COPYIR—The Ocean City Experience

Abstract

The Addiction Severity Index is a popular research and clinical tool for the characterization of individuals grappling with substance abuse problems. For research, use of the seven objectively calculated composite scores of problem severity is recommended. In contrast, clinical use of the instrument relies more upon its subjectively derived interviewer and client severity rating scores. However, little systematic research has looked at the comparability of these two sources of client data. This study compared the objec tive and subjective scores of the ASI of male (n=141) and female (n=58) clients entering substance abuse treatment. In addition, clients' narratives about their most worrisome problems were recorded and put to content analyses. While significant correlations were found among the various subjective indices, little relationship could be discerned between the objective composite scores and any of the subjective indices derived from either the ASI or the clients' narratives. As the focus of outcome research shifts from objective client and treatment characteristics to a better understanding of the process of intervention, empirical characterization of substance abuse treatment outcome may be enriched by the inclusion of subjective data that taps into the client's own perceptions of problems and treatment efficacy in addition to more objective sources of data.     

Towards the automatic computational assessment of enlarged perivascular spaces on brain magnetic resonance images: A systematic review

Enlarged perivascular spaces (EPVS), visible in brain MRI, are an important marker of small vessel disease and neuroinflammation. We systematically evaluated the literature up to June 2012 on possible methods for their computational assessment and analyzed confounds with lacunes and small white matter hyperintensities. We found six studies that assessed/identified EPVS computationally by seven different methods, and four studies that described techniques to automatically segment similar structures and are potentially suitable for EPVS segmentation. T2‐weighted MRI was the only sequence that identified all EPVS, but FLAIR and T1‐weighted images were useful in their differentiation. Inconsistency within the literature regarding their diameter and terminology, and overlap in shape, intensity, location, and size with lacunes, conspires against their differentiation and the accuracy and reproducibility of any computational segmentation technique. The most promising approach will need to combine various MR sequences and consider all these features for accurate EPVS determination. J. Magn. Reson. Imaging 2013;38:774–785. © 2013 Wiley Periodicals, Inc.     

Three Meals a Day is Passé at Progressive Hospital

Modern medical simulation technology (MST) debuted in 1960 with the development of Resusci Annie (Laerdal 2007), which assisted students in the acquisition of proper ventilation and compression techniques used during basic life support. Following a steady stream of subsequent technological advances and innovations, MST manufacturers are now able to offer training aids capable of facilitating innovative learning in such diverse areas as human patient simulators, simulated clinical environments, virtual procedure stations, virtual medical environments, electronic tutors, and performance recording. The authors list a number of the most popular MSTs presently available while citing evaluative efforts undertaken to date regarding the efficacy of MST to the medical profession. They conclude by proposing a variety of simulation innovations of prospective interest to both medical and technology personnel while offering healthcare administrators a series of recommended considerations when planning to integrate MST into existing medical systems.     

Familial Resemblance of Blood Pressure and Body Weight

Familial resemblance of blood pressure (BP) was studied in 545 families of which 370 included natural children, 24 adopted children and 151 both natural and adopted children. Mean values of four automatic BP measurements (Dinamap 845) were converted into age (adult) or height (children) and sex adjusted scores. BP was compared between parents and randomly chosen index children. A significant resemblance of BP was observed between natural children and their parents: r = 0.24 for systolic BP, r = 0.29 for diastolic BP, (n = 272 p > 0.05). BP of adopted children did not resemble that of their foster parents except for a significant correlation to BP of the adopting mothers (n = 46). Weight, heart rate, age and time of common life shared did not influence the results. The relative contribution of genetic and common environmental factors to BP correlation between family members could not be evaluated in this study. BP of children whose parents have high BP should be monitored regularly.     

Psychotherapy Borealis

In January 1987 the somatic health, psychiatric behaviour, and social adjustment of 23 chronic mental hospital patients at Ralambshov's Hospital, aged 18–45 years, were studied. Most of the patients were single schizophrenic men who had received an average of 7 years of mental hospital care. Most of the patients belonged to a low-income group but had adequate housing. The percentage of patients with working-class backgrounds was not greater than that in their immediate environment. Most members of the group, however, did have unstable family background and limited education and were socially isolated.     

An Evaluation of Operant Behavioural Economics in Functional Communication Training for Severe Problem Behaviour

ABSTRACT

Objective: This single-case experiment examined the use of behavioural economic concepts in a function-based treatment for problem behaviour.

Methods: Behavioural economic analyses were used to evaluate the strength of functions of problem behaviour and this information was used to inform elements of function-based treatment for one child with a neurodevelopmental disorder.

Results: Findings from this experiment indicated that the incorporation of behavioural economic measures resulted in positive treatment effects that were maintained throughout all phases of the evaluation, including those implemented by caregivers.

Conclusions: These results suggest that behavioural economic concepts and procedures can be successful adjuncts to evidence-based assessments and treatments for problem behaviour.     

Conceptions of Risk in the Lives of Club Drug-Using Youth

This paper describes current patterns of club drug use and local conceptions of risk among New York City area youth. The data is drawn from a NIDA-funded ethnographic study of club drug initiation among “Bridge and Tunnel” youth. The paper entails an examination of the harmony and discontinuity between folk models of risk within this population and professional models of risk. The author explores how club drug-using youth conceive of risks related to club drug use, specifically ecstasy, and how such conceptions compare and contrast with current professional models of risk. These conceptions of risk are crucial to understand, as they form an informal logic by which club drug practices are guided. Ultimately, the author examines how the relationship between folk models and professional models might inform health promotion efforts targeting youth.     

Project Towards No Drug Abuse (TND): Needs Assessment of a Social Service Referral Telephone Program for High Risk Youth

The purpose of this study was to conduct a needs assessment of a potential social service resource telephone program component among high risk youth who received the Project Towards No Drug Abuse (TND) classroom-based program (approximately 1 year earlier). Results supported youths' overwhelming receptiveness of a social service referral program. The vast majority of respondents indicated a strong desire for resource and referral information on vocational, educational, recreational, transportation, and mental health and drug counseling. Further research is needed to investigate the effectiveness of the provision of social service resource information on drug use among emerging adults.     

Arsenic exposure and tobacco consumption: Biomarkers and risk assessment

Arsenic is measurable in tobacco and cigarette mainstream smoke (MSS). Whether arsenic has an independent role in diseases associated with tobacco consumption is not known. Epidemiology and biomonitoring data and probabilistic risk assessment (PRA) methods were used to investigate this potential association. Analysis of data from the National Health and Nutrition Examination Survey (NHANES) showed that urine arsenic concentrations in tobacco consumers were not different or were lower than levels in non-consumers of tobacco. Additionally, urine arsenic levels from NHANES tobacco consumers were five-times or more lower than levels reported in epidemiology studies to be associated with adverse health effects. Results of PRA indicated that mean non-cancer hazard estimates and mean incremental lifetime cancer risk estimates were within accepted ranges. Taken together, these results suggest that arsenic may not be independently associated with tobacco consumption or diseases related to tobacco consumption.