FAMILY COURT REVIEW, Issue 1 2009
Jonathan Scher
Acknowledging the rapid growth of child sexual abuse in the United States, this Note advocates for the recognition of a limited exception to the blanket-hearsay ban on out-of-court statements made by unavailable declarants set out by the Supreme Court in Crawford v. Washington. In order to protect a criminal defendant's Sixth Amendment confrontation right, Crawford requires that hearsay evidence that is "testimonial" in nature be deemed inadmissible if the witness is unavailable and the defendant does not have a prior opportunity to cross-examine the witness against him. However, Crawford noted that, where nontestimonial hearsay is at issue, cross-examination may not be necessary. Accordingly, where a child sexual abuse victim makes statements during a structured or semi-structured forensic interview to a member of a multidisciplinary team, these statements should be deemed nontestimonial and thus admitted into evidence, without requiring cross-examination of the child. Allowing for this exception to the general hearsay ban in Crawford is not only consistent with current precedent, but it is also warranted to promote public policy and to curb the negative impact such abuse has on society. [source]

CHILD CUSTODY LITIGATION: ALLEGATIONS OF CHILD SEXUAL ABUSE BY KATHRYN KUEHNLE AND LESLIE DROZD

FAMILY COURT REVIEW, Issue 4 2007
Hon. Arline Rotman
No abstract is available for this article. [source]

SEXUAL ABUSE AND DEMENTIA IN OLDER PEOPLE

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2006
Ann W. Burgess DNSC
No abstract is available for this article. [source]

USE AND ABUSE OF LASERS IN PERIODONTICS

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 6 2005
Edward P. Allen DDS
[source]

THE INTIMATE JUSTICE SCALE: AN INSTRUMENT TO SCREEN FOR PSYCHOLOGICAL ABUSE AND PHYSICAL VIOLENCE IN CLINICAL PRACTICE

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2004
Brian Jory
This article describes development of the Intimate Justice Scale (IJS) and reports on a clinical study of the validity, reliability, and clinical usefulness of the instrument. Rather than measuring specific acts of abuse, the IJS measures ethical dynamics of couple relationships, which areevident in patterns of action and attitude expressed over the course of the relationship. Ethical dynamics appear to correlate with partner abuse. The study suggests that the IJS may reliably identify victims of abuse and may discriminate between minor and severe levels of abuse. The IJS can be completed and scored in less than 10 min and may be useful for screening in mental health, medical, and social service agencies. Clinical guidelines and a case example are presented. [source]

PARTNER AWARENESS REGARDING THE ADULT SEQUELAE OF CHILDHOOD SEXUAL ABUSE FOR PRIMARY AND SECONDARY SURVIVORS

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 2 2003
Noelle S. Wiersma
This qualitative study investigates factors that may facilitate or impede awareness within couples regarding the sequelae of chuildhood sexual abuse for adult females and their partner. Six couples were interviewed about perceived effects of the abuse for self and partner and their perceptions regarding their awareness of these effects. Transcribed data were analyzed using grounded-theory methodolgy. Emergent themes regarding potential barriers to and facilitators of agreement are outlined in the context of the expressive and receptive abilities and motivations of each partner in communicating about the abuse. Preliminary implications for marriage and family therapy and further research are provided. [source]

COUPLES THERAPY FOR WOMEN SURVIVORS OF CHILD SEXUAL ABUSE WHO ARE IN ADDICTIONS RECOVERY: A COMPARATIVE CASE STUDY OF TREATMENT PROCESS AND OUTCOME

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2001
Barry Trute
Treatment for women who are survivors of child sexual abuse and who have a history of substance abuse has largely involved gender-specific interventions. This study examines the use of conjoint couple therapy with a cohort of women who were survivors of child sexual abuse and who are in addiction recovery and with their partners. A comparative case study analysis incorporated standardized clinical measures with client and therapist interviews. Brief conjoint therapy was found to assist couples in the specific relationship skill areas of communication and mutual problem solving. Further, substantive gains were found in the realm of affective relations. The women reported an increase in support from their male partners, and the men reported a decrease in negative emotional atmosphere in the relationship. [source]

ABUSE OF POWER: ANDREW JACKSON AND THE INDIAN REMOVAL ACT OF 1830

THE HISTORIAN, Issue 6 2003
Alfred A. Cave
First page of article [source]

Juramentos AND Mandas: TRADITIONAL CATHOLIC PRACTICES AND SUBSTANCE ABUSE IN MEXICAN COMMUNITIES OF SOUTHEASTERN PENNSYLVANIA

