"Nenhuma Pessoa Idosa Merece Passar por Isso": Compreensão da Violência para Mulheres Gerontes / "Ninguna Persona Adulta Mayor Merece Pasar Por Esto": Comprensión de la Violencia para las Mujeres Adultas Mayores / "No Elderly Person Deserves to Go Through This": Understanding Violence Towards Elderly Women

Resumo Introdução: A violência contra idosos é um fenômeno crescente, ocasionando prejuízos à saúde, com diferentes desfechos e consequências às vítimas. A chance de idosas sofrerem-na no âmbito familiar supera a dos homens, sendo o gênero um fator de risco considerável. Objetivo: Analisar a compreensão da violência contra pessoas idosas segundo mulheres gerontes. Metodologia: Pesquisa descritiva com abordagem qualitativa desenvolvida com 22 idosas de uma comunidade no estado da Paraíba, Brasil, escolhidas por conveniência. Utilizou-se para coleta de dados entrevistas semiestruturadas, processadas pelo software Iramuteq, com posterior Análise de Conteúdo. Resultados: Foram evidenciadas cinco classes: ciclo de violência; rede de apoio ao idoso vítima de violência; Vivência de situações violentas; violência financeira; e simbologia da violência na sociedade, as quais denotam compreensão da violência envolvendo os diferentes tipos. Apoiam-se nos fatores da vivência familiar, cultura e outros, consubstanciando o profissional de saúde como fundamental para o desfecho. O gênero influenciou no que concerne ao olhar lançado sobre a violência física e psicológica, bem como na relevância dada às equipes de saúde para identificação de ocorrências e prevenção de possíveis danos. Conclusão: Os diversos tipos de violência contra a pessoa idosa foram reconhecidos, incluindo fatores individuais, comunitários e sociais no ciclo violento. Além disso, associaram o envelhecimento a maior suscetibilidade para sofrer violência, independente da tipologia. Destaca-se a potencialidade do serviço de saúde na assistência à pessoa idosa vítima de violência, elucidando casos e atuando precocemente para interrupção dos ciclos perpetrados, exigindo a necessidade constante de atualização profissional para lidar com situações detectadas.

Resumen Introducción: La violencia contra las personas adultas mayores es un fenómeno creciente, que causa daños a la salud, con diferentes desenlaces y consecuencias para las víctimas. La posibilidad de que las mujeres adultas mayores la sufran en el ámbito familiar supera la de los hombres, siendo el género un factor de riesgo considerable. Objetivo: Analizar la comprensión de la violencia contra las personas mayores según las mujeres adultas mayores. Metodología: Investigación descriptiva con enfoque cualitativo desarrollada con 22 mujeres adultas mayores de una comunidad en el estado de Paraíba, Brasil, elegidas por conveniencia. Para la recolección de datos, se utilizaron entrevistas semiestructuradas, procesadas por el software Iramuteq, con posterior análisis de contenido. Resultados: Se evidenciaron cinco tipos de violencia: ciclo de la violencia, red de apoyo población adulta mayor víctima de violencia, experimentar situaciones violentas, violencia financiera y simbología de la violencia en la sociedad, que denotan la comprensión de la violencia de diferentes tipos. Estas ideas están respaldadas en los factores de la experiencia familiar, la cultura y otros, donde la persona profesional de la salud se identifica como fundamental para el cuidado y apoyo. El género influyó en la mirada lanzada sobre la violencia física y psicológica, así como en la relevancia dada a los equipos de salud para la identificación de sucesos y la prevención de posibles daños. Conclusión: Se han reconocido los diversos tipos de violencia contra las personas mayores, incluidos los factores individuales, comunitarios y sociales en el ciclo de violencia. Además, asociaron el envejecimiento con una mayor susceptibilidad a sufrir violencia, independientemente de la tipología. Destaca la potencialidad del servicio de salud en la asistencia a la persona mayor víctima de violencia, mediante la identificación de casos y la actuación temprana para la interrupción de los ciclos perpetrados. De manera que, se evidencia la necesidad constante de actualización profesional para hacer frente a situaciones detectadas.

