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This study sought to determine the clinical correlates of adolescents with cannabis use and no additional drug use (CU) compared to adolescents with no drug use (NDU) among a group of adolescent psychiatric inpatients in Israel.
Two hundred and thirty-six patients consecutively admitted to an adolescent inpatient unit at a university-affiliated mental health center in Israel during a 3-year period were screened. Individuals with polydrug use were excluded from the study.
Prevalence of cannabis use was 13%. In the CU group, 39% were diagnosed with attention deficit and disruptive behavior disorders compared with 16% in the NDU group. Antipsychotics were the most common medications prescribed in both groups. Mood stabilizers were more frequently prescribed to CU than to NDU patients (39% vs 16%, respectively). A higher prevalence of alcohol abuse and criminal behaviors was found among CU compared to NDU patients (61% and 39% vs 6% and 4%, respectively).
The high prevalence of disruptive behaviors and frequent treatment with antipsychotics and mood stabilizers in the CU group may be related to the strong association between externalizing behavior and cannabis use and the non-specific pharmacological treatment of disruptive behaviors. Formal screening for cannabis use should be considered in psychiatric facilities. Specifically, adolescents with disruptive behaviors could benefit from early interventions, before and after cannabis initiation.
Poor adherence is a major obstacle in the management of patients suffering from schizophrenia. Previous studies on adherence have addressed the role of patients' subjective feelings and attitudes towards treatment. Rebelliousness is a more general cognitive-behavioral trait. No attempt has been made to investigate the correlation between rebelliousness and adherence to treatment.
To evaluate rebelliousness levels and their possible correlation with adherence among patients suffering from schizophrenia-spectrum disorders.
1) Compared rebelliousness levels among healthy subjects, patients suffering from schizophrenia spectrum disorders, and non-psychotic patients.
2) Examine the correlation between levels of rebelliousness and nonadherence among patients.
Rebelliousness was evaluated among 75 patients suffering from schizophrenia or schizoaffective disorder, 53 patients suffering from non-psychotic disorders, and 64 healthy subjects using the Rebelliousness Scale. Patients' adherence was evaluated using the Drug Attitude Inventory (DAI-10).
A significant negative correlation was found in the schizophrenia group between levels of rebelliousness and adherence (r = −.434, p < .001). In a regression model rebelliousness levels were found to be the strongest predictor of adherence (β = −0.236, p < .05) compared with other demographic variables. No significant difference was found in the levels of rebelliousness among the schizophrenia, non-psychotic disorders, or control groups.
Rebelliousness seems to be an independent predictor of adherence, specifically among patients suffering from schizophrenia. If future prospective studies replicate our results the Rebelliousness Scale might serve as an efficient tool to predict adherence.
The study of suicidal behavior among minors has to date focused on the age group in which it is more prevalent: adolescents.
We hypothesized that suicidal behavior in children stems from a different diagnosis than suicidal behavior in adolescents and thus merits its own investigation.
We studied all minors who were referred to a psychiatric emergency department (ED) due to a suicide attempt or suicidal ideation (266 referrals) over a three year period.
There was an age- related difference in diagnostic distribution among minors who were referred to the ED due to suicidal behavior (χ2(7) = 24.297, p < 0.01). Attention deficit hyperactive disorder (ADHD) was more prevalent among children (under 12y old), whereas Mood disorders were more prevalent among adolescents (12–18y old).
The findings of this study highlight the need for a separate approach to suicidal behavior in children as distinct from adolescents.
Lack of adherence to recommended treatment poses major clinical and economic challenges for psychiatry, and requires further study.
Objectives and aims:
We aimed to prospectively investigate the association between the level of understanding of psychiatric emergency department (ED) discharge recommendations and presence of a companion with short term treatment adherence.
Sixty subjects were evaluated twice: upon ED discharge and a month later. Instruments included a structured questionnaire based on the MacArthur Competence Assessment Tool for Treatment, MMSE, and corroboration of data with the computerized hospital medical file.
There was a significant association between patient understanding and adherence with medication instructions (p< .01) and adherence to psychiatric follow-up (p< .05). There was also an association between the presence of a companion and adherence to medication instructions (x2(1)=7.0, p< .01).
Ensuring patients' understanding of treatment recommendations and encouraging the company of patients are achievable, practical strategies that may improve adherence and thereby promote better outcomes.
In Visions of Social Control (1985) Stanley Cohen provided a typology of scholarly works on the punitive turn: “uneven progress,” “good intentions-disastrous consequences,” and “discipline and mystification.” This Essay applies these categories to recent punishment and society scholarship, finding a clear preference for the third category, arguing that current works do not merely point to systemic evils—they impute bad intent to individuals in the system. Against this current, I identify two works—James Forman’s Locking Up Our Own (2017) and Heather Schoenfeld’s Building the Prison State (2016)—and show the strengths of analyses that take individual actors on their own terms. Finally, relying on the recent example of the Ban the Box initiative—a well-intended but failed policy—I argue that flexibility in viewing actors’ motivations, rather than relegating them to the role of cogs in a system fraught by inherent flaws, is important not only for scholarly accuracy but for policy and strategic reasons.
