Perceived risk of heroin use among nonmedical prescription opioid users.

AIMS: The prevalence of heroin use among nonmedical prescription opioid (NMPO) users has increased in recent years. Identifying characteristics associated with heroin use in this population can help inform efforts to prevent heroin initiation and maintenance. The aim of this study was to evaluate differences in perceived risk of heroin among NMPO users with and without histories of heroin use, and to examine temporal trends in perceived risk of heroin among this population. METHODS: Data are from the 2002-2013 National Survey on Drug Use and Health, and included all past-year NMPO users (N=49,045). Participants reported perceived risk of trying heroin once or twice and regular heroin use. Responses were coded dichotomously (great risk vs. other risk) and logistic regression analyses were used to evaluate the association between lifetime heroin use and perceived risk of heroin, and to determine temporal changes in perceived risk. RESULTS: Results indicated a significant association between lifetime heroin use and lower likelihood of reporting great risk of trying heroin (OR=0.38, 95% CI: 0.33, 0.44, p<0.001), and of regular use of heroin (OR=0.39, 95% CI: 0.32, 0.48, p<0.001). There was a significant, yet modest, trend toward decreasing perception of great risk from 2002 to 2013. CONCLUSIONS: Findings from this analysis of nationally representative data indicate that NMPO users with a history of heroin use perceive heroin to be less risky than those without heroin use. Perception of risk has decreased from 2002 to 2013 in this population, consistent with increasing rates of heroin initiation.

PTSD, depressive symptoms, and suicidal ideation in African American women: a mediated model.

Although research has shown positive associations among post-traumatic stress disorder (PTSD), depressive symptoms, and suicidal ideation, the nature of these relations is unclear, especially in African American women. This study examined the associations among these comorbid psychological difficulties in a sample of 136 low-income, African American women. Specifically, the goal of this investigation was to ascertain if overall depressive symptoms, as well as both the cognitive-affective and somatic components of depression, mediated the PTSD-suicidal ideation link. Results from bootstrapping analyses revealed that overall depressive symptoms and the cognitive-affective components of depression, but not the somatic components, mediated the PTSD-suicidal ideation link.

Stigma, schizophrenia and the media: exploring changes in the reporting of schizophrenia in major U.S. newspapers.

Newspaper media are a major source of information about mental illness in the United States. Previous research has shown that some printed material has been both negative and stigmatizing, which can have a detrimental impact on individuals with mental illnesses. Such perceptions represented in the media may cause those with mental illnesses to internalize a negative and stigmatizing stereotype and hinder the public's understanding of mental illness. In recent years, advocacy groups have increased their efforts to combat stigmatization of those with mental illnesses. This study focused specifically on the use of stigmatizing language concerning schizophrenia in U.S. newspapers. Because advocacy to decrease stigmatization of mental illness has increased in recent years, this study compared media depictions of schizophrenia in 2000 and 2010 to determine if there had been a reduction in reporting of dangerousness and perpetration of crime by people with schizophrenia or in stigmatizing language. All articles published in five high-circulation newspapers from diverse urban geographical regions between January 1 and June 1 in 2000 and 2010 that contained the words "schizophrenia" or "schizophrenic" were reviewed. Articles were categorized under the categories of education, incidental reference, medical and pharmaceutical news, metaphorical use, charity, obituary, medically inappropriate, and human interest. Human interest articles were further subcategorized into advocacy, crimes committed by people with schizophrenia, crimes committed against those suffering from schizophrenia, and issues related to poor mental health care. There was a statistically significant decrease in reporting of crime committed by people with schizophrenia in 2010 compared with 2000. However, no significant difference was found in metaphorical usage of the terms schizophrenia and schizophrenic between 2000 and 2010.

Left-sided gallbladder (sinistroposition) with duplication of the common bile duct.

A left-sided gallbladder sinistroposition is a rare finding. These gallbladders are situated left of the falciform ligament and are located under the left lobe of the liver, between segments III and IV. Common bile duct duplication is also rare, and its cause is not yet fully understood. A 55-year-old woman presented to our hospital with symptoms of chronic cholecystitis. During the laparoscopic cholecystectomy, it was discovered that not only was her gallbladder to the left of the falciform ligament, but she also had a duplication of her common bile duct. Although cases of left-sided gallbladders have been reported in the past, and there has been a report of a sinistroposition of both gallbladder and common bile duct, we believe this is the first reported case of left-sided gallbladder sinistroposition with the complete duplication of the common bile duct. As we learn more about various anatomical anomalies of the gallbladder through the use of laparoscopic cholecystectomies, surgeons encountering a left-sided gallbladder should be aware of the potential for associated anomalies.