Abstract Introduction: Violence against the elderly is a growing phenomenon, causing damage to health, with different outcomes and consequences to the victims. The possibility of elderly women suffering it in the family context surpasses that of men, with gender being a considerable risk factor. Objective: To analyze the understanding of violence against the elderly according to elderly women. Method: Descriptive research with a qualitative approach developed with 22 elderly women from a community in the state of Paraíba, Brazil, chosen for convenience. The data collection was based on semi-structured interviews, processed by the Iramuteq software, with subsequent Content Analysis. Results: Five classes of violence against the elderly were evidenced: cycle of violence; support network for the elderly victims of violence; experience of violent situations; financial violence; and symbolism of violence in society, which denote an understanding of violence involving the different types. They are based on the factors of family experience, culture, and others, placing the health professional as a fundamental element for care and support. Gender influenced the perspective on physical and psychological violence, as well as the relevance given to health teams for the identification of occurrences and the prevention of possible damage. Conclusion: The various types of violence against the elderly have been recognized, including individual, community, and social factors in the violent cycle. In addition, they associated aging with greater susceptibility to suffering violence, regardless of the typology. It highlights the potential of the health service in assisting the elderly victim of violence, elucidating cases, and acting early to interrupt the cycles perpetrated, requiring the constant need for professional updating to deal with detected situations.

Influence of the typology and timing of childhood trauma in psychoticism.

PURPOSE: Child maltreatment (CM) is associated with psychosis; however little is known about the frequency, type, and timing of abuse in the personality pathology domain of psychoticism (PSY) in the DSM-5. The purpose of this study was to analyze childhood trauma typology and frequency according to gender and to identify sensitive periods of susceptibility to CM in women with high PSY. METHODS: The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the frequency, severity and timing of each type of maltreatment. The full sample consisted of 83 participants with different psychiatric diagnoses. Psychoticism was assessed with the DSM-5 Personality Inventory (PID-5). To identify the differences in CM exposure between the PSY+ (high psychoticism) and PSY- (low psychoticism) groups, the Mann-Whitney U test, the chi square test and random forest (RF) test were used. RESULTS: Comparing PSY + and PSY-, revealed gender differences in the impact of abuse, with highly frequent and severe types of abuse, in women. In women, PSY + and PSY-, were differentiated especially in non-verbal emotional abuse, peer physical bullying and parental verbal abuse. Several periods with a major peak at age seven followed by peaks at age 17 and 12 years old were identified. CONCLUSION: Increased exposure to CM occurs in women with PSY+. A sensitivity to CM exposure during early childhood and late adolescence could be a risk factor for psychoticism in women.

Validation of the PediBIRN-7 clinical prediction rule for pediatric abusive head trauma.

BACKGROUND: The PediBIRN-7 clinical prediction rule incorporates the (positive or negative) predictive contributions of completed abuse evaluations to estimate abusive head trauma (AHT) probability after abuse evaluation. Applying definitional criteria as proxies for AHT and non-AHT ground truth, it performed with sensitivity 0.73 (95 % CI: 0.66-0.79), specificity 0.87 (95 % CI: 0.82-0.90), and ROC-AUC 0.88 (95 % CI: 0.85-0.92) in its derivation study. OBJECTIVE: To validate the PediBIRN-7's AHT prediction performance in a novel, equivalent, patient population. PARTICIPANTS AND SETTINGS: Consecutive, acutely head-injured children <3 years hospitalized for intensive care across eight sites between 2017 and 2020 with completed skeletal surveys and retinal exams (N = 342). METHODS: Secondary analysis of an existing, cross-sectional, prospective dataset, including assignment of patient-specific estimates of AHT probability, calculation of AHT prediction performance measures (ROC-AUC, sensitivity, specificity, predictive values), and completion of sensitivity analyses to estimate best- and worst-case prediction performances. RESULTS: Applying the same definitional criteria, the PediBIRN-7 performed with sensitivity 0.74 (95 % CI: 0.66-0.81), specificity 0.77 (95 % CI: 0.70-0.83), and ROC-AUC 0.83 (95 % CI: 0.78-0.88). The reduction in ROC-AUC was statistically insignificant (p = .07). Applying physicians' final consensus diagnoses as proxies for AHT and non-AHT ground truth, the PediBIRN-7 performed with sensitivity 0.73 (95 % CI: 0.66-0.79), specificity 0.87 (95 % CI: 0.82-0.90), and ROC-AUC 0.90 (95 % CI: 0.87-0.94). Sensitivity analyses demonstrated minimal changes in rule performance. CONCLUSION: The PediBIRN-7's overall AHT prediction performance has been validated in a novel, equivalent, patient population. Its patient-specific estimates of AHT probability can inform physicians' AHT-related diagnostic reasoning after abuse evaluation.

