“We Lost All We Had in a Second”: Coping With Grief and Loss After a Natural Disaster.

“We lost all we had in a second”: coping with grief and loss after a natural disaster.

World Psychiatry. 2013 Feb; 12(1): 69-75
Ekanayake S, Prince M, Sumathipala A, Siribaddana S, Morgan C

Natural disasters cause immense suffering among affected communities. Most occur in developing countries, which have fewer resources to respond to the resulting traumas and difficulties. As a consequence, most survivors have to rely on their own coping resources and draw from what support remains within family, social networks and the wider community to manage and deal with their losses and consequent emotional distress. Taking the 2004 Asian tsunami as an example, this article reports findings from a qualitative study designed to investigate how survivors responded in Sri Lanka, and the range of coping strategies adopted and resources mobilized. In-depth interviews were conducted with 38 survivors purposively sampled from the Matara district of southern Sri Lanka. Survivors’ accounts emphasized the importance of extended supportive networks, religious faith and practices, and cultural traditions in facilitating recovery and sustaining emotional well-being. Government and external aid responses that promoted these, through contributing to the re-establishment of social, cultural, and economic life, were particularly valued by participants. Recourse to professional mental health care and Western psychological interventions was limited and survivors preferred to seek help from traditional and religious healers. Our findings tentatively suggest that long-term mental health following disaster may, in the first instance, be promoted by supporting the re-establishment of those naturally occurring resources through which communities traditionally respond to suffering. HubMed – addiction


A Comparison of Modified Directly Observed Therapy to Standard Care for Chronic Hepatitis C.

J Community Health. 2013 Mar 8;
Cioe PA, Stein MD, Promrat K, Friedmann PD

Hepatitis C virus (HCV) is the most common chronic blood-borne infection in the United States. Effective treatments are available, however adherence to treatment is challenging. Modified directly observed therapy (mDOT) with weekly administration of pegylated interferon might improve adherence and outcomes for patients infected with chronic HCV. The purpose of this study was to compare two treatment protocols and examine predictors of sustained virologic response (SVR). This retrospective review compares HCV treatment outcomes in two outpatient clinics at an urban academic medical center. Gastroenterology fellows provided standard treatment (SC) in one clinic; a nurse practitioner administered weekly pegylated interferon injections weekly in a primary care clinic. All patients received oral ribavirin. Data was extracted from the medical records of all treated patients over a 5-year period. 155 treatment-naïve, chronically infected HCV patients were treated. Ninety-seven patients received mDOT treatment and 58 received standard care. Mean age was 46 years. Genotype 1 represented 59 % of the sample. The mDOT patients were significantly more likely to be younger (44 vs. 50 years), have a history of injection drug use (93.1 vs. 50.0 %), and be HIV-infected (13.5 vs. 2 %) compared to SC patients. The overall SVR rate was 45.2 % and did not differ between the groups in unadjusted analyses (p = 0.95). Genotype was the only predictor of SVR. Patients treated by nurse practitioners trained in HCV care and seen weekly for interferon injections have comparable treatment outcomes to patients treated by specialists. HubMed – addiction


Bisphosphonate treatment may reduce osteoporosis risk in female cancer patients with morphine use: a population-based nested case-control study.

Osteoporos Int. 2013 Mar 8;
Lee CW, Muo CH, Liang JA, Chang SN, Chang YJ, Kao CH

Chronic use of morphine is a risk factor for endocrinopathy and osteoporosis. Bisphosphonates accentuated the protective effect to develop osteoporosis in female patients with malignancy with morphine treatment. INTRODUCTION: This study investigates the risk of osteoporosis associated with morphine use by comparing the incidence of osteoporosis in female cancer patients treated with and without morphine. METHODS: A population-based nested case-control retrospective analysis was performed using the Longitudinal Health Insurance Database 2000 and Registry for Catastrophic Illness Patients of Taiwan. A malignancy cohort of 12,467 female patients without a history of osteoporosis during 1998-2010, and then 639 patients who subsequently developed osteoporosis as the osteoporosis group, were evaluated. Control-group patients were selected from the malignancy cohort without osteoporosis and frequency matched to each osteoporosis case 2:1 for age, year of cancer diagnosis, and index year. Logistic regression was used to estimate the odds ratios and 95 % confidence intervals, and the multivariable model was applied to control for age. RESULTS: Female cancer patients who received morphine had a 10 % lower risk of developing osteoporosis than non-morphine users, but this risk reduction was not significant. For patients treated with bisphosphonates, the morphine group had significantly lower odds in developing osteoporosis than the non-morphine group. CONCLUSION: Morphine treatment is not associated with the incidence of osteoporosis, and bisphosphonates accentuated the protective effect of morphine in the development of osteoporosis in female patients with malignancy in Taiwan. HubMed – addiction


Abuse and dependence liability analysis of methylphenidate in the spontaneously hypertensive rat model of attention-deficit/hyperactivity disorder (ADHD): what have we learned?

Arch Pharm Res. 2013 Mar 8;
Dela Peña I, Cheong JH

Methylphenidate is the most prescribed stimulant medication for attention-deficit/hyperactivity disorder (ADHD). Despite the well documented clinical benefits of the drug, several questions remain unanswered concerning the effects of extended methylphenidate use (e.g. can methylphenidate be abused by ADHD patients? does repeated methylphenidate treatment produce addiction?). Preclinical studies can help address the long-term safety of clinical treatments, moreover animal studies provide valuable information on the details of drug actions. The spontaneously hypertensive rat (SHR), bred from normotensive Wistar Kyoto rat strain, is considered as the best validated and the most widely used animal model of ADHD. We reviewed the findings of research reports that investigated the abuse and dependence liability of methylphenidate in SHR. In particular, we surveyed the studies which investigated the effects of methylphenidate pretreatment on subsequent methylphenidate-induced conditioned place preference or self-administration for they may give insights into the abuse or dependence liability of long-term methylphenidate treatment in ADHD. HubMed – addiction