Comorbid substance use disorders are quite common among patients with schizophrenia. Such individuals' substance use has been associated with psychiatric instability, psychosocial problems and an increased use of health care services. / An existing data set encompassing a range of health care services was analysed, along with patient demographics such as age, living arrangements and education. The subjects were 444 patients with a lifetime diagnosis of schizophrenia, with and without a secondary substance use disorder. / It was found that 32.4% of the male patients and 14.7% of the female patients in this study had a concurrent disorder. The substance abusers tended to be younger than the non-abusers. Male patients who lived in group homes were less likely to have a substance use disorder than male patients in other living situations. Patients with a substance use disorder were more intensive users of hospital services. / The need for the development of integrated services and role of the social worker was discussed.

No description available.

Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 88-100). / ix, 100 leaves, bound ill. 29 cm

No description available.

Pterygium is an ocular surface disorder characterised by centripetal invasion of the cornea by altered limbal cells, accompanied by fibrosis and neovascularisation. One of the enigmatic features of pterygium is its wing-like shape and the mechanism(s) supporting its centripetal growth remain to be elucidated. As the growth pattern of pterygia mirrors the radial arrangement of corneal nerves, we hypothesised that neuropeptides may facilitate its directional growth. In this thesis, we investigated the roles that the sensory neuropeptide substance P (SP) may play in the pathogenesis of pterygia given its known functions in corneal cell migration, proliferation, wound healing and neurogenic inflammation. Using a modified Boyden chamber method, SP was shown to act as a chemoattractant to pterygium fibroblasts and vascular endothelial cells, and this activity was diminish by blockade of its receptor (NK1). 3H-thymidine incorporation assays confirmed that our cell migration results were unrelated to SP-stimulated proliferation. A bead-based multiplex cytokine array detected secretion of pro-inflammatory cytokines (IL-6, IL-8 and CCL2) from SP stimulated pterygium and limbal epithelial cells. Using real-time RT-PCR and immunoblotting, we show that UVB stimulated transcription of the TAC1 gene followed by secretion of SP in ocular surface epithelial cell cultures. Finally, SP and NK1receptor immunoreactivity was identified in pterygium tissue, where overall, NK1receptors were up-regulated in pterygia. Furthermore, we identified a population of NK1 receptor positive mononuclear cells in pterygia that did not express lineage markers for T or B-Iymphocytes, macrophages or mast cells, but may represent immature haemopoietic cells that may have migrated in from the blood since these cells were also present in autologous conjunctival tissue. In summary, SP may contribute to the shape of pterygia by facilitating migration of fibroblasts and vascular endothelial cells into the normally avascular cornea. Additionally, UVB stimulates SP production in epithelial cells and the presence of SP contributes to inflammation in pterygia by inducing pro-inflammatory cytokine release. Finally, we identified a population of relatively immature, NK1 receptor positive cells in pterygia that may have been attracted by the presence of SP. Collectively, these results imply that SP may contribute to the pathogenesis of pterygia.

No description available.

No description available.

Screening pregnant women for substance use appears unworthy of debate given the harmful impacts on the fetus, pregnancy outcomes, the woman herself and her offspring to adulthood. However while screening is routine for conditions such as impaired glucose control, obstetric care providers are often reluctant to intervene with substance use, citing knowledge deficits and a lack of effective screening tools. General negativity about the value of intervention and stereotypical views of substance users have also been identified. This study examined existing screening tools and investigated the World Health Organization’s ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) Version 3.0, focussed on tobacco, alcohol and cannabis, the substances most used in the targetted public hospital clinics. The ASSIST Version 3.0’s performance in pregnancy was assessed using a two-pronged harm categorization: risk to the fetus and risk to the woman as an individual user. For the latter, levels of risk concordant with cut-offs for the general population were utilized. The ASSIST Version 3.0 performed only moderately well versus established self-report tools: the Revised Fagerstrom Tolerance Questionnaire (RTQ) for tobacco, the T-ACE for alcohol, and the Timeline FollowBack (TLFB) for cannabis. Most participants used tobacco (98 of 104); predominance of tobacco use was likely linked to the recognized difficulty in stopping, despite cessation of other substances. Kappa analyses of Specific Substance Involvement Scores (SSIS) on ASSIST Version 3.0 for tobacco did not support changing cut-offs for the woman as an individual user; however, ROC curves delineated an SSIS of 4 as indicative of fetal risk for both alcohol and cannabis. As all 98 tobacco users were ‘high risk’ users, a cut-off indicative of fetal risk for tobacco could not be determined but may be feasible by further research with first trimester women. Identifying tobacco use with an established tobacco-specific tool should be the first screening for pregnant women. If tobacco use is identified, screening for other substance use can be initiated and there may be a place for the ASSIST Version 3.0 in that context. Obstetric care providers need to then be willing and competent to address identified use, whilst avoiding unhelpful stereotyping. / Thesis (Ph.D.) -- University of Adelaide, School of Medical Sciences, 2010

Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 1998. / A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.