A Cerebral Malaria Simulating an Epileptic Seizure

A 27-year-old patient, known epileptic and irregularly monitored since the age of three years. He was out of its antiepileptic treatment. He was admitted on August 12th 2015 for tonic clonic seizures associated with loss of consciousness. These subintrant convulsions (about a crisis every 30 minutes), taken at first for its seizure, led him to consult a health facility where he might have received care without success. Because of the persistence of crises, he was referred to YO University Hospital for better treatment. The examination upon admission revealed poor general condition with a clouded consciousness, colored anicteric conjunctiva, an infectious syndrome with a temperature at 39°C, moderate dehydration, a heart rate of 137 beats/min, high blood pressure at 140/90mmHg, haemoglobinuric urine. 

The thick smear came back positive, bicarbonates were lowered to 15 mmol/L, serum creatinine increased to 154.6 mmol/l. The diagnosis of severe malaria was selected. Under treatment based on artemether, PERFALGAN and bicarbonate infusion, the outcome was favourable and he was released from hospital on August 18th 2015. The occurrence of subintrant convulsive seizures in an epileptic patient should lead the clinician to systematically look for other causes of seizures such as cerebral malaria. To do this, health workers should be consequently trained.Read more....

Correlation between Cognitive Impairment and Complex Combination relating brain disorders

Most of neurodegenerative diseases accept cerebral crime as aboriginal signs or after effect of the change of these diseases. Early detection appears certain if, clinicians and advisers expect to win this war.Cognitive achievement is mainly bigger during aerial date of development that is, amid boyhood and adolescence. This important footfall is characterized by advance of the academician structures and development of the afraid system. Indeed a lot of the academician disorders are created by a abortion in one or abounding of these accustomed processing.

As an aftereffect of these imbalances, cerebral impairments in the brain, anamnesis and axial afraid arrangement can appear.The accustomed administration of cerebral measures was activated application the Kolmogorov-Smirnov’s test. To analyse Mc Nair analysis responses, array were adapted to a angled variable; and participants with a account beneath than 15 were denticulate “No cerebral complaints “vs whose account is added than or according to 15 were denticulate “Presence of cerebral complaints”. Spearman rank was acclimated to analyse the accord amid the connected variables accepted health, stress, dependency, wellbeing and Mc Nair score.Read more.....

Mentoring Students in Clinical Training

As schools and clinical training programs move into the second decade of the 21st century and the demographics in the US continues to change, it becomes more and more imperative for doctoral and master’s clinical training programs to develop ethical, appropriate, and innovative strategies to mentor students. Themajority of the clinical education and training programs focus on education, knowledge, and assessment skills. Mentoring in clinical training programs is as valuable as other core competencies in clinical programs. O’Neil et al. described mentoring as being effective across disciplines like medicine, education, business, nursing, and psychology. 

A mentor is an individual with adequate clinical experience who can help direct the early career of a mentee. A mentor must possess clinical, assessment, ethical, professional, business, and multicultural skills in order to propel the career of a mentee. Although strong mentorship relationships are considered an essential component of professional development and career preparation, many mentees report not having strong mentorship relationships. Little research exists on doctoral and master’s mentor programs incorporating cultural competence. This manuscript will discuss cultural competence, the culture-centered model (CCM), and sociopolitical development as essential mentorship tenets in any masters or doctoral clinical psychology program.Read more....

Partner Violence Risk Factors and Mental Consequences

Violence adjoin women is a accessible bloom affair and concrete affectionate accomplice abandon is the a lot of accepted anatomy of it. Concrete abandon is generally accompanied by cerebral corruption and has adverse furnishings on changeable victims’ brainy health. While the adverse brainy after-effects accomplished by women due to abandon and corruption by their ally accept been able-bodied established, it is not bright how abundant of these after-

effects are the aftereffect of concrete abandon only.

Intimate accomplice abandon (IPV) is a circuitous and bashful communicable that leaves no association untouched. IPV has adverse furnishings on changeable victims’ brainy bloom and causes a decidedly college use and amount of bloom affliction casework. Centers for Disease Control and Prevention has articular the appraisal of the bloom after-effects of affectionate accomplice abandon as a analysis priority. IPV had altered forms including physical, cerebral and animal and anniversary with altered impacts on brainy bloom. Globally, the concrete blazon of IPV has been accustomed as the a lot of accepted anatomy of abandon accomplished by women with activity time prevalence from 6% to 48%.Read more.....

Mentoring Students in Clinical Training

As schools and clinical training programs move into the second decade of the 21st century and the demographics in the US continues to change, it becomes more and more imperative for doctoral and master’s clinical training programs to develop ethical, appropriate, and innovativestrategies to mentor students. The majority of the clinical education and training programs focus on education, knowledge, and assessment skills. Mentoring in clinical training programs is as valuable as other core competencies in clinical programs. O’Neil et al. described mentoring as being effective across disciplines like medicine, education, business, nursing, and psychology. A mentor is an individual with adequate clinical experience who can help direct the early career of a mentee. 

