds ratio is 2.35 for the prevalence of betel chewing among students with fathers whose educational levels are no more than 9 years. However, parents’ vocations are not related to the prevalence of betel chewing among junior high school students. Finally, students whose parents are separated or divorced have a higher prevalence of betel chewing. An effective health education program for the high–risk group students and an evaluation procedure for the effectiveness of the program is necessary to prevent the increase of betel chewing among Taiwan's youth.
The Role of Medicaid HMO Enrollment in the Longitudinal Utilization of Medical Care Services in a Cohort of Injecting Drug users in Baltimore, Maryland
Authors: Juday Timothy R. , Wu Albert , Celentano David D. , Rick Kevin D. , Wang Mei–Cheng , Vlahov David
Published: December 2009

Although injecting drug users (IDUs) are highly dependent on Medicaid, the literature has not explored the effect of Medicaid HMO enrollment on medical care utilization. This longitudinal analysis compares 6–month utilization levels of IDUs in Medicaid HMOs with those of other Medicaid–enrolled IDUs and IDUs in other insurance arrangements. The analysis includes 1064 participants from the AIDS Link to Intravenous Experience (ALIVE) study, a natural history study of HIV infection in a community–based sample of IDUs in Baltimore, Maryland. A generalized linear modeling approach was used to examine self–reported inpatient admissions, ER visits, and ambulatory care visits from January 1995 through June 1997. Non–HMO Medicaid beneficiaries had more inpatient admissions and ambulatory care visits than Medicaid HMO enrollees. These findings suggest that HMO enrollment has been effective in lowering utilization among IDUs in Medicaid, but it is unclear whether utilization differences are the result of inappropriate utilization or access issues.
Substance Abuse and Relationship Violence among Men Court–Referred to Batterers’ Intervention Programs
Authors: Stuart Gregory L. , Moore Todd M. , Kahler Christopher W. , Ramsey Susan E.
Published: December 2009

There is extensive theoretical and empirical evidence linking substance abuse and marital violence. However in batterer populations, researchers have not compared hazardous and nonhazardous drinkers’ substance use characteristics, marital aggression, extramarital violence (i.e., general violence), depressive symptomatology, marital satisfaction, and other relevant variables. In addition, much of the previous research on substance use and abuse in batterer populations employed a single, nonstandard–ized measure of substance use, and no previous research has examined substance use in court–mandated batterers’ relationship partners. We recruited 150 men who were arrested for violence and court–referred to batterer intervention programs. We administered multiple measures of substance use and abuse and assessed the batterers ‘ marital aggression, relationship satisfaction, depressive symptomatology, use of general violence, and their relationship partners’ substance use. We also divided the sample into groups of Hazardous Drinkers (HD) and Nonhazardous Drinkers (NHD). Across the entire sample, half of the batterers had an alcohol–related diagnosis and approximately one third reported symptoms consistent with a drug–related diagnosis. Over one third of the total sample reported that their relationship partners were hazardous drinkers. Relative to the NHD group, the HD group scored significantly higher on measures of general violence, depressive symptomatology, alcohol use, alcohol problems, and drug problems. The HD group also reported significantly higher partner alcohol and drug use and abuse scores, relative to the NHD group. The results of the study suggest that substance use and abuse should routinely be assessed as part of batterer interventions and that batterer programs would be improved by offering adjunct or integrated alcohol treatment.
Alcohol Relapses Associated with September 11, 2001: A Case Report
Authors: Zywiak William H. , Stout Robert L. , Trefry Winston B. , LaGrutta Joy E. , Lawson Constance C , Khan Nazia , Swift Robert M. , Schneider Robert J.
Published: December 2009

