Inhibition of surface spoilage bacteria in processed meats by application of antimicrobial films prepared with chitosan.

A study was undertaken to evaluate the feasibility of using antimicrobial films, designed to slowly release bacterial inhibitors, to improve the preservation of vacuum-packaged processed meats during refrigerated storage. The antimicrobial films were prepared by incorporating acetic or propionic acid into a chitosan matrix, with or without addition of lauric acid or cinnamaldehyde, and were applied onto bologna, regular cooked ham, or pastrami. At various times during storage, packages were opened and the amounts of antimicrobial agents remaining in the chitosan matrix were measured. Regardless of film composition or meat product type, propionic acid was nearly completely released from the chitosan matrix within 48 h of application, whereas release of acetic acid was more limited, with 2-22% of the acid remaining in chitosan after 168 h of storage. Addition of lauric acid, but not cinnamaldehyde, to the chitosan matrix generally reduced the release of acetic acid significantly (P < or = 0.05) and the release was more limited onto bologna than onto ham or pastrami. In addition, the efficacies of the various films for inhibiting bacterial growth were tested against indigenous lactic acid bacteria and Enterobacteriaceae, and against Lactobacillus sakei or Serratia liqueficiens, surface-inoculated onto the meat products. Whereas lactic acid bacteria were not affected by the antimicrobial films under study, the growth of Enterobacteriaceae and S. liquefaciens was delayed or completely inhibited as a result of film application. Strongest inhibition was observed on drier surfaces (bologna), onto which acid release was slower, and with films containing cinnamaldehyde, as a result of its greater antimicrobial activity under these conditions.

Antimicrobial films produced from chitosan.

Antimicrobial films were prepared by dissolving chitosan into hydrochloric, formic, acetic, lactic and citric acid solutions. Below 40 degrees C, the counter ions could be classified into two groups based on their effect on zero-shear-rate viscosity in 2% solutions of organic acids. Chloride and citrate produced solutions with much lower viscosities than formate, acetate and lactate. At higher temperatures, these differences vanished, and the activation energies of viscous flow were all similar between 40 and 60 degrees C. Films prepared from these solutions were evaluated in tension for Young's modulus, stress and elongation at yield and break points. Films made from hydrochloric, formic and acetic acids were hard and brittle, whereas those from lactic and citric acids were soft and could be stretched. Good correlation was found between Young's modulus and volume of the counter ion. Film properties are essentially governed by the volume of the counter ion and not by the interactions between this counter ion and the macromolecule. Results suggest that acetate has the maximum molecular volume above which the film strength decreases very rapidly.

Use of dialectical behavior therapy in a partial hospital program for women with borderline personality disorder.

Dialectical behavior therapy, an outpatient psychosocial treatment for chronically suicidal women with borderline personality disorder, has been adapted for use in a partial hospital program for women. Patients attend the program for a minimum of five days of individual and group therapy, and full census is 12 women. About 65 percent of participants meet at least three criteria for borderline personality disorder, and most have suicidal and self-injurious behavior. Their comorbid diagnoses include trauma-related diagnoses and anxiety disorders, severe eating disorders, substance abuse, and depression. The partial hospital program is linked to an aftercare program offering six months of outpatient skills training based on dialectical behavior therapy. Both programs focus on teaching patients four skills: mindfulness (attention to one's experience), interpersonal effectiveness, emotional regulation, and distress tolerance. Two years of operation of the women's partial hospital program provides promising anecdotal evidence that dialectical behavioral therapy, an outpatient approach, can be effectively modified for partial hospital settings and a more diverse population.

An affect-management group for women with posttraumatic stress disorder and histories of childhood sexual abuse.

