Parental substance abuse and child maltreatment : a study of child protective services

Child maltreatment continues to be a serious and prevalent issue that affects a significant portionof the population each year, and has been shown to predict negative short and long term effectson victims, and the family as a unit. Much of the literature concerning child maltreatmentfocuses on Child Protective Services (CPS), a department charged with the responsibility ofintervening in cases of child abuse and neglect. One of the responsibilities of CPS is to preventrecidivism (i.e., the reoccurrence of child maltreatment after an initial finding of neglect orabuse), which transpires in an alarming number of cases. Previous literature has focused on riskfactors of recidivism, including child and parent variables. Substance use has been identified as afactor that often, but not always, has been found to predict both maltreatment severity andrecidivism. The current study aimed to investigate the presence of both alcohol and illicitsubstance abuse in a CPS sample, and understand its relationship to abuse severity, removal fromthe home, and recidivism. Findings of this study showed that neither substance nor alcohol abusewas predictive of severity as measured by CPS. However, families where parents abused alcoholand other drugs (AOD) or just substances were more likely to be removed from the home.Additionally, this research identified substance abuse as a significant predictor in both removalfrom the home and recidivism. The results of this research may provide information into furtherinvestigation of links between substance use, child maltreatment, and other parental variables

Assessing grief, depression, and coping behaviors of women participating in in vitro fertilization embryo transfer

The infertile couple invests significant amounts of time, physical and emotional energy, and hope in attempting to conceive. Presently, the rapid development in reproductive technology provides a variety of treatments for infertility. In vitro fertilization (IVF) has been found to be an acceptable alternative for some infertile women, but the cost of IVF ranges from $6,000 to$8,000 for each treatment cycle, the probability of a successful live birth using IVF is low, and each treatment cycle is accompanied with physical and emotional side effects. Also, infertility can have deleterious effects on the emotional status of women who are unsuccessful at achieving pregnancy. This study investigated differences in the levels of grief and depression between infertile women who participated in IVF or non-IVF treatment programs and were unsuccessful in achieving pregnancy. Also, the coping strategies utilized by the participants were identified. Fifty infertile women in an IVF program and 50 infertile women in a non-IVF program completed five pretest and posttest questionnaires that measured grief and depression and identified the coping strategies utilized by the subjects to reduce emotional stress. Results of t tests comparing pretest and posttest means indicated that the level of grief associated with an unsuccessful pregnancy attempt was significantly different within the IVF treatment group and the non-IVF treatment group of women. The difference in the means on the depression scores was significant only for the non-IVF program group

A spherical model for hyperbolic geometry

To contribute to the understanding of this paper, it is necessary to make some statement about notation to be used as well as various statements which shall consistently refer to a specific idea. When we say "two points" it is implied that the points are distinct unless a statement is made to the contrary. Likewise "two lines" and "two planes" shall denote distinct lines and planes

An exploratory study of social justice education in residence life

In this dissertation, I explored how residence life professionals are teaching social justice. Using critically informed qualitative methods, I conducted semi-structured interviews with 10 student affairs professionals who are responsible for ongoing social justice-oriented initiatives in residence life. I also analyzed documents associated with these initiatives. Initiatives included living and learning communities, resident advisor courses, workshops for residents, and peer education programs. I found that personal experiences, professional preparation and development, and academic resources informed the design of these initiatives; while institutional factors, stakeholders, and human resources influenced design. The seven key behaviors for delivering these initiatives were largely consistent with critical pedagogy, even as participants did not systematically draw upon this theory, or specific other theories. While there is much to praise about the work being done, there is a need to enhance training for professional staff facilitators, incorporate assessment of the impact these initiatives are having, and reconceive the competency and value of inclusion

In vitro effects of thyroxine on the chromosomes of human lymphocytes

Thyroxine, as one of the principle hormones of the thyroid gland, plays a primary role in human growth and development, as evidenced by the plethora of molecular processes with which it has been linked. Tapley (1964) reports that it causes an increase in enzyme activity, stimulates amino acid incorporation into the proteins, produces an alteration in the rate of protein leakage from the mitochondrial membrane, and more generally, increases the basal metabolic rate. Although thyroid hormones have been linked with the stimulation of more than fifty key enzymes, the mechanism of thyroxine action still remains obscure

Electron and ion microprobe analysis of calcium distribution and transport in coral tissues.

It is shown by x-ray microanalysis that a gradient of total intracellular Ca concentration exists from the outer oral ectoderm to the inner skeletogenic calicoblastic ectoderm in the coral Galaxea fascicularis. This suggests an increase in intracellular Ca stores in relation to calcification. Furthermore, Ca concentration in the fluid-filled space of the extrathecal coelenteron is approximately twice as high as in the surrounding seawater and higher than in the mucus-containing seawater layer on the exterior of the oral ectoderm. This is indicative of active Ca2+ transport across the oral epithelium. Polyps were incubated in artificial seawater in which all 40Ca was replaced by 44Ca. Imaging Ca2+ transport across the epithelia by secondary ion mass spectroscopy (SIMS) using 44Ca as a tracer showed that Ca2+ rapidly entered the cells of the oral epithelium and that 44Ca reached higher concentrations in the mesogloea and extrathecal coelenteron than in the external seawater layer. Very little Ca2+ was exchanged in the mucocytes, cnidocytes or zooxanthellae. These observations again suggest that Ca2+ transport is active and transcellular and also indicate a hitherto unsuspected role in Ca2+ transport for the mesogloea. © 2007, Company of Biologist

