No abstract

No abstract

The prevalence of alcohol abuse or dependence in current-drinking admissions was substantial, suggesting that hospitalization offers a unique opportunity to identify alcohol use disorders. Further research is needed to determine factors that may be associated with significant pairwise results, especially for race or ethnicity. We recommend alcohol screening of all hospitalized drinkers, followed, as appropriate, by diagnostic evaluation and referral or intervention.

Expanding consumer choice of plans is beneficial only to the extent that consumers make informed choices. Using data from the 1996-97 Community Tracking Study (CTS), this study compares consumers' responses on four key attributes of their health plan with information provided directly by the plan. Plan attributes relate to choice of providers and access to specialists. Although the accuracy of reporting some individual attributes was fairly high, fewer than one-third of consumers accurately reported all four health plan attributes. In general, consumers tended to overreport plan restrictions, especially the need for approval to see specialists.

No abstract

Background: There is very little work on the role of positive or benevolent childhood experiences and how such events might offer protection from the insidious effects of adverse experiences in childhood or later in life. Objectives: We set out to test, using latent variable modelling, whether adverse and benevolent childhood experiences could be best described as a single continuum or two correlated constructs. We also modelled the relationship between adverse and benevolent childhood experiences and ICD-11 PTSD and Complex PTSD (CPTSD) symptoms and explored if these associations were indirect via psychological trauma. Methods: Data were collected from a trauma-exposed sample (N = 275) attending a specialist trauma care centre in the UK. Participants completed measures of childhood adverse and benevolent experiences, traumatic exposure, and PTSD and CPTSD symptoms. Results: Findings suggested that adverse childhood experiences operate only indirectly on PTSD and CPTSD symptoms through lifetime trauma exposure, and with a stronger effect for PTSD. Benevolent childhood experiences directly predicted only CPTSD symptoms. Conclusions: Benevolent and traumatic experiences seem to form unique associations with PTSD and CPTSD symptoms. Future research is needed to explore how benevolent experiences can be integrated within existing psychological interventions to maximise recovery from traumatic stress. Experiencias adversas y benignas en la infancia en Trastorno de Estrés Postraumático (TEPT) y Tept Complejo (TEPTC): implicancias para terapias centradas en el trauma Objetivos: Nos propusimos evaluar, usando un modelo de variables latentes, si experiencias adversas y benignas en la infancia podrían ser mejor descritas como un continuo simple o bien como dos constructos correlacionados. También modelamos la relación entre experiencias adversas y benignas en la infancia y síntomas de TEPT y TEPT complejo (TEPTc) según la CIE-11 y exploramos si estas asociaciones eran indirectas a través del trauma psicológico. Métodos: Los datos fueron obtenidos de una muestra expuesta a trauma (N=275) que acudía a un centro especializado en trauma en el Reino Unido. Los participantes completaron mediciones sobre experiencias adversas y benignas en la infancia, exposición a trauma, y síntomas de TEPT y TEPTc. Resultados: Los hallazgos sugirieron que las experiencias adversas en la infancia operan sólo indirectamente en síntomas de TEPT y TEPTc a lo largo de exposición a trauma en la vida, con un importante efecto para TEPT. Las experiencias benignas en la infancia predijeron directamente sólo síntomas de TEPTc. Conclusiones: Las experiencias adversas y benignas parecen formar asociaciones particulares con síntomas de TEPT y TEPTc. Se requieren investigaciones futuras para explorar cómo las experiencias benignas pueden ser integradas en intervenciones psicológicas existentes para optimizar la recuperación de estrés traumático.

Human herpesvirus 8 (HHV-8) is thought to be highly prevalent in Mediterranean countries and sub-Saharan Africa, where it causes Kaposi's sarcoma in a small proportion of infected immunocompetent persons. However, the lack of serological tests with established accuracy has hindered our understanding of the prevalence, risk factors and natural history of HHV-8 infection. We tested 837 subjects from Congo, Botswana (mostly young adults) and Malta (elderly adults), using an immunofluorescence assay and 2 enzyme immunoassays (EIAs, to viral proteins K8.1 and orf65). Each assay found HHV-8 seroprevalence to be high (49 -87%) in the African populations and generally lower (9 -54%) in Malta. However, there was only modest agreement among tests regarding which subjects were seropositive (3-way , 0.05-0.34). We used latent class analysis to model this lack of agreement, estimating each test's sensitivity and specificity and each population's HHV-8 prevalence. Using this approach, the K8.1 EIA had consistently high sensitivity (91-100%) and specificity (92-100%) across populations, suggesting that it might be useful for epidemiological studies. Compared with the K8.1 EIA, both the immunofluorescence assay and the orf65 EIA had more variable sensitivity (80 -100% and 58 -87%, respectively) and more variable specificity (57-100% and 48 -85%, respectively). HHV-8 prevalence was 7% among elderly Maltese adults. Prevalence was much higher (82%) in Congo, consistent with very high Kaposi's sarcoma incidence there. Prevalence was also high in Botswana (87% in Sans, an indigenous group, and 76% in Bantus), though Kaposi's sarcoma is not common, suggesting that additional co-factors besides HHV-8 are needed for development of Kaposi's sarcoma. Int.

No abstract