Daily stress reactivity and risk appraisal mediates childhood parental abuse predicting adulthood psychopathology severity: An 18-year longitudinal mediation analysis.

Identifying mechanisms of childhood abuse-adulthood psychopathology relations could facilitate preventive efforts, but most prior studies used cross-sectional or two-wave designs and did not test the effects of childhood maternal and paternal abuse separately. Our 18-year three-wave study thus determined if Wave 2 daily stress reactivity and risk appraisal severity mediated Wave 1 retrospectively-reported childhood maternal and paternal abuse on Wave 3 generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), alcohol (AUD), and substance use disorder (SUD) self-rated symptom severity. Longitudinal structural equation modeling was employed, adjusting for Wave 1 psychopathology severity. Higher childhood maternal and paternal abuse consistently predicted greater future daily stress reactivity and risk appraisal, and these mediators subsequently predicted increased GAD, MDD, and PD, but not AUD and SUD severity. Daily stress reactivity and risk appraisal consistently mediated the pathways between childhood maternal and paternal abuse predicting heightened adulthood GAD, MDD, and PD (Cohen's d = 0.333-0.888) but not AUD and SUD severity. Mediation effect sizes were stronger for childhood maternal (24.5-83.0 %) than paternal (19.5-56.0 %) abuse as the predictor. The latent interaction between Wave 1 childhood maternal and paternal abuse did not moderate the effect of Wave 1 maternal or paternal abuse on any Wave 3 adulthood psychopathology severity through Wave 2 daily stress reactivity and risk appraisal. Our research emphasizes the urgent requirement for continuous evaluation and intervention initiatives in trauma-informed care, both in inpatient and outpatient treatment settings.

Prevalence, pattern and predictors of intimate partner violence amongst female undergraduates in Abia State, Nigeria; public health implications.

BACKGROUND: Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. It is a major public health problem globally. This study determined the prevalence, patterns and predictors of IPV amongst female undergraduates in Abia State. METHODS: A cross-sectional study was conducted from January - February 2022 amongst 306 female undergraduates in Abia State. A mixed method of an online structured questionnaire created on Google forms & onsite self-administered questionnaire were deployed for data collection. Descriptive, bivariate and multivariate analyses were done using IBM SPSS Version 26.0. The level of significance was set at 5%. RESULTS: A total of 306 respondents participated in the survey. The overall prevalence of IPV amongst female undergraduates was 51.2% (95% CI: 44.8-57.6%). Emotional abuse was the most common form of abuse 78.9%, followed by Physical abuse 42.0% and Sexual abuse 30.8%. Predictors of IPV reported include female earning/receiving more than their partner monthly (aOR = 2.30; 95% CI: 1.20-4.41); male (partner) alcohol consumption (aOR = 5.17; 95% CI: 2.46-10.88), being a smoker of cigarette/marijuana (aOR = 11.01; 95% CI: 1.26-96.25) and having witnessed domestic violence as a child (aOR = 3.55; 95% CI: I.56-8.07). Adverse effects such as unwanted pregnancies (12%), miscarriages (10%), eating/sleeping disorders (21%) and bruises (23%) amongst others were noted in some of the victims. CONCLUSION: Over half of all female undergraduates in Abia State have experienced IPV with emotional abuse being the commonest. Some Individual and relationship factors were identified as predictors of IPV. We recommend intensifying primary prevention campaigns against risk factors identified like smoking and alcohol consumption.

Towards understanding the role of content-based and contextualized features in detecting abuse on Twitter.

This paper presents a novel approach for detecting abuse on Twitter. Abusive posts have become a major problem for social media platforms like Twitter. It is important to identify abuse to mitigate its potential harm. Many researchers have proposed methods to detect abuse on Twitter. However, most of the existing approaches for detecting abuse look only at the content of the abusive tweet in isolation and do not consider its contextual information, particularly the tweets posted before the abusive tweet. In this paper, we propose a new method for detecting abuse that uses contextual information from the tweets that precede and follow the abusive tweet. We hypothesize that this contextual information can be used to better understand the intent of the abusive tweet and to identify abuse that content-based methods would otherwise miss. We performed extensive experiments to identify the best combination of features and machine learning algorithms to detect abuse on Twitter. We test eight different machine learning classifiers on content- and context-based features for the experiments. The proposed method is compared with existing abuse detection methods and achieves an absolute improvement of around 7%. The best results are obtained by combining the content and context-based features. The highest accuracy of the proposed method is 86%, whereas the existing methods used for comparison have highest accuracy of 79.2%.