A mentor must possess clinical, assessment, ethical, professional, business, and multicultural skills in order to propel the career of a mentee. Although strong mentorship relationships are considered an essential component of professional development and career preparation, many mentees report not having strong mentorship relationships. Little research exists on doctoral and master’s mentor programs incorporating cultural competence. This manuscript will discuss cultural competence, the culture-centered model (CCM), and sociopolitical development as essential mentorship tenets in any masters or doctoral clinical psychology program.

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An Worldwide Serious Neurological Disorder

Objective: Epilepsy is the most common serious neurological disorder worldwide, affecting 50 million people. Epilepsy is one of the most stigmatizing disorders worldwide and a prototype for a stigmatizing disorder with its dramatic and often scaring symptoms and signs. In this review, I discuss the following definition; stigma and discrimination; historical background; factors affecting stigma; how to decrease the stigma of epilepsy and burden of stigma and conclusion.

Result: People with epilepsy (PWE) devalued and stigmatized. False historical background, uncorrected knowledge and attitude about epilepsy, psychosocial factors of epilepsy and uncontrolled epilepsy lead to stigma of epilepsy. The factors affect stigmas are false historical background of epilepsy, psychological aspects of epilepsy, knowledge, attitudes towards patients with epilepsy, uncontrolled epilepsy and effect of Antiepileptic drugs.

Significance: To proper manage of epilepsy, we should know the factors lead to stigma. Stigma of epilepsy has impact effect upon patients, relatives and society.Read more.....

A Runaway Phenomenon of Our Time?

Is addiction a runaway phenomenon of the 21st century? The answer depends on the definitions we use. Addiction is a common term referring to behaviors of a compulsive, consuming nature that an individual has difficulty relinquishing despite its adverse consequences to oneself and others. However, in the Diagnostic Statistical Manual- IV-TR, addiction is not a diagnostic category. 

Substance abuse and dependency are classified under Substance Abuse Disorders while other compulsive behaviors, such pathological gambling and kleptomania, are currently classified as Impulse Control Disorders. A Task Force is considering the addition of Addiction and Related Disorders to the DSM-V that will encompass both substance use disorders and non-substance addictions.Read more......

On the Splitting of the Ego in the Process of Reality-Interpreting, Ego-Trauma, Defence, and Fantasy

My name is David Gordon Bain. I am putting this essay lecture out here as a trial balloon. If it goes over well, then there could be many to follow. I have studied psychology for more than 40 years now, and the work-as-a-whole that I have in mind under the title given above, would constitute the main essence of what I have learned in these 40 years, in as comprehensive and integrative a fashion as I can present it. First, let me give you a quick resume of my education and experience in psychology.

I entered The University of Waterloo, Ontario in 1974, and in my last year there, in 1979, I wrote my Honours Thesis in psychology for one of the earliest cognitive-behaviour theorists and therapists Dr Donald Meichenbaum. Today, looking back at that essay from a psychoanalytic or neopsychoanalytic perspective, I would say that it was an essay on 'Central Ego Functioning and Dysfunctioning' from a largely Cognitive-General Semantic, and Humanistic-Existential perspective.

However, by the time I finished that essay, I realized that there was a much 'deeper' body of knowledge that I needed to study and investigate specifically, or at least mainly, the 'cognitive templates' that exist in our subconscious mind that have been there since we were children. Read more......

Child Abuse

Child abuse is an important pediatric health problem. But during my daily medical practice for more than 30 years, I have a question; Does child abuse is a practice with some degree of acceptance and appreciation in some communities?There are many definitions for child abuse, but the simplest one is, it is any intentional action from side of the person who is caring the child that lead to real or potential harms to a child. The person who endanger the life of the child may be one of his parents

There are many types of child abuse including psychological, sexual as well as physical abuse. Child negligence is a part of child abuse.The child can suffer any of these forms at home, in schools as well as during his daily life among his community.

There is a definition postulated by the World Health Organization (WHO) for this problem, including this simple definition and extending these harms to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power.In developed countries, there are great effort to prevent child abuse, and by laws child abuse is a high priority issue.But, what about the social and cultural acceptance to child abuse?Some cultures appreciate and accept some forms of child abuse, where cultural, social and sometime religious believes play a major support to these practice.In this review, I will discuss in brief 4 conditions of this type of child abuse.Female genital mutilation (FGM) is considered as a violation of the human rights of girls and is an example of child physical as well as sexual abuse. The victims for this uncivilized practice are usually girls between infancy and adolescence. The procedure is common in Africa, the Middle East and Asia where social, cultural and religious factors support and appreciate practicing this procedure.

