A Field Test of the Sweat Patch

The sweat patch is a new, noninvasive method designed to estimate the ethanol consumption of drinking subjects. It consists of salt-impregnated absorbent pads protected by a plastic chamber with attached water-tight adhesive. The patch reportedly collects transepidermal fluid at a steady rate for up to 10 days. Recent laboratory research has indicated a linear relationship between the concentration of ethanol in transepidermal fluid and mean concentration of ethanol in blood. Levels of ethanol in the sweat patch allowed identification of persons drinking at least 0.5 g of ethanol/kg/day with 100% sensitivity and specificity. The study reported here was conducted to test the field effectiveness of this sweat patch in normal, active research subjects. First, several pretests were conducted to determine the optimal location of the patch on the body and its fluid uptake at various sites. A laboratory experiment using nonalcoholic subjects was conducted to replicate previous work, and methods of measuring ethanol concentration in the patch were refined. A field test of the patch was then carried out. Healthy active volunteers drank a single "moderate" dose of ethanol (0.5 g of ETOH/kg of body weight) and then remained abstinent for the next 3 days. A week later, a "heavy" dose (1.0/kg of body weight) was consumed. Only a trace of ethanol was detected in any of the patches worn in either experiment. The patch did not measure ethanol in the transepidermal fluid under field conditions. Thus, further design modifications and pilot testing are required before the full benefits of this unobtrusive measure of drinking can be realized.     

Evaluation of substance abuse problems in a psychiatric hospital

Hospital-wide rumors and anecdotal reports had suggested that there was a potentially serious problem of alcohol and drug abuse among the psychiatric patients of this hospital. The authors describe a systematic, evaluative approach which gave direct and detailed information on the nature and extent of the problem thus permitting effective administrative solutions. Results of the study indicated that there were two qualitatively different populations of substance abusing patients. A considerable population of patients were routinely using alcohol and "soft" drugs on the hospital grounds, while another disturbing percentage of patients gave evidence of psychological or physical dependence on alcohol or hard drugs. Data from the evaluation was instrumental in implementing additional security measures to deal with casual substance abuse and additional, confidential treatment resources to deal with the more serious substance abuse problems in patients and staff.     

A new approach to teaching Normal Human Growth and Development

A new approach to teaching Normal Growth and Development to preclinical medical students is described. By using specially constructed multidisciplinary clinical simulations as training and evaluation devices, students were gradually and simultaneously exposed to: (1) subject matter; (2) the concept of multidisciplinary health care delivery; and (3) the objectives, strategies, and techniques of problem solving and diagnostic reasoning that characterize experienced physicians. The course, designed by a child psychiatrist and medical educators, was taught by a multidisciplinary teaching team drawn from faculty and health care representatives. Student evaluations of the course were favorable.     

Coping in thebarrio: Case studies of Mexican-American families

This paper reports preliminary findings of a study of coping abilities of Mexican-American families. The purpose of the study was to identify variables related to styles of behavior that can be characterized as adaptive. A complex of factors differentiated families who were judged to be dealing effectively with their environment (copers) from those who were not (noncopers). The factors included the health status of the children, various child-rearing attitudes and practices, and patterns of decision making as they related to a more general ability of parents to conceptualize and organize time.The authors wish to thank Bernard R. Cavazos and Maria Rosario de los Santos for their help in data collection and interpretation.     

Covert forms of child abuse: A preliminary study

Child abuse has generally been recognized only in its more obvious physical manifestations. The possibility of less obvious though serious forms of abuse is considered by offering a more expansive definition of child abuse, which includes a category that the investigators term covert abuse. The question is raised as to whether or not these more subtle forms of abuse result in a negative developmental outcome in the child. To answer this question, the investigators hypothesized that in the histories of young adult drug abusers, a high incidence of covert abuse would be found. To test this hypothesis, a self-report questionnaire was designed and administered to the 57 male and female residents (mean age of 20.2 years) in two facilities of a nationally based drug treatment program in the United States. As expected, it was found that the population reported a consistently high incidence of family disruption during childhood. A statistically significant relationship was demonstrated between hard-core drug abuse in the subjects and a lack of parental demonstrativeness toward each other. Results of the study suggest that overt forms of abuse are not the only types of abuse that may be developmentally destructive to a child; covert forms of abuse are possible contributors to a negative developmental outcome as well.This research was supported in part by a grant from the National Institute on Drug Abuse (N.I.D.A. DA H81 01698-02).     

