Risk Factors For Abuse Research Articles

Long-term Safety, Dose Stability, and Efficacy of Opioids for Patients With Restless Legs Syndrome in the National RLS Opioid Registry.

Restless legs syndrome (RLS) is a sensory-motor neurologic disorder. Low-dose opioids are prescribed for patients with refractory or augmented RLS. The long-term safety, dose stability, and efficacy of these medications for RLS treatment is still unclear. In this study, we report the 2-year longitudinal data in a sample of patients treated with opioids for RLS in the community. The National RLS Opioid Registry is an observational longitudinal study consisting of individuals taking a prescribed opioid for diagnosed and confirmed RLS, most of whom experienced augmented symptoms from dopamine agonists. Information on opioid dosages, side effects, past and current concomitant RLS treatments, RLS severity, psychiatric symptoms, and opioid abuse risk factors was collected at initial Registry entry and every 6 months thereafter by surveys on REDCap. No feedback or intervention was provided by the study staff to local providers. Registry participants (n = 448) with 2-year longitudinal data available were mostly White, female, older than 60 years, and, at Registry entry, had been on opioids for a median of 1-3 years at a mean morphine milligram equivalent (MME) of 38.4 (SD = 43.5). No change in RLS severity in the overall cohort was observed over the 2-year follow-up period. The median change in daily opioid dose from baseline to 2 years was 0 MME (interquartile range = 0-10). While 41.1% of participants increased their dose during the follow-up period (median increase = 10 MME), 58.9% decreased their dose or saw no change. Only 8% and 4% saw increases of >25 MME and >50 MME, respectively. Ninety-five percent of those who increased opioid dose >25 or >50 MME had one of the following features: switching opioids, discontinuation of nonopioid RLS treatment medications, at least mild insomnia at baseline, a history of depression, male sex, younger than 45 years, and opioid use for comorbid pain. Low-dose opioid medications continue to adequately control symptoms of refractory RLS over 2 years of follow-up in most of the participants. A minority of patients did see larger dose increases, which were invariably associated with a limited number of factors, most notably changes in opioid and nonopioid RLS medications and opioid use for a non-RLS condition. Continued longitudinal observations will provide insight into the long-term safety and efficacy of opioid treatment of severe, augmented RLS. This study provides Class IV evidence that opioid doses increase in roughly 40% of patients, in most by small amounts, over a 2-year period when prescribed for adult refractory restless leg syndrome.

Violence and sexual abuse rates before and during the Covid-19 pandemic: A prospective population-based study on Norwegian youth

BackgroundConsiderable concern is raised as to whether the pandemic has led to an increase in violence and sexual abuse against children. ObjectiveThe present study objective is to provide rates of violence and sexual abuse against adolescents the year before the pandemic compared to one year into the pandemic. Participants and settingTwo samples of Norwegian 12–16-year-olds were approached. A representative pre-pandemic sample of 9240 adolescents (M age (SD) = 14.11(0.88), and a sample recruited one year into the pandemic resulting in 3540 responses (M age (SD) = 14.5 (0.96)). MethodsAn online survey was administered during school hours including established measures of violence and sexual abuse exposure. Sociodemographic characteristics were assessed. ResultsThere was 1.4 percentage point increase in sexual abuse by an adult, and a 3.9 percentage point decrease in psychological violence by a parent during the pandemic compared to the year before the pandemic. Otherwise, violence and sexual abuse rates remained stable across these two time periods. Risk factors for violence and sexual abuse were amplified during the pandemic. ConclusionNorway, a high-income welfare state, imposed measures to counteract the burden of the pandemic mitigation actions for adolescents. This might partly explain the absence of the feared increase in violence towards adolescents. The disproportionate risk for violence and sexual abuse for some groups of adolescents is however concerning, and should be followed up over time.

The effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents; application of the health promotion model.