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Pleasant Attitude of a Teacher

I am indebted to my father for living, but to my teacher for living well -Alexander the Great. It is a good quote and teachers always direct students not only their studies but also to settle well in their life. Students can acquire knowledge, experience, and skills in their organizations only through teachers. At different stages of education (schools, colleges, and universities), students can learn their subjects and also skills that will help them to be more competitive in this modern atmosphere.

I had a terrible education. I attended a school for emotionally disturbed teachers -Woody Allen.

The behaviour of teachers has a strong influence on the uplifting of students. Teachers should be polite, knowledgeable and have good moral characters so that it creates a favourable atmosphere for the students at the time of teaching or learning. If the teachers are friendly and easily approachable, then students will have the opportunity for interactions or discussions. Otherwise, students may not engage in these activities; and it will discourage their learning habits. Teaching also should not be unilateral, but it should be bilateral so that there should be a mutual interaction between the teachers and students. Interactions of students will also depend on the attitude of the teachers. Negative teaching attitude will damage the psychological well-being of the students. Negative behaviour of teachers can cause various disorders to students such as shyness and anxiety.

Continuous Suicide Attempts

Suicide attempt is defined as a self-inflicted, potentially injurious behaviour with a nonfatal outcome for which there is evidence of intent to die; a suicide attempt may result in no injuries, or death. The existing literature is heterogeneous about the operational definition of “suicide reattempters”. Some studies suggest that SRs can be defined as such after an “index” suicide attempt, or that they are patients who committed two or more suicide attempts; other Authors consider SRs those who made three or more suicide attempts. 

Although this may represent a limitation, nonetheless we should be aware that in clinical ER settings clinicians are often compelled to work without the possibility to use scales and clinical interviews which are likely used afterwards, for instance if the patient is referred to the Psychiatry Ward. The clinician-rated actual intent to die may be higher in SSAs than in SRs, and that the latter may be more likely to perform attempts on an impulsive basis.

The existing literature is heterogeneous about the operational definition of “suicide reattempters” (SRs): some studies suggest that SRs can be defined as such after an “index” suicide attempt, or that they are patients who committed two or more suicide attempts; other Authors consider SRs those who made three or more suicide attempts. 

Furthermore the existing literature defines as “grand repeaters” patients with four or more suicide attempts (Mendez-Bustos et al.,2013). Despite these limitations, several studies have investigated the possible socio-demographic, psychological and clinical correlates of SRs. Nonetheless, the identification of predictors for repetition of non-fatal suicide attempts is difficult, and it is even more difficult for suicide deaths. Moreover, some predictors for initial, non-fatal attempts may prove weaker predictors for non-fatal repetition (Beghi, Rosenbaum, Cerri & Cornaggia, 2013

Substitute Addictions: Catching the Animagi and Throwing Away the Metamorphmagi

The phenomenon refers to any addictive behavior that serves at least one key function previously achieved by another addictive behavior (e.g., relaxation, escape, excitement, pleasure, reduction of negative affect, social lubrication; e.g. Zweben, 1987). It describes situations in which people substitute one form of addiction with another during recovery. This may involve substituting drug for drug, drug for behavior or vice versa, or behavior for a behavioral addiction. Examples include Benzodiazepine substituting alcohol, overeating for smoking, exercise for gambling, sex for opioid addiction, and so on. Last year a group from Columbia University and the New York Psychiatric institute published the first epidemiological survey that examined whether remission from one SUD predicts new onset of another SUD (Blanco et al., 2014). Despite the authors’ assertion that it did not predict such a change, they concede in the limitation the following: they relied on self-reporting by patients, no urinalysis was done and short follow up period.

What they did not concede was the omission of substitution to behavioral or process addictions. This is surprising given the wellestablished evidence of involvement of the dopaminergic neurons in the mesocorticolimbic reward system of the brain (ventral tegmental area via Nucleus accumbens) in both SUDs and process addictions, leading to the assumption that the same mechanisms involved in substituting drug for drug may be involved in substituting behavior for drug. Despite these, limitations they found one fifth of the nationallyrepresentative sample of 34 653 adults from the National Epidemiologic Survey on Alcohol and Related Conditions in the US, approximately one-fifth (n = 2741) of the total sample had developed a new-onset SUD at the wave 2 assessment. To me this proves the point, rather than refute it.

Obsessive Compulsive Disorder in a Patient with Down Syndrome

Introduction:

Despite the fact that individuals with intellectual disabilities are at an increased risk for psychiatric problems, a fact that has been well documented in scientific literature for decades, many mental health professionals do not properly recognize the co-occurrence of psychiatric disorders and intellectual disorders . Most mental health professionals do not receive training in the diagnosis and treatment of dual diagnosed individuals, and most clinical treatment studies list intellectual disabilities as exclusion criteria. 

