Development of a controlled drinking self-efficacy scale and appraising its relation to alcohol dependence

There is no specific self-efficacy measure that has been developed primarily for problem drinkers seeking a moderation drinking goal. In this article, we report the factor structure of a 20-item Controlled Drinking Self-Efficacy Scale (CDSES Sitharthan et al., 1996; Sitharthan et al., 1997). The results indicate that the CDSES is highly reliable, and the factor analysis using the full sample identified four factors: negative affect, positive mood/social context, frequency of drinking, and consumption quantity. A similar factor structure was obtained for the subsample of men. In contrast, only three factors emerged in the analysis of data on female participants. Compared to women, men had low self-efficacy to control their drinking in situations relating to positive mood/social context, and subjects with high alcohol dependence had low self-efficacy for situations relating to negative affect, social situations, and drinking less frequently. The CDSES can be a useful measure in treatment programs providing a moderation drinking goal. (C) 2003 Wiley Periodicals, Inc.

A case study of the resolution of paediatric dysphagia following brainstern injury: clinical and instrumental assessment

The coexistance of a swallowing impairment can severely impact upon the medical condition and recovery of a child with traumatic brain injury [ref.(1): Journal of Head Trauma Rehabilitation 9 (1) (1994) 43]. Limited data exist on the progression or outcome of dysphagia in the paediatric population with brainstem injury. The present prospective study documents the resolution of dysphagia in a 14-year-old female post-brainstem injury using clinical, radiological and endoscopic evaluations of swallowing. The subject presented with a pattern of severe oral-motor and oropharyngeal swallowing impairment post-injury that resolved rapidly for the initial 12 weeks, slowed to gradual progress for weeks 12-20, and then plateaued at 20 weeks post-injury. Whilst a clinically functional swallow was present at 10 months post-injury, radiological examination revealed a number of residual physiological impairments, reduced swallowing efficiency, and reduced independence for feeding, indicating a potential increased risk for aspiration. The data highlight the need for early and continued evaluation and intensive treatment programs, to focus on the underlying physiological swallowing impairment post-brainstem injury, and to help offset any potential deleterious effects of aspiration that may affect patient recovery, such as pneumonia. (C) 2003 Elsevier Ltd. All rights reserved.

Analysis of articulatory dynamics in dysarthria following brain injury in childhood using electromagnetic articulography and electropalatography

Two physiological assessments, electromagnetic articulography (EMA) and electropalatography (EPG), were used simultaneously to investigate the articulatory dynamics in an 18-year-old male with dysarthria 9 years following traumatic brain injury (TBI). Eight words consisting of /t, s, integral, k/ in word initial and word final positions were produced up to 10 times. A nonneurologically impaired male served as a control subject. Six parameters were analyzed using EMA: velocity, acceleration, deceleration, distance, duration, and motion path of tongue movements. Using EPG, the pattern and amount of tongue-to-palate contact and the duration of the closure/constriction phase of each consonant produced were assessed. Timing disturbances in the TBI speaker's speech were highlighted in perceptual assessments in the form of prolonged phonemes and a reduced speech rate. EMA analysis revealed that the approach and release phase durations of the consonant productions were within normal limits. Kinematic strategies such as decreased velocity and decreased distances traveled by the tongue, however, may have counterbalanced each other to produce these appropriate results. EPG examination revealed significantly longer closure/constriction phase periods, which may have contributed to the prolonged phonemes and reduced speech rate observed. The implications of these findings for the development of treatment programs for dysarthria subsequent to TBI will be highlighted.

