A Note on CBD: It's All in a Name

I recently saw an article with the following title: “Medical cannabis relieves symptoms in children with autism.” On reading it, I realized that the Drug Target Review was talking about cannabidiol, otherwise known as CBD, not THC (tetrahydrocannabinol, the psychoactive ingredient in cannabis). I also realized the words cannabis and marijuana are no longer useful in talking about marijuana now that CBD has been moved to Schedule V of the Controlled Substances Act when manufactured by GW Pharmaceuticals. Still, it is common to see CBD lumped with the hundreds of other cannabinoids, especially if not produced by a Food and Drug Administration (FDA)–approved pharmaceutical company where it is still classified as Schedule I by the Drug Enforcement Administration (DEA). I think this has implications for popular understanding and clinical utility.     

Laggards or Leaders: Conservers of Traditional Agricultural Knowledge in Bolivia

Many sustainable agricultural practices are based on local and traditional farming knowledge. This article examines the conservation and loss of three traditional practices in the Bolivian Altiplano that agronomic research has shown increase the resiliency of small farmers in the face of climate‐related risks. These practices are the use of manure, the use of local forecasts and risk‐management strategies, and the preservation of crop biodiversity. Although these practices are widely used today, farmers have been steadily abandoning them during the past decade. This article examines the characteristics of those who maintain and those who abandon traditional practices to see if the abandonment of local knowledge can be explained by the adoption‐diffusion literature. This research does not support the adoption‐diffusion literature; although the factors related to conservation are slightly different for each practice, the findings do not support the idea that young, educated, and wealthier farmers are more likely to reject local knowledge. Instead, off‐farm activities such as migration, employment, and trade seem to be related to the decline in local practices as each affects the availability of labor and the availability of people to learn these practices.     

Traumatic Experiences and Drug Use by LGB Adolescents: A Critical Review of Minority Stress

High rates of illicit drug use found among lesbian, gay, and bisexual (LGB) adolescents are often attributed to unique and chronic traumatic events tied to sexual minority identity. Although initiation of drug use is relatively common within adolescence, little research contributes to our understanding of the disparities found among LGB adolescents. This review synthesized existing literature to determine if the minority stress model is applicable to LGB drug use disparities and fits within a trauma framework. Findings indicate that minority stress experiences have been inconsistently related to drug use among LGB adolescents. Implications for future research and practice are described.     

Clinical Results Using Virtual Reality

Abstract

Virtual Reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible to deliver using traditional methods are now being developed that take advantage of the assets that are available with VR technology. As research evidence continues to indicate clinical efficacy, VR applications are being increasingly regarded as providing innovative options for targeting the cognitive, psychological, motor, and functional impairments that result from various clinical health conditions. VR allows for the precise presentation and control of stimuli within dynamic multisensory 3-D computer generated simulations as well as providing advanced methods for capturing and quantifying behavioral responses. These characteristics support the rationale for the use of VR applications in clinical assessment, intervention, and training. This article begins with a brief review of the history and rationale for the use of VR with clinical populations. We then detail one use-case for the clinical application of VR—the exposure therapy treatment of anxiety disorders and post-traumatic stress disorder. While significant work is cited in other areas of Clinical VR (e.g., pain management, cognitive/physical assessment/rehabilitation, eating disorders, social skills/clinical training, etc.), a full overview of such a broad literature is beyond the scope of this article. Thus, we have opted to provide more in-depth analysis of one specific clinical area that clearly illustrates how VR has been successfully applied and is supported by an encouraging and evolving scientific literature.     

Neutralization theory and the denial of risk: some evidence from cannabis use among French adolescents

In contemporary societies, risk culture and risk profiling lead to the stigmatization of unhealthy behaviours as 'risky'. Risk denial theory refers to a cognitive way to deal with risky behaviours and can be considered as an updated variant of Sykes and Matza's neutralization theory. People neutralize the 'risky' label using specific techniques that must be added to those previously enlisted by Sykes and Matza. This paper introduces and discusses three techniques of risk denial: scapegoating, self-confidence and comparison between risks. As it is usually defined and studied as a 'risky behaviour', cannabis use provides a relevant example to illustrate these types of risk denial, thanks to various ethnographic studies (including Becker's seminal work on marijuana smokers) and quantitative French data from the 1999 European School Survey on Alcohol and Other Drugs (ESPAD). In order to deny the 'risky' label, cannabis users scapegoat 'hard drugs' users, they emphasize their own ability to control their consumption personally, or they compare cannabis and alcohol risks. The paper concludes with suggestions for further analyses of risk denial.     

A MODEL FOR COLLABORATIVE TEAM PROCESSING IN BRIEF SYSTEMIC FAMILY THERAPY*

While there has been considerable growth in recent years in the use of collaborative teamwork in Systemic Family Therapy, there has been a dearth of literature concerning the process of team functioning. Based upon a careful analysis of actual teamwork, a model for conducting more efficient and effective team conferences has been developed. The ensuing discussion examines the risks in working in teams and proposes ways to counteract these. Further avenues of research are suggested.     

