A Multidimensional Model for the Research and Treatment of Alcoholism

It was thought that several motivational theories might explain heroin use and account for the heterogeneity of personality traits found in the addict population. Greaves' existential theory and McClelland et al.'s conceptualization of the power motive were examined. These theories were operationalized and then compared with groups of addicts, alcoholics, and medical patients in a VA hospital. None of the hypotheses derived from the existential theory were supported. The power motivation theory gained considerable support in that addicts exhibited greater power concerns than the medical patients. It was found that addicts manifested an avoidance style of power concerns while the alcoholics showed more impulsive power strivings.     

Ignoring ‘downstream infection’ in the evaluation of harm reduction interventions for injection drug users

Harm reduction interventions to reduce blood-borne disease incidence among injection drug users (IDUs). A common strategy to estimate the long-term impact of such interventions is to examine short-term incidence changes within a specific group of individuals exposed to the intervention. Such evaluations may overstate or understate long-term program effectiveness, depending upon the relationship between short-term and long-term incidence and prevalence. This short paper uses steady-state comparisons and a standard random-mixing model to scrutinize this evaluation approach. It shows that evaluations based upon short-term incidence changes can be significantly biased. The size and direction of the resulting bias depends upon a simple rule. For modest interventions, such analyses yield over-optimistic estimates of program effectiveness when steady-state disease prevalence exceeds 50% absent intervention. When steady-state prevalence is below 50%, such analyses display the opposite bias.     

Drug Addiction in East Africa

Forty-six habitual users of cannabis, who had been treated for psychosis during the years 1966-1970, were reported following an inquiry sent to Swedish psychiatric clinics and mental hospitals. Twenty-four of these cases had had psychotic episodes generally lasting 1-5 weeks, whereas 22 cases were running a chronic course. In 14 chronic cases an endogenous psychosis seemed to have been present before the drug debut. Seven of these showed a marked aggravation of the psychotic symptoms during periods of cannabis abuse. Eight cases of chronic psychosis occurred in earlier nonpsychotic subjects.

Thirty cases occurred in formerly nonpsychotic individuals, though 23 of them had shown psychoneurotic traits. In seven of these, relapse into a second psychotic episode occurred following renewed cannabis abuse. The symptomatology reminded one of schizophrenic or manic-depressive endogenous psychoses in most instances, but confusional states were also seen. Evidence supporting the existence of a cannabis-induced psychosis has been discussed.     

Demarginalizing the marginalized in substance abuse treatment: Stories of homeless,active substance users in an urban harm reduction based drop-in center

This article reports stories of demarginalization in treatment as told by participants of a nonabstinence-based treatment program based on a harm reduction model targeting homeless active users. The stories told are ones where drug users–marginalized due to their drug and/or alcohol use–experienced the treatment setting in a destigmatizing, normalizing, humanizing and nonjudgmental manner. The purpose of this article is to describe the sense of demarginalization that participants experienced and to posit that demarginalization is a critical component in engaging “hard-to-reach” populations in substance abuse treatment. It assumes that listening to consumer voices about what is/is not meaningful to them in treatment can reveal much about program uptake or disconnect.     

过期妊娠54例临床分析

目的 提高对过期妊娠危害性的认识，减少围生儿的发病率和病死率。方法 将54例过期妊娠定为研究组，随机抽取同期待产妇54例作为对照组。对两组年龄、胎次、病人来源、对围生儿的影响及分娩方式进行比较、分析。结果 两组在年龄、胎次上差异有显著意义(P＜0．05)；农村过期妊娠的发生率高于城市，差异有非常显著意义(P＜0．01)；研究组难产发生率明显高于对照组，剖宫产率达61．1％，两组差异有非常显著意义(P＜0．01)。结论 过期妊娠对母婴危害大，应加强孕期保健工作，采取适宜的干预措施。     

No association between 5-HTTLPR and harm avoidance in Korean college students

There have been numerous studies on the association between 5-HTTLPR (polymorphisms in the promoter region of the serotonin transporter gene) and anxiety-related personality traits, with conflicting results. In this study, we administered Korean version of the Temperament and Character Inventory (K-TCI) to a sample of 158 Korean college students and genotyped for the 5-HTTLPR in order to compare the TCI dimensional scores including harm avoidance according to the 5-HTTLPR genotype and sex. We could not find the association between 5-HTTLPR and harm avoidance and other TCI measures. Considering known allele frequencies differences of 5-HTTLPR among different ethnic groups, further cross-cultural studies with a larger sample would be needed.     

General justifications for public health regulation

Convention holds that government intervention designed to promote population health and well-being is an unmitigated good. However, government should justify interventions because, almost invariably, they intrude on individual rights and interests and incur economic costs. This paper presents three general justifications for government intervention: (1) risk to others; (2) protection of incompetent people; and (3) risk to self. The first justification is the standard, well-accepted idea that government may intervene to prevent harm to others or punish individuals for inflicting harm. The second justification supports government action to protect the health and safety of those who are incapable of safeguarding their own interests. The third justification, and by far the most controversial, is paternalism; the protection of the health or safety of competent individuals irrespective of their own expressed wants or desires. This paper argues that the government gains the greatest legitimacy when regulating for the protection of harms to others, but even paternalism can support state action when health risks are socially embedded and harmful to the public.