The age of onset of substance abuse among adolescents has recently decreased worldwide. Parents play an important role in preventing their children from drug abuse. This study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the health promotion model (HPM). This interventional study was based on 118 parents of high school students in Sabzevar, Iran (2019). Multi-stage random sampling was used to divide the participants into the experimental (n = 65) and control (n = 65) groups. The data were collected through a researcher-made questionnaire based on Pender's HPM. A website was designed to perform all stages of the study. The web-based educational intervention was performed for the experimental group. Both groups completed the questionnaires 2 months after the educational intervention. The data were analyzed using t-test, paired t-test, regression, correlation, and analysis of covariance. There was a significant difference between the scores of prior related behavior, perceived benefits of action, activity-related effect, situational influences, competitors, and commitment in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05). Moreover, a significant difference was observed between preventive behaviors of substance abuse and the mean score of perceived barriers to action, perceived self-efficacy, interpersonal influences, and role model in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05). Overall, designing an educational intervention based on the constructs of Pender's HPM could be an effective strategy for promoting preventive behaviors of substance abuse in parents.

Risk Factors for Abuse in Children with Congenital Heart Disease Presenting at a Pediatric Tertiary Care Hospital

Risk Factors for Abuse in Children with Congenital Heart Disease Presenting at a Pediatric Tertiary Care Hospital

The Prevalence and Risk Factors of Elder Abuse during the COVID-19 Pandemic in the Fayoum Governorate, Egypt

Abstract Background Elder abuse has evolved into a global public health and human rights issue. COVID-19 had a significant impact on Egypt’s economic development and style of life. Aim This research aimed to estimate the prevalence of elder abuse in the Fayoum Governorate of Egypt during the COVID-19 pandemic and assess the prevalence of different elder abuse subtypes and study the effect of different demographic characteristics on these abuse subtypes. Methods This study was a cross-sectional, descriptive survey among 201 older adults aged 60 and above in the Fayoum Governorate. The structured questionnaire used in the study had three sections demographic characteristics, the Hwalek–Sengstock elder abuse screening test, and the Questions to Elicit Elder Abuse screening tool. Results This research documented that the prevalence of elder abuse was (72.6%) and the most prevalent types were emotional and neglect abuse (71.1% and 64.7%, respectively). In our study, 22.9% of older adults were exposed to a single type of abuse, 29.9% to two types, 26.9% to three types, and 10.4% to four types. Female is significantly higher than male abuse exposure (66.7% vs. 33.3%). 52.4% versus 7.1% were more likely to be abused than elderly persons who earn enough income. Conclusion According to this study, emotional and neglect abuse were the most common types of elder abuse. Risk factors for elder abuse included being between the ages of 60 and 70 years, being a woman, residing in a rural location, being illiterate, jobless, married, earning little money, and belonging to a middle-class socioeconomic group. For the general public to better comprehend the consequences of elder abuse on their health and human rights, awareness and education must be increased.

Child maltreatment and Covid-19: A crisis within a crisis

The fight against the SARS-CoV-2 pandemic was carried out through strong restrictive measures, including general population lockdown, which allowed the convergence of risk factors for child abuse. During this period, the French national hotline for children in danger recorded a 56% increase in calls. Calls followed by an alert to departmental child protection services increased by 30%. Through an algorithm created by our team, we showed a 50% increase in the relative frequency of hospitalizations for physical abuse in children aged 0-5 years during the lockdown. This has fueled thinking about subsequent health measures to protect the youngest children. Our goal is now to use this algorithm for epidemiological purposes as a barometer of abuse or in daily practice to help the diagnosis of physical abuse in young children.

Elder Mistreatment and Dementia: A Comparison of People with and without Dementia across the Prevalence of Abuse.

This paper examines the prevalence of different types of elder mistreatment, care needs, and risk factors amongst older adults living with and without dementia in any setting (community or institution). Three years (2014-2017) of anonymized reported incidents of elder mistreatment to a national UK helpline were examined in an exploratory study, using a matched sample design (N = 598) comparing adults with dementia (n = 299) to those without (n = 299) on mistreatment type, care needs, and risk factors for abuse. Financial exploitation was more common among older adults with dementia who required more daily care than those without. Risk factors for elder mistreatment among older adults without dementia were often chronic in nature (such as poor physical health) whereas risk factors for people with dementia were associated with a dementia diagnosis. Raising implications for health and social care, results show that older adults diagnosed with dementia had increased care needs and vulnerability to abuse.

