False-positive and false-negative rates in meconium drug testing

To determine the number of false-negative results produced by inefficient extraction of drugs from meconium, three published procedures were compared by using previously confirmed positive and negative meconium specimens. The methods were not equivalent in their ability to extract drugs from the matrix. To determine the number of false positives reported by the use of screen-only (unconfirmed) results, 535 screen-positive meconium specimens were subjects to confirmation by gas chromatography-mass spectrometry. Fifty-seven percent of the samples were confirmed positive for one or more of the drugs under investigation, showing that a false-positive rate as high as 43% may exist when unconfirmed screening results are used.     

Comorbid substance use disorder: prevalence, patterns of use, and course

Research on the prevalence, patterns, and course of substance use disorders in severe mental illness gives key insights into the complex interaction of substance use and mental disorder. Understanding the literature on comorbidity has implications for the design of clinical services and for the direction of future research in the field.     

The effect of freedom-threatening instructions and monetary inducement on compliance.

Reports 3 experiments with a total of 800 ss chosen from the toronto phone book. Questionnaires were sent to all ss with 1 of 4 sets of instructions: 1/2 were normal requests to fill out the questionnaire, and 1/2 were designed to pressure ss to comply (and consequently reduce their perceived freedom). Monetary reward for compliance was given to 1/2 of the ss in each of these conditions. In all 3 experiments, money included with the request significantly increased rates of return. The "pressure" instructions had no significant over-all effect. However, in the 3rd experiment, where 20 was included (instead of 10 as in the 1st 2) and where the instructions in the increases-pressure conditions were most severe, significantly more ss returned the money and the blank questionnaire than in any other condition. (french summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Covert contraceptive use: prevalence, motivations, and consequences

This article examines women's covert use of contraceptives, that is, their use of a method without their husbands' knowledge. Three questions are addressed: (1) How is covert use measured? (2) How prevalent is it? and (3) What are the factors underlying covert use? Existing studies are used together with survey and qualitative data collected in 1997 in an urban setting in Zambia from married women and their husbands. Women's covert use of contraceptives is estimated to account for 6 to 20 percent of all current contraceptive use, and it is more widespread when contraceptive prevalence is low. The multivariate analysis indicates that difficult spousal communication about contraception is the strongest determinant of covert use. Husbands' disapproval of contraception works through spousal communication rather than as a direct influence on covert use. Husbands' pronatalism had no significant effect. The article concludes with implications of covert use for reproductive health and family planning programs, especially women's (and men's) needs for confidential services.     

The confidence-accuracy relationship in eyewitness identification: Effects of lineup instructions, foil similarity, and target-absent base rates.

Discriminating accurate from mistaken eyewitness identifications is a major issue facing criminal justice systems. This study examined whether eyewitness confidence assists such decisions under a variety of conditions using a confidence-accuracy (CA) calibration approach. Participants (N = 1,200) viewed a simulated crime and attempted 2 separate identifications from 8-person target-present or target-absent lineups. Confidence and accuracy were calibrated for choosers (but not nonchoosers) for both targets under all conditions. Lower overconfidence was associated with higher diagnosticity, lower target-absent base rates, and shorter identification latencies. Although researchers agree that courtroom expressions of confidence are uninformative, our findings indicate that confidence assessments obtained immediately after a positive identification can provide a useful guide for investigators about the likely accuracy of an identification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Radiation-associated hyperparathyroidism: comparison of adenoma growth rates, inferred from weight and duration of latency, with prevalence of mitosis

In sporadic parathyroid adenomas, the birth rate of new cells, based on the proportion of S-phase cells at the time of surgical excision, is much too low to account for growth of the tumor from a single cell, as is required by monoclonal origin, even if the mutation occurred in utero, indicating that the rate of cell proliferation has slowed down during the course of the disease. In radiation-associated hyperparathyroidism, the age at irradiation provides a more accurate upper limit to the age of the tumor. The purpose of this study was to relate this age to the prevalence of mitosis as an alternative index of current cell proliferation. In 56 such patients, the geometric mean for the minimum cell birth rate needed for growth from a single cell to the observed size in the time available was 54.4%. In 44 patients, including 31 of the previous 56 and an additional 13, sampling an average of 220,000 cell profiles, 15 mitoses were found, an overall prevalence of 0.15/10(5), which corresponds to a cell birth rate of 2.7%/yr, assuming the duration of mitosis to be 0.5 h. If cases with no mitosis were assigned a value of half the detection limit, the geometric mean mitotic index was 0.360/10(5), and the corresponding cell birth rate was 6.4%/yr. This is more than 8 times smaller than the minimum birth rate required and 20 times smaller than the cell birth rate in meningiomas, suggesting that such extreme reduction of cell birth rate is a unique feature of parathyroid adenomas, rather than a general feature of all benign tumors. The data support the set-point hypothesis, which reconciles the earlier concept of focal hyperplasia with monoclonal origin and provides an alternative nonneoplastic mechanism of etiology for the usual nonprogressive form of the disease.     