Identification of Child Abuse and Neglect Based on the Perception of Training Physicians in Jeddah, Saudi Arabia.

Introduction Child abuse and neglect (CAN) affects many countries, including Saudi Arabia (SA). CAN in SA is more commonly detected in hospitals. Therefore, healthcare professionals must identify and report the cases. This study aims to assess knowledge and perceptions toward CAN among training physicians. Methodology A cross-sectional survey was conducted through a self-administrated structured questionnaire and involved 123 residents and fellows who deal with children in Jeddah, SA. The participants were recruited using convenient sampling methods. Descriptive statistics, t-test, and Chi-square test were used for statistical analysis. Results We found that approximately 78% would report their findings to the legal authority, document them, and assess their consistency with parents and the child's explanation. However, only 41.5% of the participants would report CAN to the proper authority. Most participants believed that CAN should be redefined according to Saudi culture and religious standards. In contrast, 68.9% of the participants believed that CAN cases are under-reported in SA. The main barrier to not reporting is the fear of consequences (63.4%). About 77% of the participants agreed to the need for further training. Identifying the CAN indicators was higher among those who handled a CAN case previously (median = 66.67, p = 0.023). Conclusions In conclusion, the study showed that appropriate undergraduate and postgraduate curriculum training should be developed to strengthen future healthcare practitioners in dealing with CAN cases to protect children's welfare.

Thoracolumbar fracture-dislocation in a two-year-old female child following child abuse: A case report and literature review.

Child abuse is a matter of serious concern that can often result in devastating injuries. Incidence of spinal injuries from child abuse has been reported in <1-3 % of spinal injury cases. In the present study, a case of thoracolumbar translational injury (AO type C) is presented following an incidence of child abuse in a 2-year-old female. After successful management with operative fixation, the child showed a remarkable recovery in her neurological function with ambulatory power.

Infertile Jordanian Women's Self-Perception About Societal Violence: An Interpretative Phenomenological Study.

Background: Infertility affects one in six couples globally and is compounded by stigma and violence, particularly for women, in Jordan's culture. While existing research has illuminated societal pressures faced by infertile women, there is, yet no comprehensive understanding of the violence they encounter in their daily lives. Objective: This Interpretative Phenomenological study seeks to unravel the experiences of infertile women regarding societal violence in Jordan. By focusing on different types of community violence - physical, psychological, and emotional - The study aims to provide nuanced insights into the challenges these women confront. It also endeavors to identify contributing factors, including societal attitudes, cultural beliefs, and individual encounters, while informing policy and practice to mitigate this issue. Methods: Employing a qualitative approach, this study conducted semi-structured interviews with purposively sampled infertile women. Thematic analysis was utilized to uncover recurring patterns and themes, facilitating a comprehensive exploration of their experiences. Results: Five main themes were identified: How the surrounding people view me as an infertile woman; I am suffocated by their questions; they interfere in the smallest details; I got burned and turned to ashes, and I have no right to complain; The problem of childbearing and the treatment plan is a matter for me and my husband only; and who supports me and what do I want from those around me? Implications: This study's implications are significant for policy and practice. By foregrounding the prevalent violence faced by infertile women, it underscores the urgency of interventions. Raising awareness, providing education, and extending support can counteract societal stigma and violence. Creating a more compassionate societal fabric can ensure a safer, more inclusive environment for these women.

Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals' assessment practice.