The timing of the terrible events of September 11, 2001 (9–11), and an ongoing randomized clinical trial of case monitoring have allowed a prospective examination of the effects of trauma upon the relapse rates of a group of clients following alcohol detoxification. The clients studied in this report were enrolled in case monitoring prior to 9–11. Case monitoring consists of telephone contacts on a tapering schedule designed to help clients avoid relapses, reduce the severity of relapses that do occur, and get clients back into treatment, at less intense levels, than would occur without case monitoring. For those clients completing a telephone contact before and a telephone contact after 9–11, none of the clients drank between detox discharge and 9–11, while 42% drank by the first telephone contact after 9–11. Data from another study were analyzed and results counter the rival hypothesis that the case monitoring study results reflect an annual seasonal effect. Results suggest that terrorist events may lead to a greater likelihood of relapse for those in alcohol recovery. These effects may be ameliorated by public education and outreach.
Perceptions of Smoking among African American Light Smokers
Authors: Okuyemi Kolawole S. , Scheibmeir Monica , Butler James , Ahluwalia Jasjit S.
Published: December 2009

Despite smoking fewer cigarettes per day, African Americans extract more nicotine per cigaretts smoked, and have higher than expected tobacco–related morbidity and mortality. The present study explores perceptions about smoking and motivations for smoking cessation among African American light smokers. Four focus groups consisting of 22 adults were conducted at an inner–city community health center. Participants were recruited through flyers and referral by clinic staff. Two major themes were identified: (1) similar smoking patterns, and (2) perceived differences from heavy smokers. Many participants perceived themselves as addicted to nicotine, experienced withdrawal symptoms with past quit attempts, and are interested in smoking cessation. Perceptions about nicotine addiction, difficulty with quitting, and interest in smoking cessation suggest a need to design and test cessation interventions among this understudied population.
Screening for substance use among ethnic minority adolescents: Patterns and prevention approaches
Authors: James William H. , Moore David D.
Published: December 2009

The purpose of this study was to determine if differences exist in the patterns of drug use between adolescent ethnic minorities from African American, Asian, Hispanic, and Native American backgrounds through the use of the Adolescent Substance Battery. The clinical use of the ASB has been used to evaluate and monitor adolescents who are suspected of drug abuse. To evaluate these differences systematically, a sample of 152 ethnic minority adolescent diagnostic assessments were analyzed. Gender differences were found, as 64% of the sample were males and 36% were females. Ethnic differences were found, as 56% of the sample were African American, and 75% of these were males. A total of 60 adolescents, or 39% of the sample, was diagnosed as chemically dependent. The analysis of substance use by ethnic minorities would appear to be helpful in developing ethnic‐ and gender‐specific prevention, intervention, and treatment programs.
Completers from a Detoxification Unit: Some Cost‐Benefit Considerations after using Psychometric Tests
Authors: Berg John E.
Published: December 2009

Completion of residential treatment has been taken to imply an improvement in prognosis toward rehabilitation and a life without drug abuse. On a sample of 61 consecutive clients in a detoxification and counseling unit, Antonovsky's Sense of Coherence test (SOC) and Hopkins Symptom Checklist (HSCL) were administered to detoxified clients in the second week of a 4‐week residential stay in order to indicate noncompletion. Eighteen clients (29.5%) did not complete their stay, and 17 of them had abnormal scores on the SOC and 12 on the HSCL scale, respectively. No attempt was made to use the information from the tests to influence completion rate. Increased emphasis on revealing the preferences of the clients toward values in life based on test results purportedly reduces noncompletion. The benefit to public budgets of using such information to prevent defection was calculated for three areas of interest: imputed reduction of future residential detoxification, reduction of future treatment sessions, and increase in taxable income from rehabilitated drug addicts. The total benefit per client was NKR19 000 (£1900, $2920) and NKR69 000 per noncompleter. High‐cost detoxification units would also benefit from reduction of noncompletion.
Pain among Drug users Completing an Inpatient Detoxification Program
Authors: Stein Michael D. , Wimbush Julian , Paull Nancy
Published: December 2009