The Use of Owner Resources in Small and Family Owned Businesses: Literature Review and Future Research Directions

This paper integrates relevant literature and the Sustainable Family Business Model regarding interchange of financial resources between family and business. Two distinct literatures on the use of owner resources in small businesses are examined: the intermingling of business and household resources from the family firm literature and financial bootstrapping studies from the small business finance literature. What has not been addressed in both literatures about the use of owner resources is discussed and the risks that owner resource bootstrapping and intermingling may place on the household and the business are considered. Recommendations and propositions for future research are suggested. To fully understand the makeup and success of household financial portfolios and family businesses, it is important to understand the use of owner resources in a holistic manner.     

Les ajustements de la technique médicale face aux règles de droit

During the 1990s, partly as a result of accusations of medical malpractice, doctors’ obligations were reinforced; and patients’ rights, recognized. In a lawsuit brought on the grounds of liability, the doctor and his/her qualifications are accused; and the doctor's identity and sense of professional honor, affected. This has serious risks for medical practices and, more broadly, medicine. This research based on interviews with doctors shows that the specialty, type of practice and nature of the establishment expose doctors to more or fewer risks and thus partly determine how they adjust techniques to cope with the risks of a lawsuit. The professional identity (including the values and practices to which interviewees referred) and the consciousness of their symbolic status (related to the place and type of practice) are keys for understanding practitioners’ behaviors. Assuming that a doctor's sense of professional identity is shaped by his/her sense of responsibility, relations with patients and concern for achievement, it is hypothesized that these three dimensions and their possible combinations explain the adjustments, or lack thereof, made by doctors.     

Investigating the mediational role of negative urgency in the anxiety sensitivity pathway to cannabis problems and dependence symptoms among postsecondary students

Objectives: Anxiety sensitivity (AS) is associated with cannabis use. People high in AS may use cannabis to cope with elevated anxiety. This association is consistently supported in the literature. However, we have much to learn about the mechanisms of the AS pathway to cannabis use. We aimed to examine negative urgency—the tendency to act impulsively when distressed—as a mediator of the association of AS with cannabis problems and cannabis dependence symptoms. We hypothesized that negative urgency would uniquely mediate the association of AS with cannabis outcomes after controlling for other facets of impulsivity. Participants and Methods: Postsecondary students (N = 91; Fall 2012) completed online self-reports. To participate, students needed to be ≥18 years old, enrolled in postsecondary studies, and needed to report current cannabis use. Results: Negative urgency uniquely mediated associations between AS and cannabis problems and dependence symptoms. Conclusions: Our findings suggest a mechanistic role of negative urgency in the AS pathway to cannabis misuse.     

Moral Incongruence and Pornography Use: A Critical Review and Integration

Internet pornography use (IPU) remains a controversial topic within sexual behavior research fields. Whereas some people report feeling dysregulated in their use of pornography, mental health and medical communities are divided as to whether IPU can be addictive. The present review sought to examine this issue more closely, with a focus on how variables other than pornography use, such as moral disapproval and moral incongruence (i.e., feeling as if one’s behaviors and one’s values about those behaviors are misaligned), might specifically contribute to self-perceived problems around pornography use. Through an examination of recent literature, the present work reviews evidence that moral incongruence about IPU is a common phenomenon and that it is associated with outcomes relevant to current debates about pornography addiction. Specifically, moral incongruence regarding IPU appears to be associated with greater distress about IPU, greater psychological distress in general, greater reports of problems related to IPU, and greater reports of perceived addiction to IPU. The implications of this body of evidence for both clinical and research communities are discussed, and future directions for research are considered.     

Persistence and desistance in heavy cannabis use: the role of identity,agency, and life events

Many cannabis users ‘mature out’ of their drug use, and factors of cannabis use cessation have been identified. However, very little in-depth knowledge is available about the mechanisms underlying this phenomenon. Criminological studies have gained interesting insights in desistance from crime, yet these perspectives are rarely used in drug research. This qualitative, three-year longitudinal study explored the processes involved in desistance from frequent cannabis use for young adults. Using a narrative approach, desisters (frequent users who successfully quit their cannabis use) and persisters (frequent users with a persistent desire and unsuccessful attempts to quit) were compared. In the course of the study, desisters mainly exhibited increasing agency and goal setting, established strategies to achieve these goals, and could envision another self. Desistance was generally induced by life events that became turning points. Persisters experienced largely similar events, but lacked goals and strategies and held external factors responsible for their life course and failed quit attempts. Identity change is at the core of desistance from frequent cannabis use, and the meaning-giving to life events and experiences is essential. Agency is a necessary ingredient for desistance, develops over time and through action, and leads to a new drug-free identity with desistance in turn increasing agency.     

Marriage and State-level Economic Outcomes

Past research has examined various state-level measures that predict state economic growth and other economic and social indicators. This research has largely ignored the potential role of family structure in contributing to state-level outcomes, despite the extensive literature on links between family structure and economic outcomes at the individual level. We estimated a state-level panel model and found that both the proportion of adults and the proportion of parents who are married are strongly related to important state-level economic outcomes, including economic growth, median household income, median personal income, and poverty.     

