Providentia

Posttraumatic Growth following a Relative's Illness

Posttraumatic growth (PTG) involves personal psychological growth in response to a traumatic or very stressful event. Using theoretical guidance from Tedeschi and Calhoun's cognitive model, a study published in Families, Systems and Health evaluated the relationship between specific individual, distress, and stress-processing factors and PTG among young adults who experienced an illness-related trauma earlier in life due to a relative's serious illness. Sixty individuals with a relative with a serious illness completed measures of PTG, posttraumatic stress symptoms (PTSS), anxiety, and coping. Results showed that PTG was positively associated with trait anxiety, PTSS, and the use of active, problem-focused coping strategies. Factors associated with PTG development in individuals who have a relative with a chronic illness are similar to that of individuals who had a serious illness themselves. The relationship between PTSS and PTG is moderated by whether the relative's current illness status is resolved versus not resolved.

For the abstract.

Krokodil Epidemic Skyrocketing in Russia

By all accounts, the designer drug known as krokodil is cheap and easy to make.  Which may well account for its skyrocketing popularity among young Russians over the past three years.   Drug abuse in  Russia has been a longstanding problem with an estimated two million heroin users and a third of all heroin-related deaths occurring there.  For that reason,  the prospect of a new designer drug which is more inexpensive and deadlier than the Afghan-supplied heroin that Russian drug agencies have largely failed to curb is especially terrifying. 

First appearing in Siberia and the Russian Far East in 2002, krokodil use has spread throughout Russia and the Federal Drug Control Service has noted a 23-fold increase in krokodil seizures since 2009 alone.   Although the primary ingredient is codeine,  users of krokodil (a.k.a. desomorphine) often mix it with other chemicals including gasoline, paint thinner, hydrochloric acid, iodine, and red phosphorus.    Codeine is often "cooked" from inexpensive headache pills (non-prescription) while the other ingredients can be found in household chemicals.   Producing a high far greater than any other opiate (and much cheaper to obtain than street heroin), krokodil can be easily mixed in any kitchen or bathroom.  With recipes and lists of ingredients freely available on the Internet,  hundreds of thousands of drug users have taken krokodil and many regions have implicated the drug in at least half of all drug-related deaths.   A typical "hit" of krokodil can last from 90 minutes to two hours (less than heroin) and addicts are often forced to mix repeated batches to maintain their highs.

The signs of krokodil use are apparent to drug abuse centres across the country.  Not only is krokodil neurotoxic, causing brain damage in most chronic users, but the drug's name comes from the characteristic scaly skin and  rotting sores found on chronic users .  Disturbing photographs of long-term krokodil users have shown graying and peeling skin, often with the bones exposed.    Ove 100,00 drug addicts are believed to be using krokodil or related homemade drugs (approximately 5 per cent of known drug addicts) and the percentage is expected to rise in the years to come.    Drug treatment clinics have found krokodil withdrawal especially difficult to treat.  While conventional heroin withdrawal pains can last for five to ten days,  krokodil withdrawal can last for weeks and addicts often relapse because they find the physical withdrawal pain to be unbearable.   In addition to krokodil, other homemade drugs made from non-prescription drugs are also being used increasingly.  One of these, tropicamide, is an anti-muscarinic drug used as eye-drops and prescribed by opthalmologists.   Known to produce psychiatric side-effects, including suicidal ideation, the drug is often sold as a street drug by pharmacy workers for a tremendous profit.

Despite a campaign to ban the sale of codeine tablets to stem the krokodil epidemic, Russian government agencies remain resistant to the idea.  Although President Dmitry Medvedev has called for krokodil recipe websites to be shut down, legislation to make codeine prescription-only will not be introduced in the forseeable future.  Opposition groups have blamed the government inaction on lobbying from pharmaceutical companies.    In the meantime, the designer drug epidemic is expected to worsen as long as krokodil and similar drugs represent a cheap and easy alternative to heroin. 

 

For more information.