Home relaxation practice in hypertension treatment: Objective assessment and compliance induction.

50 Ss (mean age 51.1 yrs) with essential hypertension were randomly assigned to 1 of 4 conditions: individualized relaxation, group relaxation (GR), GR plus contingency contracting (CC) for home practice, or a waiting list. Treated Ss were given tape players and relaxation tapes and were instructed to practice daily for 10 wks. Unknown to the Ss, the tape players had a concealed capacity to electronically monitor the amount of relaxation practice. All relaxation conditions showed significantly greater reductions in both systolic and diastolic blood pressure than waiting-list controls but did not differ from each other. Monitored relaxation predicted systolic but not diastolic changes. Self-reports exceeded monitored practice by 91%, and only 32% of the Ss averaged 1 practice/day. GR plus CC Ss showed the lowest rate of practice across most weeks. Rated self-efficacy, age, and pretreatment expectations of benefit were positively correlated with relaxation compliance. Data support the use of relaxation for hypertension but suggest that noncompliance is common in both individual and group relaxation training. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of time of artificial insemination on pregnancy rates, calving rates, pregnancy loss, and gender ratio after synchronization of ovulation in lactating dairy cows

In order to assess the optimal time of artificial insemination (AI) in relation to ovulation, lactating dairy cows (n = 732) from herds with rolling herd averages of 9980 to 11,800 kg from three milkings per day were randomly assigned to five groups by stage of lactation and parity. Ovulation was synchronized by administration of GnRH followed 7 d later with PGF2 alpha followed 2 d later with a second treatment with GnRH. Cows were inseminated at 0, 8, 16, 24, or 32 h after the second injection of GnRH (ovulation occurs between 24 and 32 h after GnRH). Pregnancy diagnoses were performed by ultrasound at 25 to 35 d post-AI. Pregnancy rates per AI were similar for the groups inseminated at 0, 8, 16, and 24 h and lower for the group inseminated at 32 h. A significant quadratic effect of treatment suggests that the middle time periods (8, 16, and 24 h) may produce the greatest pregnancy rate per AI. However, the group inseminated at 0 h had lowest pregnancy loss, and the group inseminated at 32 h tended to have the greatest pregnancy loss compared with that of the other groups. The calving rate was similar between the groups inseminated at 0, 8, 16, and 24 h and lower in the group inseminated at 32 h. The time of AI also appeared to affect gender of calf: cows bred at 0 and 32 h having a higher percentage of female offspring. In conclusion, there appears to be substantial flexibility in the time of AI after the second injection of GnRH, and lower reproductive rates were observed only when AI was after the time of ovulation.     

Jury instructions: Past, present, and future.

This introduction provides an overview of the relevant issues addressed in this special theme issue of Psychology, Public Policy, and Law, which is devoted to the topic of jury instructions. It begins with a brief history of jury instruction research. This is followed by a summary of the articles represented in this issue. Next, the strengths and weaknesses of the typical methodology used in jury instruction research are considered. Finally, the specific goals of this special issue are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing pregnancy and induced abortion rates in China: family planning with husband participation

OBJECTIVES: This study assessed the effectiveness of a family planning intervention with and without husband's participation in reducing pregnancy and abortion rates in Shanghai, China. METHODS: In this 3-arm randomized trial among 1800 nonsterilized married women, educational interventions targeting both spouses and targeting the wife only were compared with usual family planning care. RESULTS: Among women not using intrauterine devices (IUDs), the intervention with husband's participation had an effect in reducing pregnancy rates (adjusted odds ratio [OR] = 0.36, 95% confidence interval [CI] = 0.12, 1.1) and abortion rates (adjusted OR = 0.29, CI = 0.09, 0.94) compared with control subjects, and a significant effect in reducing pregnancy rates (adjusted OR = 0.29, CI = 0.10, 0.85) and abortion rates (adjusted OR = 0.24, CI = 0.07, 0.77) compared with wife-only subjects. CONCLUSIONS: Family planning interventions involving husbands may reduce pregnancy and abortion rates among non-IUD users.     