Daily,high‐potency cannabis linked to first psychosis

Daily use of marijuana (cannabis) is associated with a greater than three times increased risk of psychotic disorder compared to never users, according to a study published in Lancet Psychiatry. This risk increased to nearly five times if high‐potency cannabis was used. Across the 11 sites included in the study, if high‐potency cannabis were not available, 12.2 percent of cases of first‐episode psychosis could be prevented, rising to 30.3 percent in London and 50.3 percent in Amsterdam.     

Online gambling participation and problem gambling severity: is there a causal relationship?

Studies of Internet gambling have consistently shown that online gamblers are more likely to report disordered gambling behaviour than offline gamblers. However, little research has focused on whether this is a causal relationship or whether this risk factor is capturing a relationship with one or more missing variables. To address whether there is a strong causal argument for the effect of online gambling participation on problem gambling severity, we use a secondary data method that corrects for potential omitted variable bias. Once this issue is addressed, we find that past-year participation in online gambling is related to a decrease in problem gambling severity, which is the opposite of the popular view in current literature. The estimates in this study are found to be robust to various forms of online gambling, control variables and problem gambling measurement instruments. The findings were also consistent when using a representative sample from the United Kingdom and when using an online research panel from Ontario, Canada. As a primary force against the widespread adoption of Internet gambling has been public health concern over problem gambling, this study provides evidence that such decisions should be more closely considered by policymakers.     

Methodical failure: the use of case study method by public relations researchers

Case studies comprise up to a third of published articles in the public relations literature. There has, however, been little discussion in the literature of their methodological advantages or shortcomings as a research tool, or reflection on the quality of published case studies. This paper reviews the literature on case-study research, and surveys 5 years of case studies published in Public Relations Review to determine the quality of their methodology. The results indicate that few researchers understand or apply good case method.The paper concludes that case studies, if thoughtfully conceived and well executed are a research tool well suited to the study of public relations. It is suggested that poor methodology has undermined the role of case research in the development of theory. If properly applied case research could usefully balance the influence of quantitative research which tends to isolate research problems from the processes of public relations practice that are embedded in social or organizational contexts.     

Cannabis found more harmful to cognition than alcohol in teens

Lasting effects of adolescent cannabis use are even more pronounced than those for alcohol, researchers suggest in a new study of the role of impaired cognition on substance use. According to the study, published in the February issue of the American Journal of Psychiatry, both alcohol and cannabis misuse are related to impaired cognition, but is this cause or correlation? To infer cause, researchers in general use four theoretical models.     

Medical cannabis physician decries lack of education

“This is all new to them.” That's how David G. Ostrow, M.D., Ph.D., vice president of the American Academy of Cannabinoid Medicine (AACM), describes medical cannabis, which has actually been legal in some states for many years. It was the precursor to recreational cannabis, but it's not the same thing. Patients with real medical problems ask their doctors about it — and their doctors don't know what to say.     

Prospective role for telemedicine as a communication tool for rural rehabilitation practice

The current trend of cost containment in health care has prompted a search for innovative methods of providing the best quality care at the lowest possible cost. One method that has received much attention is the use of telemedicine to conduct evaluations at rural locations. There has been much research conducted in the area of telemedicine for radiology, and some other medical specialties, however there has been very little research examining the utilization of telemedicine for allied health, vocational rehabilitation, and Assistive Technology evaluations. In addition to providing an overview of telemedicine service delivery history and mechanisms, results of a focus group are discussed, and specific applications for the field of vocational rehabilitation are considered.     

Differences between medical and recreational cannabis

Every state has its own process for regulating legal cannabis, but we have been particularly interested in Massachusetts, which has a carefully structured process for regulation of both medical (established in 2013) and the recently approved recreational dispensaries — we visited a medical dispensary recently (see ADAW, June 24).     

Day Labourers' Work Related Injuries: An Assessment of Risks,Choices, and Policies

Literature and theory surrounding the informal economy in international contexts suggest that informal work arrangements may entail assuming various levels of risk, and that the higher the level of risk in an employment arrangement, the higher the premium paid to the worker. This study is designed to assess if a wage compensation for risk exists within the United States' day labour job market ‐ the most visible sector of the United States' informal economy. Using data from the 2005 National Day Labour Survey we find a statistically significant wage premium indicating that a risk‐wage tradeoff within the day labour informal economy exists. Ultimately, we argue that current policy interventions facilitated through day labour centres into the day labour market appear to be effective in mitigating the risks associated with this type of employment.

• Evidence of a risk‐wage premium in the day labour market suggests there is an incentive to assume higher levels of risk in work arrangements which presents significant concerns for worker safety.
• Higher levels of work related risks assumed by day labourers, may be minimized if they receive proper safety training through a formal venue such as a worker centre.
• Worker centres only serve 20 per cent of all day labourers in the United States, suggesting a need for the establishment of additional worker centres in other connected or industry based work sites, to help mitigate potential work related risks and injuries in the day labour market.