We determined the prevalence of persistent pain among illicit drug users who have completed inpatient clonidine detoxification and are returning to the community. We found that 17% of drug users have substantial unexplained pain at discharge, and that drug injectors have significantly more pain than non‐injectors. Drug users with substantial pain reported worse self‐perceived health, interference with daily activities and sleep than pain‐free drug users. Our findings suggest that assessing pain at the first outpatient primary care appointment after drug treatment may be an important aspect of the longitudinal care of this population.
Sexual Trauma and Depression in African‐American Women who Smoke Crack Cocaine
Authors: Boyd Carol , Henderson Dorothy , Ross‐Durow Paula , Aspen Jennifer
Published: December 2009

The purpose of this descriptive study was to characterize five mutually exclusive groups of female crack cocaine abusers: (1) women with no history of sexual trauma, (2) women who had been sexually traumatized by a stranger (raped), (3) women who had been sexually traumatized by someone they knew but not a family member (date raped, molested, etc.), (4) women who had experienced sexual trauma by a family member (incest), and (5) women who experienced sexual trauma from a stranger and from a family member. Using a convenience sample of 208 African‐American women with a history of crack smoking, participants were interviewed for 2 to 4 hr and asked a variety of questions about their health, relationships, sexuality, and drug use. Sixty‐one percent (127) reported at least one sexually traumatic sexual event during their lives, with 67% of the 127 women experiencing sexual trauma before the age of 16. Women who experienced sexual trauma by a family member had significantly higher depression scores [as measured by the Beck Depression Inventory (BDI)] than women who had been traumatized by both a stranger (rape) and a male family member (incest).
Substance Abuse Risk Reduction: Verbal Mediational Training for Children by Parental and Nonparental Models
Authors: Corby Elizabeth A. , Russell J. Curtis
Published: December 2009

Little is known regarding the etiology and maintenance of substance abuse, especially factors which place children at higher risk for later drug use. The present study evaluated the impact of a 12‐week verbal mediational program (Think Aloud), which teaches children and parents cognitive and social problem‐solving skills and addresses early childhood risk factors related to the onset of drug use in adolescence. Fifty children and parents were included in the present study and were randomly divided into four groups: two groups received either a verbal mediation condition comprising the Think Aloud training or time to complete homework assignments. Each of the topic groups was subdivided into two groups, one in which the parents served as models and one in which the experimenter served as the model. Measures of family cohesion, expressiveness, and conflict, family organization and control, social skills, level of disruptiveness of the child's peer choice, academic competence, and the child's problem behaviors were administered to the parents and the teachers pre‐ and postinterventivefy. Children in the verbal mediation condition with parental models were expected to show the greatest reduction in risk factor scores, and children in the verbal mediation condition with the experimenter model were predicted to show the second greatest reduction in risk factor scores at posttest. Results of the study demonstrated partial support for experimental hypotheses in that the children involved in the Think Aloud program showed improvement on four of the six factors on posttest measures. The superiority of the parental model was not found.
Treatment Failures? Scope of the Treatment System for Long‐term Heroin Addicts
Authors: Krausz Michael , Watermann Ute , Degkwitz Peter
Published: December 2009

In a study of 50 long‐term heroin addicts in Hamburg with an average usage period of 17.4 years, it was found that heroin usage patterns differed in the course of addiction. It appeared that two‐thirds of the sample had had longer periods of uncontrolled heroin use that were interrupted by phases of abstinence or by phases of controlled use. Almost all of them use different drugs. Currently, as well as in the course of their addiction, they use numerous other drugs in an uncontrolled way, especially benzodiazepines. Long‐term heroin addicts on the whole have less treatment experience than persons in the reference studies. The percentage of treatment dropouts is as high among them as among the persons surveyed in other studies. Completed treatment correlated with better results with regard to the duration of abstinence following treatment. The level of information regarding the pending treatment was low among long‐term heroin addicts.
The Substance‐Abusing Patient and Primary Care: Linkage via the Addiction Treatment System?
Authors: Saitz Richard , Mulvey Kevin P. , Samet Jeffrey H.
Published: December 2009

