Barriers to Integrated Treatment of Substance Abuse and Trauma Among Women

Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.     

Alternative and complementary therapies for the menopause

Despite a re-evaluation of risks in recent years, hormone replacement therapy is still surrounded by controversy. Almost 30% of women in a recent survey sought a natural approach to combat climacteric symptoms. Nevertheless, a large proportion of patients felt that they wanted a good safety profile and strong evidence base for treatment. This article seeks to review the evidence supporting non-hormonal approaches to treatment. There is only conflicting evidence at best to support alpha-2 agonists, e.g. clonidine and limited evidence for dihydroepiandrosterone and natural progesterones. There is limited randomized controlled trial data for gabapentin, selective norepinephrine re-uptake inhibitors (SNRIs) and selective serotonin re-uptake inhibitors (SSRIs), many of these studies being related to breast cancer patients. Of the herbal medicinal products, the largest evidence base rests with phytoestrogens. A Cochrane Database review looking at all types of phytoestrogens, e.g. red clover extracts, dietary soya and soya extracts concluded that there was no evidence to support improvement in climacteric symptoms and the meta-analysis of a 178 studies on soy products was inconsistent. Nevertheless, other studies disagree. Mammographic density is not affected by soy or phytoestrogen products and recent in vitro work shows only a weakly proliferative effect of soy isoflavone on breast cancer cells and evidence that soy isoflavone blocks the proliferative effect of estradiol on these cells. There are no studies looking at clinical outcome measures for cardiovascular disease but a number of studies looking at biochemical markers including arterial wall stiffness and apolipo protein B. Recent studies have also looked at the effects of red clover isoflavone on mood and depression, using specific depression rating scales. Finally, it is important to note that herbal medicinal products should not be used without caution. Some may produce quite marked side-effects in high doses and others can interact with pre-existing medication. A strategy for which patients are suitable for herbal medicinal products is reviewed.     

Who Is Supporting Homeless Youth? Predictors of Support in Personal Networks

Homeless youth lack the traditional support networks of their housed peers, which increases their risk for poor health outcomes. Using a multilevel dyadic analytic approach, this study identified characteristics of social contacts, relationships, and social networks associated with the provision of tangible and emotional support to homeless youth (N = 419, M age = 20.09, SD = 2.80). Support providers were likely to be family members, sex partners, or non–street‐based contacts. The provision of support was also associated with contacts' employment and homelessness status, frequency of contact, shared risk behaviors, and the number of network members that were homeless and employed. The results provide insights into how homeless youth could be assisted to develop more supportive social networks.     

Health and safety of students in vocational training in Quebec: a gender issue?

Health and safety issues in a vocational training center were explored in this study. Several sources and methods were used: group interviews with students in traditionally female [F] and male [M] trades, i.e. hairdressing (7 F) and automated systems electromechanics (8 M, 1 F); self-administered questionnaires on injuries sustained at the school; observations of activities in these programs; and analysis of ministerial documents. Findings indicate that the partially divergent ways that OHS is addressed in these programs cannot be explained only by the specific characteristics of the two trades. Some aspects put female students in hairdressing at a disadvantage: status accorded to OHS in the study programs, learning activities, and conditions for learning and managing prevention and injuries. The discussion focuses on a gender-differentiated analysis, the importance of improving the way OHS is addressed in the programs, in particular, those primarily involving female students, and the need to pursue research. In addition, the results from individual interviews with women (5 F) training for non-traditional trades lead to discussion on the interrelated effects of sex-based gender and professional gender.     

Interactions between task repetition and psychosocial factors

Psychosocial factors, individual factors, workplace requirements, and workplace organizational factors have all been reported as being associated with the risk of musculoskeletal disorders [11]. Huang, Feuerstein, and Sauter [5] described the various concepts and models proposed to link occupational stress and work-related upper extremity disorders, as well as the difficulty in verifying the suggested linkages. Huang et al. [5] suggested that decomposing a complex model would be an appropriate method to begin the investigations of the proposed models. Task repetition is a workplace requirement that is considered a potential risk factor for cumulative trauma and its relationship to psychosocial factors was investigated. The study found only weak to no statistically significant relationship between task repetition and reported psychosocial factors of job stress in workers in Taiwan.     

Rhythmic Grouping Biases Constrain Infant Statistical Learning

Linguistic stress and sequential statistical cues to word boundaries interact during speech segmentation in infancy. However, little is known about how the different acoustic components of stress constrain statistical learning. The current studies were designed to investigate whether intensity and duration each function independently as cues to initial prominence (trochaic‐based hypothesis) or whether, as predicted by the Iambic‐Trochaic Law (ITL), intensity and duration have characteristic and separable effects on rhythmic grouping (ITL‐based hypothesis) in a statistical learning task. Infants were familiarized with an artificial language (Experiments 1 and 3) or a tone stream (Experiment 2) in which there was an alternation in either intensity or duration. In addition to potential acoustic cues, the familiarization sequences also contained statistical cues to word boundaries. In speech (Experiment 1) and nonspeech (Experiment 2) conditions, 9‐month‐old infants demonstrated discrimination patterns consistent with an ITL‐based hypothesis: intensity signaled initial prominence and duration signaled final prominence. The results of Experiment 3, in which 6.5‐month‐old infants were familiarized with the speech streams from Experiment 1, suggest that there is a developmental change in infants’ willingness to treat increased duration as a cue to word offsets in fluent speech. Infants’ perceptual systems interact with linguistic experience to constrain how infants learn from their auditory environment.     

Risk factors for child maltreatment in South Korea: An investigation of a nationally representative sample

This study investigated the risk factors associated with the occurrence of child physical and psychological abuse in South Korea based on the ecological theory of child maltreatment. A subsample of 3‐ to 18‐year‐old children from “A Study on the Current State of Child Abuse and Neglect,” a nationally representative study on child abuse and neglect, was utilized for secondary data analysis. The sample was divided into two age groups (third graders in elementary school and below and fourth graders and above). We utilized hierarchical logistic regression for each age group separately to analyze the data. The variables at each level of the system (i.e., ontogenic development, microsystem, and exosystem) were entered into the model in sequential order. The results showed the common risk factors for both age groups are the caregiver's experience of abuse in childhood, the child's problem behavior, exposure to domestic violence, community size, and informal social control. The child's age was also significant in both groups but in the opposite direction. Social support was a significant predictor for the younger age group only, while the caregiver's level of education was significant for the older age group only. Implications for future research and practice are discussed based on the study results.