GLOBAL ELDER ABUSE: A MEGA-MAP OF SYSTEMATIC REVIEWS

Abstract Elder abuse is an increasingly prevalent public health problem that requires a global political and evidence-based response. To make global evidence on elder abuse easier to locate and analyze, we constructed a mega-map – an interactive map that systematically identifies and overviews existing systematic reviews – on elder abuse prevalence, consequences, risk and protective factors, and interventions. Following Campbell Collaboration methodological guidelines, we conducted a comprehensive database and grey literature search of the global elder abuse literature (n=2,776) to identify systematic reviews that examine one or more of these four abuse domains among adults age 60+ (n=111). We then coded the reviews to identify key characteristics, including the types of abuse, settings, World Health Organization (WHO) geographic regions, and demographic subgroups represented in each review, that can be filtered in the mega-map. We also adapted the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Review and Research Syntheses to appraise the quality of each review. We found that the focus of existing evidence syntheses is most commonly interventions (n=59), followed by prevalence (n=52), risk factors (n=51), consequences (n=31), and protective factors (n=16). The majority of published elder abuse studies have been conducted in the European, Western Pacific, and Region of the Americas WHO geographic regions. Few reviews examine systemic abuse and system-level interventions. Future studies on elder abuse should address these gaps in research on protective factors and systemic aspects of elder abuse, and build evidence about elder abuse in the African, South-East Asian, and Eastern Mediterranean WHO geographic regions.

INVESTIGATING THE CONNECTION BETWEEN AGEISM AND ELDER ABUSE

Abstract Elder abuse is recognized as a pervasive public health problem with detrimental consequences for older adults and society. Although considerable research has examined elder abuse risk factors at the individual level, there is a growing call for the field to move beyond proximal causes and consider broader socio-cultural and structural factors that influence elder abuse. Illustrating this shift, organizations, advocacy groups and researchers have proposed a connection between ageism and elder abuse. However, despite the assertion that ageism is a causal factor for elder abuse, there is a scarcity of research to demonstrate this relationship, and a coherent theoretical framework linking ageism to elder abuse remains to be articulated. The purpose of the current study was to examine the conceptual pathways and limited empirical research connecting ageism and elder abuse, and to develop a conceptual model that links ageism and elder abuse. We conducted a comprehensive review and synthesis of the ageism/elder abuse literature, as well as research from other domains of interpersonal/family violence. Based on this synthesis, the proposed model includes plausible mediators (social isolation, devaluation, depersonalization, infantilization, powerlessness, blame) and moderators (intersection with socio-cultural identities, internalized ageism, policy/social norms) that could be targeted as mechanisms of change in interventions designed to address the issue. As such, it provides a framework for hypothesis-testing and future research on the topic. This study informs a research agenda to bring conceptual clarity and empirical evidence to the study of the connection between ageism and elder abuse.

An approach for studying the contributions of childhood sexual abuse and HPA axis dysregulation to substance use disorders

An environmental risk factor for substance abuse and dependence is childhood sexual abuse (CSA). We piloted an approach we developed to test the hypothesis that hypothalamic-pituitary-adrenal (HPA) axis dysregulation from the stress of CSA is a biological mediator. We based our hypothesis on the allostasis model. New admissions to residential treatment for substance use disorders (N = 41) were evaluated for CSA history and two HPA axis regulation measures at baseline, one month, and two months. The two HPA axis regulation measures were morning cortisol level and the dexamethasone suppression test. Five potential covariates were also measured to increase reliability of the findings. Feasibility outcomes were mostly favorable, and included rates of participation (57 %), attrition (46 % at one month and 71 % at two months), and compliance with data collection procedures (87 % for morning cortisol level and 84 % for the dexamethasone suppression test). High attrition rates at one and two months were entirely attributable to high rates of leaving treatment, an important consideration for future studies. Baseline correlations among variables showed a significant negative correlation between dexamethasone suppression and perceived stress, a potential covariate (rho = −0.458). This finding suggests that individuals with lower stress levels have better negative feedback regulation of the HPA axis, which results in the benefit of lower cortisol exposure—a finding congruent with the allostasis model.