Promoting Health By Strengthening Community Partnerships

Social inequities, such as employment, living conditions, and food insecurity, can adversely affect health. Our project explores the efficient integration of social determinants of health into patient care. Social determinants of health are the conditions in the environments in which people live, work, and play that impact overall wellbeing and quality of life. We propose leveraging the VCU Health system to support already existing community partnerships to improve housing access and social assistance for vulnerable populations, specifically targeting Medicare and Medicaid beneficiaries. We will connect patients to community resources to reduce health disparities, improve health outcomes, and lower costs

Generic Medications and Blood Pressure Control in Diabetic Hypertensive Subjects

OBJECTIVE To investigate temporal improvements in blood pressure (BP) control in subjects with diabetes and policy changes regarding generic antihypertensives. RESEARCH DESIGN AND METHODS In a cross-sectional study we used logistic regression models to investigate the temporal relationship between access to generic antihypertensive medications and BP control (<130/80 mmHg) in 5,375 subjects (mean age, 66 ± 9 years; 61% African American) with diabetes and hypertension (HTN) enrolled in the national Results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study between 2003 and 2007. At enrollment, BP was measured and medications in the home determined by medication label review by a trained professional. Generic antihypertensive medication status was ascertained from the U.S. Food and Drug Administration. RESULTS The percentage of subjects accessing generically available antihypertensive medications increased significantly from 66% in 2003 to 81% in 2007 (P < 0.0001), and the odds of achieving a BP <130/80 mmHg in 2007 was 66% higher (odds ratio 1.66 [95% CI 1.30–2.10]) than in 2003. Nevertheless, <50% of participants achieved this goal. African American race, male sex, limited income, and medication nonadherence were significant predictors of inadequate BP control. There was no significant relationship between access to generic antihypertensives and BP control when other demographic factors were included in the model (0.98 [0.96–1.00]). CONCLUSIONS Among African American and white subjects with HTN and diabetes, BP control remained inadequate relative to published guidelines, and racial disparities persisted. Although access to generic antihypertensives increased, this was not independently associated with improved BP control, suggesting that poor BP control is multifactorial

The Effectiveness of a Home Care Program for Supporting Caregivers of Persons with Dementia in Developing Countries: A Randomised Controlled Trial from Goa, India

OBJECTIVES: To develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. METHODOLOGY AND PRINCIPAL FINDINGS: This was a randomised controlled trial in which the person with dementia-caregiver dyad was randomly allocated either to receive the intervention immediately or to a waiting list group which received the intervention after 6 months. It was carried out in communities based in two talukas (administrative blocks) in Goa, India. Mild to moderate cases with dementia (diagnosed using the DSM IV criteria and graded using the Clinical Dementia Rating scale) and their caregivers were included in the trial. Community based intervention provided by a team consisting of Home Care Advisors who were supervised by a counselor and a psychiatrist, focusing on supporting the caregiver through information on dementia, guidance on behaviour management, a single psychiatric assessment and psychotropic medication if needed. We measured caregiver mental health (General Health Questionnaire), caregiver burden (Zarit Burden Score), distress due to behavioural disturbances (NPI-D), behavioural problems in the subject (NPI-S) and activities of daily living in the elder with dementia (EASI). Outcome evaluations were masked to the allocation status. We analysed each outcome with a mixed effects model. 81 families enrolled in the trial; 41 were randomly allocated to the intervention. 59 completed the trial and 18 died during the trial. The intervention led to a significant reduction of GHQ (-1.12, 95% CI -2.07 to -0.17) and NPI-D scores (-1.96, 95%CI -3.51 to -0.41) and non-significant reductions in the ZBS, EASI and NPI-S scores. We also observed a non-significant reduction in the total number of deaths in people with dementia in the intervention arm (OR 0.34, 95% CI 0.01 to 1.03). CONCLUSION: Home based support for caregivers of persons with dementia, which emphasizes the use of locally available, low-cost human resources, is feasible, acceptable and leads to significant improvements in caregiver mental health and burden of caring. ClinicalTrials.gov NCT00479271

Population normative data for the 10/66 Dementia Research Group cognitive test battery from Latin America, India and China: a cross-sectional survey

Background: 1) To report site-specific normative values by age, sex and educational level for four components of the 10/66 Dementia Research Group cognitive test battery; 2) to estimate the main and interactive effects of age, sex, and educational level by site; and 3) to investigate the effect of site by region and by rural or urban location. Methods: Population-based cross-sectional one phase catchment area surveys were conducted in Cuba, Dominican Republic, Venezuela, Peru, Mexico, China and India. The protocol included the administration of the Community Screening Instrument for Dementia (CSI &apos;D&apos;, generating the COGSCORE measure of global function), and the Consortium to Establish a Registry for Alzheimer&apos;s Disease (CERAD) verbal fluency (VF), word list memory (WLM, immediate recall) and recall (WLR, delayed recall) tests. Only those free of dementia were included in the analysis. Results: Older people, and those with less education performed worse on all four tests. The effect of sex was much smaller and less consistent. There was a considerable effect of site after accounting for compositional differences in age, education and sex. Much of this was accounted for by the effect of region with Chinese participants performing better, and Indian participants worse, than those from Latin America. The effect of region was more prominent for VF and WLM than for COGSCORE and WLR. Conclusion: Cognitive assessment is a basic element for dementia diagnosis. Age- and education-specific norms are required for this purpose, while the effect of gender can probably be ignored. The basis of cultural effects is poorly understood, but our findings serve to emphasise that normative data may not be safely generalised from one population to another with quite different characteristics. The minimal effects of region on COGSCORE and WLR are reassuring with respect to the cross-cultural validity of the 10/66 dementia diagnosis, which uses only these elements of the 10/66 battery.Clinical NeurologySCI(E)SSCI17ARTICLEnull