Adolescent substance use is a key public health problem in rural Ohio. Primary care nurses lack substance use screening knowledge and skills. Early screening and detection of possible substance use issues aids in directing patients to appropriate health services. This project involved the implementation of an educational intervention on the CRAFFT screening tool for primary care nurses in rural Ohio. Guided by Kurt Lewin's 3-step model to emphasize prevalence of substance use and need for screening among adolescents, the purpose of this project was to provide training on the CRAFFT screening approach and share guidelines to implement routine substance abuse screening for adolescents seen in this rural primary healthcare setting. The project, based on a pretest and posttest design, was implemented among a sample of 7 nurses to evaluate whether the educational intervention had a significant impact on nurses' knowledge on using the CRAFFT screening tool. Data were collected using a questionnaire and were analyzed using descriptive and inferential statistics. The results showed a significant increase in the pretest scores (M =51.43, SD = 19.51) and the posttest score (M =94.29, SD = 7.868); t(6)=7.039, p = .000). The project findings support that the benefit of this educational intervention to improve the nurses' substance use screening knowledge using a lunchtime educational training to ensure that vulnerable adolescent patients with substance use receive early and appropriate preventive and treatment measures. For positive social change, early identification of substance use among adolescents may inform the adoption of preventive and treatment measures such as referral to mental health specialists, thereby improving adolescent health outcomes.

There are more women enlisting in the military and, as a result, the Veterans Administration (VA) is experiencing an increase in women veteran's utilization of healthcare services. This study examined the factors that facilitate and/or impede women veterans with a substance use disorder seeking VA substance use treatment. The current study examined predisposing, enabling, and need factors related to utilization of VA substance use treatment. An intact dataset of 1004 participants were utilized in addition to a subset of 143 women veterans with a substance use disorder who sought substance use treatment. Predisposing factors significantly differentiated women veterans with and with a substance use disorder. A significant difference was not found between severity of substance use diagnosis and health insurance status. Marital status and socio-economic status were the only predictor variables that significantly predicted women veterans with a substance use disorder and utilization of VA substance use treatment. The results provide mixed support related to previous research. Future directions for research are discussed.

MENTALLY ILL CAREGIVERS AND DIFFERENTIAL PATTERNS OF SUBSTANCE ABUSE IN A SAMPLE OF UNIVERSITY STUDENTS Teliyah A. Cobb1, Alyssa P. Gretak1, MA, Kelcey L. Puszkiewicz1, MA, Jill D. Stinson1, PhD, and Megan Quinn2, DrPH, MSc, East Tennessee State University, Johnson City, TN 1Dept. of Psychology, College of Arts and Sciences 2Dept. of Biostatistics and Epidemiology, College of Public Health Existing literature demonstrates a dose-responsive relationship between adverse childhood experiences (i.e., abuse, neglect, and household dysfunction) and the risk of problematic substance use later in life. While controlling for the effects of early adversity, a recent study found that childhood household dysfunction independently increased the risk of excessive alcohol use in adulthood. However, there are few studies focusing specifically on differences in substance use behaviors in individuals who had a caregiver with a mental health diagnosis. This study aims to fill this gap by examining whether having a caregiver with mental illness during one’s childhood increases the risk of abusing alcohol and illegal or prescription drugs in adulthood in a college sample. Our sample includes University students in the Southeastern U.S. (N = 995) who are mostly Caucasian (84%) and female (63%). Participants completed an online, anonymous survey for course credit. Approximately 23% (n = 227) reported having a caregiver with mental illness or who attempted or died by suicide. Regarding substance abuse, nearly 11% of the sample (n = 106) reported abuse of alcohol, 13% (n = 126) indicated abuse of illegal drugs, and almost 5% (n = 47) reported abuse of prescription medication. Pearson Chi-square tests were conducted to analyze the relationship between caregiver mental illness, including a caregiver who attempted or died by suicide, and abuse of alcohol, illegal, and prescription drugs in adulthood. Interestingly, individuals with a mentally ill caregiver were less likely to abuse alcohol, c2 (1, N = 983) = 12.56, p = .000, and illegal drugs, c2 (1, N = 984) = 22.68, p = .000, as an adult, compared to those without a mentally ill caregiver. In contrast, students with a mentally ill caregiver were more likely to abuse prescription drugs as adults, c2 (1, N = 979) = 32.54, p = .000, compared to those without a caregiver suffering from a mental illness. Thus, findings suggest that having a mentally ill caregiver differentially impacted the risk of abusing varying types of substances. Additional analyses examining the influence of mental illness in biological versus non-biological caregivers (e.g., stepparent, foster parent) and further discussion of implications will be included.