Resilience as a protective factor against elder abuse by family caregivers: findings from a cross-sectional study in Hong Kong

PurposeThis study aims to explore the risk and protective factors of abuse on older adults by family caregivers, with a special focus on the protective role of caregiver resilience in elder abuse.Design/methodology/approachThis cross-sectional survey was conducted on a purposive sample of 600 family caregivers of community-dwelling older adults in Hong Kong (mean age = 71.04 and female = 67.2%). Caregivers reported in a guided interview about elder abuse behaviours, caregiver burden, care recipients’ agitated behaviours, caregiver resilience, self-efficacy, social support and basic demographic characteristics. Hierarchical linear regression analyses were conducted to examine the predictors of different forms of elder abuse.FindingsCaregiver resilience was predictive of lower levels of verbal abuse, physical abuse, injury and financial exploitation but not potentially harmful behaviour (PHB). Social support was independent with all forms of elder abuse, while self-efficacy predicted greater physical abuse after the adjustment of confounding variables. Caregiver burden and agitated behaviours by care recipients remained as significant risk factors in the final models when protective factors were considered.Research limitations/implicationsThis study extends current knowledge on the protecting role of resilience in elder abuse in family caregiving. Mixed findings revealed on social support and self-efficacy also highlight the complexity of the prediction of caregiver abuse. Further research should address this area.Practical implicationsThe findings of this study warrant the inclusion of caregiver resilience as a key component in developing interventions to prevent elder abuse. Addressing caregiver burden and agitated behaviours have the potential in preventing elder abuse.Social implicationsThe findings raise awareness of the importance of supporting caregivers in the community to prevent elder abuse.Originality/valueResearch concerning the protective factors of elder abuse is in a preliminary stage. To the best of the authors’ knowledge, this study is among the first which successfully demonstrates the protective role of resilience in caregiver abuse on older adults. The findings shed invaluable light on the design of effective interventions.

Factors Associated With Knowledge on Risk Factors of Sexual Abuse among House Girls and House Boys in Singida Municipality, Central Zone-Tanzania: A Cross-Sectional Study

Background: Sexual abuse is a situation whereby any people or individual entered in any sexual malpractice or sexual contact without his/her will. Sexual abuse among house girls and house boys is among of general medical issue in our nation particularly in the urban areas and towns. The aim of the study was to examine predicators associated with knowledge on risk factors of sexual abuse among house girls and house boys in Singida Municipality. Methods: The cross section study involved a total of 252 participants from the selected house hold in Singida Municipality. A multistage sampling technique was used to obtain sample and data was collected by using self-administered structured questionnaire. Chi-square and logistic regression were used to determine the association between knowledge on risk factors and sexual abuse among house girls and house boys. Results: The large numbers of respondents with mean age of 22years old were single. Only 53.1% of house girls were knowledgeable on risk factors associated with sexual abuse compared to house boys. After control of the confounders the predictors of knowledge about risk factors on sexual abuse were educational level (AOR = 0.332, p = 0.002, 95%CI:0.167; 0.659), how did you find a job(AOR=2.412, p=0.001, 95%CI:1.433; 2.523), and type of family he/ she living(AOR=4.672, p=0.002, 95%CI:0.0709; 0.719, nuclear family (AOR=4.023, p=0.023, 95%CI:0.101;0902). Conclusion: The findings depicted that the study participants have inadequate knowledge on risk factors associated with sexual abuse and it discovered that the influencing factors were education level, means of getting a job and type of family.

Substance Abuse Amongst Adolescents: An Issue of Public Health Significance.