Our objective was to describe and assess the prevalence and characteristics of substance‐abusing persons without primary care physicians. We interviewed a convenience sample at one point in time. Patients/participants were persons presenting for addictions treatment in a public substance abuse treatment system. Of 5824 respondents, 41% did not have a physician. In a multivariable analysis, the following were associated with not having a physician: no health insurance [adjusted odds ratio (OR), 2.05; 95% confidence interval (CI), 1.79–2.35], no history of a chronic (OR, 1.70; CI, 1.47–1.97) or an episodic (OR, 1.20; CI, 1.05–1.39) medical illness, male gender (OR, 1.49; CI, 1.29–1.71), and younger age (by decade) (OR, 1.12; CI, 1.04–1.38). Prior addictions or mental health treatment or a recent emergency‐room visit were not significantly associated with having a physician. Many patients with addictions serious enough to prompt presentation for treatment stated that they did not have physicians. Although younger persons, males, and those without insurance or past medical illness were more likely to report not having a physician, neither prior addictions or mental health treatment nor a recent emergency‐room visit decreased this likelihood. To achieve improved linkage of substance‐abusing patients with primary medical care, all health‐care contacts should be utilized.
Brief Intervention in Hazardous Drinking: An Important Adjunct to Medical School ATOD Curriculum
Authors: Popp Sharon M. , Schwartz Kendra L. , Schoener Eugene P.
Published: December 2009

Most medical school alcohol, tobacco and other drug (ATOD) curricula emphasize the diagnosis and treatment of alcohol abuse and dependence, even though a significant amount of alcohol‐related morbidity and mortality is associated with the hazardous use of alcohol An increased emphasis on screening for hazardous drinking and the use of early intervention has been shown to be effective in reducing heavy drinking in the primary care setting. This paper describes a family medicine clerkship seminar on clinical preventive medicine that focuses on tobacco and alcohol use. Results indicate that students team that brief intervention counseling can influence patient behavior and plan to continue to use it in future patient encounters. However, the low number of students electing to intervene in hazardous drinking suggests that more cumcular time is needed to overcome student resistance to addressing the alcohol use patterns of their patients.
Temperament Style and Substance Abuse Characteristics
Authors: Henderson Melinda J. , Galen Luke W. , DeLuca John W.
Published: December 2009

The relationship of temperament to different patterns and types of alcohol abuse has received much attention over the last decade in order to provide clues to matching patients optimally to treatment strategies. The purpose of this study was to examine the relationship of temperament with a number of relevant substance abuse characteristics in a substance abusing population. One hundred forty‐five male veterans were interviewed on their lifetime use of substances and on their psychiatric symptoms, problems associated with use, context, and family history of substance abuse. Subjects filled out the TPQ and the MPQ, which were subjected to factor analysis and revealed four factors: (1) Negative Affectivity/Impulsivity, (2) Positive Affectivity/Sociability, (3) Persistence/Achievement, and (4) Constraint. There was partial support for the hypotheses. Impulsivity was negatively correlated with age of onset and positively correlated with substance‐related problems and a family history of substance abuse. Subjects with a history of depression scored significantly lower on the Positive Affectivity/ Sociability factor than those who had not experienced a significant depression. Individuals who used alone scored lower on this factor than those who used in social contexts. The temperament factors of Persistence/Achievement and Constraint were, for the most part, unrelated to substance abuse.
Reliability of Form 90D: An Instrument for Quantifying Drug Use
Authors: Westerberg Verner S. , Tonigan J.Scott , Miller William R.
Published: December 2009