Systematic research on effective treatment for survivors of childhood sexual abuse with posttraumatic stress disorder (PTSD) is virtually non-existent. The aim of the present study was to compare the effectiveness of an affect-management treatment (AM) group to a wait list control condition for female survivors of childhood sexual abuse with PTSD. Forty-eight female survivors of childhood sexual abuse with PTSD were randomly assigned to either a 15-week affect-management treatment group or to a wait list control condition. All subjects received individual psychotherapy and pharmacotherapy for the duration of the study, and for at least 1-month prior to the study. Controlling for pretreatment scores, subjects who completed the affect-management treatment group (n = 17) reported significantly fewer posttreatment symptoms of PTSD and dissociation than subjects in the wait list control condition (n = 16). Our findings suggest that an affect-management group treatment is beneficial as an adjunct to individual psychotherapy and pharmacotherapy for survivors of childhood sexual abuse with PTSD.

Antibacterial activity of selected fatty acids and essential oils against six meat spoilage organisms.

The antibacterial activity of selected fatty acids and essential oils was examined against two gram-negative (Pseudomonas fluorescens and Serratia liquefaciens) and four gram-positive (Brochothrix thermosphacta, Carnobacterium piscicola, Lactobacillus curvatus, and Lactobacillus sake) bacteria involved in meat spoilage. Various amounts of each preservative were added to brain heart infusion or MRS (deMan, Rogosa and Sharpe) agars, and the minimum inhibitory concentration was determined for each organism. Essential oils were analysed by gas-liquid chromatography to determine the concentration of selected components commonly found in spices. B. thermosphacta, P. fluorescens and S. liquefaciens were not affected by fatty acids, and generally overcame the inhibitory effect of essential oils after 24 h of exposure. Among the fatty acids, lauric and palmitoleic acids exhibited the greatest inhibitory effect with minimum inhibitory concentrations of 250 to 500 micrograms/ml, while myristic, palmitic, stearic and oleic acids were completely ineffective. For essential oils, clove, cinnamon, pimento, and rosemary were found to be the most active. The 1/100 dilution of those oils inhibited at least five of the six tested organisms. A relationship was found between the inhibitory effect of essential oils and the presence of eugenol and cinnamaldehyde.

The validation of the Trauma Symptom Checklist-40 (TSC-40) in a sample of inpatients.

This study examined the construct validity of the Trauma Symptom Checklist-40 (TSC-40; Elliot & Briere, 1992) in a sample of 130 female psychiatric inpatients. Consistent with other findings, the TSC-40 displayed criterion-related validity in relation to childhood sexual abuse. Survivors of sexual abuse obtained significantly higher scores than those without such a history on the overall TSC-40 and on each of the six subscales, except the Depression subscale. Convergent validity of three subscales was demonstrated, and divergent validity on the total TSC-40 and each of its subscales was established. Further, among a range of abuse-effects measures, the Sexual Abuse Trauma Index (SATI) subscale was the most powerful predictor of sexual abuse. The SATI and Dissociation subscales were the subscales most sensitive to the specific features of the sexual abuse.

The long-term sequelae of sexual abuse: support for a complex posttraumatic stress disorder.

This study examined the relationship between childhood sexual abuse and symptoms of a newly proposed complex posttraumatic stress disorder or disorder of extreme stress not otherwise specified (DESNOS). Compared to 34 women without histories of sexual abuse, 74 survivors of sexual abuse showed increased severity on DESNOS symptoms of somatization, dissociation, hostility, anxiety, alexithymia, social dysfunction, maladaptive schemas, self-destruction and adult victimization. In addition, a logistic regression found that a complex of symptoms representing DESNOS was significantly related to a history of sexual abuse. Consistent with other studies, the results of this study provide support for the idea that symptoms of DESNOS characterize survivors of sexual abuse.

The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation.

The overall purpose of the present study was to further our understanding of the mechanisms of self-mutilative behavior in a sample of female inpatients. The study found that self-mutilators (n = 103) displayed a greater degree of dissociative symptoms and alexithymia and a greater number of self-injurious behaviors, as well as higher rates of childhood sexual abuse, than nonmutilators (n = 45). In addition, the study found that among these variables, the number of self-injurious behaviors had the strongest relationship to self-mutilation. However, both dissociative symptoms and alexithymia were independently associated with self-mutilative behavior. Implications of our findings for clinicians and researchers are discussed.