Adolescence is a crucial time for biological, psychological, and social development. It is also a time when substance addiction and its adverse effects are more likely to occur. Adolescents are particularly susceptible to the negative long-term effects of substance use, including mental health illnesses, sub-par academic performance, substance use disorders, and higher chances of getting addicted to alcohol and marijuana. Over the past few decades, there have been substantial changes in the types of illegal narcotics people consume. The present article deals with the review ofsubstance abuse as a public health problem, its determinants, and implications seen among adolescents. A systematic literature search using databases such as PubMedand Google Scholar was undertaken to search all relevant literatureon teenage stimulant use. The findings have been organized into categories to cover essential aspects like epidemiology, neurobiology, prevention, and treatment. The review showed that substance addiction among adolescents between 12 to 19 years is widespread, though national initiatives exist to support young employment and their development. Research on psychological risk factors for teenage substance abuse is vast, wherein conduct disorders, including aggression, impulsivity, and attention deficit hyperactivity disorder, have been mentioned as risk factors for substance use. Parents' attitudes toward drugs, alcohol, academic and peer pressure, stress, and physical outlookare key determinants. Teenage drug usage has a significant negative impact on users, families, and society as a whole. It was found that a lot has been done to provide correct intervention to those in need with the constant development of programs and rehabilitative centers to safeguard the delicate minds of youths and prevent them from using intoxicants. Still, there is much need for stringent policy and program guidelines to curb this societal menace.

Risk and Protective Factors for Childhood Physical Abuse and Suicidal Ideation: The Effect of Brain-Derived Neurotrophic Factor Polymorphism and Social Support.

This study aimed to explore the relationship between childhood physical abuse and suicidal ideation considering the effects of genetic and environmental factors in patients with post-traumatic stress disorder (PTSD) by focusing on brain-derived neurotrophic factor (BDNF) polymorphism and social support, respectively. One-hundred fourteen patients with PTSD and 94 healthy controls (HCs) were genotyped with respect to BDNF Val66Met polymorphism. All participants underwent psychological assessments. The hierarchical regression analysis and the simple slope analysis were conducted. As for patients with PTSD, the moderation effect of BDNF polymorphism was significant but not for social support. Specifically, the BDNF Val/Val genotype worked as a risk factor and strengthens the relationship between childhood physical abuse and suicidal ideation. As for the HCs, the significant moderation effect was found only in social support, but not for BDNF polymorphism. The relationship between childhood physical abuse and suicidal ideation was weakened for the HCs with high social support. This study demonstrated a significant BDNF genetic vulnerability for suicide in patients with PTSD who experienced childhood physical abuse. Our results suggested that social support provided a mitigating effect on the relationship between childhood physical abuse and suicidal ideation only in the HCs.

A RARE CASE OF ACTINOMYCES EMPYEMA

A RARE CASE OF ACTINOMYCES EMPYEMA

S2989 Excessive Hormonal Therapy in a Male Transitioning to a Female Causing Cirrhosis

Introduction: High doses of progestins/estrogens can cause elevated liver enzymes, serum aminotransferase elevations with no changes in alkaline phosphatase or bilirubin, 1 to 2 weeks after treatment. These side effects are usually transient and resolve with dose modification or discontinuation. We present a unique case where a male in-transition to female was found to be cirrhotic from hormonal dose therapy. Gastroenterologists should be aware of the importance of starting hormonal therapy in the transgender process as exogenous estrogen therapy may lead to underlying liver disease. Case Description/Methods: This is a 63 year male on hormone replacement therapy who presented to the hospital for evaluation of hyperlipidemia, hypertension, diabetes, and gender dysmorphia with concerns of questionable abdominal pain and early findings of cirrhosis. During evaluation, he complained of abdominal pain, jaundice, and dark urine. His LFTs were unremarkable prior to the visit. Upon inquiry of a prior history of fatty liver disease, he admitted not following up with his doctor. The patient then described how he had recently begun hormonal therapy to transition to a female. He reported first starting on an estrogen patch with a transition to estradiol 2mg daily. He denied having a prior history of alcohol abuse or other risk factors of cirrhosis. His liver function tests were noted to be T. Bili of 6.3, D. Bili of 3.2, ALK phos of 263, AST of 51, ALT of 176 and lipase of 100. Given his elevated LFTs an ultrasound and MRCP were performed which showed cirrhosis with portal hypertension and cholelithiasis. He did not have any synthetic liver dysfunction. Upon discontinuation of his estradiol his LFTS resolved back to baseline after five days. Discussion: Gastroenterologists should be aware of gender-affirming hormonal therapies in the transgender population as they can lead to long term sequale such as developing cirrhosis. Evidence in the literature is sparse with no consensus on the long term effects of high dose hormone therapy. Further studies should focus on the risk factors of starting hormonal therapy using demographic characteristics, BMI, and alcohol use as further parameters for gauging cirrhosis. We present the case of a 63-old trans-female patient whose hormone therapy can be associated directly with liver cirrhosis.

