Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Best practices for online Canadian prenatal health promotion: A public health approach

Background

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.

Disasters,local organizations,and poverty in the USA, 1998 to 2015

Disaster research has drawn attention to how natural hazards transform local organizational dynamics and social inequalities. It has yet to examine how these processes unfold together over time. We begin to fill this gap with a county-level, longitudinal analysis that examines how property damages from natural hazards correlate not only with local shifts in poverty a year later but also counts of for-profit as well as bonding and bridging social capital organizations. Results show that poverty and all organizational types tend to increase with local hazard damages. They also show that poverty tends to increase most where the number of bonding social capital organizations is also increasing. This pattern suggests a Janus-faced dynamic in which bonding, or more inwardly focused, organizations that arise after disaster may end up inadvertently marginalizing those in more dire need.     

‘Scarier than another storm’: values at risk in the mapping and insuring of US floodplains

How do people respond to the ways in which insurance mediates environmental risks? Socio‐cultural risk research has characterized and analyzed the experiential dimension of risk, but has yet to focus on insurance, which is a key institution shaping how people understand and relate to risk. Insurance not only assesses and communicates risk; it also economizes it, making the problem on the ground not just one of risk, but also of value. This article addresses these issues with an investigation of the social life of the flood insurance rate map, the central technology of the U.S. National Flood Insurance Program (NFIP), as it grafts a new landscape of ‘value at risk’ onto the physical and social world of New York City in the aftermath of Hurricane Sandy. Like other risk technologies, ubiquitous in modern societies as decision‐making and planning tools, the map disseminates information about value and risk in order to tame uncertainty and enable prudent action oriented toward the future. However, drawing together interview, ethnographic, and documentary data, I find that for its users on the ground, the map does not simply measure ‘value at risk’ in ways that produce clear strategies for protecting property values from flooding. Instead, it puts values‐beyond simply the financial worth of places‐at risk, as well as implicates past, present, and future risks beyond simply flooding. By informing and enlarging the stakes of what needs protecting, and from what, I argue that plural and interacting ‘values at risk’ shape how people live with and respond to environmental risks that are mediated by insurance technologies.     

Community-based arts research for people with learning disabilities: challenging misconceptions about learning disabilities

This article presents some of the community-based artwork of a group of men with learning disabilities, who aimed to challenge some of the misconceptions associated with learning disabilities. People with learning disabilities regularly face many forms of direct and indirect stigma. The consequences of such negative perceptions may affect individuals’ social relationships and ensure that barriers are strengthened which prevent their full inclusion. The men in this project used a series of visual and creative methods to challenge some of these misconceptions by telling stories through art, demonstrating skill through photography, using poetry to talk about sexual identity and improvising drama and filmmaking to challenge stigma, and through sculpture expressed their voices. Thus, by doing so, they were able to challenge some of the stigma associated with learning disabilities, indicating that community-based arts research is a valuable way in which to promote the voices of people with learning disabilities.     

Cross-validation of the screening scale in an adult protective services sample

Adult Protective Services (APS) professionals are often called on to assess decision-making capacity when investigating financial exploitation. Previous research found that in consecutive APS cases, a decision-making screening scale (LFDSS) also detected financial exploitation. The purpose of this study was to apply the clinical cutoff scores derived from the previous study to a new sample of APS cases. Using a sample of 105 participants, from APS workers across 5 counties this study investigated the clinical utility of the LFDSS to detect financial exploitation based on ratings by APS professionals using the scale. Results demonstrate that the LFDSS has excellent internal consistency and clinical utility properties. This paper provides support for use of the LFDSS as a reliable and valid instrument. Instructions for use of the LFDSS are included in the article, along with information about online support tools.     