Obsessive Compulsive Disorder (OCD) likewise tends to be under recognized and missed during mental health examinations  and even when it is diagnosed properly, mental health clinicians often do not initiate appropriate, evidence based treatment . Therefore, it is not surprising that little is known about the clinical presentation and treatment of OCD in individuals who haveDown Syndrome. We describe a case of OCD in an individual with Down Syndrome in which the diagnosis of OCD was overlooked for four years after first contact with mental health professionals. The treatment of the patient is reviewed, including medication management as well as the challenges in using evidence based psychotherapy.

Acute Cocaine Differentially Induces PKA Phosphorylation Substrates in Male and Female Rats

Introduction:

Cocaine use among women has steadily increased, rising to approximately 30% of users in the United States. As researchers pay more attention to hormonal effects on drug abuse, it is becoming apparent that men and women react differently to cocaine. Overall, women are more vulnerable to some aspects of cocaine abuse, such as being more sensitive to the addictive properties of cocaine, experiencing more nervousness after intermittentadministration of cocaine, taking longer to feel its subjective effects, reporting less euphoria, and having more severe cravings in response to cocaine-associated cues . Women also increase their rate of cocaine consumption more rapidly than do men, and once addicted it is more difficult for them to quit . Likewise, after abstinence, women use cocaine for longer periods than do men .

Similar to humans, female rodents also show exaggerated and more robust psychomotor responses to cocaine than do males . Females also more quickly develop cocaine-induced conditioned place preference (CPP) with lower doses and more readily acquire cocaine self-administration . Taken together, human and animal studies suggest that sex-specific differences exist at all stages of cocaine abuse including induction maintenance, and relapse.

Sex differences in the mesocorticolimbic dopamine (DA)system- -a regulator of cocaine’s psychomotor and rewarding effects have been demonstrated . As recently reviewed by Becker and Hu, there are sex differences in the levels of DA receptors in the striatum, in the efficacy of DA antagonists and agonists to block DA receptors, and in cocaine-induced accumbal DA release/reuptake. The sexually dimorphic pattern in DA system activation after cocaine treatment is postulated to be correlated with sex differences in cocaine-induced DA mediated intracellular responses.

The Treatment of Obsessive Compulsive Disorder

Despite the fact that individuals with intellectual disabilities are at an increased risk for psychiatric problems, a fact that has been well documented in scientific literature for decades, many mental health professionals do not properly recognize the co-occurrence of psychiatric disorders and intellectual disorders . Most mental health professionals do not receive training in the diagnosis and treatment of dual diagnosed individuals, and most clinical treatment studies list intellectual disabilities as exclusion criteria. Obsessive Compulsive Disorder (OCD) likewise tends to be under recognized and missed during mental health examinations  and even when it is diagnosed properly, mental health clinicians often do not initiate appropriate, evidence based treatment . Therefore, it is not surprising that little is known about the clinical presentation and treatment of OCD in individuals who have Down Syndrome. We describe a case of OCD in an individual with Down Syndrome in which the diagnosis of OCD was overlooked for four years after first contact with mental health professionals. The treatment of the patient is reviewed, including medication management as well as the challenges in using evidence based psychotherapy.

Case Presentation

Mr. B. is a 21 year old white male with a past medical history significant for a diagnosis of Trisomy 21 which was diagnosed at birth. He presented to our clinic accompanied by his parents with complaints of behavioral concerns effecting him at home as well as at his supported work program. He had become irritable at both work and home, would refuse to go to work, and was using vulgarity while at his place of employment. He would repeat certain vulgarities over and over, and the words did not always seem to be precipitated by a specific person or event, and were often not targeted at any individual. He described this as an intentional ritual done to relieve distress and it did not appear tic-like. He was also noted to have unusual behaviors- specifically he would continuously ask his mother if she was “OK”. She could not simply answer “yes”, but she had to use a very specific phrase when responding to him: any other phrasing would prompt him to become anxious and ask the question again. This would occur multiple times in an hour. He was unable to go to bed unless the kitchen and living room was arranged in a specific way resulting in a diminished sleep schedule. He would experience crying spells when his living space was rearranged. 

Introduction:

Problematic Internet use in Older Adults, A Critical Review of the Literature

Lately, the use of Internet has become increasingly common as a potent information tool, as a communication enhancer and as a relevant healthcare tool recognized by WHO. The other side of the coin is that problematic use of Internet is increasingly reported in adults and adolescents with significant somatic and psychiatric issues.

Problematic Internet use as a disorder is subject to debate. Some researchers’ tend to hypothesize it as an impulse control disorder, others as an obsessive-compulsive disorder and, finally, others as an addiction. The phenomenon was first described in 1996. K.Young exposed that in most situations, patients described moderate to severe consequences of Internet use on their quality of life and failed in controlling their behaviour.

Scientific research since then has provided a growing evidence for Internet addiction reality and its psycho-physiological and neurobiological closeness to addictive disorder. Internet Gaming Disorder has been recently listed in DSM V Section III to encourage more clinical research and experience. As Internet provides easy access to some engines (online stores, online casinos ...) it could also represent a potential worsening vector to a pre-existingoffline addiction (e.g., pathological gaming or gambling, compulsive buying). Nevertheless, addictive properties of the vector Internet itself have also been discussed.