ANNALS OF ANTHROPOLOGICAL PRACTICE, Issue 1 2009
Víctor García
This article describes the use of traditional Catholic beliefs and practices by Mexican sojourners in southeastern Pennsylvania to deal with and overcome substance abuse. Two practices in particular are the focus: juramentos and mandas. Juramentos are ritual promises to a saint, made by a drinker or drug user, to abstain from drinking or using drugs; whereas mandas are requests or pleas for divine intervention in protecting a loved one from dangers, including from substance abuse, made by the wives and mothers of the substance users. These religious practices were observed and studied while conducting alcohol and drug abuse research in southeastern Pennsylvania and teaching an ethnographic field school in Mexican sending communities to this region of the United States. [source]

THE ABSURDITY OF THE USE OF ,ALCOHOL ABUSE'

ADDICTION, Issue 1 2009
DAVID MARJOT
No abstract is available for this article. [source]

Alcohol and injuries: a review of international emergency room studies since 1995

DRUG AND ALCOHOL REVIEW, Issue 2 2007
CHERYL J. CHERPITEL
Abstract This paper provides a review of emergency room (ER) studies on alcohol and injury, using representative probability samples of adult injury patients, and focuses on the scope and burden of the problem as measured by estimated blood alcohol concentration (BAC) at the time of the ER visit, self-report drinking prior to injury, violence-related injury and alcohol use disorders. A computerized search of the English-language literature on MEDLINE, PsychINFO and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol and Alcohol Problems Science Database (ETOH) was conducted for articles published between 1995 and 2005, using the following key descriptors: (1) emergency room/emergency department/accident and emergency, (2) alcohol/drinking and (3) injuries (intentional and unintentional). Findings support prior reviews, with injured patients more likely to be positive for BAC and report drinking prior to injury than non-injured, and with the magnitude of the association substantially increased for violence-related injuries compared to non-violence-related injuries. Indicators of alcohol use disorders did not show a strong association with injury. Findings were not homogeneous across studies, however, and contextual variables, including study-level detrimental drinking pattern, explained some of the variation. This review represents a broader range of ER studies than that reported previously, across both developed and developing countries, and has added to our knowledge base in relation to the influence of contextual variables on the alcohol-injury relationship. Future research on alcohol and injury should focus on obtaining representative samples of ER patients, with special attention to both acute and chronic alcohol use, and to organisational and socio-cultural variables that may influence findings across studies. In-depth patient interviews may also be useful for a better understanding of drinking in the injury event and associated circumstances. [source]

From scrubland to vintage wine: Australia's response to substance-related problems in the last 40 years,

DRUG AND ALCOHOL REVIEW, Issue 3 2003
FAChAM (Hon), FAFPHM, FRACP, FRCPC, Professor JAMES G. RANKIN MB
Abstract Over the last 40 years Australia's response to substance-related problems compared with most western nations has been outstandingly good. Since the 1960s concerns about problems of substance use have expanded from a focus on alcohol to include tobacco and a wide range of other licit as well as illicit psychoactive substances. During this period there have been major advances in our knowledge and understanding of substance-related problems and effective methods of prevention, intervention and treatment. In parallel has been the development of a large number of non-government, government and professional organizations concerned with problems of substance use. These groups, individually and collectively, have contributed to the development of policies, plans, resources and programmes to prevent and minimize substance-related harm. Although significant progress in these endeavours took place between 1960 and 1986, there has been accelerated growth since and largely as a result of the establishment of the National Campaign Against Drug Abuse in 1986 and the ensuing National Drug Strategy and the Illicit Drug Strategy. However, much of this more recent success was possible because of the existence of the organizations, networks and infrastructures established in the earlier period and the Nation's general health, social and educational programmes. These initiatives have been associated with reductions in alcohol and tobacco use and related problems and evidence of reductions in some problem areas associated with illicit drug use. Despite these gains, there have been areas of failure and missed opportunities. Finally, it is critical to ensure that past achievements and opportunities for continued successful initiatives are not undermined by identifiable impediments and risks that could imperil the philosophy, goals, infrastructure and programmes that form the basis for Australia's success to date. [source]

Do ,9 -tetrahydrocannabinol concentrations indicate recent use in chronic cannabis users?