 

When Adolescents abuse Inhalants

Inhalants are widely misused by adolescents and are among the most toxic of psychoactive substances.  In the United States alone, nearly 16 % of 8th grades report lifetime use of inhalants with prevalence of inhalant use climbing to nearly 40% in samples of antisocial users.  A study published in a recent issue of Experimental and Clinical Psychopharmacology examined the prevalence and correlates of adverse consequences of acute inhalant intoxication. Adolescent inhalant users (n = 279) in residential care completed structured interviews including assessments of the characteristics of their inhalant use. Multivariate logistic and linear regression and path analyses identified correlates of adverse inhalant intoxication-related experiences. Results of this study indicated that high-risk behaviors and adverse outcomes experienced during episodes of inhalant intoxication were common in this sample. High-frequency inhalant users were significantly more likely than moderate- and low-frequency users to experience adverse consequences of inhalant intoxication. Certain risky behaviors and consequences, such as engaging in unprotected sex or acts of physical violence while high on inhalants, were dramatically more common among high-frequency users than low-frequency users. Prior traumatic experiences, trait impulsivity, self-medication use of inhalants, and polydrug use were significant correlates of adverse inhalant-intoxication-related consequences. Adverse events and high-risk behaviors commonly occurred during episodes of inhalant intoxication in this sample of adolescents. High-frequency inhalant users and youth who used inhalants to medicate negative affective states were at elevated risk for such events.

For the abstract.

Waiting for Doomsday

The  French village of Bugarach has enjoyed a colourful reputation for decades.

Nestled in the Corbieres mountain range in the Languedoc-Roussillon region of southwestern France, Bugarach lies at the foot of Pic de Bugarach which is commonly referred to as the "upside-down mountain" due to its odd geological features.    Since the 1960s, Bugarach has enjoyed a strange reputation with New Age supporters who have been frequent visitors over the years due to persistent rumours relating to the mountain and its surroundings.  According to one rumour,  an underground civilization lies hidden beneath the mountain in the extensive limestone caves known to exist there.  Early writers such as Jules Verne have openly speculated on the mysterious cavern structure in the region, many parts of which remain unexplored.  

Despite having only 200 inhabitants,  settlements have sprung up in the surrounding area resulting from a predication that Bugarach will be one of the few places to survive the impending devastation of December 21, 2012.   The settlements were established by members of J.Z. Knight's Ramtha School of Enlightenment.   Acting as an agent for Ramtha, a Lemurean warrior who fought Atlanteans 35,000 years ago, Knight has made repeated predictions relating to the coming destruction in 2012.  Although a local representative for the Ramtha movement has denied apocalyptic teachings or any links with the village of Bugarach, French authorities have expressed concerns about the influx of apocalypse watchers and the potential effect on the Bugarach residents.

The French agency MIVILUDES has been monitoring events in Bugarach and has alerted the French government about the risk of mass suicides occurring as December 2012 approaches. MIVILUDES head, George Fenech, has recently told news agencies that he informed the prime minister and other government officials about the potential impact the the "message of fear" could have on "fragile members of the French population".    The fear of mass suicide has been heightened by a 2002 incident in Nantes, France involving an end of the world prophecy and several suicides among a small circle of believers.  Also uppermost in many minds is the rash of murders and  suicides that occurred in the late 1990s in France, Switzerland, and Canada by followers of the Order of the Solar Temple.  

Fenech carefully stressed that "We know from history and experience that apocalyptic discourse can lead to tragedy.  This is why we have taken measures to notify police and other public authorities in order to monitor the situation."    He added that "Around 500 000 French people belong to cults. They affect all kinds of people from all kinds of social backgrounds, including children."    Fenech has also commented on the increasingly worrisome attention that Bugarach is receiving. 