Entry into advanced age is particularly marked by somatic disorders and a resurgence of factors leading to the emergence of psychiatric disorders. In these circumstances, the question arises as to the place Problematic Internet use (PIU) takes (or will take in the future) in old people, despite its controversial belonging to addictive or other psychiatric disorders.

Place Effects on Alcohol Consumption: A Literature Review

Introduction:

There is a growing recognition that numerous features of places in which people live and work exert an independent influence on health  behaviour and health outcomes . There are many place features including the physical and social environment that have been considered to influence health behaviour and health outcomes . However, much of the existing literature has focused on the effects of place on outcomes of general health and less on health related  behaviours.  

Moreover, those that have reviewed alcohol consumption concentrate on health and social outcomes including density of outlets and hospital admission, crime, violence, and drink driving. There is no review of place effects on alcohol consumption. It is against this backdrop that a focus on place effects on alcohol consumption is both timely and necessary. This is a review of existing empirical evidence of how features of place influence alcohol consumption.

Key among these has been theory of deprivation and how it has influenced health and health behaviour. Research has linked obesity, poor diet and smoking to poverty in the USA ghettos and black neighborhoods. More recently, researchers have developed more complex theories that question key factors in a deprived area that affect health and health behaviour. They are more concerned with explaining the processes rather than making associations, especially with new evidence that deprived areas expose individuals to poor environmental quality.

Confounding of the Comparative Safety of Prenatal Opioid Agonist Therapy

There has been a striking increase in rates of opioid use in pregnant women and in neonatal abstinence syndrome (NAS) in their infants in the United States and Canada. NAS is a drug withdrawal syndrome that most commonly manifests from in utero opioid exposure and affects the neonate’s postnatal life adaptation in critical areas of sleep, feeding, and autonomic function. NAS incidence rose from 1.20 to 3.39 per 1,000 American live-births from 2000 to 2009, and from 0.28 to 4.29 per 1000 Canadian live-births from 1992 to 2011.Total hospital charges for NAS grew from $190 to $720 million United States during this period. Significant increases in the rate of neonatal intensive care unit admissions for NAS, the median length of neonatal hospitalization for NAS, and neonatal receipt of pharmacotherapy for NAS in the Unites States from 2004 to 2014 were recently observed.

Studies have attributed this increase in NAS to rising rates of opioid addiction in pregnant women.Some cohort studies and randomized controlled trials (RCTs) have observed decreased NAS severity, lower risk of NAS treatment, and higher gestational age at birth , birth weight, body length and head circumference in buprenorphine vs. methadone exposed neonates. Evidence, however, is subject to bias from study drop out in RCTs and by confounding in cohort studies . A meta-analysis showed that confounding may account for some of the protective effect of buprenorphine vs. methadone on NAS severity, and that limited data on confounding of the comparative safety of buprenorphine vs. methadone on NAS are available.

Consequently, when the regression model is unadjusted for an important confounder-such as an important difference in clinical profile—the estimated measure of effect (i.e., risk ratio, mean difference) is a mix of the effect of prenatal opioid agonist exposure on NAS and the confounder effect on NAS. Confounding can attenuate, increase, or reverse the true effect of prenatal opioid exposure to buprenorphine vs. methadone on neonatal outcomes. The impact of confounding depends on the strength of the relationships between the confounder and the exposure, the confounder and the outcome, and the prevalence of the confounder.

Validity of the Adult Needs and Strengths Assessment with Substance Abuse Populations

Introduction:

How researchers and practitioners measure substance use patterns can have a profound impact on treatment protocols. Throughout the United States and around the world, various agencies employ sundry intake devices to determine the severity of substance abuse patterns and related problems from both a recent and lifetime perspective. Some of the more commonly used measures include the Addiction Severity Index (ASI) from National Institutes of Health (NIH), Substance Abuse Subtle Screening Inventory (SASSI) from Multi-Health Systems (MHS), and the Simple Screening Instrument for Alcohol and Other Drugs (SSI-AOD) from the Center for Substance Abuse Treatment (CSAT).

In recent years, however, the Adult Needs and Strengths Assessment (ANSA) has become the preferred instrument for many providers of substance abuse treatment. The ANSA was created to support decision-making in relation to level of care and service planning, facilitate quality improvement initiatives, and allow for monitoring of outcomes. 

The ANSA currently is being utilized in a number of locations within the United States and Canada, in such diverse settings as hospitals, emergency rooms, rehabilitation programs, and mental health centers.

The ANSA was developed to craft a linkage between the assessment process and the design of individualized service planning founded upon evidence-based practices. The original version, the Severity of Psychiatric Illness (SPI), was created in the 1990s to study decisionmaking in psychiatric emergency systems. The ANSA expanded on the concepts of the SPI to include a broader description of functioning and to incorporate strengths with a recovery focus.