ADDICTION, Issue 12 2009
Erin L. Karschner
ABSTRACT Aims To quantify blood ,9 -tetrahydrocannabinol (THC) concentrations in chronic cannabis users over 7 days of continuous monitored abstinence. Participants Twenty-five frequent, long-term cannabis users resided on a secure clinical research unit at the US National Institute on Drug Abuse under continuous medical surveillance to prevent cannabis self-administration. Measurements Whole blood cannabinoid concentrations were determined by two-dimensional gas chromatography-mass spectrometry. Findings Nine chronic users (36%) had no measurable THC during 7 days of cannabis abstinence; 16 had at least one positive THC ,0.25 ng/ml, but not necessarily on the first day. On day 7, 6 full days after entering the unit, six participants still displayed detectable THC concentrations [mean ± standard deviation (SD), 0.3 ± 0.7 ng/ml] and all 25 had measurable carboxy-metabolite (6.2 ± 8.8 ng/ml). The highest observed THC concentrations on admission (day 1) and day 7 were 7.0 and 3.0 ng/ml, respectively. Interestingly, five participants, all female, had THC-positive whole blood specimens over all 7 days. Body mass index did not correlate with time until the last THC-positive specimen (n = 16; r = ,0.2; P = 0.445). Conclusions Substantial whole blood THC concentrations persist multiple days after drug discontinuation in heavy chronic cannabis users. It is currently unknown whether neurocognitive impairment occurs with low blood THC concentrations, and whether return to normal performance, as documented previously following extended cannabis abstinence, is accompanied by the removal of residual THC in brain. These findings also may impact on the implementation of per se limits in driving under the influence of drugs legislation. [source]

Addiction research centres and the nurturing of creativity: The Swiss Institute for the Prevention of Alcohol and Drug Problems.

ADDICTION, Issue 5 2009
future, present
ABSTRACT The aim of this paper is to offer an account of the history, the current status and the future of substance use research at the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). Although founded originally by the temperance movement in 1901, its policy has shifted over time towards one which accepts an alcohol-consuming culture made up of self-determined but well-informed consumers, while still supporting those who choose to live an abstinent life. In the beginning, SIPA was involved primarily in collecting alcohol-related information and making it available to professionals and the general public. From the late 1960s SIPA began conducting its own research projects; by the mid-1970s it had set up its own in-house research department. In 2001, SIPA was appointed a World Health Organization (WHO) Collaborating Centre for Substance Abuse, Research, Prevention and Documentation. As a private non-governmental organization, most of its funding comes from external research commissions. SIPA participates in a variety of international projects [e.g. Gender Alcohol and Culture: An International Study (GenACIS), European School Survey Project on Alcohol and Drugs (ESPAD) and Health Behaviour in School-aged Children (HBSC)] and contributes to numerous national research projects dealing with substance use. It has also forged close links with more than 50 other research institutions in Switzerland and world-wide. Thanks to its work over the last 30 years, SIPA has become a chief port of call for alcohol use research in Switzerland. In the future, SIPA will continue to monitor substance use, while stepping up its prevention research activities and ensuring that it is able to react more promptly to emerging phenomena. [source]

Methadone and impairment in apprehended drivers

ADDICTION, Issue 3 2009
Jean-Paul Bernard
ABSTRACT Aims According to Norwegian guidelines, patients who are in opioid-assisted rehabilitation programmes are permitted to drive a motor vehicle provided that certain requirements are met. The purpose of this study was to investigate apprehended drivers who had methadone in their blood at the time of apprehension and, further, the relationship between blood methadone concentration and impairment as measured by the clinical test of impairment (CTI). Methods The division of Forensic Toxicology and Drug Abuse (DFTDA) at the Norwegian Institute of Public Heath analyses blood samples from all drivers suspected of driving under the influence of drugs nation-wide. Cases with positive results for methadone in blood were collected over the period 2001,2006. Results A total of 635 drivers with methadone found in their blood samples were identified. The majority of drivers were men (>80%), aged between 30 and 40 years. Methadone was the only psychoactive drug detected in blood in only 10 cases. Benzodiazepines were a frequent finding (in approximately 90% of cases). A significant difference in blood methadone concentration was found between cases where only methadone was detected [median 0.46 mg/l (range 0.19,0.65)] and cases where methadone was detected in combination with other psychoactive drugs [median 0.28 mg/l (range 0.06,1.24)]. A CTI had been carried out, in conjunction with blood sampling, in 577 of the cases. A concentration,impairment relationship was not seen for methadone in these cases. Conclusions Cases of driving impairment involving methadone alone were very rare, with combination use most frequent. No correlation between methadone concentration and impairment as judged by the CTI was seen either for these cases or for the material as a whole. [source]

