The Japanese movie“0.5mm”connects the life clips between the nursing-care helper Sawa and several old people in the form of a road movie,highlighting many thought-provoking social problems,and revealing how the elem...The Japanese movie“0.5mm”connects the life clips between the nursing-care helper Sawa and several old people in the form of a road movie,highlighting many thought-provoking social problems,and revealing how the elements of emotional abuse hidden between the old people and their relatives and friends affect people’s dignity and decency,and at the same time trying to offset the persecution from the emotional abuse with the warm kindness between the elderly and the care workers.The film’s implicit description of emotional abuse and explicit display of good deeds are blended in the quiet and mysterious narrative character,achieving the effect of synchronizing the artistic narrative rhythm with the flow of life,reflecting the unique aesthetic characteristics of Japanese films.展开更多
Objective: Utilizing Mendelian Randomization, this study employs Single Nucleotide Polymorphisms (SNPs) as instrumental variables to explore the causal relationships between bibulosity, smoking, and Primary Open Angle...Objective: Utilizing Mendelian Randomization, this study employs Single Nucleotide Polymorphisms (SNPs) as instrumental variables to explore the causal relationships between bibulosity, smoking, and Primary Open Angle Glaucoma (POAG). Methods: GWAS data for bibulosity, smoking, and POAG were obtained from the Social Science Genetic Association Consortium website and the IEU OpenGWAS Project website, respectively. Using a P-value threshold of −8, a linkage disequilibrium coefficient (r2) of 0.001, and a linkage disequilibrium region width of 10,000 kb, the data were aggregated, resulting in 6 SNPs for bibulosity and 253 SNPs for smoking. Three regression models, MR-Egger, Weighted Median Estimator (WME), and Random-Effects Inverse-Variance Weighted (IVW) were applied to analyze the causal impact of bibulosity and smoking on POAG. Results: The GWAS data for alcohol consumption and smoking were derived from European populations, while the GWAS data for Primary Open-Angle Glaucoma (POAG) were sourced from East Asian populations, with no gender restrictions. Analysis using three different regression models revealed that neither excessive alcohol consumption nor smoking significantly increased the risk of developing POAG. Specifically, the odds ratios with 95% confidence intervals for the alcohol consumption group were 0.854 (0.597 - 1.221) in MR-Egger regression, 0.922 (0.691 - 1.231) in WME regression, and 0.944 (0.711 - 1.252) in IVW regression. For the smoking group, the odds ratios were 1.146 (0.546 - 2.406) in MR-Egger regression, 0.850 (0.653 - 1.111) in WME regression, and 0.939 (0.780 - 1.131) in IVW regression. Given the significant heterogeneity in the SNPs associated with smoking, the focus was primarily on the results from the IVW regression model. Conclusion: Alcohol consumption and smoking are not significant risk factors for the development of POAG.展开更多
Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less...Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.展开更多
This essay will reexamine research on the relationship between human memory and addiction. This paper will review several studies that discussed how memory systems in the human brain are involved in the acquisition of...This essay will reexamine research on the relationship between human memory and addiction. This paper will review several studies that discussed how memory systems in the human brain are involved in the acquisition of behavior that is learned and is associated with the development of drug addiction and drug relapse. Additional information reveals that when individuals make the transition from recreational drug or impulsive use to compulsive drug abuse, which may result in a neuroanatomical change in areas of the brain from cognitive control guided by the hippocampus/dorsomedial striatum towards conditioned control of behavior managed by the dorsolateral striatum (DLS) [1]. This review also looked at studies that involved experiments with humans and lower animals, which suggested that the hippocampus mediates a cognitive/spatial type of memory, while the dorsal striatum manages stimulus-response (S-R) habit memory, and the amygdala governs the classical conditioning form of learning and stimulus-affective-associative relationships [1]. Overall, these studies utilize the hypothesis of the memory systems view of addiction, and the involvement of learning and memory in the context of drug addiction, which was proposed by them [2]. This theory has been proposed in response to drug addiction research and includes alcohol, amphetamine, and cocaine [1]. The research also explains how stress and anxiety can play a role in how strong emotional excitement can lead to dependent habit memory in rodents and humans [1]. .展开更多