BACKGROUND: Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to CSA is significantly higher in Child and Adolescent Psychiatry (CAP) than in the general population. Healthcare professionals report that uncovering CSA is a complex and challenging task. However, we know little about how they proceed when uncovering CSA. More knowledge of healthcare personnel's experience is therefore necessary to facilitate and increase CSA disclosure. The study aims to explore how CAP healthcare professionals in Norway proceed when assessing and detecting CSA, how they experience this work, and what hinders or facilitates their efforts. METHODS: The study employed a mixed method approach. Data was collected through an anonymous online survey, generating both quantitative and qualitative data. The sample consisted of 111 healthcare professionals in CAP, of whom 84% were women, with a mean age of 40.7 years (range 24-72; sd = 10.8). Mean years of CAP clinical experience were 8.3 years (range 0-41; sd = 7.5). The quantitative data was analysed using descriptive statistics, correlations, and independent sample t-tests, while the qualitative data was analysed using a team-based qualitative content analysis. RESULTS: The results showed that detection of CSA was viewed as an important, but complex task in CAP, and the existing procedures were deemed to be insufficient. The therapists mostly felt confident about how to proceed when they suspected or detected CSA, yet they seldom detected CSA. In their initial assessment they applied standardised procedures, but if their suspicion of possible CSA persisted, they seemed to rely more on clinical judgement. Specific challenges and facilitators for CSA detection were identified, both in the individual and in the organisation. CONCLUSIONS: The study highlights the challenges and complexities healthcare professionals and the CAP system face when assessing CSA, which may account for the low detection rate. The results show that healthcare professionals believe room for clinical autonomy and targeted competence development may improve CSA detection. Additionally, the findings suggest a need for CAP to define roles and responsibilities within and between agencies.

Estimated Number of Injection-Involved Overdose Deaths in US States From 2000 to 2020: Secondary Analysis of Surveillance Data.

BACKGROUND: In the United States, both drug overdose mortality and injection-involved drug overdose mortality have increased nationally over the past 25 years. Despite documented geographic differences in overdose mortality and substances implicated in overdose mortality trends, injection-involved overdose mortality has not been summarized at a subnational level. OBJECTIVE: We aimed to estimate the annual number of injection-involved overdose deaths in each US state from 2000 to 2020. METHODS: We conducted a stratified analysis that used data from drug treatment admissions (Treatment Episodes Data Set-Admissions; TEDS-A) and the National Vital Statistics System (NVSS) to estimate state-specific percentages of reported drug overdose deaths that were injection-involved from 2000 to 2020. TEDS-A collects data on the route of administration and the type of substance used upon treatment admission. We used these data to calculate the percentage of reported injections for each drug type by demographic group (race or ethnicity, sex, and age group), year, and state. Additionally, using NVSS mortality data, the annual number of overdose deaths involving selected drug types was identified by the following specific multiple-cause-of-death codes: heroin or synthetic opioids other than methadone (T40.1, T40.4), natural or semisynthetic opioids and methadone (T40.2, T40.3), cocaine (T40.5), psychostimulants with abuse potential (T43.6), sedatives (T42.3, T42.4), and others (T36-T59.0). We used the probabilities of injection with the annual number of overdose deaths, by year, primary substance, and demographic groups to estimate the number of overdose deaths that were injection-involved. RESULTS: In 2020, there were 91,071 overdose deaths among adults recorded in the United States, and 93.1% (84,753/91,071) occurred in the 46 jurisdictions that reported data to TEDS-A. Slightly less than half (38,253/84,753, 45.1%; 95% CI 41.1%-49.8%) of those overdose deaths were estimated to be injection-involved, translating to 38,253 (95% CI 34,839-42,181) injection-involved overdose deaths in 2020. There was large variation among states in the estimated injection-involved overdose death rate (median 14.72, range 5.45-31.77 per 100,000 people). The national injection-involved overdose death rate increased by 323% (95% CI 255%-391%) from 2010 (3.78, 95% CI 3.33-4.31) to 2020 (15.97, 95% CI 14.55-17.61). States in which the estimated injection-involved overdose death rate increased faster than the national average were disproportionately concentrated in the Northeast region. CONCLUSIONS: Although overdose mortality and injection-involved overdose mortality have increased dramatically across the country, these trends have been more pronounced in some regions. A better understanding of state-level trends in injection-involved mortality can inform the prioritization of public health strategies that aim to reduce overdose mortality and prevent downstream consequences of injection drug use.

Effectiveness of a Web-Based Individual Coping and Alcohol Intervention Program for Children of Parents With Alcohol Use Problems: Randomized Controlled Trial.