A Research on the Prevention of Fatal Child Abuse: 40 Case Studies from News

Bu makalede ölümcül çocuk istismarının çok boyutlu ve karmaşık durumunun son on yılda medyaya yansıyan ve anne-babaları tarafından öldürülen çocuk haberleri (olgular) üzerinden açıklanması ve tartışılması amaçlanmaktadır. Olguların meydana gelmesine yönelik risk faktörleri ve tetikleyicileri ortaya çıkarılarak ölümcül çocuk istismarlarının meydana gelmesine neden olan etkenlerin doğru değerlendirilmesi sağlanacaktır. Böylelikle çocuk koruma hizmetlerindeki önleyici mekanizmaların, bu alanda oluşturulacak sosyal politikaların doğru zamanda müdahalede bulunmasına yönelik öneriler oluşturulacaktır. Araştırmada içerik analizi tekniği nitel bir yöntem olarak kullanılmıştır. Ölümcül çocuk istismarı haberleri tematik içerik analizi kapsamında incelenip elde edilen verilerin sentezlenmesi ve yorumlanması yapılmıştır. Olguların tematik içerik analizi ile sentezlenmesi sonucunda, olguların meydana geliş biçimlerinin büyük ölçüde benzerlik gösterdiği tespit edilmiştir. Olguların meydana geliş biçimlerinin belirli kategorilere ayrılması, bu kategorilerin de çocuk istismarı risk faktörleri ile uyumlu olması literatürdeki bilgileri doğrulamaktadır.20’si anne, 20’si de baba kaynaklı olmak üzere, ebeveynleri tarafından öldürülen çocuklara ait 40 haber kapsamında ölümcül çocuk istismarının gerçekleştiği durumlar araştırmanın çalışma grubunu oluşturmaktadır. Araştırmada on yıldan daha eski olan olgular güncel durumların analiz edilerek sosyal politikalara güncel verileri sunması amacıyla dışlanmıştır. Verilerin doygunluğa ulaşmasıyla çalışma grubu kırk ebeveyn ile sınırlı tutulmuştur. Anneler tarafından gerçekleştirilen istismar vakalarında altta yatan nedenlerin başında psikolojik sorunlar, erken yaşta evlilik ve çocuk sahibi olma ile evlilik dışı bir birliktelik içerisinde bulunma gelmektedir. Paternal Filiside yol açan etkenler arasında boşanma ve ayrı yaşama ile ilgili sorunlar, ekonomik sıkıntılar ve madde kullanımına bağlı sorunlar bulunmaktadır. Sonuç olarak çocuk ihmal ve istismarı kontrol listesi de göz önünde bulundurulduğunda, bu vakaların hepsinin önlenebilir olduğuna ulaşılmaktadır. Ölümcül çocuk istismarlarının yaşandığı bu olgulara çocuk koruma uygulamalarında önleyici hizmetler kapsamında müdahalede bulunularak riskli durumlarda ailelerin desteklenmesi sağlanmalıdır.