abstract: Although child welfare services are anticipated, in part, to lessen the negative influence of maltreatment on childhood and adolescent development, there is evidence that involvement in the foster care system negatively affects adolescent substance use. Within the literature, limited empirical research has emerged in regard to this issue. The present study aims to fill this critical gap in the literature by examining the association between baseline biological, psychological, and social risk and protective factors on adolescent involvement in substance use, and frequency of substance use, over a period of 24 months for foster care involved youth. Furthermore, the present study compares substance use behaviors between youth with differing experiences of maltreatment subtypes and severity levels. Data come from VOYAGES, a longitudinal study of older adolescents in the custody of the Missouri Children’s Division for foster care services. The current analysis reports on those youth who completed both the baseline and the final interview (N=323). Key findings include significant associations between baseline peer substance use, lowered levels of school commitment, mentorship, and familial support with later adolescent substance use. Overall, the existence of numerous individual risk factors far outweighs the potential of protective factors buffering against subsequent substance use in the current study. The foster care system, although well-intentioned, potentially barricades individuals from successfully navigating through adolescence and early adulthood without engaging in risky behaviors such as substance use. Given the high prevalence of substance use among those placed in the care of the foster care system, prevention efforts for this population requires an improved understanding of psychosocial risk and protective factors. / Dissertation/Thesis / Masters Thesis Criminology and Criminal Justice 2019

It is a settled principle in our tax law that a court will not be deceived by the form of a transaction, but that effect will be given to the true substance thereof. This principle, embodied in the common law doctrine of substance over form, has been affirmed and applied by the judiciary for well over a century, especially in matters where taxpayers avoid the imposition of potential tax through simulating their transactions. If a court was satisfied that the parties subjectively intended to give effect to some other agreement between them, the court would only have regard to the actual rights and obligations created by the parties and impose tax on their real transactions in accordance with the provisions of a taxing statute. The law in respect of simulated transactions was clear. However, in Commissioner for the South African Revenue Service v NWK Ltd [2011 (2) SA 67 (SCA)] the court ostensibly introduced the requirement of commercial substance as a criterion to determine simulation. The requirement postulates that a transaction which lacks commercial substance will be regarded as simulated, irrespective of the parties’ genuine intention to give effect to the agreement between them. The requirement appears to overrule the entrenched test under the common law doctrine of substance over form and ostensibly established a new objective, independent common law criterion to determine simulation. The NWK requirement invariably ventures into the sphere of legitimate tax planning by virtue of its wide-ranging nature. Taxpayers need to understand the boundaries within which they may legitimately structure their affairs to reduce a potential tax burden as this advances the predictability of the law and respects the rule of law. NWK has, however, rendered the law on this subject rather uncertain and it is therefore crucial to establish the effect and applicability of the requirement to provide guidance to taxpayers on how to structure their affairs to legitimately avoid tax. The question, therefore, is whether the requirement is capable of independent application to determine simulation, or whether the requirement is only indicative of the presence of simulation in a transaction? If the latter, the common law position prior to the judgment will continue to prevail. In this dissertation, compelling arguments which illustrate the incapability of the requirement to function independently to determine simulation is researched, analysed and advanced. These arguments support the view that from a legal and logical point of view, the requirement cannot constitute an independent criterion to determine simulation. In the premise, it is submitted that the established common law doctrine of substance over form, as enunciated in Zandberg v Van Zyl [1910 AD 302], remains reflective of the law on simulated transactions and that the commercial substance requirement is only indicative of the presence of possible simulation in a transaction. / Dissertation (LLM)--University of Pretoria, 2013. / am2014 / Mercantile Law / unrestricted