The direct coupling of solid-phase microextraction(SPME)to mass spectrometry(MS)(SPME-MS)has proven to be an effective method for the fast screening and quantitative analysis of compounds in complex matrices such as b...The direct coupling of solid-phase microextraction(SPME)to mass spectrometry(MS)(SPME-MS)has proven to be an effective method for the fast screening and quantitative analysis of compounds in complex matrices such as blood and plasma.In recent years,our lab has developed three novel SPME-MS techniques:SPME-microfluidic open interface-MS(SPME-MOI-MS),coated blade spray-MS(CBS-MS),and SPME-probe electrospray ionization-MS(SPME-PESI-MS).The fast and high-throughput nature of these SPME-MS technologies makes them attractive options for point-of-care analysis and anti-doping testing.However,all these three techniques utilize different SPME geometries and were tested with different MS instruments.Lack of comparative data makes it difficult to determine which of these methodologies is the best option for any given application.This work fills this gap by making a comprehensive comparison of these three technologies with different SPME devices including SPME fibers,CBS blades,and SPME-PESI probes and SPME-liquid chromatography-MS(SPME-LC-MS)for the analysis of drugs of abuse using the same MS instrument.Furthermore,for the first time,we developed different desorption chambers for MOI-MS for coupling with SPME fibers,CBS blades,and SPME-PESI probes,thus illustrating the universality of this approach.In total,eight analytical methods were developed,with the experimental data showing that all the SPME-based methods provided good analytical performance with R^(2)of linearities larger than 0.9925,accuracies between 81%and 118%,and good precision with an RSD%≤13%.展开更多
Abuse of Lithium-ion batteries,both physical and electrochemical,can lead to significantly reduced operational capabilities.In some instances,abuse can cause catastrophic failure,including thermal runaway,combustion,a...Abuse of Lithium-ion batteries,both physical and electrochemical,can lead to significantly reduced operational capabilities.In some instances,abuse can cause catastrophic failure,including thermal runaway,combustion,and explosion.Many different test standards that include abuse conditions have been developed,but these generally consider only one condition at a time and only provide go/no-go criteria.In this work,different types of cell abuse are implemented concurrently to determine the extent to which simultaneous abuse conditions aggravate cell degradation and failure.Vibrational loading is chosen to be the consistent type of physical abuse,and the first group of cells is cycled at different vibrational frequencies.The next group of cells is cycled at the same frequencies,with multiple charge pulses occurring during each discharge.The final group of cells is cycled at the same frequencies,with a partial nail puncture occurring near the beginning of cycling.The results show that abusing cells with vibrational loading or vibrational loading with current pulses does not cause a significant decrease in operational capabilities while abusing cells with vibrational loading and a nail puncture drastically reduces operational capabilities.The cells with vibration only experience an increase in internal resistance by a factor of 1.09–1.26,the cells with vibration and current pulses experience an increase in internal resistance by a factor of 1.16–1.23,and all cells from each group reach their rated lifetime of 500 cycles without reaching their end-of-life capacity.However,the cells with vibration and nail puncture experience an increase in internal resistance by a factor of 6.83–22.1,and each cell reaches its end-of-life capacity within 50 cycles.Overall,the results show that testing multiple abuse conditions simultaneously provides a better representation of the extreme limitations of cell operation and should be considered for inclusion in reference test standards.展开更多
Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days afte...Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days after delivery. Long term separation and less attractive, less responsive appearance of preterm infants also make it difficult to build mother-child relationships. In addition, the mothers of preterm infants are likely to have mood disorders such as depression, anxiety, and stress-related disorders. The mothers’ psychiatric illnesses affect the psychosocial development of preterm infants and are often regarded as a risk factor for child abuse and maltreatment in later life. Child abuse and maltreatment are also prevalent among preterm infants than the full term infants. Intervention from the early period of preterm birth is an important issue for both preterm infants and their mothers. Medical and co-medical professionals should pay attention to developmental outcome of preterm as well as psychosocial conditions of their mothers for the improvement of their mental health.展开更多