With numerous Internet sites declaring the Pic de Bugarach to be an "alien garage" housing alien visitors,  properties being bought by cultists in surrounding areas, and reports of underground bunkers with extensive food supplies being built,  Bugarach is receiving thousands of visitors who have disrupted local life with their frequent processions and mass prayer sessions.   Although national suicide organizations in France have not received any calls about the 2012 phenomenon to date, Suicide Ecoute president, Isabelle Chaumeil Gueguen, has commented that "It's certainly true that people who are mentally unstable can react strongly to dramatic announcements in the press. If it begins to be mentioned a lot in the media, especially on television, we can expect to have calls about it. People of a weak mental disposition are also much more likely to be influenced by cults, and messages spread by social networking sites can be equally dangerous." 

In the meantime, residents of Bugarach are waiting anxiously  as December 21, 2012 comes nearer although their threatened apocalypse seems far closer to home.

For more information.

How Does Childhood Abuse Affect Later Medical Problems?

Child abuse has negative consequences on health functioning and the self-concept. Prior studies have garnered support for these relationships in younger adults; yet few studies have looked at the effects of abuse on health in older adults and the psychosocial variables, specifically self-efficacy, that may influence the abuse-health relationship. A study published in Psychology and Violence examined data obtained from a two-wave panel study in Florida's Miami-Dade county.  The study explored the impact of child abuse on current medical problems among older adults who were screened on physical disability status (N = 1396, Mean age = 67, SD = 10.2). Conducted in South Florida, the researchers used a multiethnic sample that is representative of the general population in the area. Results showed that child abuse was associated with a number of current medical problems and disability. Child abuse was also related to lower self-efficacy, and self-efficacy explained the relationship between abuse and the number of health problems. The authors concluded that there are far-reaching effects of child abuse on older adults' health and self-concept. Health care providers and gerontologists need to be aware that child abuse is a lifelong risk factor for increased disability and specific health problems, especially among the elderly. Future research should examine treatments designed to increase self-efficacy, especially among those who experienced child abuse, and observe any positive effects on health functioning

For the abstract

UN Report Estimates 115 Million Child Workers In Danger

A chilling new report from the United Nations International Labour Organization indicates that more than half of the estimated 215 million child labourers worldwide engage in hazardous work that puts them at risk for injury of death.  The report, titled "Children in Hazardous Work: What we know what, we need to do" was released in conjunction with the upcoming World Day Against Child Labour which falls on Sunday, June 12 this year.   

According to the report, while the overall number of children aged 5 to 17 engaged in hazardous work actually declined between 2004 and 2008, child workers in the 15 t0 17 age bracket rose by 20 per cent during that same period.    International efforts to curb child labour have slowed in recent years and agencies fear that the recent economic recession may halt process towards the current goal of eliminating the worst forms of child labour by 2016.  While some forms of child labour such as use of child soldiers and sexual trafficking of children have received relatively greater media attention, child labour is often found in a range of industries including agriculture, manufacturing, mining and quarrying, construction, and service positions.   Due to insufficient information concerning child susceptibility to toxic environmental factors (including lead and mercury exposures), mind-numbing repetitive tasks, isolation, and threats of violence, physical and emotional trauma remains common.  Studies from both indusrialized and developing countries indicate that a child labourer experiences a work-related accident, psychological trauma, or other medical issue resulting from hazardous work every minute.

As part of the report, a graphic description is given describing how children are being used in the West African mining operations that produce one-fifth of the world's gold as well as rare minerals for cell phones.  Along with the hazardous work conditions, children are also exposed to dangerous levels of mercury which can have devastating consequences for their later neurological development.  By region, sub-Saharan Africa has the highest percentage of children in hazardous work settings (15.1%) followed by Latin American countries (6.7%).  Boys outnumber girls in hazardous work among all age groups and the percentage of boys in high-risk employment has remained stable over time while use of girls in hazardous work has declined 24% from 2004 to 2008.  In the United States alone, 374 children in the 15-17 age group died in work-related accidents during the period from 1998 to 2007 (a fatality rate of 2.9 per 100,000 equivalent which is nearly twice that of workers 25 years or older).

