滥用海洛因对心血管系统的损害

海洛因滥用对人体各个系统产生严重的损害,其中对心血管系统的损害作用是多方面的。本文就滥用海洛因对心率、血压、心电图、心功能、血液循环、心血管内一些物质的变化、心血管并发症等进行综述,为相关的研究提供参考。     

Elevated Risk of Arrest for Veteran's Administration Behavioral Health Service Recipients in Four Florida Counties

This paper examines the relative contribution of mental and substance abuse disorders to criminal justice involvement by examining the relative risk of arrest for three groups of adult male recipients of VA behavioral health care services. These groups include men served for both substance abuse and mental health, for only substance abuse, and for only mental health. The relative risk of multiple offences is compared to relative risk of a single offense for each group. Results indicated that relative risk of multiple arrests for the dual diagnosis group is substantially greater than for either of the single diagnosis groups, and greater than the relative risk for recipients of nonbehavioral health services. Relative risk of arrest for recipients of only mental health services is no different than the relative risk for other veterans living in the region under examination.     

Jurors' Perceptions of Adolescent Sexual Assault Victims Who Have Intellectual Disabilities

Children and adolescents with intellectual disabilities are especially likely to be sexually abused. Even so, their claims are not likely to be heard in court, possibly because people assume that jurors will not believe them. We tested this assumption in a mock-trial study in which 160 men and women watched videotaped excerpts from an actual trial. As predicted, when the 16-year-old sexual assault victim was portrayed as mildly mentally retarded instead of as having average intelligence, jurors were more likely to vote guilty and had more confidence in the defendant's guilt; considered the victim to be more credible and the defendant to be less credible as witnesses; and rated the victim as more honest, less capable of fabricating the sexual abuse accusation, and less likely to have fabricated the sexual abuse accusation. Men and women were affected similarly by the disability manipulation, but women were generally more pro-prosecution in their case judgments and perceptions than were men. Finally, jurors who had more liberal views toward persons with disabilities were more likely than other jurors to make pro-prosecution judgments on measures of guilt. Implications for psychological theory and the law are discussed.     

Post-Release Substance Abuse Treatment for Criminal Offenders: A Cost-Effectiveness Analysis

This study conducted a cost-effectiveness analysis of Delaware's CREST Outreach Center, a work release therapeutic community (TC) and aftercare program for criminal offenders. Treatment effectiveness was assessed using the number of days reincarcerated during an 18-month, post-release follow-up period. The 6-month CREST program cost $1937 for the average participant, and led to 30 fewer days incarcerated (29% less) than the average participant in a standard work release program. This implies that the CREST program reduced incarceration for criminal offenders at an average cost of $65 per day. The additional investment of $935 per client to provide aftercare services led to 49 fewer days incarcerated (43% less) than CREST work release-only participants. This suggests that by adding an aftercare component to the CREST work release program, a day of incarceration is avoided at an average cost of $19 per day. These findings have implications for future investments in post-release substance abuse treatment for criminal offenders. However, the results must be interpreted with caution given potential selection bias in the groups that participated in the CREST work release and aftercare programs. Selection bias and the policy implications of this research are noted and discussed.     

A Comparative Study of Children and Adult Homicide Rates in the USA and the Major Western Countries 1974–1999: Grounds for Concern?

The aim of this study is to examine the changing patterns of child homicide in the USA and the other 9 major Western countries between 1974 and 1999. On the basis of standardized WHO mortality data, 5-year mean rates of Baby (<1 year), Infant (1–4), Child (5–14), and General Population Rates for Homicide (GPRH) were analyzed for 1974–78 and 1995–99 for the USA and major Western countries. The analysis provided ratios of change for children's homicide between 1974 and 1999 and ratio of ratios between adult' and children's homicide. Over the period USA male Baby homicide rose by 78% and Females 44% with a combined rise in All Children [0–14] homicides of 45%, within the context of a declining adult GPRH. In the 1970s, 3 major Western countries had either higher or similar children's homicide rates to the USA, but by the late 1990s none did. Moreover, between 1974 and 1999, the USA had the biggest rise in Baby (<1) and All Children's deaths, and only France had substantial increases, whereas Baby homicide rates fell significantly in 6 other countries. The findings indicate a worrying deterioration in U.S. child homicides. Possible links with child abuse and explanations for the results are briefly discussed. Urgent case-specific research is required to determine the cause/s for and how to reverse the worsening child homicide situation in the USA.     