Buprenorphine tapering schedule and illicit opioid use

ADDICTION, Issue 2 2009
Walter Ling
ABSTRACT Aims To compare the effects of a short or long taper schedule after buprenorphine stabilization on participant outcomes as measured by opioid-free urine tests at the end of each taper period. Design This multi-site study sponsored by Clinical Trials Network (CTN, a branch of the US National Institute on Drug Abuse) was conducted from 2003 to 2005 to compare two taper conditions (7 days and 28 days). Data were collected at weekly clinic visits to the end of the taper periods, and at 1-month and 3-month post-taper follow-up visits. Setting Eleven out-patient treatment programs in 10 US cities. Intervention Non-blinded dosing with Suboxone® during the 1-month stabilization phase included 3 weeks of flexible dosing as determined appropriate by the study physicians. A fixed dose was required for the final week before beginning the taper phase. Measurements The percentage of participants in each taper group providing urine samples free of illicit opioids at the end of the taper and at follow-up. Findings At the end of the taper, 44% of the 7-day taper group (n = 255) provided opioid-free urine specimens compared to 30% of the 28-day taper group (n = 261; P = 0.0007). There were no differences at the 1-month and 3-month follow-ups (7-day = 18% and 12%; 28-day = 18% and 13%, 1 month and 3 months, respectively). Conclusion For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper. [source]

Rethinking Substance Abuse: What the Science Shows, and What We Should Do About It

ADDICTION, Issue 11 2007
SARAH E. WOOLF
No abstract is available for this article. [source]

Why do we need an Addiction supplement focused on methamphetamine?

ADDICTION, Issue 2007
Richard A. Rawson
ABSTRACT Methamphetamine is a substantial public health problem in many communities in the United States and in other parts of the world. In order to bring new knowledge about methamphetamine to policy makers, clinicians and researchers, this volume has compiled a set of articles containing new information about the drug and its effects. The articles contain information presented by researchers at two special methamphetamine meetings sponsored by the National Institute on Drug Abuse in 2005. [source]

Cocaine Rapid Efficacy Screening Trial (CREST): a paradigm for the controlled evaluation of candidate medications for cocaine dependence

ADDICTION, Issue 2005
Deborah B. Leiderman
ABSTRACT Aim Development of effective medications for the treatment of cocaine dependence remains a major priority for the National Institute on Drug Abuse (NIDA) at the National Institutes of Health. The Cocaine Rapid Efficacy Screening Trial (CREST) paradigm was developed by the Division of Treatment Research and Development (DT R&D) at NIDA with the goal of enhancing pilot clinical trial validity when systematically assessing a range of medications and drug classes for potential utility in treatment of cocaine dependence. Design CREST utilizes a randomized, controlled, parallel group, blinded methodology for comparing one or more marketed medications against a standard, pharmaceutical grade placebo. The trial design is comprised of a flexible 2,4-week screening/baseline period followed by randomization to an 8-week treatment period. Measures Standard measures of outcomes for the CREST included urinary benzoylecgonine (primary metabolite of cocaine), retention, cocaine craving, depression, clinical global impression and HIV-risk behaviors. In order to facilitate comparisons of data from the CREST studies across sites, drug classes and time, standardized procedures, measures and psychosocial counseling were used. Results A total of 19 medications were evaluated in out-patient treatment research clinics in Boston, Cincinnati, Los Angeles, New York and Philadelphia. Conclusions Findings supported decisions to move forward three medications (cabergoline, reserpine, tiagabine) using full-scale, adequately powered, randomized placebo-controlled trial designs. Lessons learned from the CREST experience continue to shape cocaine pharmacotherapy trial design and execution. [source]

Handbook of the Medical Consequences of Alcohol and Drug Abuse

ADDICTION, Issue 1 2005
JUAN C. NEGRETE
No abstract is available for this article. [source]

Possible age-associated bias in reporting of clinical features of drug dependence: epidemiological evidence on adolescent-onset marijuana use

ADDICTION, Issue 1 2003
Chuan-Yu Chen
ABSTRACT Aims, To probe recent evidence on apparent excess occurrence of marijuana dependence when marijuana smoking starts in adolescence. Design and participants, A national sample of recent-onset marijuana users was identified within public data files of the National Household Survey on Drug Abuse (NHSDA), 1995,98 (1866 adolescents and 762 adults). Measurements, Marijuana dependence was assessed via seven standardized questions about its clinical features, such as being unable to cut down. Multivariate response models (GLM/GEE and MIMIC) were used to evaluate adolescent excess risk and possible item biases. Findings, Among people who had just started to use marijuana, clinical features of marijuana dependence occurred twice as often among adolescents compared to adults, even with statistical adjustment for other covariates (P < 0.01 from GLM/GEE). MIMIC analyses suggest that adolescent-onset users have somewhat higher levels of marijuana dependence, and they also provide evidence of age-associated response bias for some but not all clinical features of marijuana dependence. That is, even with level of marijuana dependence held constant, adolescent recent-onset users were more likely than adults to report being unable to cut down (P = 0.01) and tolerance (P = 0.029). Conclusion, Nosologic, methodological and substantive reasons for observed age-related excess in occurrence of marijuana dependence problems among early onset users deserve more attention in future research. [source]