The self-reported impact of legal and non-legal sanctions on a group of recidivist drink drivers

Concern remains regarding the efficacy of legal sanctions to reduce drink driving behaviours among repeat offenders. The present study examined the impact of traditional legal sanctions (e.g., fines and licence disqualification periods), nonlegal sanctions, alcohol consumption and the frequency of recent offending behaviour(s) on intentions to re-offend for a group of recidivist drink drivers (N=166). The analysis indicated that participants perceived legal sanctions to be severe, but not entirely certain nor swift. In addition, self-reported recent drink driving behaviours and alcohol consumption levels were identified as predictors of future intentions to drink and drive. The findings of the study confirm the popular assumption that some repeat offenders are impervious to the threat and application of legal sanctions and suggests that additional interventions such as alcohol treatment programs are required if the drinking and driving sequence is to be broken for this population. (c) 2005 Elsevier Ltd. All rights reserved.

The relative influence of social support, rehabilitation program participation, and inmate preincarceration characteristics on incarcerated substance abusers' perceptions of adjustment to community reintegration

This dissertation identifies, examines, and assesses the relative influence of identified empirically and conceptually relevant variables on incarcerated substance abusers' expectations of postrelease adjustment. A purposive sampling procedure was used to recruit 101 male and female substance-abusing offenders participating in prison- and jail-based drug treatment programs in south Florida. A 92-item survey questionnaire was used to collect basic demographic data; measure inmate preincarceration characteristics, social support, and rehabilitation program participation; and record archival data. Regression equations were developed utilizing ten different measures of the participants' expectations of their postrelease adjustment. Two equations yielded statistically significant F ratios; maintaining a stable living and maintaining abstinence. Twenty-two percent of the variance in respondents' expectations of maintaining a stable living was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 1.89; df = 13,87; p $<$.05). The only significant predictor variable was perception of social support (b = $-$.05; t = $-$3.6; p $<$.001). Twenty-three percent of the variance in respondents' expectations of maintaining abstinence from substances was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 2; df = 13,87; p $<$.05). Once again, the only significant predictor variable was perception of social support. The results of the analyses indicate that social support was the only important variable for understanding these respondents' efficacy expectations of postrelease abstinence and stable living. The results of this investigation demonstrate the complexity of the social support variable for prisoners, and identify social support as a potential rehabilitative resource for substance-abusing inmates. The results of this investigation underscore the importance of continued, detailed empirical study in order to understand and clarify how social support, efficacy expectations, and actual postrelease performance interrelate for this population of offenders.

The effects of American Sign Language on general self-efficacy and anxiety among mothers in a residential rehabilitation facility for drug addiction and substance abuse

Globally, approximately 208 million people aged 15 and older used illicit drugs at least once in the last 12 months; 2 billion consumed alcohol and tobacco consumption affected 25% (World Drug Report, 2008). In the United States, 20.1 million (8.0%) people aged 12 and older were illicit drug users, 129 million (51.6%) abused alcohol and 70.9 million (28.4%) used tobacco (SAMHSA/OAS, 2008).Usually considered a problem specific to men (Lynch, 2002), 5.2% of pregnant women aged 15 to 44 are also illicit drug and substance abusers (SAMHSA/OAS, 2007). During pregnancy, illicit drugs and substance abuse (ID/SA) can significantly affect a woman and her infant contributing to developmental and communication delays for the infant and influencing parenting abilities (Budden, 1996; March of Dimes, 2006b; Rossetti, 2000). Feelings of guilt and shame and stressful experiences influence approaches to parenting (Ashley, Marsden, & Brady, 2003; Brazelton, & Greenspan, 2000; Ehrmin, 2000; Johnson, & Rosen, 1990; Kelley, 1998; Rossetti, 2000; Velez et al., 2004; Zickler, 1999). Parenthood is an expanded role that can be a trying time for those lacking a sense of self-efficacy and creates a high vulnerability to stress (Bandura, 1994). Residential treatment programs for ID/SA mothers and their children provide an excellent opportunity for effective interventions (Finkelstein, 1994; Social Care Institute for Excellence, 2005). This experimental study evaluated whether teaching American Sign Language (ASL) to mothers living with their infants/children at an ID/SA residential treatment program increased the mothers’ self-efficacy and decreased their anxiety. Quantitative data were collected using the General Self-Efficacy Scale and the State-Trait Anxiety Inventory showing there was both a significant increase in self efficacy and decrease in anxiety for the mothers. This research adds to the knowledge base concerning ID/SA mothers’ caring for their infants/children. By providing a simple low cost program, easily incorporated into existing rehabilitation curricula, the study helps educators and healthcare providers better understand the needs of the ID/SA mothers. This study supports Bandura’s theory that parents who are secure in their efficacy can navigate through the various phases of their child’s development and are less vulnerable to stress (Bandura, 1994).