The report calls for renewed action on the following three fronts over the next five years:

• Making a renewed effort to ensure that all children are in school, at least until the minimum
  age of employment;
• Strengthening workplace safety and health for all workers, but with specific safeguards for
  youth between the minimum age of employment and the age of 18;
• Providing the crucial legal foundation for action against hazardous child work, with the support
  of workers and employers.

As part of the initiative to curb excesses in child labour, more than 173 nations have ratified the ILO's Worst Forms of Child Labour Convention (1999, No. 182).    The convention defines specific "worst forms of child labour" including: sexual exploitation of children, use of children from criminal purposes, and child slavery.  Only ten of the 183 ILO nations have failed to ratify the convention.   As well,  the ILO passed the Minimum Age Convention in 1973 calling on ratifying nations to a establish minimum age for children to enter the workforce.  As of March 2011, 157 nations have ratified the treaty with fourteen or fifteen being the typical minimum age for children to enter the workforce.

While significant changes seem unlikly in the short-term, the report lists a series of positive signs of reform including the increased use of social media (blogs, Facebook, YouTube videos) to organize young workers and inform them of health and safety issues.  The use of Internet bulletin boards have also been instrumental in collective bargaining for youth workers.    The report summarizes its findings by recommending strengthened initiatives to:

1. preventing younger children from becoming engaged in hazardous work
2. protecting older children in the workplace, and
3. strengthening the underlying policy framework

Further progress needs to rely on joint cooperation of governments, local communities, and worker's organizations.    As part of the effort to meet that 2016 goal of eliminating the worst forms of child labour, the Director-General of the ILO has caled for "“new and large-scale efforts” and a “re-energized campaign” and urges the international community to "recapture the sense of urgency and level of hope and energy that it had when it started down this path over a century ago, to protect children who were working in mines, factories and on ships".  

Helping children trapped in hazardous work is everybody's job.

For more information

To download the report.(PDF format)

That Healthy Glow (Part 2)

Continued from Part I

While the resulting publicity over the U.S. Radium case led to reform for factory workers, it had surprisingly little impact on the sale of the various health products containing radium.   "Dr" William J. Bailey  was a prime example of the entrepreneurs who dominated the radium industry at the time.     A former employee of U.S. Radium, Bailey founded his own company in 1918 and energetically advertised radium as a cure for a wide range of ailments (including coughs, flu, anemia, and constipation).   A Harvard University dropout with no university credentials  (though he was a member of the American Association for the Advancement of Science),  Bailey's lack of real academic standing didn't deter him from marketing radium-laced products.   For years, Bailey Radium Laboratories' main product was a patent medicine called Radithor.  Billed as a "cure for the living dead" as well as "perpetual sunshine",  Radithor was basically distilled water with concentrated amounts of radium 226 and 228 as the active ingredients.    Not only was Radithor touted as a cure for a lengthy list of diseases, but it was also billed as a rejuvenating agent that could revitalize inactive glands and force bodies to become young again.

Bailey was hardly the only radium entrepreneur around though.   Numerous newspaper and magazine boasted of the healing powers of radium and how it could combat the effects of old age.  One best-selling hair care product,  Caradium, featured "radioactive water" as its main ingredient and was advertised as a cure for dandruff and gray hair.    Another product, the Radiendocrinator, was a three-inch gold case containing 250 millicuries of Radium.  Patients were urged to wear it nightly over their endocrine glands or, in the case of men, to wear like an athletic supporter directly under the scrotum (the instructions also advised patients to "radiate as directed").    Products such as Radithor were often sold over the counter as well as being prescribed by physicians.   William J. Bailey even offered physicans a hefty rebate for each does of Radithor prescribed and patients soon came to demand it for dealing with assorted ailments.

Patients such as Eben McBurney Byers...