Effect of lidocaine on ventricular conduction in acutely ischemic dog hearts

The effect of graded doses of lidocaine (1.25-10 mg/kg) on endocardial Purkinje and transmural conduction at different heart rates as well as during extrasystolic stimulation was studied in dogs, 30 min after ligation of the anterior descending coronary artery. The drug had no effect on endocardial conduction within the ischemic zone except at the highest dose. Transmural conduction time was increased by ischemia in only 50% of dogs. Transmural conduction time was increased further at high heart rates but not by short coupled extrasystoles. Lidocaine slowed conduction further in the ischemic myocardium by a process that was both rate and interval dependent. "Apparent" supernormal transmural conduction was observed during short coupled extrasystoles but not at fast drive rates. This phenomenon was blocked only by administration of high doses of lidocaine.     

Teaching a human sexuality course to psychiatric patients: The process,pitfalls, and rewards

A course in Human Sexuality was taught to psychiatric inpatients and outpatients enrolled in an educational treatment program at a Veterans Administration Hospital. The course both imparted factual information and created an atmosphere where the patients could discuss their feelings. The patients were helped to deal with delusions, fears, and guilt and to think about more adaptive or socially acceptable ways to express their sexuality. The patients seemed to enjoy and benefit from the course, and this response has encouraged the program to continue offering Human Sexuality courses in the future.     

In vitro studies of intragastric digestion

Following consumption of a meal, 99% of the large food particles are emptied only after intragastric fragmentation has reduced their diameter to less than 2 mm. Anin vitro model was constructed to evaluate some of the factors which may play a role in the process of intragastric digestion. Gastric mixing of food was simulated in a silicone rubber tube (ID 19 mm) placed in a peristaltic pump. Peristaltic waves progressed upwards along the tube at a frequency of 0, 1, or 3/min, reducing the internal diameter of the tube to 5 mm. Cooked chicken liver particles (2–2.8 mm in diameter) were placed in the tube with one of the following: (1) 150 mM NaCl, (2) 150 mM HCl with or without pepsin, or (3) phosphate buffer at pH 7, 5.4, or 2.6 + pepsin. After 30 min, the extent of particle reduction and of solubilization of proteins were determined and expressed as percent of the initial liver weight. The diameter of liver particles was reduced to a greater extent in NaCl than in pH 7 buffer or acid solutions with or without pepsin. In contrast, the amount of proteins solubilized was enhanced two- to threefold by acid pepsin solutions compared to NaCl or pH 7 phosphate. The presentin vitro studies suggest that changes in motor and/or secretory activity of the stomach significantly modify intragastric digestion.     

Alcohol and Sober Mood State in Female Social Drinkers

The goals of the present study were to measure the relationship between alcohol consumption in 93 female social drinkers and their cognitive functioning and mood in the sober state, and to investigate the possible causal effects of alcohol consumption on these variables. In the first test session, a limited relationship was seen between previous alcohol consumption and sober cognitive performance. A strong relationship was found between alcohol consumption and self-reported depression and anger in the sober state. Either a prolonged reduction in alcohol consumption or a prolonged maintenance of alcohol consumption was undertaken by random subsets of the original sample. In the second test session 6 weeks later, women who had been randomly selected to reduce their alcohol intake showed decreases in depression, anger, and mental confusion when they were sober, relative to women who maintained or increased their alcohol consumption over the same period of time. We found no changes in cognitive performance in these groups. We concluded that the simplest explanation of the findings is that relatively low levels of alcohol consumption produce substantial increases in depression and anger in the sober state in female social drinkers. The value of considering alcohol consumption as a continuous variable rather than a dichotomous variable with "safe" and "unsafe" zones was discussed.     

Reading, Demographic, Social and Psychological Factors Related to Pre-adolescent Smoking and Non-smoking Behaviors and Attitudes

The purpose of this study was to examine reading, demographic, social and psychological factors related to pre-adolescent smoking and non-smoking behaviors and attitudes. The school-home humanistic education program was implemented in a large, urban public school system. It stressed responsible decision-making, increased self-esteem and the inter-relationships among the acquisition of knowledge of the consequences of smoking, personal feelings, family relationships and behavior. The results showed that family involvement was necessary to affect smoking attitudes and behaviors. Of all the variables studied, reading had a most pervasive relationship. Peer influence and self-esteem also were related to smoking knowledge, smoking attitude, future smoking intentions and the "purchase" of cigarettes. Two of several conclusions drawn from the results are: 1. Family involvement is necessary to affect attitudes and behaviors. 2. Health education research that does not investigate the relationship between program outcomes and reading achievement may be misleading.