Stressors and close relationships during childhood and dissociative experiences in survivors of sexual abuse among inpatient psychiatric women.

The purpose of this study was to examine which childhood events were associated with more extensive use of adult dissociative states in 90 female inpatients with histories of sexual abuse. The study found that childhood stressors of maltreatment (physical neglect, witnessing sexual abuse, and witnessing physical abuse) were associated with higher levels of dissociative symptoms. In contrast, childhood stressors of loss (parental separation and death of a close relative) were not related to increased severity of dissociative symptoms. The study also demonstrated that a close relationship with either a parent, sibling, extraparental adult, or friend did not have a mediating effect on the degree of adult dissociative symptoms. Directions for future research are presented.

The relationship between characteristics of sexual abuse and dissociative experiences.

Childhood sexual abuse has been associated with adult dissociative symptomatology. The purpose of this study was to examine the relationship between specific characteristics of sexual abuse and dissociative experiences in adulthood. Fifty-six female inpatients with a history of physical abuse and severe sexual abuse reported on their history of abuse and dissociative experiences. A logistic regression that controlled for physical revictimization showed that sexual abuse by a greater number of different sex abuse offenders was significantly related to an elevated level of dissociation. In exploring how many sex abuse offenders are associated with dissociative experiences, a logistic regression revealed a significant relationship between four or more sex abuse offenders and greater dissociative symptomatology. The reported age of onset of the sexual abuse was not a significant predictor of dissociation when sexual revictimization was included in the analysis. These findings suggest that severely traumatized patients with a history of multiple sex abuse offenders are highly likely to use dissociation as a primary psychological defense. The implications of the study are discussed.

Volunteer bias in a study of male alcoholics' sexual behavior.

Studies on sexual behavior frequently require that subject volunteers engage in intrusive/sensitive assessment procedures. While earlier investigators have found that these demands may result in volunteer bias (volunteers differing from nonvolunteers), these studies were limited to nonclinical samples. The present study involved 182 males admitted to an inpatient alcoholism rehabilitation program. Those patients who volunteered to participate in an intrusive study examining sexual functioning were dissimilar to nonvolunteers. Compared to nonvolunteers, volunteers reported a greater interest in sex, less satisfaction with sex, more concerns about sexual functioning, a greater incidence of premature ejaculation, and a greater incidence of negative sexual experience. Volunteers also had a higher MAST score, used outpatient substance-abuse counseling more often, and more frequently had a diagnosis of cocaine/amphetamine dependence and cannabis dependence. These differences between volunteers and nonvolunteers suggest a need to use caution when generalizing the results of similar studies to the overall population. Procedures that may help to minimize volunteer bias are offered.

The sexual relationship of male alcoholics and their female partners during periods of drinking and abstinence.

The quality of the sexual relationship between alcoholic male veterans admitted to an alcohol treatment program and their stable nonalcoholic female partners was assessed in relation to time intervals of abstinence and drinking. Repeated measures analyses performed on the LoPiccolo Sexual History Form provided information on sexual problems associated with the desire, arousal and orgasm phases of the sexual response cycle and other kinds of information relevant to sexual functioning. Results indicate that the sexual relationship varies in relation to drinking or abstinence. Sexual intimacy appears quite normal and satisfactory during abstinent periods; however, female partners present an internally consistent picture of neither desiring nor enjoying sex during drinking periods, though accepting sex reluctantly. For male alcoholics, satisfaction with sex while drinking continues to be reported despite awareness of their partner's negative emotional reactions during sex. Clinicians and researchers are cautioned to differentiate drinking and abstinent periods when assessing the sexual relationship of alcoholic couples.

Family history of alcoholism in males: absence of distinguishing features for treatment matching.