Patterns of Intimate Partner Violence Among Married Women in the Military: Type, Level, Directionality and Consequences

While separate evidence exists that married military women have high rates of both intimate partner violence victimization and aggression, little is known about the context of this violence, including the extent to which the violence committed toward and by military women is physical, psychological or sexual, whether the violence is unilateral or bi-directional, and the extent of injury sustained or inflicted. In order to gain a more multi-dimensional understanding of the violence in the lives of military women, this study involved 248 enlisted females who completed a self-report survey about themselves and their spouses’ behavior. Results indicate that the majority of violence reported was bi-directional and symmetrical in terms of type and level of severity. However, enlisted females were more than three times as likely to be victims of unilateral severe violence as their male civilian spouses. Demographic factors associated with these patterns of violence were also identified.

Victim or Offender? Heterogeneity Among Women Arrested for Intimate Partner Violence

Mandatory arrest laws for intimate partner violence (IPV) have increased both the number and proportion of arrests that involve female defendants. Whether these numbers should be as high as they are remains a source of controversy. Most practitioners argue that women are usually arrested for defensive actions used in the face of assaults perpetrated by their spouse/partner. Others believe that these higher arrest rates more accurately reflect the true prevalence of physical aggression perpetrated by women. One way to help clarify this debate is to take a closer look at the women charged with IPV. The present study used self-reported information and criminal justice records on prior aggression to classify 485 women convicted of IPV into four distinct subtypes (i.e., no prior violence, primary victim, primary aggressor, and primary aggressor not identified). Despite the fact that all of these women were arrested for and convicted of IPV, analyses consistently found that few of the women could be considered as the primary aggressor in their relationship. Nor, however, were all of the women classified as primary victims. Methodological issues are discussed as well as the policy, practice, and research implications of this study.

The Parent Opinion Questionnaire and Child Vignettes for Use with Abusive Parents: Assessment of Psychometric Properties

Psychometric properties of the Parent Opinion Questionnaire (POQ) and the Child Vignettes (CV) were examined. Participants included 78 abusive and 77 comparison mothers and fathers. Scores on the POQ were very low, and there were no differences between abusive and comparison parents on any of the six rationally-derived scales of the POQ or the full scale. Results of factor analysis and assessment of internal consistency did not support the six scales. Full scale scores were associated with parental psychopathology, parenting stress, self-reported discipline practices, and IQ, but were unrelated to observed parenting behavior. On the CV, abusive parents indicated more negative attributions and harsher intended punishment for children's aversive behavior than did comparison parents. Negative attribution ratings and intended punishment ratings on the CV were related to parental psychopathology and parenting stress; scores on intended punishment were related to parents’ perceptions of their children's adjustment, self-reported disciplinary practices, and observed negative parenting behavior.     

History of Traumatic Abuse and HIV Risk Behaviorsin Severely Mentally Ill Substance Abusing Adults

Epidemiological studies in the United States estimate HIV seroprevalence rates ranging between 4% and 23% for serious mentally ill adults (SMIA; i.e., schizophrenia, bipolar disorder, and other chronic disorders with psychotic features), with substantially greater estimates for risky sexual behaviors. Among the most consistent factors linked to HIV risk in non-SMIA populations is a history of emotional, physical, or sexual abuse. The current study examined the intersection of abuse history and HIV sexual risk behavior in SMIAs with a group of men (n = 64) and women (n = 115) recruited from eight geographically diverse and representative clinical sites around Florida. A cross-sectional interview revealed a high prevalence of alcohol and other drugs problems, as well as a history of emotional, physical, or sexual abuse in 75% of the participants, with 68% of these reporting multiple types of abuse. Compared to nonabused counterparts, those with a history of abuse reported significantly greater: (a) lifetime and current psychiatric symptoms, (b) recent unprotected sexual intercourse, and (c) crack cocaine, heroin, and marijuana use. No gender differences were detected in the associations of abuse history and sexual risk behaviors. These results underscore the need for HIV prevention efforts targeted to SMIAs and the critical importance of addressing abuse history in interventions with this underserved population.