SCREENING FOR ALCOHOL AND DRUG USE AMONG PERSONS WITH DISABILITIES

People with disabilities experience many barriers when attempting to gain employment. Substance Use Disorders (SUDS) is one particular challenge that has been identified in this research paper. Individuals with SUDS experience an increase in unsucessful case closures in state funded vocational rehabilitation agencies. Screening for SUDS has been overlooked in many agencies and his paper intends to identify barriers of a screening protocal in state VR and provide recommendations for subcontracted-state comprehensive vocational evaluation programs to contribute to screening for SUDS

Pain symptomology, functional impact, and treatment of people with Neurofibromatosis type 1

Introduction: Neurofibromatosis type 1 (NF1) is a neurogenetic disorder affecting 1 in 3000 people worldwide, where individuals are prone to develop benign and malignant tumors. In addition, many people with NF1 complain of pain that limits their daily functioning. Due to the complexity of the disorder, there are few options for treating pain symptoms besides surgery and medications. Moreover, the spectrum of pain symptomatology and treatment, as well as the mechanisms underlying NF1-associated pain, has been understudied. Methodology: To address this knowledge gap, we conducted a survey of 255 adults with NF1, leveraging the Washington University NF1 Patient Registry Initiative (NPRI) database. Demographic and pain data were collected using a Qualtrics survey. Results: All participants had at least one surgical procedure, with 55% reporting having at least one surgery within the last year and 17% being currently prescribed opioid medication. A positive relationship was shown ( Conclusion: The current study demonstrates that individuals with NF1 report a higher incidence of pain severity and interference than observed in NF1 previous studies, with pain symptoms not localized to any specific region of the body. The consideration for alternative treatments and careful monitoring of current treatments that are more conservative or have less potential adverse side effects may improve pain management and reduce the risk of developing medication dependence

Alcohol-Related Cause of Spinal Cord Injury and the Impact on Service Recommendations

Healthcare professionals from whom clients might seek services should provide the best quality care regardless of biases, predispositions, worldview, and personal values. The purpose of this study was to explore how the perceived cause of spinal cord injury (SCI) affected service delivery recommendations from bachelor-level rehabilitation services trainees. Specifically, causal attribution of disability was the dependent variable in two case vignettes, one where the person was personally responsible for the cause of the SCI (i.e., driving under the influence, leading to a motor vehicle accident) and one with an external cause (i.e., motor vehicle accident caused by another driver). The impact on acute care, lifelong care, and specific specialist recommendations was assessed. There was a significant difference in the scores for external cause (M = 1.85, SD = .89) and internal cause (M = 1.4, SD = .60) of SCI and recommendation for life-long care, t(245) = 4.62, p = .000. Acute care and specialist recommendations revealed no differences. Implications for training to address attitudes are discussed

Demonstrating the validity of the Video Game Functional Assessment-Revised (VGFA-R)

Problematic video play has been well documented over the course of the last decade. So much so the DSM-5 (APA, 2013) has included problematic video gaming as disorder categorized as Internet Gaming Disorder. The field of applied behavior analysis has been utilizing functional assessments for the last 30 years and has showed evidence of effective results across different populations and environments. Therefore, the purpose of this investigation (comprising three studies) was to validate an indirect functional assessment entitled the Video Game Functional Assessment-Revised (VGFA-R). Using academic experts in the field of video game addiction and applied behavioral analysis (n=6), the first study examined the content validity of the VGFA-R and was able to demonstrate the assessment exceeded the criterion for an established assessment. A second study comprising a survey of 467 gamers examined the factorability by using a confirmatory factor analysis, and found that VGFA-R had an overall variance above .60. Within the third laboratory-based study using gamers (n=11), the VGFA-R was examined for construct validity and found the VGFA-R was able to predict 85% of the appropriate function of behavior. Implications of the study are discussed along with the strengths and limitations of the study and future research directions

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Effects of VHA Policy Directive 1163 on Acceptance and Employment Rates for Veterans with Substance Use Disorders Referred to VHA Vocational Rehabilitation

Introduction: Research has shown that Veterans with Substance/Alcohol Use Disorders (SUDs/AUDs) are at a greater risk for employment-related issues (eg, lower labor force participation rates), and interventions such as Vocational Rehabilitation (VR) have been used as a tool to reduce employment obtainment and maintenance. The purpose of the current study was to evaluate acceptance rates and employment rates at closure for Veterans with SUDs/AUDs prior to the implementation of VHA Policy Directive 1163 (mandated that Veterans are not refused services based on prior or current SUD/AUDs). SUD/AUDs were coded to reflect DSM 5-TR criteria of active use and in-remission. Methods: Data from a VHA Vocational Rehabilitation program in the Veterans Integrated Service Network 12 network were obtained for the purpose of the current study. Results: Findings showed that Veterans with AUDs were less likely to be accepted for VR services prior and after implementation of VHA Policy Directive 1163. Conclusions: When examining active and inactive SUDs/AUDs, findings showed that implementation of VHA Policy Directive 1163 was not effective for Veterans with AUDs. One factor that was not explored but could explain disparities in program acceptance rates is duration of program entry. If a Veteran has a consult placed for VHA Vocational Rehabilitation services, and their program entry date (date accepted) is a significant duration, then perhaps Veterans with active AUDs start drinking again given that they are waiting for vocational assistance. Thus, it would be important to assist Veterans with active AUDs into services in a timely manner (perhaps prior them being discharged from SUD treatment)