State-of-the-art methodologies in alcohol-related health services research

ADDICTION, Issue 11s3 2000
Harold I. Perl
Many of the failures to replicate clinical findings of treatment efficacy in more realistic field and community settings can be attributed to inappropriate research designs and other methodological shortcomings. In order to increase research designers' awareness of existing methodologies that may be better suited to answer the critical questions inherent in health services research on alcohol-related issues, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) convened an expert conference with three specific goals: (1) to identify the critical issues involved in alcohol services research; (2) to develop a primer that explicated each key area; and (3) to compile the resulting primers into an accessible resource for researchers, policy makers and consumers. The 9 papers in this special supplement are the product of that conference and are organized broadly around three phases of the research process: study design and implementation, data collection and use, and the analysis and interpretation of data. A final summary paper discusses the issues and offers a synthesis of key themes as well as some direction for the future. [source]

Patient Descriptors in Injection Drug Abuse

ACADEMIC EMERGENCY MEDICINE, Issue 6 2002
Barbara Herbert MD
No abstract is available for this article. [source]

Arbitrage and Abuse of Rights in the EC Legal System

EUROPEAN LAW JOURNAL, Issue 3 2008
Pierre Schammo
Its aim is to explain the concepts, describe their relationship and identify the legal and policy issues which they raise within the EC legal system. Arbitrage and abuse figure prominently in the ECJ's case-law, especially on the freedom of movement. In its more recent case-law, the ECJ has adopted a more developed approach to abuse of rights by laying down a two-prong test. This article seeks to draw legal and policy conclusions by examining inter alia the virtues and vices of the EC doctrine of abuse of rights. [source]

INTIMATE PARTNER VIOLENCE IN THE MILITARY: SECURING OUR COUNTRY, STARTING WITH THE HOME1

FAMILY COURT REVIEW, Issue 2 2009
Simeon StammArticle first published online: 13 MAR 200
This Note discusses domestic violence in the military. Currently, in cases of domestic violence in the military, the Case Review Committee uses the Incident Severity Index for Spouse Abuse to determine the severity of abuse. The Case Review Committee uses this index when determining treatment options for the perpetrator of domestic violence. However, this index is extremely inconsistent with the current views and emerging research of domestic violence. This Note identifies the problems with the current system and gives recommendations for ways to improve the system. The Note concludes that a new system would enhance the military's ability to combat domestic violence. [source]

Abuse in the elderly , a perennial problem

GERODONTOLOGY, Issue 1 2005
James P Newton Editor
No abstract is available for this article. [source]

A Retrospective, Comparative Study on the Frequency of Abuse in Migraine and Chronic Daily Headache

HEADACHE, Issue 3 2007
B. Lee Peterlin DO
Objective.,To assess and contrast the relative frequency of a past history of physical and/or sexual abuse in patients with chronic daily headache (CDH) versus migraine. Background.,A number of risk factors have been identified as risk factors for chronification of headache disorders. Limited data exist regarding the influence of physical and/or sexual abuse on primary headache disorders. Methods.,This was a retrospective chart review of 183 consecutive new headache patients seen from December 2004 through August 2005 at an outpatient tertiary-care center. Patients were included in the study if they had chronic daily headache (with criteria for medication over-use headache or chronic migraine), or migraine with or without aura. A history of physical and/or sexual abuse was systematically asked of all headache patients at their first visit in the clinic. This information was then transferred to a semi-standardized form and the relative frequency of abuse in both groups contrasted. Results.,Of the 161 patients included in the study, 90.1% were female with a mean age of 36.4 ± 12.0. A total of 59.0% of the patients were diagnosed with CDH and 41.0% were diagnosed with migraine. Overall, 34.8% of all patients, 40.0% of CDH patients, and 27.3% of migraine patients had a history of physical and/or sexual abuse. The relative frequency of a history of physical and/or sexual abuse was higher in the CDH group as compared to the migraine group (P= .048). Conclusion.,The relative frequency of abuse is higher in CDH sufferers than migraineurs, suggesting that physical and sexual abuse may be risk factors for chronification. [source]