Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context

Ertl V, Saile R, Neuner F, Catani C. Drinking to ease the burden: a cross-sectional study on trauma, alcohol abuse and psychopathology in a post-conflict context. BMC Psychiatry. 2016;16(1): 202.Background It is likely that alcohol use and abuse increase during and after violent conflicts. The most prominent explanation of this phenomenon has been referred to as self-medication hypothesis. It predicts that psychotropic substances are consumed to deal with conflict-related psychic strains and trauma. In northern Uganda, a region that has been affected by a devastating civil war and is characterized by high levels of alcohol abuse we examined the associations between war-trauma, childhood maltreatment and problems related to alcohol use. Deducing from the self-medication hypothesis we assumed alcohol consumption moderates the relationship between trauma-exposure and psychopathology. Methods A cross-sectional epidemiological survey targeting war-affected families in post-conflict northern Uganda included data of male (n = 304) and female (n = 365) guardians. We used standardized questionnaires in an interview format to collect data on the guardians’ socio-demography, trauma-exposure, alcohol consumption and symptoms of alcohol abuse, PTSD and depression. Results Symptoms of current alcohol use disorders were present in 46 % of the male and 1 % of the female respondents. A multiple regression model revealed the unique contributions of emotional abuse in the families of origin and trauma experienced outside the family-context in the prediction of men’s alcohol-related symptoms. We found that alcohol consumption moderated the dose-effect relationship between trauma-exposure and symptoms of depression and PTSD. Significant interactions indicated that men who reported more alcohol-related problems experienced less increase in symptoms of PTSD and depression with increasing trauma-exposure. Conclusions The gradual attenuation of the dose-effect the more alcohol-related problems were reported is consistent with the self-medication hypothesis. Hence, the functionality of alcohol consumption has to be considered when designing and implementing addiction treatment in post-conflict contexts

Clinical pharmacology consultation: a better answer to safety issues of drug therapy during pregnancy?

PURPOSE: drug safety classifications give a very basic estimation of risk and should only be used as general guideline when assessing risk of pregnancy-related drug exposure or planning treatment. We conducted a study to assess the strength of association between both the clinical pharmacologists' risk assessment and the FDA risk categorization, and adverse pregnancy outcomes. ----- METHODS: we retrospectively reviewed records of 1,076 patients consecutively referred to the clinical pharmacology outpatient clinic for pregnancy-related drug exposure (2000-2008). Clinical pharmacologists' risk assessments were reviewed in relation to FDA drug categorization and available pregnancy outcomes. ----- RESULTS: overall, clinical pharmacologists' risk estimation was in agreement with the FDA risk categorization system in only 28% of consulted women, and in only 9% of women with high-risk exposure (FDA DX). Clinical pharmacologists' risk assessment confirming high-risk drug exposure had a better positive predictive value for adverse pregnancy outcomes than the FDA DX categorization (25% vs 14% respectively), while the negative predictive values were similar (92% vs 94% respectively). Clinical pharmacologists' risk assessment was a better predictor of adverse pregnancy outcomes compared with FDA risk categorization (OR 2.11 [95%CI 1.5-3.1; p < 0.001] vs OR 1.52 [95%CI 1.1-2.1; p = 0.014] respectively). ----- CONCLUSIONS: additional evaluation beyond the FDA drug classification is essential for safer and more rational drug use in pregnancy. Clinical pharmacologists who have undergone rigorous medical training are ideally placed to consult on administration of medicines in pregnant women, thus making the prescribing of treatments in that patient category substantially safer and more rational

Summer brood interruption as integrated management strategy for effective Varroa control in Europe