Generations of criminal courtroom scholars were raised on Malcolm Feeley’s book The Process Is the Punishment (1979b) as the gold standard of criminal courtroom ethnography. In the book, and in some of his other work from the 1970s and early 1980s (Feeley 1973; Feeley 1977; Feeley, 1982), Feeley examined lower criminal courts from an organizational perspective, a view that shaped several of the classic criminal court studies, such as Eisenstein and Jacob’s Felony Justice (1978) and Nardulli’s The Courtroom Elite (1978). In the first of Feeley’s works in this vein, “Two Models of the Criminal Process: An Organizational Perspective” (1973), he offered a sociological counterpart to Herbert Packer’s The Limits of the Criminal Sanction (1968) and a primer on courts as organizations.
We live in what some sociolegal scholars might be tempted to call a Feeleyian moment in the course of law and liberal societies. “What?” you might say, “Feeleyian?” That would be a reference, of course, to the influential and wide-ranging scholarship of political scientist and legal scholar Malcolm Feeley. While history may not repeat itself, its well-known propensity for echoing or rhyming (the latter being attributed with no apparent evidence to the writer Mark Twain) seemed evident when a group of noted scholars in sociolegal scholarship gathered in Berkeley to present new work in the fields that Feeley sowed in some cases decades earlier.
Malcolm Feeley, one of the founding giants of the law and society field, is also one of its most exciting, diverse, and contemporary scholars. His works have examined criminal courts, prison reform, the legal profession, legal professionalism, and a variety of other important topics of enduring theoretical interest with a keen eye for the practical implications. In this volume, The Legal Process and the Promise of Justice, an eminent group of contemporary law and society scholars offer fresh and original analyzes of his work. They asses the legacy of Feeley's theoretical innovations, put his findings to the test of time, and provide provocative historical and international perspectives for his insights. This collection of original essays not only draws attention to Professor Feeley's seminal writings but also to the theories and ideas of others who, inspired by Feeley, have explored how courts and the legal process really work to provide a promise of justice.
Eating breakfast may reduce appetite, body weight and CVD risk factors, but the breakfast type that produces the greatest health benefits remains unclear. We compared the effects of consuming a high-fibre breakfast, a non-fibre breakfast, or no-breakfast control on body weight, CVD risk factors and appetite. A total of thirty-six overweight participants (eighteen men and eighteen women) (mean age 33·9 (sd 7·5) years, mean BMI 32·8 (sd 4·7) kg/m2) were randomly assigned to consume oat porridge (n = 12), frosted cornflakes (n = 12) or a water control (n = 12) breakfast daily for 4 weeks. Appetite ratings were collected on the first day and weekly thereafter. Before and after the intervention, body weight, composition, blood pressure and resting energy expenditure (REE) were measured and a fasting blood sample was collected. Across the 4 weeks, fullness was higher and hunger was lower in the oat porridge group compared with the control group (P < 0·05). Mean weight change over the intervention was significantly different in the control group (−1·18 (sd 1·16) kg) compared with both the cornflakes (−0·12 (sd 1·34) kg) and oat porridge (+0·26 (sd 0·91) kg) groups (P < 0·05). However, the control group also showed elevated total cholesterol concentrations relative to the cornflakes and oat porridge groups (P < 0·05). There were no differences between groups in changes in body composition, blood pressure, REE or other CVD risk factors. In conclusion, although skipping breakfast led to weight loss, it also resulted in increased total cholesterol concentrations compared with eating either oat porridge or frosted cornflakes for breakfast.
To place the Mediterranean diet (MedDi) in the context of the cultural history of the Middle East and emphasise the health effects of some of the biblical seven species – wheat, barley, grapes, figs, pomegranates, olives and date honey.
Review of the literature concerning the benefits of these foods.
Middle East and Mediterranean Basin.
Mediterranean populations and clinical studies utilising the MedDi.
Results and conclusions
The MedDi has been associated with lower rates of CVD, and epidemiological evidence promotes the benefits of consuming fruit and vegetables. Recommended foods for optimal health include whole grain, fish, wine, pomegranates, figs, walnuts and extra virgin olive oil. The biblical traditional diet, including the seven species and additional Mediterranean fruits, has great health advantages, especially for CVD. In addition to the diet, lifestyle adaptation that involves increasing physical activity and organised meals, together with healthy food choices, is consistent with the traditional MedDi. The MedDi is a manageable, lifestyle-friendly diet that, when fortified with its biblical antecedent attributes, may prove to be even more enjoyable and considerably healthier in combating the obesogenic environment and in decreasing the risks of the non-communicable diseases of modern life than conventional, modern dietary recommendations. The biblical seven species, together with other indigenous foods from the Middle East, are now scientifically recognised as healthy foods, and further improve the many beneficial effects of the MedDi.