Clients just entering treatment for nonalcohol primary drug use were asked to report on their frequency of drug use at two times 2 days apart. Test‐retest correlations for the lifetime use of drugs were fair to excellent, and those for drug use in the last 90 days, although variable, were generally very good. For lifetime use, correlations were highest for opiates and stimulants and lowest for inhalants, whereas for the recent period correlations were highest for opiates and lowest for stimulants. Correlations were uniformly high for measures of general life functioning. Initial validity assessments with urine drug screen results as criterion were good, with no false negative errors in four of six drug use categories. Overall Form 90D appears to be a reasonably reliable and valid interview instrument for measuring drug use occurrence and frequency for both lifetime and recent use. Care is warranted in assessing classes of drugs that are used less frequently.
Integrating Substance Abuse Content into Social Work Courses: Effects of Intensive Faculty Training
Authors: Amodeo Maryann , Litchfield Leon
Published: December 2009

An evaluation was conducted in a graduate school of social work to assess the integration of substance abuse content into basic and advanced courses by instructors with and without specialized substance abuse training. Students in these courses completed questionnaires that asked about the amount, type, and usefulness of substance abuse content presented during the semester. Instructors with and without specialized substance abuse training completed questionnaires that examined their perceptions of the amount, type, and usefulness of the substance abuse content they had taught. Results showed that (1) faculty with specialized substance abuse training were more likely than faculty without such training to integrate substance abuse content; (2) courses taught by trained faculty received higher ratings from students on the quality of the content; (3) both groups of faculty (trained and untrained) perceived that more substance abuse content had been taught than their students perceived; and (4) neither faculty nor students perceived that too much substance abuse content had been taught. This approach could be useful to social work programs and other disciplines interested in measuring the effects of changes in course content.
Drinking Patterns and Problems: A Comparison of Primary Care with the Emergency Room
Authors: Cherpitel Cheryl J.
Published: December 2009

A comparison is made of drinking patterns and problems of probability samples of noninjured patients drawn from the emergency room (ER) (n = 974) versus primary care clinics (n = 767) in the same metropolitan community. Those in the primary care sample were significantly less likely to report heavier drinking, consequences of drinking, alcohol dependence, and ever having treatment for an alcohol problem, controlling for demographic differences between the two sites. The data suggest that while primary care settings remain an important site for early identification and intervention for problem drinking, the ER may hold more potential for targeting prevention efforts in an era of reduced resources.
Baseline Differences in Social Support among Treatment‐Seeking Alcoholics with and without Social Phobia
Authors: Thevos Angelica K. , Thomas Suzanne E. , Randall Carrie L.
Published: December 2009

Differences on demographics and seven measures of social support between matched, treatment‐seeking alcoholics with and without social phobia (SP and NSP groups, respectively) were examined. The groups did not differ on most demographic variables, although the SP group (n = 397) had a lower occupational status and had fewer years of education (both p's < .01) than the NSP group (n = 397). On social support measures, the SP group had less perceived social support from friends and had a lower performance on the social behavior role scale than the NSP group (both p's < .001). The two groups were unexpectedly more similar than different on the measures of interest in this study; however, the differences identified are meaningful for treatment planning. It is important to ascertain the quantity and sources of social support which are available to these clients in order to maximize positive treatment outcomes.
Markers for Patients with Alcohol Problems in an Outpatient General Medicine Clinic
Authors: Isaacson J. Harry , Nielsen Craig , Urbanic Richard , Challgren Eric
Published: December 2009