Study on Factors Associated with Repeated Gambling Among Gamblers Anonymous Participants

People who participate in public gambling in Japan (hereinafter, gamblers) are estimated to include 16.7 million pachinko gamblers, 14.9 million horse race gamblers, 2.5 million boat race gamblers, and 2 million bicycle race gambler. Some gamblers can never resist the desire and drive for gambling and gamble repeatedly without taking any breaks, resulting in having social life problems such as multiple debts, unemployment, and family collapse. This state is called gambling disorder in the DSM-5. The number of gambling disorder estimated from the adult population in Japan is as many as 5.36 million (4.8% of adult population) in total, including 4.38 million men (8.7% of adult male) and 0.98 million women (1.8% of adult female) (Ministry of Health, Labour and Welfare). Treatment takes a few years and its purpose is to make patients quit gambling. However, many of the patients succumb to their addiction, and it can be said that this gambling disorder is a disease that is difficult to completely cure.
An effective therapeutic approach for gambling disorder is psychological therapies. However, at present, there are a small number of specialized medical institutions that provide psychological therapies for

this disease. Gamblers Anonymous (GA) actually plays a psychotherapy-like role . GA is a self-help group aiming at recovery from gambling addiction, in which anonymity, i.e., no need to reveal the real names of participants, is ensured and regular meetings (4 to 12 times per month) are held. In the meetings, an environment is created in which participants “just speak, just listen, and do not discuss” so that they can talk without anxiety. Furthermore, the participants implement “12 steps for recovery” such as “having an insight into the disease, reviewing failure, and making amends for wrongs” to prevent gambling addictive behavior, to recover their humanity, and to improve their way of life.

Descriptive national survey of substance use in Nigeria

Introduction:

There were no epidemiological data on alcohol and drug use in Nigeria, prior to the Second World War. In the 1940’s, the abuse of drugs, such as amphetamine, phenobarbitone, pethidine, Lysergic Acid Diethylamide (LSD) and Cannabis were reported. In the 1960s, isolated reports of drug abuse problems, were also reported by the few psychiatric hospitals at that time . Subsequently, sporadic community surveys, such as the pioneering effort of Odejide, who surveyed a rural community in Western Nigeria, emerged. This was followed in 1988, by the International Council on Alcohol and Addictions’ (ICAA) study in the urban and rural communities of five university towns in three, of the current six geopolitical zones.

 It took another decade before the (1998) UNDCP-funded, multi-city; rapid situation analysis of drug problems in Nigeria was conducted. This study was carried out in four geographically representative states. The study was followed closely by the (1999) Rapid situation assessment of drug abuse in Nigeria, also by the UNDCP, in which 19,550 community samples from twenty-two of the thirty-six states of the country were interviewed. 

In 2002 - 2003 there was a household community survey on drug use among 6,752 participants in 21 states of Nigeria that covered 5 of the current 6 geopolitical zones.

These studies had some limitations. Though the ICAAstudy analysed data from multiple sources in five states, the actual community survey was conducted in only two states. The (1999) UNDCP, Rapid Situation Assessment study did not have defined criteria for urbanrural classification of communities surveyed. The more inclusive, large sample size study in 2002 – 2003 did not evaluate the possible ruralurban differences of drug use.

Are Cannabis Expectancies Related to Subjective Drug Experiences and Schizotypy

Do expected effects of cannabis relate to the experiences people have when using the drug? An individual’s expectancies for a substance capture how they expect to be affected during substance use and are shaped by information from the environment (e., media, peers, observing others) as well as subjective experiences with that particular substance when use occurs . Traditionally, expectancies have been considered in alcohol research, and are related to both adult and adolescent drinking behaviours. More recently expectancies have been investigated in relation to cannabis use, with the previous results from alcohol research largely being replicated . Given the role for expectancies to shape patterns of substance use, the investigation of cannabis expectancies has relevance not only for substance use problems in the general (psychologically healthy) population, but also for individuals with serious mental health problems. For instance, compared to the general population, rates of cannabis use are elevated in patients with schizophrenia and psychosis prone healthy volunteers from the general population. In those with schizophrenia, substance use can lead to variability in treatment and symptom outcomes. Therefore determining whether cannabis expectancies vary according to vulnerability for a mental illness such as schizophrenia could highlight reasons for use, potentially explain variations in subjective experiences with a substance and assist in the development of effective psychological interventions to target substance use in psychologically vulnerable populations.

Few studies have investigated cannabis expectancies in patients with schizophrenia. Green, Kavanagh and Young reported that patients with psychosis had the same expectancies for cannabis and used the same quantities on each occasion but with less frequency when compared to healthy controls. However, psychosis patients displayed more cannabis dependent-like behaviours (e.g., withdrawal symptoms) and were more driven to change their consumption than healthy controls. Self-reported negative effects of cannabis predicted of cannabis use over a four week follow up period in the patients with psychosis but not control participants. Despite there being no differences between the patients and controls on their overall expectancies for cannabis, cannabis expectancies appeared to behave in differential manner in the two groups.