Electronic Nicotine Delivery Systems (ENDS) use increases risk of nicotine addiction, impairs brain development, and exposes users to harmful chemicals. Despite these risks, rates of use have been increasing among college student populations. Moreover, family history of addiction (FHA) is a risk factor for substance use disorders. Research has yet to examine the extent FHA has on the risk of ENDS use. The current research examines the effect of FHA on lifetime ENDS use and whether ENDS use is more common in participants with FHA and current alcohol or drug use. Participants (N=2,174) were undergraduates recruited from eight southern universities. Participants were 18 to 24 (Mage=19.25). The sample was 73% female, with the following racial identifications: Caucasian (74.9%), followed by Black/African American (8.8%), Asian (6.7%), multiracial (4.7%), other (3.7%), Middle Eastern (.8%), and American Indian/Alaska Native (.3%). Lifetime ENDS use was measured using the Cigarette and E-Cigarette Use Questionnaire. FHA was measured by participant report of first-degree relatives with a drug or alcohol addiction history. Participant alcohol and drug use were measured via the Alcohol Use Disorders Identification Test and Drug Use Disorders Identification Test. Fifty-five percent of participants had used ENDS products during their lifetime (Mage of first use=13.16, SD=4.63), and 12.5% of the sample reported FHA. A linear regression examined if FHA corresponded with ENDS use. The results were significant, F(1,2158)=10.37, p=.001, R2=.005. FHA significantly predicted ENDS use, β=-0.069, t(2158)=-3.22, p=.001. A chi-square of independence examined the relation between ENDS use and alcohol intake in individuals who disclosed FHA. A significant relation was found, χ2=(1,N=176)=32.20, pχ2=(1,N=176)=9.49, p=.002, with participants who reported no drug use being more likely to engage in ENDS use (86%), compared to those who did report drug use (14%). The present study’s results documented there was a significant negative relation between FHA and ENDS use, such that participants who reported FHA presented decreased ENDS use. These findings are contrary to the literature that documents increased cigarette use among young adults with FHA. In addition, participants who disclosed FHA and current alcohol intake exhibited increased ENDS use. However, the participants who disclosed FHA and current drug use exhibited decreased ENDS use. Our results suggest that future research should examine the extent at which individuals who engage in drug use focus more on their substance of choice rather than ENDS products, as well as investigate other risk behaviors that could impact lifetime ENDS use among this population.

The researcher examined a relatively unexplored and limited territory dealing with higher education organizational pluralism pertaining to particalized substance abuse programs in private sectarian institutions of higher learning with student populations of under five thousand. The conceptual framework, which was a recapitulation of Lee G. Bolman and Terrence E. Deal's (1984) "multifaceted lens," applied to the human resource framework, the structural framework, the symbolic/cultural framework and the political framework in the administration of these selected substance abuse programs. The frames under which the respective substance abuse programs operate were identified by utilizing a semi-structured interview protocol. The study found usage of management frames by substance abuse program administrators to be in agreement with Bolman and Deal's "four frames theory," with the preferred management style consistent across the frames. The administrators of the substance abuse programs prefer the human resource frame almost categorically. Each institution places a strong emphasis on recruitment of an ideal type of student, modeled after a very clear and concise institutional mission statement. The pervasive theme of the mission message seeks potential Christian leaders only. Almost exclusively, the institutions studied do not tolerate substances of any sort. The administrators interviewed were knowledgeable about the various organizational frames and expressed concerns regarding the symbolic/cultural framework. With the exception of one institution, administrators of programs believe that the Christian ethic practiced throughout their institutions is the most significant factor preventing their institutions from utilizing the political frame during times of dwindling economic resources, thus remaining congruent with the institutional mission. The institutions studied were not complex in management structure and provide relatively unambiguous environments. The students and personnel have free access to administrators of substance abuse programs, who utilize prayer and the Christian ethic as important tools in intervention. This qualitative approach captured the essence of the organizational dimensions of these substance abuse programs in the selected private sectarian institutions of higher studies in Texas.

No description available.

This series of poems documents the speaker’s experience working as a wilderness field guide for a substance abuse program in North Carolina. The poems explore what it looks like to work direct care and to hold responsibility for a group of women’s physical and emotional wellbeing. There is a secondary narrative that interrogates the speaker’s relationship to substances as well as the speaker’s father’s identity as a recovering alcoholic.

Purpose: The current study was conducted to ascertain whether the effects of nativity (i.e., U.S. born vs. immigrant) on Hispanic adolescent substance use is mediated by ecological processes such as family functioning, school connectedness, and perceived peer substance use. Methods: The effects of family, peer, and school processes on adolescent substance use were examined in a nationally representative sample of 742 (358 male, 384 female) Hispanic youth (mean age = 15.9; SD = 1.8). Results: Results from a structural equation model indicated that the higher rates of substance use among U.S.-born Hispanics (compared with foreign-born Hispanics) are partially mediated by perceived peer substance use (as measured by the adolescent). The results also showed that perceived peer substance use and school connectedness mediate the relationship between family processes and substance use, suggesting that family processes may offset some of the deleterious effects of negative peer selection on adolescent substance use. Conclusion: These findings imply that public health behavioral interventions to prevent substance use among both U.S.-born and foreign-born Hispanics may need to attend to multiple ecological processes, including family, school, and peers.