Drug testing, drug treatment, and marijuana use: A fairness perspective.

The authors conducted a random statewide telephone survey of 1,484 individuals to study the relationship between marijuana use (in terms of participants' history of marijuana use) and reactions to drug testing and to study 2 hypothetical drug-treatment policies. Job safety sensitivity was related to perceived fairness of drug testing for the participant's job, and more recent marijuana use was associated with more negative reactions. Safety sensitivity was related to perceived fairness of drug treatment. Organizations with voluntary treatment were more attractive than ones with monitored treatment. Marijuana use interacted with drug treatment policy type in predicting reactions to drug treatment. Results suggest that organizations should consider job and employee characteristics when developing a drug treatment policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preoperative pregnancy testing: a survey of current practice

STUDY OBJECTIVE: To examine contemporary practices and opinions regarding preoperative testing requirements, with special emphasis on perioperative pregnancy recognition and consequences thereof. DESIGN AND SETTING: Anonymous questionnaire survey distributed to 300 (almost exclusively American) physicians attending the 1996 Society of Obstetric Anesthesia and Perinatology meeting. MEASUREMENTS AND MAIN RESULTS: Responses from 169 anesthesiologists indicated that approximately one-third mandated pregnancy testing via departmental policy. More anesthesiologists (p = 0.02) mandated routine pregnancy testing of all elective (30%) versus all emergency (17%) surgical patients. Sixty-six percent versus 20% percent, respectively, would require rather than simply offer pregnancy testing when history indicated possible pregnancy; 20% and 15%, respectively, of those surveyed indicated elective surgery would be canceled by the anesthesiologist if the patient were pregnant or refused testing (p = NS). Although 98% of respondents recognized a legal requirement to report child abuse, and 82% believed pregnancy in a juvenile (i.e., the child's age is under local legal defined age for consent to sex) by definition constituted child abuse, fewer than 4% would report this information to the police, even if the impregnating male were known to be an adult. CONCLUSIONS: The desire to identify pregnancy using patient history was most prevalent among anesthesiologists, with less than one third using mandatory, departmentally imposed screening programs. Positive test results in minors are shared primarily with surgeons and patients, occasionally with parents and social services, but rarely with police, although a positive test almost universally signified child abuse, and mandatory reporting laws were acknowledged by anesthesiologists surveyed.     

Wayfinding by children and adults: Response to instructions to use look-back and retrace strategies.

The wayfinding abilities of 6- and 12-yr-old children were compared with those of 22-yr-old adults. After their 1st walk across a university campus, participants were asked to lead the way back along the same route. Participants in 2 conditions (look back and retrace) were given instructions intended to prevent wandering, whereas those in a 3rd (uninstructed) condition were only told that they were going on a tour. A series of instructions to look back at the return path increased subsequent travel on route by the 2 older age groups. Instructions to monitor the familiarity of landmarks and to stop and retrace to a known portion of the path when feeling unsure did not effectively reduce travel off route. In general, wayfinding performance by 12-yr-old children did not reliably differ from that of 22-yr-old adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy

BACKGROUND: There are no data on prevalence or incidence of treated epilepsy, and no data on fertility of women with epilepsy from an unselected UK population. METHODS: We used the General Practice Research Database to ascertain the incidence and prevalence of people with treated epilepsy in an unselected population of 2,052,922 people in England and Wales, and also age-specific fertility rates. We defined period prevalence of treated epilepsy as the number of people with epilepsy taking an antiepileptic drug per 100,000 people during 1995. The incidence of treated epilepsy was defined as the number of new cases of treated epilepsy per 100,000 people during the same period. We calculated fertility rates among women with treated epilepsy between 1991 and 1995 and compared these rates with the population rates for England and Wales in 1993. FINDINGS: The period prevalence of treated epilepsy in 1995 was 5.15 per 1000 people (95% CI 5.05-5.25). The prevalence was lower in children (age 5-9 years 3.16 [2.86-3.48]; 10-14 years 4.05 [3.70-4.42]), and higher in older people (65-69 years 6.01 [5.50-6.57]; 70-74 years 6.53 [5.97-7.14]; 75-79 years 7.39 [6.73-8.11]); 80-84 years 7.54 [6.78-8.39]; 85 years and older 7.73 [6.98-8.66]). The incidence of treated epilepsy was 80.8 per 100,000 people (76.9-84.7). The incidence was lower in children (5-9 years 63.2 [50.5-79.1]; 10-14 years 53.8 [42.4-68.3]) and higher in older people (65-69 years 85.9 [68.5-107.3]; 70-74 years 82.8 [65.0-105.2]; 75-79 years 114.5 [116.9-179.2]; 80-84 years 159 [125.2-202.6]; > or = 85 years 135.4 [100.4-178.7]). Fertility was lower among women with treated epilepsy, with an overall rate of 47.1 livebirths per 1000 women aged 15-44 per year (42.3-52.2), compared with a national rate of 62.6 in the same age-group. The standardised fertility ratios were significantly lower between the ages of 25 and 39 years in women with epilepsy (p<0.001). INTERPRETATION: Compared with previous studies, we found that the incidence of epilepsy was higher in elderly people and lower in children. The prevalence rates also increase with age. Women aged 25-39 years with treated epilepsy have significantly lower fertility rates than those in the general population. Research is needed to identify any potentially preventable causes for the low fertility rates.     

Maternal assessment of infant development: associations with alcohol and drug use in pregnancy

Surveillance by parental concern has been advocated to assess whether formal child developmental testing is needed. To determine whether alcohol intake or illicit drug use in pregnancy is associated with differences in maternal perception of infant development, mothers with acknowledge alcohol and drug habits during pregnancy (N = 120) were interviewed at 11 months' postpartum, within 1 month before infant testing by use of the Bayley Scales of Infant Development. Women with heavy alcohol intake during pregnancy (> 3.5 oz absolute alcohol per week) were 15-fold more likely to overestimate their infant's mental development (P < 0.05), whereas mothers using illicit drugs were 4-fold more likely to overestimate their infant's physical development (P = 0.02). Given the frequent denial of substance abuse, we suggest that health care providers be cautious in accepting a lack of parental concern about a child's development and rely more heavily on formal testing, particularly in high-risk populations.     

The effect of a propofol-based sedation technique on cumulative embryo scores, clinical pregnancy rates, and implantation rates in patients undergoing embryo transfers with donor oocytes

STUDY OBJECTIVE: To determine the effect, if any, of a propofol-based sedation technique on the reproductive outcomes of patients undergoing embryo transfers with donor oocytes. These ova recipients form a unique subgroup, whose clinical outcomes are unrelated to direct anesthetic effects on their reproductive tracts. DESIGN: Retrospective chart review. SETTING: A 1200-bed university medical center. PATIENTS: 117 patients who received fresh embryo transfer cycles between January 1991 and December 1995. MEASUREMENTS AND MAIN RESULTS: The anesthesia records of 106 women who donated ova were reviewed for propofol usage during the transvaginal needle aspiration of the ova. The medical records of the 117 patients who received these donated embryos were reviewed for cumulative embryo scores, clinical pregnancy rates, and implantation rates. Fourteen patients received ova from women who were sedated with fentanyl and midazolam during ovum retrievals, while 103 patients received ova from women who had been given fentanyl, midazolam, and propofol in doses of 1.87 mg/kg to 8 mg/kg. The pregnancy rate among all patients who received ova from women who received propofol (44 of 103 = 42.7%) was 14.1% greater than those whose ovum donors did not receive propofol (4 of 14 = 28.6). 78.6% of both propofol and non propofol-exposed groups had cumulative embryo scores of greater than 50. Among patients who became pregnant, 52.3% of propofol-exposed and 50% of nonpropofol-exposed cases had greater than 20% implantation rates. CONCLUSION: There is no evidence from our data that the administration of propofol during the aspiration of ovarian follicles for oocyte donation had a negative impact on the oocytes as measured by cumulative embryo scores, probability of a clinical pregnancy, or implantation rate.