A Comparison of Suboxone and Methadone in the Treatment of Opiate

A comparison of suboxone and methadone in the treatment of opiate addiction

The rate of opiate addiction and dependence is growing exponentially in the United States. Since 1990, the rate of drug overdoses have more than tripled and the majority of these are caused by opiates. Opiates are a class of medication defined as a psychoactive substance that is derived naturally or synthetically but has similar effects to morphine. This includes medications such as codeine, oxycodone, heroin, and even methadone and buprenorphine. Opiates are legally prescribed to patients for pain management of acute, chronic, or surgical pain. 

Patients taking these medications long term often develop a tolerance, or need for increased dosages to achieve analgesia. This can further develop into an opiate dependence, in which the patient requires continued dosages to prevent withdrawal symptoms. However, some people also develop an addiction to opiates, which is defined as the inappropriate use of medication for purposes other than those it was prescribed for and despite medical, legal, and social consequences. Addiction is frequently associated with psychological attributes while dependence and tolerance are more physiological, but addiction and dependence are often coexistent. 

Addiction and dependence can occur in any person and is regularly the result of taking more than the prescribed opiate dose or obtaining opiates illegally so the user can experience desired effects such as analgesia or euphoria. As a result of the analgesia and euphoric effects, there is a high addiction potential for many individuals, which is why opiate addiction and dependence is such a widespread problem.

The growing incidence of opiate addiction and dependence necessitates that effective treatment is developed to treat addiction and prevent overdose. Currently, treatment for opiate addiction is a difficult, complicated, and a multifocal process. Addiction is a complicated disease and has many physical and psychological components that need to be addressed in order for treatment to be effective. Addressing the psychological components of addiction are key in long term success of treatment, but helping the patient end their dependence on the opiate and preventing them from restarting use of the drug is very difficult. 

Alcohol Consumption for People Admitted in French Emergency Departments: A Protocol for a Multi-Center Cluster Trial

Introduction

According to a new report published by the World Health Organization (WHO) in May 2014 in Geneva, around the world, people aged 15 or older consume, on average, 6.2 liters of pure alcohol per year. But it is in Europe that alcohol consumption per person is the most prevalent. In 2012, harmful use of alcohol was responsible for 3.3 million deaths worldwide. Drinking alcohol can not only lead to alcohol dependence, but it also increases the risk of developing more than 200 diseases, including liver cirrhosis and some cancer.

In France, recent data from a national epidemiological study show that in the general population in 2014, 86% of persons aged 15–75 said they had drunk alcohol in the last 12 months, an estimated average weekly consumption of 5.5 drinks. Almost half of 15–75-year-olds had consumed alcohol at least once a week, and one in 10 drank it daily. These consumption levels were relatively stable in 2010, except for the daily alcohol consumption, which decreased from 11% to 10%, in line with a trend that has been observed over several decades. Regarding clinical populations, i.e. those hospitalized in medical services or surgery, prevalence of misuse was higher. Reynaud et al. found, in a study of about 10,000 patients hospitalized in medicine, surgery, obstetrics and gynecology and psychiatry departments, on a given day in Auvergne, the prevalence of patients with excessive alcohol consumption and/or possibly alcohol dependence was approximately 20% using the CAGE screening questionnaire. Half of these patients has been classified as having alcohol dependence. Men has been more frequently classified as experiencing alcohol-related issues (34%) than women (8%).

The Emergency Departments (ED) will constitutes a privileged center of care for the identification, early intervention and orientation of patients suffering from alcohol-related issues, especially when the emergency admission is related to somatic or surgical problem. Regarding (ED) in France and despite little available data, 16.5% to 37.5% of all injuries seen by emergency room staff have been reported to be linked to drinking . An older work in United States has observed that 40% of patients entering the ED had consumed alcohol within the six hours before admission. Among these patients, over half have presented pathological consumption of alcohol (risk use, abuse or dependence as defined by the DSM IV–TR).

Top Cited Articles in Dental Trauma; A Bibliometric Study

A citation is an abbreviated alphanumeric expression embedded in the body of an intellectual work that denotes an entry in the bibliographic references section of the work for the purpose of acknowledging the relevance of the works ofothers to the topic of discussion at the spot where the citation

appears. This definition from Google Scholar indicates that a citation can be a reference to any item, be it an article, book, dissertation, newspaper editorial or similar material. It not only provides adequate information at the end of the scholarlywork, to locate the item from where the information has been

borrowed but also helps to acknowledge the author of that information. In fact, plagiarism issues arise when the author uses a specific source in his body of work but fail to indicate what has been borrowed or do not mention the original author of the referenced material. To cite a particular work serves several important purposes including safeguarding  Intellectualhonesty and integrity as well as giving credit to the original author for his authentic thinking and idea . Itprovides the readers certain autonomy because they can decide, after reading through the references, whetherthe referenced material supports or refutes the author’sargument in the way it has been claimed. 