The son of a prominent American industrialist, Eben Byers acquired a well-deserved reputation as an athlete and an international playboy.   After injuring his arm in a 1927 accident, Byers was advised to take Radithor by his physiotherapist, Charles Moyar.   While the pain relief that he received was purely due to the placebo effect, Byers was sufficiently impressed by the benefit of Radithor to begin taking increasingly large doses.    The instructions on each bottle of Radithor suggested that patients consume an entire bottle after each meal but Byers decided that he needed even more.    He began consuming three bottles of Radithor a day and was impressed enough to keep taking it on a regular basis.   In fact, Byers became a walking testimonial for Radithor.  Not only did he recommend it to all of his friends (including sending them free cases), he also gave it to one of his sick racehorses.  By 1930, he had consumed up to 1400 bottles before the first symptoms began to set in.  These symptoms included severe headaches and jaw pain which an x-ray specialist (who had also treated several of the Radium Girls) diagnosed as radium poisoning. 

By then it was too late for Eben Byers.  The scandal of a prominent socialite and athlete being fatally poisoned by a health drink led to a massive media campaign to ban Radithor.  In a final  interview with a representative from the Federal Trade Commission, Byers  was described as "Young in years and mentally alert, he could hardly speak. His head was swathed in bandages. He had undergone two successive operations in which his whole upper jaw, excepting two front teeth, and most of his lower jaw had been removed. All the remaining bone tissue of his body was slowly disintegrating, and holes were actually forming in his skull."    By the time he died on March 31, 1932, Eben Byers only had six teeth left and both jaws were rotted.  An autopsy turned up 36 micrograms of radium in his body (two micrograms is considered a fatal dose).    He was buried in a Pennsylvania cemetery in a lead-lined coffin. 

Eben Byers wasn't the only Radithor casualty.  A close friend, Mary F. Hill, died of similar causes (remember those cases of Radithor he freely distributed to his friends?)   Despite the adverse publicity and calls for federal regulation, William Bailey was never actually prosecuted for the Radithor deaths.   He defended himself by maintaining that Radithor was only sold by prescription and that Byers had died from natural causes.  He also maintained that he drank as much Radithor as Byers did and never experienced any health problems.   Although the Federal Trade Commission issued an order against his business, that didn't keep Bailey down for long.   He founded a new company, the Radium Institute, and continued marketing radioactive products (including radioactive paper-clips, belt-buckles, and irradiated water).   He also manufactured a line of aphrodisiac tablets which "renewed happiness and youthful thrill into the lives of married peoples whose attractions to each other had weakened"

Although publicity over the Radithor deaths (and Marie Curie's own high-profile death from radium poisoning in 1934) ensured that no more physicians would be prescribing radium-laced products,  the radium industry still managed to lurch along.  William Bailey managed to die a wealthy man in 1949 (of what, I haven't been able to learn) although the same couldn't be said for many of his business competitors.  As consumer protection legislation became stronger (spurred on partially by the Eben Byers case), more stringent protections for consumers helped prevent additional radium deaths.  While radium still plays a role in medical diagnosis and treatment, the history of misuse in the early days following its discovery represents a sobering example of how easily revolutionary inventions can lead to tragedy. 

Especially when gullibility and greed are involved.

How Stable is Intelligence Over Time?

Investigating the predictors of age-related cognitive change is a research priority. However, it is first necessary to discover the long-term stability of measures of cognitive ability because prior cognitive ability level might contribute to the amount of cognitive change experienced within old age. These two issues were examined in a recent paper published in Psychology and Aging using data taken from the Lothian Birth Cohorts of 1921 and 1936. Cognitive ability data were available from age 11 years when the participants completed the Moray House Test No. 12 (MHT). The Lothian Birth Cohort 1936 (LBC1936) completed the MHT a second time at age 70. The Lothian Birth Cohort 1921 (LBC1921) completed the MHT at ages 79 and 87. The authors examined cognitive stability and change from childhood to old age in both cohorts, and within old age in the LBC1921. Raw stability coefficients for the MHT from 11–70, 11–79, and 11–87 years were .67, .66, and .51, respectively; and larger when corrected for range restriction in the samples. Therefore, minimum estimates of the variance in later-life MHT accounted for by childhood performance on the same test ranged from 26–44%. The study also examined, in the LBC1921, whether MHT score at age 11 influenced the amount of change in MHT between ages 79 and 87. It did not. Higher intelligence from early life was apparently protective of intelligence in old age due to the stability of cognitive function across the lifespan, rather than because it slowed the decline experienced in later life.