A Comparison of the Efficacy of Different Forensic Methods in Detection of Narcotic Substances from Blood and Urine Samples by Rapid Antigen Test Kit

Introduction: Bangladesh is the most vulnerable country for narcotic drug addiction which is rising at alarming rate and spreading all over the country. These drugs cause serious health injuries to our young generation and child abusers. Our society is facing adverse effects due to drug addiction such as killing, hijacking, raping, western party celebrations etc. Department of narcotic drug control agency seized them every month which includes Heroin, Phensedyl (Codeine preparations), intravenous Morphine, Pethidine, Diazepam, Bromazepam, Yaba (Methamphetamine, Amphetamine with caffeine) and energy drinks containing sildenafil citrate and tadalafil citrate substances. Most of the addicted people are multiple drug users. So these substances should be detected by a rapid, reliable and cost effective method. The aim of the study was to understand the cause and risk factors of drug abuse. Methods: This cross-sectional analytical study was conducted at the outpatient department of Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the period from July 2019 to july 2020 with a responsive sample size of 36. Data was analyzed using Microsoft Excel. During study the ethical clearance was obtained from proper authority. Clearance regarding handling of narcotic samples was also taken from the Ministry of Home Affairs. Result: This study was conducted with a responsive sample size of 36. Of the total 36 samples, 34 were cases and 2 were controls. Post analysis of the used drugs pattern showed that 8.33% of cases used Benzodiazepine+Opioid+PCP, 8.33% of cases used Cocaine+Opioid+THC, 25% of the cases used Opioid+THC, 8.33% cases used BZD+Cocaine+Opioid+THC, 25% cases used BZD+Opioid+THC, 8.33% of cases used Cocaine+Opioid and the rest 16.67% were control and tested negative at the time of data collection. Conclusion: Sources at the department of narcotics control intelligence wing also said that around 10,000 cases are filed and 9,000 people are arrested every year in connection with drug-related violence and crimes. In the present, people are using multiple drugs rather than a single substance. For the rapid detection of drug of abuse the method of priority should be rapid blood sample test by kit to avoid unwanted tempering and a reliable result

Elder abuse prevalence and risk factors: findings from the Canadian Longitudinal Study on Aging.

Elder abuse (EA) is a pervasive problem with serious consequences. Previous population-based EA risk factor research has largely used cross-sectional designs that limit causal inferences, or agency records to identify victims, which threatens external validity. Based on a national, prospective, population-based cohort sample of older adults (n = 23,468) over a 3-year period from the Canadian Longitudinal Study on Aging, the current study sought to estimate the prevalence of EA and identify risk and protective factors. Past-year prevalence of any EA was 10.0%. Older adults with greater vulnerability related to physical, cognitive and mental health, childhood maltreatment and shared living were at higher EA risk, while social support was protective against EA. Older adults identifying as Black or reporting financial need were at heightened EA risk. This longitudinal, population-based study advances our understanding of EA risk/protective factors across several domains and informs the development of EA prevention strategies.

Child physical abuse risk factors: A systematic review and a meta-analysis

Child physical abuse (CPA) is a pervasive societal problem with serious outcomes. Understanding CPA risk factors is necessary to identify those at risk for CPA perpetration and to inform efforts to prevent the occurrence of CPA. The present study provides an updated review of conceptual models of CPA, a review of model-related CPA risk factors, and a meta-analytic review of CPA risk factors found in cross-sectional, case-controlled studies. The review of conceptual models yielded >70 explanatory models of CPA from which >140 putative CPA risk factors were extracted. A three-level random-effects meta-analysis of CPA risk factors was conducted. Database and literature searches yielded 58 studies that met the inclusion criteria from which 300 effect size (ES) estimates were identified. In the meta-analysis, 292 ESs were placed into 38 CPA risk factor domains. Twenty significant individual CPA risk factor domain ES estimates and five significant relationship CPA risk factor domain ESs were found. Future studies that simultaneously consider CPA risk and protective factors from within and between ecological levels and that establish causal CPA factors are needed to better inform CPA prevention and treatment efforts. • A literature review yielded >70 explanatory CPA models. • More than 140 CPA risk factors were extracted from >70 CPA models. • A three-level meta-analysis yielded 25 significant CPA risk factor domains. • Twenty individual and five relationship CPA risk factor domains were found.