Our purpose was to determine the correlation among alcohol problems, certain health habits, and hypertension in a general internal medicine outpatient setting. Two‐hundred eighty‐seven patients who were undergoing complete examinations in a general internal medicine department of a large multispecialty clinic were asked to participate in a “lifestyle survey”; interview, which included questions regarding social history, gastrointestinal complaints, anxiety/depression, sexual dysfunction, and the Alcohol Use Disorders Identification Test (AUDIT). Charts were screened for documentation of alcohol problems and the presence of hypertension. Correlations between alcohol problems (defined as an AUDIT score ≥8) and the presence of hypertension were made using chi‐square tests for categorical variables and the t test for continuous variables. Of the 287 patients contacted, 12 refused, 3 were ineligible, and 29 had incomplete data precluding analysis, yielding a total of 233 patients (81%) who were included in the analysis. Sixty percent were female, 76% were white, and the mean age was 53 years. The overall prevalence of alcohol problems was 7.3% and less than one‐quarter of those patients had chart documentation of an alcohol problem. Thirty percent of those patients had a diagnosis of hypertension. No statistically significant correlation between a positive A UDIT and hypertension was found. Failure to use seat belts (P = 0.020), history of smoking (P < 0.001), alcohol use within 24 hr of the office visit (P < 0.001), and self‐reported family history of alcoholism (P = 0.012) were significantly more likely in patients with active alcohol problems. There was no difference in somatic complaints between patients with and patients without alcohol problems. We identified certain health behaviors which served as markers for patients with active alcohol problems in an outpatient setting. Physician diagnosis of alcohol problems (sensitivity of 24% in this study) may be improved with attention to such markers. Despite the known relationship of excess alcohol use and elevations in blood pressure, we found no statistically significant correlation between these variables in our study. Symptomatic concerns of the patient appear to be too nonspecific to distinguish patients with and without alcohol problems.
Cocaine Addiction: Neurobiology and Related Current Research in Pharmacotherapy
Authors: Panikkar Gopakumar P.
Published: December 2009

In this article, recent research studies in the field of cocaine addiction are reviewed, with an eye toward emergent options for treatment innovation. Particular attention is paid to the neurobiology and specific neurotransmitter and receptor mechanisms involved in cocaine abuse, dependence, and other unique phenomena of addiction such as sensitization, craving, compulsive drug use, and withdrawal. The vicissitudes in the dopamine theory of brain reward mechanisms, dopaminergic effects of cocaine, and emerging roles of GABA, serotonin, glutamate, and nitric oxide in cocaine addiction and its sequelae are discussed. Neuroanatomic findings elicited with imaging studies using PET and functional MRI are summarized. These findings support the role of specific brain regions within the dopaminergic system such as the ventral tegmentum and nucleus accumbens in the induction of the cocaine “high”; and craving, respectively. Research approaches to the problem of developing effective pharmaco‐therapeutic options to render cocaine ineffective and modalities under study, such as dopamine uptake inhibitors and immunotherapy, are also discussed in the context of a variety of practical problems faced by these experimental therapies. Pharmaco‐therapeutic strategies and new directions in this research, such as the adaptive changes of the opioid system in cocaine addiction, are reviewed. Potential areas for further study are brought forth for further debate and possible clinical evaluation.
The Use of Required Treatment for Substance Abusers
Authors: Fagan Ron
Published: December 2009

Studies show that typically less than 10% of alcohol and other drug abusers voluntarily enter treatment for their substance abuse, and once in treatment, drop out rates are high. One controversial way to get clients into, and to participate in, treatment is the use of legally encouraged or required treatment. Grounded in the parents patriae doctrine of state protection, the primary rationale for required treatment is that some substance abusers require external pressure to enter and remain in treatment. The history of required treatment for alcohol and other substance abuse, the primary issues surrounding its use, the use of required treatment in the criminal justice system, the primary treatment models for alcohol and other substance abuse, ways to increase internal and external motivation for treatment, and therapist and treatment personnel responsibilities in using required treatment are discussed.
Veiling in Style: How Does a Stigmatized Practice Become Fashionable?
Authors: Sandikci Özlem , Ger Güliz
Published: December 2009

Although stigma is prevalent in everyday life, consumer researchers’ interest on the topic remains scant and focuses mostly on stigma management. We move beyond individual coping strategies and examine the processes of stigmatization and destigmatization. Through an ethnographic study of fashion consumption practices of urban Turkish covered women, we explore how veiling, a deviant practice stigmatized in the secular and urban mind-set, first became an attractive choice for some middle-class women and then transformed into a fashionable and ordinary clothing practice for many. We map out the global multi-actored work that underlies the emergence of veiling as an attractive choice and explicate its gradual routinization and destigmatization. We discuss the findings in terms of their implications for understandings of choice and free will, the formative role of fashion in the evolution of a new habitus and social class, and the relationship between the market and religion.
Universal relations on stable map spaces in genus zero
Authors: Mustaţǎ Anca , Mustaţǎ Andrei
Published: December 2009