One variable for subtyping the alcoholic population that could influence treatment-matching efforts is family history of alcoholism. This study compared two groups of male patients undergoing rehabilitation for alcohol dependence (39 family history positive [FHP] versus 36 family history negative [FHN]) on a number of salient dimensions for which specific targeted intervention components might be implemented. The FHP were similar to FHN subjects on all variables except that FHP had significantly fewer years of education than did FHN. Several possible explanations to account for these findings are discussed.

Detoxification of alcoholics: improving care by symptom-triggered sedation.

This study evaluated a staff training program on alcohol detoxification. Training consisted of didactic presentations on the pathophysiology of alcohol withdrawal syndrome and information on use of the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A). Treatment course was assessed on 100 patients admitted before or after the training. Whereas 73% of patients were given drug therapy before, only 13% of patients received drug therapy after. Significantly more benzodiazepine was administered before training (M = 108.48 mg) than after training (M = 42.97 mg). After excluding those who received no drug therapy, patients who received benzodiazepine after the training received significantly higher amounts of benzodiazepine (M = 252.50 mg) than those who received drug before (M = 144.64 mg). The average number of hours from the first benzodiazepine dose to the last was reduced from 13 to 5 hr. Clinical implications of matching patient symptomatology with appropriate drug therapy, thus preventing both over- and under-treatment for alcohol withdrawal symptoms, are discussed.

Behavioral treatment of alcohol and drug abuse. What do we know and where shall we go?

Over the last 20 years there has been a substantial increase in the use of alcohol and drugs in industrialized nations and a concomitant shift in the emphasis of treatment for alcohol and drugs. Rather than seeking treatment for alcohol alone or a single class of drug, many individuals are seeking treatment for alcohol and/or a number of drugs. While theoreticians have been exploring the similarities in the addictive behaviors, clinical researchers are only just beginning to do so. Unfortunately, most treatment research has focused almost exclusively on alcohol abusers or drug abusers, with little research conducted to date with alcohol and drug abusers. Behavioral interventions developed for alcohol abuse are now being tested with drug abusers, and vice versa. The purpose of this chapter is fourfold: (1) to briefly discuss the similarities in the assessment of alcohol and drug abuse; (2) to describe behavioral interventions that have been supported by research and briefly review this treatment outcome research; (3) to discuss the theoretical similarities in behavioral interventions for alcohol and drug abuse; and (4) to make recommendations for future advancements in treatment and research.

Family functioning of male alcoholics and their female partners during periods of drinking and abstinence.

Family functioning of 20 alcoholic male veterans and their female partners was assessed in relation to drinking (wet) and abstinent (dry) intervals. Repeated measures analyses performed on the McMaster Family Assessment Device (FAD) indicated that on all 7 scales of the FAD, alcoholics and their mates perceived family functioning to be better during dry than wet periods. In contrast to their alcoholic mates, female partners gave healthier ratings to all FAD scales except Roles in the dry condition and Affective Involvement in the wet condition. According to published cutoff scores for healthy and unhealthy family functioning, alcoholics as a group viewed their wet and dry family functioning as unhealthy, although the female group regarded the family's dry Problem Solving and Behavioral Control as healthy. These findings suggest that the family functioning of alcohol-involved couples is biphasic, oscillating between drinking and abstinent periods.

Evaluation of a program designed to help family and significant others to motivate resistant alcoholics into recovery.

Little empirical work has been done in the alcohol field on the issue of motivating reticent people into treatment. This study explored the impact of a program that involved counseling an alcoholic's social network to eventually confront the alcoholic in urging him or her to seek treatment. Twenty-four social networks (relatives plus significant others) participated in this study and of these, seven formally confronted the alcoholic. Social networks were not randomized to confronting vs nonconfronting conditions, although the comparison groups were equivalent on several important dimensions. Results indicate that alcoholics who were confronted were significantly more likely to enter an alcohol detox or rehabilitation program and to remain continuously abstinent than were nonconfronted alcoholics. This study suggests that the alcoholic's social network can be helped to become highly influential in motivating the alcoholic to seek treatment.