Influence of religious coping on the substance use and HIV risk behaviors of recent Latino immigrants

This study examines the influence of acculturative stress on substance use and HIV risk behaviors among recent Latino immigrants. The central hypothesis of the study is that specific religious coping mechanisms influence the relationship that acculturative stress has on the substance use and HIV-risk behaviors of recent Latino immigrants. Within the Latino culture religiosity is a pervasive force, guiding attitudes, behaviors, and even social interactions. When controlling for education and socioeconomic status, Latinos have been found to use religious coping mechanisms more frequently than their Non-Latino White counterparts. In addition, less acculturated Latinos use religious coping strategies more frequently than those with higher levels of acculturation. Given its prominent role in Latino culture, it appears probable that this mechanism may prove to be influential during difficult life transitions, such as those experienced during the immigration process. This study examines the moderating influence of specific religious coping mechanisms on the relationship between acculturative stress and substance use/HIV risk behaviors of recent Latino immigrants. Analyses for the present study were conducted with wave 2 data from an ongoing longitudinal study investigating associations between pre-immigration factors and health behavior trajectories of recent Latino immigrants. Structural equation and zero-inflated Poisson modeling were implemented to test the specified models and examine the nature of the relationship among the variables. Moderating effects were found for negative religious coping. Higher levels of negative religious coping strengthened an inverse relationship between acculturative stress and substance use. Results also indicated direct relationships between religious coping mechanisms and substance use. External and positive religious coping were inversely related to substance use. Negative religious coping was positively related to substance use. This study aims to contribute knowledge of how religious coping influence's the adaptation process of recent Latino immigrants. Expanding scientific understanding as to the function and effect of these coping mechanisms could lead to enhanced culturally relevant approaches in service delivery among Latino populations. Furthermore this knowledge could inform research about specific cognitions and behaviors that need to be targeted in prevention and treatment programs with this population.

The Effects of American Sign Language on General Self- Efficacy and Anxiety Among Mothers in a Residential Rehabilitation Facility for Drug Addiction and Substance Abuse

Globally, approximately 208 million people aged 15 and older used illicit drugs at least once in the last 12 months; 2 billion consumed alcohol and tobacco consumption affected 25% (World Drug Report, 2008). In the United States, 20.1 million (8.0%) people aged 12 and older were illicit drug users, 129 million (51.6%) abused alcohol and 70.9 million (28.4%) used tobacco (SAMHSA/OAS, 2008).Usually considered a problem specific to men (Lynch, 2002), 5.2% of pregnant women aged 15 to 44 are also illicit drug and substance abusers (SAMHSA/OAS, 2007). During pregnancy, illicit drugs and substance abuse (ID/SA) can significantly affect a woman and her infant contributing to developmental and communication delays for the infant and influencing parenting abilities (Budden, 1996; March of Dimes, 2006b; Rossetti, 2000). Feelings of guilt and shame and stressful experiences influence approaches to parenting (Ashley, Marsden, & Brady, 2003; Brazelton, & Greenspan, 2000; Ehrmin, 2000; Johnson, & Rosen, 1990; Kelley, 1998; Rossetti, 2000; Velez et al., 2004; Zickler, 1999). Parenthood is an expanded role that can be a trying time for those lacking a sense of self-efficacy and creates a high vulnerability to stress (Bandura, 1994). Residential treatment programs for ID/SA mothers and their children provide an excellent opportunity for effective interventions (Finkelstein, 1994; Social Care Institute for Excellence, 2005). This experimental study evaluated whether teaching American Sign Language (ASL) to mothers living with their infants/children at an ID/SA residential treatment program increased the mothers’ self-efficacy and decreased their anxiety. Quantitative data were collected using the General Self-Efficacy Scale and the State-Trait Anxiety Inventory showing there was both a significant increase in self efficacy and decrease in anxiety for the mothers. This research adds to the knowledge base concerning ID/SA mothers’ caring for their infants/children. By providing a simple low cost program, easily incorporated into existing rehabilitation curricula, the study helps educators and healthcare providers better understand the needs of the ID/SA mothers. This study supports Bandura’s theory that parents who are secure in their efficacy can navigate through the various phases of their child’s development and are less vulnerable to stress (Bandura, 1994).