Integrating self-care into clinical practice with trauma clients

ABSTRACT

Self-care is recognized as an important aspect of social work practice. Beginning in educational settings, developing social workers are encouraged to learn about and practice self-care. However, self-care is typically promoted through strategies and approaches outside of the practice context. Social workers are oftentimes encouraged to use individualized self-care plans, which often feature a variety of relaxation and secondary techniques; focus on self-awareness and self-reflection; and have proper use of supervision. Although these strategies are invaluable, they do little to directly benefit the social worker during direct practice or while in session with a client which is a time period when clinicians are particularly vulnerable to distress or burnout. The importance of real-time self-care strategies is particularly critical for clinicians, especially those who engage in trauma work, given the sensitivity of topics that clients may have endured or benefit from assistance in processing. Further, little information has been published on the use of self-care techniques during a session with a client or in a clinical context. The purpose of the present paper is to discuss self-care strategies that can be useful both outside of and within a clinical setting and present a model of such strategies that focus on integrating self-care in clinical practice particularly for those engaging in trauma work. The paper will conclude by discussing the relevancy of the developed model in practice.     

Gender in academic STEM: A focus on men faculty

In this study, we explore how men faculty understand the role of gender in shaping faculty experiences in academic science, technology, engineering and mathematics (STEM) and how they position themselves in relation to inequalities disfavouring women. Our data reveal diversity among men in their understandings regarding challenges facing women in STEM. The majority of our participants revealed gender‐blind perspectives and argued that the egalitarian structure of academia does not allow gender to impact attainments in STEM in any significant way. However, a considerable number of them felt privileged compared to women and described subtle ways in which gender shapes opportunities. Our findings show the important implications of men's sensitivity to gender in the ways they perform their professional roles as, for example, mentors, colleagues and teachers in relation to women in STEM. They further call for attention to men's perceptions of gender issues when designing institutional interventions for improving women's conditions in STEM.     

New masculinities in universities? Discourses,ambivalence and potential change

In this article, we explore forms and possible implications of new masculinities in universities, and elucidate how they relate to hegemonic masculinity. ‘New masculinities’ coins a particular tradition of naming in Nordic masculinity studies. In the Nordic context, gendered social relations are shaped by State policies and equality discourses, which are increasingly embracing father‐friendly initiatives. New masculinities refers to the increased involvement of men in caring practices and especially in fathering. Our empirical study comprises in‐depth interviews with young male academics in a Finnish business school. We elucidate, first, the ambivalence and struggles between masculinities in the discourses of these men and, second, how the construction of masculinities is specific to societal, sociocultural and local contexts. Relations of class, and middle‐class notions of the ‘good life’ in particular, emerge as central for understanding the experiences of these men. Beyond the Nordic countries, we argue that while the change potential of caring masculinity stems from particular contexts, the concept of new masculinities is helpful in capturing the ambivalence and struggles between hegemonic and caring masculinities rather than dismissing the latter as subordinate to the former.     

Managing Risk as a Duality of Harm and Benefit: A Study of Organizational Risk Objects in the Global Insurance Industry

This study examines how organizations construct and manage risk objects as a duality of harm–benefit within their normal operations. It moves beyond the existing focus on accidents, disasters and crisis. We study the risk‐transfer processes of 35 insurers where they navigate the tension of retaining risk in their insurance portfolio to increase the benefit of making profit and transferring risk to reinsurance to reduce the harm of paying claims. We show that organizations’ constructions of risk are underpinned by everyday risk management practices of centralizing, calculating and diversifying. Through variation in these practices, not all organizations seek balance and we in turn uncover the sensemaking processes of abstracting and localizing that enable organizations to prioritize harm or benefit. This contributes to the risk literature by illuminating the co‐constitutive relationship between risk sensemaking processes and everyday risk management practices. Following the complex linkages involved in the construction of risk objects as sources of harm–benefit, our analysis also contributes to the literature on dualities. It shows that while immediate trade‐offs between harm–benefit occur, prioritizing one element of the duality is ultimately a means for attaining the other. Thus, while initial imbalance is evident, prioritization can be an enabling approach to navigating duality.