Alcohol burden in low-income and middle-income countries

Child maltreatment in low- and middle-income countries overburdens health systems, compromises education, perpetuates gender inequalities and slows down development. Research suggests that parenting programmes are effective for the early prevention of child maltreatment. However, wide deployment in LMICs where violence towards children is high is yet to take place. In this overview article, we identify some critical challenges that LMICs currently face in ensuring the sustained implementation of parenting programmes for the early prevention of child maltreatment. The article is structured in three main sections: (1) a brief review of the effectiveness of parenting programmes for preventing child maltreatment; (2) a discussion of the critical challenges in LMICs for the widespread and sustained implementation of parenting programmes; and (3) we propose recommendations to promote effective implementation in these countries. We also suggest a series of steps to overcome these challenges, such as investing on capacity-building for sustainability

Plans for the next GRAPE balloon flight

The Gamma RAy Polarimeter Experiment (GRAPE) was first flown on a 26-hour balloon flight in the fall of 2011. GRAPE consists of an array of Compton polarimeter modules (based on traditional scintillation technologies) designed to operate in the energy range from 50 keV up to 500 keV. The ultimate goal is to operate GRAPE in a wide FoV configuration for the study of gamma-ray bursts. For the first (demonstration) balloon flight, GRAPE was configured in a collimated mode to facilitate observations of known point sources. The Crab nebula/pulsar, the active Sun, and Cygnus X-1 were the primary targets for the first flight. Although the Crab was detected, the polarization sensitivity was worse than expected. This paper will review the plans for the next GRAPE balloon flight, which is scheduled to take place in the fall of 2014 from Ft. Sumner, NM. These plans involve several modifications designed to improve the polarization sensitivity, including an expansion of the array of polarimeter modules from 16 to 24 and improvements to the instrument shielding. Sensitivity estimates of the resulting instrument, based on GEANT4 simulations, will be presented

Consistency of the Health of the Nation Outcome Scales (HoNOS) at inpatient-to-community transition

OBJECTIVES: The Health of the Nation Outcome Scales (HoNOS) are mandated outcome-measures in many mental-health jurisdictions. When HoNOS are used in different care settings, it is important to assess if setting specific bias exists. This article examines the consistency of HoNOS in a sample of psychiatric patients transitioned from acute inpatient care and community centres. SETTING: A regional mental health service with both acute and community facilities. PARTICIPANTS: 111 psychiatric patients were transferred from inpatient care to community care from 2012 to 2014. Their HoNOS scores were extracted from a clinical database; Each inpatient-discharge assessment was followed by a community-intake assessment, with the median period between assessments being 4 days (range 0-14). Assessor experience and professional background were recorded. PRIMARY AND SECONDARY OUTCOME MEASURES: The difference of HoNOS at inpatient-discharge and community-intake were assessed with Pearson correlation, Cohen\u27s κ and effect size. RESULTS: Inpatient-discharge HoNOS was on average lower than community-intake HoNOS. The average HoNOS was 8.05 at discharge (median 7, range 1-22), and 12.16 at intake (median 12, range 1-25), an average increase of 4.11 (SD 6.97). Pearson correlation between two total scores was 0.073 (95% CI -0.095 to 0.238) and Cohen\u27s κ was 0.02 (95% CI -0.02 to 0.06). Differences did not appear to depend on assessor experience or professional background. CONCLUSIONS: Systematic change in the HoNOS occurs at inpatient-to-community transition. Some caution should be exercised in making direct comparisons between inpatient HoNOS and community HoNOS scores

Craving mediates the effect of impulsivity on lapse-risk during alcohol use disorder treatment

Rash impulsiveness, the propensity for approach behaviour despite potential negative consequences, is associated with stronger alcohol craving in patients with Alcohol Use Disorder (AUD). This relationship is poorly understood and implications for treatment response are unexamined. This study explored the relationship between rash impulsiveness, craving, and treatment response among 304 outpatients enrolled in a 12-week abstinence-based Cognitive-Behavioural Therapy (CBT) program for AUD. Assessments were completed pre-and-post treatment, with craving and alcohol consumption monitored at each treatment session. Higher rash impulsiveness predicted more frequent craving over treatment (b = 0.95, 95% CI = 0.40, 1.50). Higher craving was associated with greater lapse-risk (b = 0.04, 95% CI = 0.03, 0.05), with the association between craving and lapse-risk increasing as treatment progressed (b = 0.01, 95% CI = 0.01, 0.02). Craving positively mediated the relationship between rash impulsiveness and lapse-risk (µ = 0.38, 95% CI = 0.10, 0.70). Contrary to hypotheses, the risk of lapse in response to craving was not moderated by rash-impulsiveness. These results suggest that AUD patients with a predisposition for rash impulsiveness are more vulnerable to alcohol craving, and subsequently, poorer treatment outcomes

The topography of multiple drug use among adolescent Australians: findings from the National Drug Strategy Household Survey

Introduction and aims: Despite evidence that many Australian adolescents have considerable experience with various drug types, little is known about the extent to which adolescents use multiple substances. The aim of this study was to examine the degree of clustering of drug types within individuals, and the extent to which demographic and psychosocial predictors are related to cluster membership

Additive effectiveness of mindfulness meditation to a school-based brief cognitive-behavioral alcohol intervention for adolescents

This randomized controlled trial is the 1st study to evaluate the additive efficacy of mindfulness meditation to brief school-based universal cognitive behavior therapy (CBT + MM) for adolescent alcohol consumption. Previous studies have lacked strong controls for nonspecific effects, and treatment mechanisms remain unclear. The present study compared a CBT + MM condition to an active control CBT intervention with progressive muscle relaxation (CBT + PMR) for nonspecific effects and an assessment-only control (AoC).Cluster sampling was used to recruit Australian adolescents ( = 404; 62% female) ages 13-17 years ( = 14.99, = .66) of mostly Australian-New Zealand or European descent. School classes were randomized to 3 intervention conditions (CBT + PMR = 8 classes, CBT + MM = 7 classes, AoC = 7 classes), and adolescents completed preintervention, postintervention, and 3- and 6-month follow-up assessments, including measures of alcohol consumption, mindfulness, impulsivity, and the alcohol-related cognitions of alcohol expectancies and drinking refusal self-efficacy.Multilevel modeling analyses revealed that both intervention conditions reduced the growth of alcohol consumption compared to the AoC ( = -.18, = .014), although CBT + MM was no more effective than was CBT + PMR ( = -.06, = .484). Negative alcohol expectancies increased for adolescents in the intervention conditions compared to the AoC ( = 1.09, = .012), as did positive alcohol expectancies ( = 1.30, = .008). There was no effect of interventions on mindfulness, drinking refusal self-efficacy, or impulsivity.There was no evidence of mindfulness-specific effects beyond existing effects of CBT within a brief universal school-based CBT intervention. Hypothesized mechanisms of change were largely unsupported. (PsycINFO Database Record (c) 2019 APA, all rights reserved)