Causes of Childhood Blindness in North Ghana: Results From a School for the Blind in Wa, Upper West Region

Background: Because most developing countries lack sufficient resources and infrastructure to conduct population-based studies on childhood blindness, it can be difficult to obtain epidemiologically reliable data available for planning public health strategies to effectively address the major determinants of childhood blindness. The major etiologies of blindness can differ regionally and intra-regionally. The objective of this retrospective study was to determine (1) the major causes of childhood blindness (BL) and severe visual impairment (SVI) in students who attend Wa Methodist School for the Blind in Upper West Region, North Ghana, and (2) any potential temporal trends in the causes of blindness for this region.

Methods: In this retrospective study, demographic data and clinical information from an eye screening at Wa Methodist School for the Blind were coded according to the World Health Organization/Prevention of Blindness standardized reporting methodology. Causes of BL and SVI were categorized anatomically and etiologically. We determined the major causes of BL/SVI over time using information provided about the age at onset of visual loss for each student.

Results: The major anatomical causes of BL/SVI among the 190 students screened were corneal opacity and phthisis bulbi (n=28, 15%), optic atrophy (n=23, 13%), glaucoma (n=18, 9%), microphthalmos (n=18, 9%), and cataract (n=18, 9%). Within the first year of life, students became blind mainly due to whole globe causes (n=23, 26%), cataract (n=15, 17%), and optic atrophy (n=11, 13%). Those who became blind after age one year had whole globe causes (n=26, 26%), corneal opacity (n=24, 24%), and optic atrophy (n=13, 13%).

Conclusion: At the Wa Methodist School for the Blind, the major anatomical causes of BL/SVI were corneal opacity and phthisis bulbi. About half of all students became blind within the first year of life, and were disproportionately affected by cataract and retinal causes in comparison to the other students who became blind after age one year. While research in blind schools has a number of implicit disadvantages and limitations, considering the temporal trends and other epidemiological factors of blindness may increase the usefulness and/or implications of the data that come from blind school studies in order to improve screening methods for newborns in hospitals and primary care centers, and to help tailor preventative and treatment programs to reduce avoidable childhood blindness in neonates and schoolchildren.

Factors of Inflammation in Haitian Americans and African Americans with and without Type 2 Diabetes

Chronic low-grade inflammation has been implicated in the processes leading to the development of type 2 diabetes (T2D) and its progression. Non-Hispanic Blacks bear a disproportionate burden of T2D and are highly susceptible to inflammation. This cross-sectional study assessed and compared the serum levels of established adipocytokines; interleukin-6 (IL-6), C-reactive protein (CRP), leptin, and novel adipocytokines; chemerin and omentin in Haitian and African Americans with and without T2D. The relationships of these adipocytokines with metabolic syndrome (MetS), anthropometric and HOMA2 measures by ethnicity and diabetes status were also assessed. Serum levels of IL-6, CRP, leptin, chemerin and omentin were determined by the ELISA method. HOMA2 measures were calculated for insulin sensitivity (HOMA2-IS) and insulin resistance (HOMA2-IR). Analyses of available data for 230 Haitian Americans and 241 African Americans (240 with and 231 without T2D) for the first study showed that Haitian Americans with and without MetS had lower levels of IL-6 and CRP compared to African Americans with and without MetS (P Ethnic-specific diabetes intervention and treatment programs must be designed to target Haitian Americans and African Americans as separate unique groups, in order to reduce the burden of T2D among the non-Hispanic Black community. Further research is needed to gain better understanding of the role of inflammation and T2D in this population.