BACKGROUND: Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Many would benefit from support programs, but the figures reveal that only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children. Research on digital interventions aimed at this target group is scarce. We have developed a novel digital therapist-assisted self-management intervention targeting adolescents whose parents had alcohol use problems. This program aims to strengthen coping behaviors, improve mental health, and decrease alcohol consumption in adolescents. OBJECTIVE: This study aims to examine the effectiveness of a novel web-based therapist-assisted self-management intervention for adolescents whose parents have alcohol use problems. METHODS: Participants were recruited on the internet from social media and websites containing health-related information about adolescents. Possible participants were screened using the short version of the Children of Alcoholics Screening Test-6. Eligible participants were randomly allocated to either the intervention group (n=101) or the waitlist control group (n=103), and they were unblinded to the condition. The assessments, all self-assessed, consisted of a baseline and 2 follow-ups after 2 and 6 months. The primary outcome was the Coping With Parents Abuse Questionnaire (CPAQ), and secondary outcomes were the Center for Epidemiological Studies Depression Scale, Alcohol Use Disorders Identification Test (AUDIT-C), and Ladder of Life (LoL). RESULTS: For the primary outcome, CPAQ, a small but inconclusive treatment effect was observed (Cohen d=-0.05 at both follow-up time points). The intervention group scored 38% and 46% lower than the control group on the continuous part of the AUDIT-C at the 2- and 6-month follow-up, respectively. All other between-group comparisons were inconclusive at either follow-up time point. Adherence was low, as only 24% (24/101) of the participants in the intervention group completed the intervention. CONCLUSIONS: The findings were inconclusive for the primary outcome but demonstrate that a digital therapist-assisted self-management intervention may contribute to a reduction in alcohol consumption. These results highlight the potential for digital interventions to reach a vulnerable, hard-to-reach group of adolescents but underscore the need to develop more engaging support interventions to increase adherence. TRIAL REGISTRATION: ISRCTN Registry ISRCTN41545712; https://www.isrctn.com/ISRCTN41545712?q=ISRCTN41545712. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/1471-2458-12-35.

Association between school learning models and psychological and social health visits to the emergency room.

Objectives: We aimed to assess the impact of in-person and distance school learning models on children's visits to the emergency department (ED) for psychological or social ("psychosocial") complaints. Methods: We analyzed presentations to one emergency department in a mid-sized Midwestern city. We used the public school system schedule to determine in-person and distance learning periods by the grade level. We calculated the incidence of visits to the emergency department during academic years 2018-2019, 2019-2020, and 2020-2021, with particular attention to the time after March 13, 2020, which was the pandemic period. We compared the incidence of visits during in-person versus distance learning school models. Results: A total of 7181 visits occurred during the academic years studied, 17.1% due to psychosocial complaints. The incidence of psychosocial visits to the ED was lower during distance learning than during the pandemic in-person learning period (given per 1000 student years: 20.5 vs. 24.1, p = 0.14). This difference was statistically significant among middle schoolers (23.3 vs. 46.6, p < 0.001). While not statistically significant, the difference among high schoolers was pragmatically relevant (38.2 vs. 49.3, p = 0.086). Conclusions: Distance learning was associated with a decrease in the incidence of psychosocial visits to the emergency department relative to in-person learning. Future investigation is required to verify results and better understand any causative relationships.

The workplace culture, mental health and wellbeing of early- and mid-career health academics: a cross-sectional analysis.

There are reports of poor working conditions for early and mid-career academics (EMCAs) in universities, however, empirical data using validated tools are scarce. We conducted an online, cross-sectional survey using validated tools to assess workplace satisfaction, exposure to workplace abuse, and mental health. Participants included employees of medical and health faculties of two of the largest Australian universities, surveyed between October 2020 and January 2021.Overall, 284 participants responded. Many reported job insecurity: half (50.7%) working on contracts with less than one remaining year. Workloads were considerable, with 89.5% of participants working overtime and 54.8% reporting burnout. Workplace abuse in the forms of bullying (46.6%), sexual harassment (25.3%), sexism (49.8%) and racism (22.5%) were commonly reported. Clinically significant symptoms of depression (28.0%), anxiety (21.7%) and suicidal ideation or self-harm (13.6%) were reported; with a higher prevalence among those working more overtime, and those exposed to workplace abuse. Priorities include providing a stable and safe workplace, increasing accountability and transparency in addressing workplace abuse, and supporting professional development.In summary, EMCAs in our study were commonly exposed to precarious employment conditions and workplace abuse. Our findings provide empirical evidence on where universities and funding bodies should direct resources and change organisational risk factors, to improve workplace culture.

Active Amphetamine Abuse in Total Hip Arthroplasty Carries Increased Risk for Postoperative Surgical and Medical Complications.