We introduce a factorization for the map between moduli spaces of stable maps which forgets one marked point. This leads to a study of universal relations in the cohomology of stable map spaces in genus zero.
Singularly perturbed nonlinear Dirichlet problems with a general nonlinearity
Authors: Byeon Jaeyoung
Published: December 2009

LetΩ\Omegabe a bounded domain inRn,\mathbf {R}^n,n≥3,n \ge 3,with a boundary∂Ω∈C2.\partial \Omega \in C^2.We consider the following singularly perturbed nonlinear elliptic problem onΩ\Omega:\[ε2Δu−u+f(u)=0,  u>0 on Ω,u=0 on ∂Ω,\varepsilon ^2 \Delta u - u + f(u) = 0, \ \ u > 0 \textrm { on }\Omega , \quad u = 0 \textrm { on } \partial \Omega ,\]where the nonlinearityffis of subcritical growth. Under rather strong conditions onf,f,it has been known that for smallε>0,\varepsilon > 0,there exists a mountain pass solutionuεu_\varepsilonof above problem which exhibits a spike layer near a maximum point of the distance functionddfrom∂Ω\partial \Omegaasε→0.\varepsilon \to 0.In this paper, we construct a solutionuεu_\varepsilonof above problem which exhibits a spike layer near a maximum point of the distance function under certain conditions onff, which we believe to be almost optimal.
The Diophantine equation 𝛼₁^{𝑥₁}⋯𝛼_{𝑛}^{𝑥_{𝑛}}=𝑓(𝑥₁,…,𝑥_{𝑛}). II
Authors: Corvaja P. , Schmidt W. , Zannier U.
Published: December 2009

We will deal with the equation of the title where

α

1

,
…
,

α

n

\alpha _{1},\dots ,\alpha _{n}

are multiplicatively independent complex numbers and

f
f

is a polynomial. We will give a bound for the number of solutions which depends only on

n
n

and the degree of

f
f

. Two further results which play a rôle in the proof are of independent interest.
Screening for Antiviral Activities of Isolated Compounds from Essential Oils
Authors: Astani Akram , Reichling Jürgen , Schnitzler Paul
Published: December 2009

Essential oil of star anise as well as phenylpropanoids and sesquiterpenes, for example, trans‐anethole, eugenol, β‐eudesmol, farnesol, β‐caryophyllene and β‐caryophyllene oxide, which are present in many essential oils, were examined for their antiviral activity against herpes simplex virus type 1 (HSV‐1) in vitro. Antiviral activity was analyzed by plaque reduction assays and mode of antiviral action was determined by addition of the drugs to uninfected cells, to the virus prior to infection or to herpesvirus‐infected cells. Star anise oil reduced viral infectivity by >99%, phenylpropanoids inhibited HSV infectivity by about 60–80% and sesquiterpenes suppressed herpes virus infection by 40–98%. Both, star anise essential oil and all isolated compounds exhibited anti‐HSV‐1 activity by direct inactivation of free virus particles in viral suspension assays. All tested drugs interacted in a dose‐dependent manner with herpesvirus particles, thereby inactivating viral infectivity. Star anise oil, rich in trans‐anethole, revealed a high selectivity index of 160 against HSV, whereas among the isolated compounds only β‐caryophyllene displayed a high selectivity index of 140. The presence of β‐caryophyllene in many essential oils might contribute strongly to their antiviral ability. These results indicate that phenylpropanoids and sesquiterpenes present in essential oils contribute to their antiviral activity against HSV.