Qualidade dos cuidados a idosos dependentes de cuidadores informais com risco de úlcera de pressão

Para garantir a qualidade nos cuidados de saúde é necessário conhecer as principais componentes do conceito de qualidade, elaborar um programa de garantia da qualidade, avaliar de uma forma sistemática a execução do programa e definir o modelo conceptual a aplicar. A prevenção das úlceras de pressão é uma preocupação dos profissionais de saúde que prestam cuidados aos idosos dependentes de cuidadores informais, sendo a sua prevenção um desafio para a equipa de enfermagem, uma vez que a incidência de úlcera de pressão é frequente nestes. A aposta na prevenção e tratamento da UP terá um efeito positivo na qualidade de cuidados prestados. Tendo em conta esta problemática, foi feito o diagnóstico de situação com base na observação dos registos de enfermagem, bem como os procedimentos inerentes à prevenção e tratamento de úlceras de pressão, com a finalidade de contribuir para a implementação de um programa de melhoria contínua da qualidade dos cuidados a idosos dependentes de cuidadores informais com risco de úlceras de pressão. Após esta fase definiram-se algumas estratégias que consideramos pertinentes implementar. Com as atividades desenvolvidas neste trabalho, esperamos melhorar a informação produzida conseguindo obter dados que permitem melhorar os cuidados de enfermagem aos idosos/família com risco de UP, assim como, contribuir para a identificação de problemas e definições de estratégias de melhoria no futuro.

Self-reported substance use and intervention experience of prisoners with intellectual disability

Background It has been increasingly recognised that many offenders with intellectual disability (ID) have substance use issues, yet surprisingly little is known about the treatment needs of this population.Method In order to explore pre-sentence patterns of substance use, the role of substance use in offending behaviour, and experience with substance treatment programs, interviews were conducted with 33 sentenced prisoners.Results The findings of this study identified hazardous and harmful rates of alcohol use and high rates of substance use among prisoners with ID. Most participants reported being intoxicated at the time of their offence. Participants experience of substance intervention programs varied. Although many reported a positive experience, others reported significant participation barriers.Conclusions This study supports the increasingly recognised link between substance use and offending behaviour among prisoners with ID and highlights the importance of tailored and coordinated treatment initiatives, both within corrections facilities and the community.

Benzodiazepine use of community-based violent offenders : a preliminary investigation

Objective: To explore the relationship between benzodiazepine use and violent crime in a sample of community-based offenders. Methods: Participants were recruited via drug diversion and treatment programs in Melbourne, Australia. Data regarding benzodiazepine and other substance use, mental health, personality characteristics, and crime involvement were collected through semistructured interviews conducted in 2011. Participants (n = 82, 79.3% male) were 21–56 years old, predominantly Australian-born (89%), with 14.6% identifying as Aboriginal or Torres Strait Islanders. Eligibility criteria were having been charged with a criminal offence in the previous six months and at least monthly benzodiazepine use. Group differences between violent (n = 11) and nonviolent offenders were assessed via independent samples t-tests (two-tailed) and nonparametric tests. Results: Individuals charged with violent index offences were significantly more likely to use higher average doses of alprazolam (p = 0.040) and exhibit benzodiazepine dependence (p = 0.037) as well as report high levels of sensation seeking, prior violence, and the diagnoses of depression and personality disorder than individuals charged with nonviolent index offences. Conclusions: The findings suggest the existence of a complex dynamic between mental health and violent offending that may be influenced by benzodiazepine use, in particular alprazolam. A core implication of these preliminary findings includes attending to the interpersonal skills and adaptive coping resources of violent offenders.