Background: The impact of amphetamine abuse on total hip arthroplasty (THA) outcomes has yet to be studied. As the rates of methamphetamine abuse continue to rise, understanding the risk profile of this population is imperative. This study aims to determine the risk of major surgical and medical complications for those with amphetamine abuse undergoing THA, with the hypothesis that amphetamine abuse carries increased risk. Methods: A retrospective review was performed with all-claims data files of a large national database querying International Classification of Disease, tenth revision, procedure codes identifying 333,038 primary THA, and 1027 with active amphetamine abuse. Medical and surgical complications including infection, dislocation, implant failure, periprosthetic fracture, and revision, as well as length of hospital stay and 90-day readmission rate, were identified. Univariate analysis compared rates of dependent outcomes. To account for independent variables, logistic regression was performed using age, Charlson comorbidity index, sex, obesity, tobacco use, and alcohol use. The results were presented as odds ratios (OR) and P values with significance set at <0.05. Results: Patients with active amphetamine abuse carried an increased risk of dislocation (OR 1.82, P ≤ .001), infection (OR 2.37, P ≤ .001), mechanical complications (OR 1.64, P ≤ .001), periprosthetic fracture (OR 1.53, P ≤ .05), revision (OR 1.70, P ≤ .001), 90-day readmission (OR 1.79, P ≤ .001), as well as medical complications (1.43, P = .02) compared to those without documented amphetamine abuse. Conclusions: Patients with amphetamine abuse are at increased risk of postoperative surgical and medical complications following THA. We recommend consideration of these risks prior to primary THA in this patient population.

Coordination among frequent genetic variants imparts substance use susceptibility and pathogenesis.

Determining the key genetic variants is a crucial step to comprehensively understand substance use disorders (SUDs). In this study, utilizing whole exome sequences of five multi-generational pedigrees with SUDs, we used an integrative omics-based approach to uncover candidate genetic variants that impart susceptibility to SUDs and influence addition traits. We identified several SNPs and rare, protein-function altering variants in genes, GRIA3, NCOR1, and SHANK1; compound heterozygous variants in LNPEP, LRP1, and TBX2, that play a significant role in the neurotransmitter-neuropeptide axis, specifically in the dopaminergic circuits. We also noted a greater frequency of heterozygous and recessive variants in genes involved in the structural and functional integrity of synapse receptors, CHRNA4, CNR2, GABBR1, DRD4, NPAS4, ADH1B, ADH1C, OPRM1, and GABBR2. Variant analysis in upstream promoter regions revealed regulatory variants in NEK9, PRRX1, PRPF4B, CELA2A, RABGEF1, and CRBN, crucial for dopamine regulation. Using family-and pedigree-based data, we identified heterozygous recessive alleles in LNPEP, LRP1 (4 frameshift deletions), and TBX2 (2 frameshift deletions) linked to SUDs. GWAS overlap identified several SNPs associated with SUD susceptibility, including rs324420 and rs1229984. Furthermore, miRNA variant analysis revealed notable variants in mir-548 U and mir-532. Pathway studies identified the presence of extensive coordination among these genetic variants to impart substance use susceptibility and pathogenesis. This study identified variants that were found to be overrepresented among genes of dopaminergic circuits participating in the neurotransmitter-neuropeptide axis, suggesting pleiotropic influences in the development and sustenance of chronic substance use. The presence of a diverse set of haploinsufficient variants in varying frequencies demonstrates the existence of extraordinary coordination among them in attributing risk and modulating severity to SUDs.

The Role of Positive and Negative Affect in Illicit Substance Use and Alcohol Use: An Ecological Momentary Assessment Study.

BACKGROUND: Theories suggest that experiences of negative and positive affect are important precursors to alcohol and illicit substance use. Research utilizing ecological momentary assessments (EMA) has generally supported the relation between momentary experiences of positive affect, but not negative affect, and subsequent substance use. Unfortunately, most of these studies have focused on alcohol use and not other substance use. The goal of this paper was to further explore the relation between momentary affect and use of both alcohol and illicit substances within a population of individuals with a history of substance use. Additionally, this study aimed to understand whether the relations between affect and substance use would vary depending on the timing of EMA assessments of affect prior to substance use. METHOD: Participants with a history of heavy substance use (N = 59) completed EMA's measuring affect and substance use using random prompts 4 times a day for 14 days. RESULTS: We found that positive affect was significantly related to later engagement in drinking, illicit substance use, and marijuana use. Moreover, timing of the affect was important. When affect was assessed in the last hour prior to substance use, relative to 7 hours prior, the relation between positive affect and illicit substance use was stronger. Negative affect was related to a lower likelihood of subsequent marijuana use, but more so when it was measured a few hours versus several hours before the use. CONCLUSION: This study further supported the relation between positive affect and both alcohol and illicit substance use.