The results of the analysis of the most frequently cited articles arealso the determining aspect of journals’ impact factor, whichare figures of merit frequently looked upon by researcherswhen they are submitting their original research to a particularjournal. In fact Journal Citation Report (JCR) ranks journals oncitation data . Although a high rank according to citationsalone cannot be held as the ultimate criteria for the relevanceand quality of the article, it does however indicate the impactthat article has in that particular field of science.Nevertheless, citation analysis of literature and articles invarious specialties is a well-accepted means of scientificrecognition.Various t

ools have been devised and suggested as a meansof counting citations. Several resources can be utilized in thisregard, in order to fully capture an article’s or an author’s impact in terms of the citations received. Each of theseresources produces slightly variable results revealing the needfor using more than one data base to count citations. EugeneGarfield founded the Institute for Scientific Information(ISI), which since 1945, has been the largest database forbibliographic information of more than 10,000 internationaljournals through the Science Citation Index Expanded (SCI). 

Cannabis Smoke Causes Up-Regulation of Akt and Bax Protein in Subfertile Patients Sperm Cells

Emerging worldwide evidences in support of adverse effects of cannabis smoke indicate its significant role in declining male fertility. The aim of the present study was to compare the percentage of damaged sperm cells and the expression profiles of cell survival protein p-Akt and pro-apoptotic protein Bax in non-smoker, tobacco smoke addicted and cannabis smoke addicted subfertile subjects.

Since last few decades, a sharp decline in male fecundity has been observed all over the world. In addition to congenital abnormalities, environmental and occupational exposures, changed lifestyle factors were also found to impact male reproductive health. Several studies reported direct association of excessive tobacco and alcohol consumption with the declining male fertility . Emerging studies have also correlated addiction to cannabis smoke with poor semen quality of men.Contents of cannabis smoke reduce antioxidant defence mechanism and increase oxidative stress in seminal plasma.

It has been estimated that around 150 million people across the globe were addicted to cannabis in the beginning of this millennia .The hallucinogenic effects caused by this recreational drug, entices people of different age groups and socio-economic classes in different countries all over the world. ‘Cannabis’ is a generic term used for marijuana, hashish and hash oil and it is derived from the Cannabis sativa plant. Δ9-Tetrahydrocannabinol (THC) is the unique compound of cannabis with major psychoactive effects and is said to act upon a specific cannabinoid receptor (CB1) in the brain.

In the 1990s, it was observed that cannabinoid compounds are naturally synthesized in human body from fatty acid derivatives termed as endogenous cannabinoids or endocannabinoids . Endocannabinoids modulate several pathophysiologic processes like neuropathic pain, movement disorders such as Parkinson disease, Huntington disease and many other conditions like atherosclerosis, obesity as well as reproductive health. However, the association between cannabis smoking and cancer is highly disputed as different case-control studies had inferred different result. Both cannabinoid and nicotine  receptors are coupled to the protein kinase B (Akt) signalling pathway. Akt is a serine threonine kinase which induces anti-apoptotic signal and inhibits apoptosis. However, the role of Akt coupled with cannabinoid receptor, varies from one disease to another

Influences of Barriers to Cessation and Reasons for Quitting on Substance Use among Treatment-Seeking Smokers Who Report Heavy Drinking

Influences of barriers to cessation and reasons for quitting on substance use among treatment-seeking smokers who report heavy drinking. Strong associations between tobacco and alcohol use have been documented. Roughly 85% of smokers drink alcohol, and drinkers are 75% more likely to smoke relative to those who abstain from alcohol. Smokers with alcohol problems (relative to smokers without alcohol problems) tend to also report lower tobacco quit rates, be more dependent on nicotine, and die at higher rates from diseases linked with smoking as opposed to alcohol causes. Concurrent use has reciprocal effects such that use of one substance predicts use of the other, and concurrent use also has multiplicative effects greater than the independent risk of either substance.

Multiple perspectives have emerged with respect to treatment for co-use. One perspective suggests that coping with withdrawal symptoms following treatment for concurrent alcohol and tobacco use may be a barrier to successful cessation . Another perspective suggests one drug may become a conditioned stimulus for the other; and thus, concurrent treatment may improve abstinence rates relative to treating each substance separately. Research has explored efficacy of concurrent treatment , and findings largely support targeting cooccurring substance use. However, further work is needed to understand effects of behaviorally- and cognitively-based quit processes on concurrent substance use. Examination of quit processes among smokers who drink heavily is important in elucidating the extent to which changes in behavioral (the use of quit methods) and cognitive (e.g., quit barriers, reasons for quitting) variables are linked with use, and whether these processes uniquely or differentially influence substance use outcomes.