Most Varroa induced colony losses occur during the autumn or winter season as a consequence of an elevated Varroa infestation level and an insufficient health status of the adult bees. Even with an initial low Varroa infestation in early spring, critical mite and virus infection levels can be reached before winter if colonies continuously rear brood throughout the whole season. To overcome this challenge, beekeepers can artificially interrupt brood production by suitable management procedures, depending on their type of beekeeping operation. To assess their efficacy, associated workload, and impact on colony development, different methods for brood interruption (queen caging with the combination of oxalic acid treatment, total brood removal, trapping comb technique) were tested during two seasons in 11 locations on 370 colonies in 10 European countries. A protocol was developed to standardize the methods' application across different environmental conditions. The efficacy of queen caging depended on the mode of oxalic acid application and ranged from 48.16% to 89.57% mite removal. The highest efficacies were achieved with trickling a 4.2% solution (89.57%) and with the sublimation of 2 g of oxalic acid (average of 88.25%) in the broodless period. The efficacy of the purely biotechnical, chemical-free trapping comb and brood removal methods did not differ significantly from the queen caging groups. We conclude that a proper application of one of the described brood interruption methods can significantly contribute to an efficient Varroa control and to the production of honey bee products meeting the highest quality and food-safety standards

Conservative and endodontic treatment performed under general anesthesia: A discussion of protocols and outcomes

International audienc

Categorization of everyday sounds by cochlear implanted children

International audienceAuditory categorization is an important process in the perception and understanding of everyday sounds. The use of cochlear implants (CIs) may affect auditory categorization and result in poor abilities. The current study was designed to compare how children with normal hearing (NH) and children with CIs categorize a set of everyday sounds. We tested 24 NH children and 24 children with CI on a free-sorting task of 18 everyday sounds corresponding to four a priori categories: nonlinguistic human vocalizations, environmental sounds, musical sounds, and animal vocalizations. Multiple correspondence analysis revealed considerable variation within both groups of child listeners, although the human vocalizations and musical sounds were similarly categorized. In contrast to NH children, children with CIs categorized some sounds according to their acoustic content rather than their associated semantic information. These results show that despite identification deficits, children with CIs are able to categorize environmental and vocal sounds in a similar way to NH children, and are able to use categorization as an adaptive process when dealing with everyday sounds. When an infant is identified as having profound-to-total bilateral hearing loss, the surgical implantation of coch-lear implants (CIs) is envisaged as a means of restoring his or her access to auditory information. The benefits of CIs for speech perception in children with prelingual hearing loss have been widely documented over the past three decades, resulting in an extension of prescription criteria 1,2. One of the greatest proven benefits of CIs is speech comprehension 3,4. Alongside improvements in oral language skills, speech comprehension is seen as one of the key objectives of rehabilitation with CIs. A CI does not function in the same manner as a conventional hearing aid (i.e., by contributing to the amplification of sounds). Instead, it turns sounds into trains of electrical pulses that directly stimulate the auditory nerve. This information is then relayed to the auditory centres of the brain, which in turn transform the impulses into auditory percepts. However, the auditory information provided by the implant is spectrally degraded 5 and lacks the fine spectrotemporal information that is crucial to certain aspects of speech comprehension-most notably the perception of prosodic information 6-9. This means that other aspects of auditory perception are also problematic for CI users, such as the identification and recognition of environmental and musical sounds. Development of nonlinguistic sound perception The recovery and/or development of speech comprehension is normally seen as the main goal of CI implantation. Accordingly, only limited attention has been paid to the perception of nonlinguistic sounds in CI users. For example, whilst CIs may enhance users' awareness of their immediate auditory environment 10 , a substantial deficit remains in the perception and identification of specific environmental sounds 11-13 , that is, those not classified as speech or music. This deficit has a negative impact on how CI users interact with their environment, and it is therefore important for more studies to be conducted on this topic. To our knowledge, the identification of nonlinguistic sounds by implanted adults with postlingual deafness has only been reported in a small number of studies 11-15. There have been even fewer studies among children with CIs 16,17. Furthermore, owing to a lack of standardized protocols for assessing auditory performance and the use of different evaluation procedures (open-set or closed-set identification assessments, written words or images