Effects of Subjective Social Status and Self-Esteem in the Association Between Childhood Abuse and Adulthood Anxiety.

Background: Subjective social status influences anxiety, but at present, the mechanism is not fully understood. It has been reported that negative childhood experiences, such as abuse, can influence depressive symptoms through subjective social status and personality traits, such as self-esteem. A similar mechanism is presumed to underlie anxiety symptoms in adulthood. Therefore, we hypothesized that subjective social status and self-esteem are intermediate factors in the indirect effects of childhood abuse on state anxiety in adulthood, and analyzed the indirect effects via these factors using a path analysis. Subjects and Methods: Child Abuse and Trauma Scale, Subjective Social Status, Rosenberg Self-Esteem Scale, and State-Trait Anxiety Inventory Form Y questionnaires were administered in a self-report format to 404 adult volunteers from January 2014 to August 2014. In addition, a path analysis was conducted to determine whether subjective social status and self-esteem are associated with the indirect effects of childhood abuse on anxiety symptoms in adulthood. Results: Childhood abuse did not directly affect state anxiety in adulthood, but affected state anxiety via subjective social status and self-esteem. Subjective social status affected state anxiety via self-esteem. This model explained 25.2% of the variation in state anxiety in adult volunteers. Conclusion: The present study demonstrated that childhood abuse affects anxiety in adulthood through subjective social status and self-esteem. Therefore, interventions that enhance subjective social status and self-esteem for adults who experienced childhood abuse may help reduce their anxiety.

A critical review of workplace drug testing methods for old and new psychoactive substances: Gaps, advances, and perspectives.

Workplace drug testing (WDT) is essential to prevent drug abuse disorders among the workforce because it can impair work performance and safety. However, WDT is limited by many challenges, such as urine adulteration, specimen selection, and new psychoactive substances (NPS). This review examined the issues related to WDT. Various scientific databases were searched for articles on WDT for drug detection published between 1986 (when WDT started) and January 2024. The review discussed the history, importance, and challenges of WDT, such as time of specimen collection/testing, specimen adulteration, interference in drug testing, and detection of NPS. It evaluated the best methods to detect NPS in forensic laboratories. Moreover, it compared different techniques that can enhance WDT, such as immunoassays, targeted mass spectrometry, and nontargeted mass spectrometry. These techniques can be used to screen for known and unknown drugs and metabolites in biological samples. This review assessed the strengths and weaknesses of such techniques, such as their validation, identification, library search, and reference standards. Furthermore, this review contrasted the benefits and drawbacks of different specimens for WDT and discussed studies that have applied these techniques for WDT. WDT remains the best approach for preventing drug abuse in the workplace, despite the challenges posed by NPS and limitations of the screening methods. Nontargeted techniques using high-resolution liquid chromatography-mass spectrometry (MS)/gas chromatography-tandem MS can improve the detection and identification of drugs during WDT and provide useful information regarding the prevalence, trends, and toxicity of both traditional and NPS drugs. Finally, this review suggested that WDT can be improved by using a combination of techniques, multiple specimens, and online library searches in case of new NPS as well as by updating the methods and databases to include new NPS and metabolites as they emerge. To the best of the author's knowledge, this is the first review to address NPS as an issue in WDT and its application and propose the best methods to detect these substances in the workplace environment.

The dichotomy between health and drug abuse in bodybuilding.

Aim: The aim of the present study was to investigate the expansion and prevalence of anabolic steroid use by examining the divergent effects between health and drug abuse and to create more awareness around the harmful consequences of these drugs when administered at abusive levels. Methods: A focused and concise literature search was conducted, and 101 high-quality articles were included in the review. Results: The findings underscore the adverse health risks of steroid abuse, emphasizing the stark contrast between health and drug abuse. Conclusions: While steroids and other performance-enhancing drugs can yield muscle growth, strength and even fat loss, abusing these substances can lead to adverse health outcomes. Furthermore, within the fitness subculture, particularly in the realm of bodybuilding, steroid abuse fosters an atmosphere of cheating and deception, frequently downplaying or ignoring the negative and sometimes deadly consequences it brings.