For the abstract.

New Approach Needed To Address National 'Epidemic Of Mass Incarceration'

In an article scheduled for release in the June 2 issue of the New England Journal of Medicine, researchers from Brown University's Center of Prisoner Health and Human Rights state that the United States is dealing with an "epidemic of mass incarceration".    According to Josiah D. Rich, M.D., M.P.H.,  who is co-director of the Center as well as a professor of medicine at Brown University,  many of the 2.3 million Americans who are behind bars and the estimated 10 million who cycle in and out of prison each year suffer from substance abuse and mental illness.  The inadequate treatment options in most communities has been exacerbated by the severe policy changes of the past 30 years which has been linked to the ongoing "War on Drugs".  Dr. Rich stresses that "More than half of all inmates have a history of substance use and dependence or mental illness, yet they are often released to the community without health insurance or access to appropriate medical care and treatment.  Sadly, without these linkages to transitional care in the community, the majority of these individuals will re-enter the revolving door of the criminal justice system, which already costs our county $50 billion annually."

According to Dr. Rich and his co-authors, Sarah E. Wakeman, M.D., of Massachusetts General Hospital, and Samuel L. Dickman, A.B., of Harvard Medical School, incarceration has risen by 600 per cent over the last 40 years.    With an estimated 1 in 100 Americans currently incarcerated, no other country comes close to the United States in terms of incarceration rate.  Given that most Americans in prison come from low-income and minority populations,  racial and socioeconomic disparities in availability of health care risk being perpetuated indefinitely.     Psychiatric problems in prisoners remain a special concern since major depression and psychotic disorders are four to eight times as prevalent as in the general population.    Only 22 per cent of state prisoners and 7 per cent of jail inmates receive any form of mental health care while incarcerated.

With the growing number of substance abusers in prisons, the prevalence of infectious disease among inmates has also increased dramatically.  An estimated 25 per cent of all HIV-positive Americans and a third of all individuals with Hepatitis C pass through the criminal justice system each year.  Other chronic illnesses that are overrepresented in prison populations include hypertension and diabetes.  The cost of care is expected to rise in coming decades as dementia becomes more prevalent among prisoners due to increased incidence of Alzheimer's disease, AIDS-related dementia, and similar illnesses.

For more information.

Domestic Violence and Farmworkers

Although there are over one million farmworkers in the United States, little is known about intimate partner violence (IPV) among this population. Given the particular demands of agricultural labor, however, farmworkers and their partners are highly susceptible to a host of occupation-specific stressors that may result in relationship conflict, and thereafter IPV. In cases where one or both members of the dyad engage in problematic drinking, the likelihood of violence increases exponentially. A recent study published in Cultural Diversity and Ethnic Minority Psychology examined the prevalence of IPV among a mixed gender sample of farmworkers in San Diego County, California, and assessed the association of potential correlates (acculturation- and work-related stress, problem drinking, and impulsivity) to IPV. Bilingual interviewers conducted survey data collection by using standardized instruments (e.g., Revised Conflict Tactics Scale; Migrant Farm Work Stress Inventory; Alcohol Use Disorders Identification Test). Nearly all participants (n = 100) were Mexican born. Results showed that approximately 16% of female individuals (n = 61) and 32% of male individuals (n = 37) reported partner violence perpetration, victimization, or both, in the past year. Significant correlates of IPV were problem drinking (among males) and impulsivity (among females). This study demonstrated the feasibility of conducting IPV research among male and female farmworkers. Additional research is warranted to more fully explore the role of acculturation- and work-related stress, drinking, and other personal characteristics and environmental factors in precipitating couple conflict and thereafter IPV

For more information.