Karst aquifers occur worldwide and exhibit groundwater flow responses that differ considerably from aquifers lacking fractures, bedding planes, and other karst conduits where significant and rapid groundwater flow can...Karst aquifers occur worldwide and exhibit groundwater flow responses that differ considerably from aquifers lacking fractures, bedding planes, and other karst conduits where significant and rapid groundwater flow can occur. The regional, karst Floridan aquifer system underlies the United States (US) Southeastern Coastal Plain Physiographic Region and exhibits hydrologic interconnections with overlying surficial aquifers and throughout other zones of the aquifer system, as is characteristic of other karst aquifer systems. Anthropogenic groundwater declines in this regional karst aquifer system have been documented in published literature for decades, but the impacts of those declines in this coastal plain region and the embedded ecosystems that provide essential and critical habitat for native, endemic, and federally endangered and threatened species have not been considered previously. Those anthropogenic groundwater declines reduce surfacewater levels and flows due to the capture of both groundwater and overland flow of surfacewater, resulting in induced recharge through semi-confining zones and interbasin flow through fractures and other karst conduits. This case study identifies examples from the Greater Okefenokee Swamp Basin study area and comparison areas of how those declines result in loss of historic base flow to surface waters and other capture of surface waters, ultimately increasing saltwater intrusion. Those results alter and degrade the physical, chemical, and biological integrity of the nation’s waters, in violation of the US Clean Water Act (CWA) of 1972. Historic groundwater declines from mining and other anthropogenic groundwater withdrawals from this regional karst aquifer system already threaten the survival and recovery of federally endangered and threatened species, as well as existing and proposed critical habitat for those species within this regional extent, in violation of the Endangered Species Act (ESA) of 1973. This case study and its companion publication (Part 2) appear to be the first to provide scientific support for this regional karst aquifer system as the unifying factor in habitat responses to irreversible groundwater impacts on aquatic and marine ecosystems. These adverse impacts strongly suggest that the extent of the regional Floridan aquifer system should be designated as the Southeastern Coastal Plain Ecoregion for the purpose of managing natural resources. Mining activities continue to expand in our study area, which is the Greater Okefenokee Swamp Basin. Despite that fact, no comprehensive Areawide Environmental Impact Statement (AEIS), similar to the AEIS required for phosphate mining within the Central Florida Phosphate District (CFPD) approximately a decade ago has been conducted for any of the numerous mining projects that are occurring and are proposed within the Greater Okefenokee Swamp Basin. This case study also provides examples of why a comprehensive AEIS is essential to consider all of the adverse direct, indirect, and cumulative impacts of those mining activities to the CWA, the ESA, and the irreversible losses to local economies, because federal agencies responsible for considering those adverse impacts rely on public comments to identify those adverse impacts. The mining activities authorized throughout the regional Floridan aquifer system under Category 44 Nationwide Permits (NWP) result in the same type of adverse impacts as the mining activities evaluated under Individual Permits in that region. Therefore, those Category 44 NWP mining activities also should be required to obtain Individual Permits and be evaluated under an AEIS in the Greater Okefenokee Swamp Basin. This case study also describes how Florida’s assumption of the CWA Section 404 regulatory authority in 2020 severs four sub-basins within the Greater Okefenokee Swamp Basin study area at the state line between Florida and Georgia.展开更多
The present article will provide an overview of use of dried blood sampling method for analysis of drug of abuse. Relatively short half life and instability in blood, calls for alternative sampling method for determin...The present article will provide an overview of use of dried blood sampling method for analysis of drug of abuse. Relatively short half life and instability in blood, calls for alternative sampling method for determination of drugs of abuse. Dried blood spot (DBS) method has many advantages over the conventional sampling methods. The available method for DBS sample collection, storage and transport are described here. The techniques involved in and the factors that may influence the accuracy and reproducibility of the DBS methods for determination of drugs of abuse are presented. The DBS sampling has the potential to be a useful technique to detect drugs of abuse. The use of DBS for any drug should be judged against the potential error involved with the method.展开更多
Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense commit...Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense committed with violence, coercion, threat or surprise on the person of others. It is a criminal act punishable by the laws in force in almost every country in the world. Study Objectives: 1) draw up an epidemiological profile of female victims of sexual abuse;2) develop the treatment protocol. Methodology: This is a 7-year descriptive retrospective study from January 1, 2010 to December 31, 2016 at the Center Hospitalier National de Pikine (Dakar). Included in this study were all of the patients admitted during our investigation period who were the victims of suspected or certain sexual abuse, with or without requisition. For each case, the following parameters were studied: the epidemiological characteristics (age, gestation, parity and place of residence), the circumstances of the attack (time and place), the characteristics of the aggressor (age, link with the victim, number of aggressor), the type of sexual contact, the possible lesions found during the physical examination (genital and extra-genital), the mode of admission, the delay of the consultation, the attitude after the sexual abuse, the gynecological and obstetrical status of the victim, the repercussions and psychological follow-up, the paraclinical assessment, the treatments administered. Data were collected using a survey form and analyzed with SPSS software. Results: During the study period, 183 victims of sexual abuse were received and treated at the level of our structure out of a total of 39,760 patients, representing a frequency of 0.46%. The age of the victims varied between 2 and 36 years with an average of 13 years. The 11 to 15 age group was the most represented. Students were the most represented among victims of sexual abuse (87.4%). Workers represented 9.3% of the victims. Infants made up 3.3% of the victims;the average age of the alleged attackers was 31 when they were known to their victim. Half of the victims (50.3%) were in the pre-pubertal stage. Among those who were in genital activity (91 cases or 49.7%), 16 cases of pregnancy were reported;which represented 8.7% of cases. Only 20.2% of victims had genital trauma. Prescription of emergency contraception was carried out for 47% of the victims who were in genital activity. After the clinical examination, 17% of the victims had received antibiotic prophylaxis. Conclusion: Sexual abuse is currently a real socio-cultural drama. Preventing them involves raising public awareness. Their management must be early and adapted in order to prevent sexually transmitted infections and psychological consequences.展开更多
What should academic institutions be doing in order to benefit students,the community at large,and society in the new era?Particularly,as computing is impacting all aspects of human society,it also brings many challen...What should academic institutions be doing in order to benefit students,the community at large,and society in the new era?Particularly,as computing is impacting all aspects of human society,it also brings many challenges and opportunities for the academic departments of computer science.Some of these challenges include the increasing impact of software on society,issues involving privacy and data abuse,and ethical issues concerning AI.Towards addressing these challenges,the Korea Advanced Institute of Science and Technology(KAIST)leverages its position as an educator in order to train the future computing workforce to be more aware of these issues.To achieve this goal,KAIST mainly adopts three strategies:Combining science&technology and humanities together;putting academy and industry together;training software experts while making them understand people and the world.展开更多
Dolores Claiborne is one of Stephen King's finest works.It gives a comprehensive and stunning view at the judiciary and social corruption on domestic violence issues.And it has been made into a movie.The movie pre...Dolores Claiborne is one of Stephen King's finest works.It gives a comprehensive and stunning view at the judiciary and social corruption on domestic violence issues.And it has been made into a movie.The movie precisely describes the life of an abused woman.Dolores,the main character,covers all the characteristics of a typical abused housewife.Even the child molesta tion and the domestic cold violence typical in a domestic abuse family are presented in the movie.This movie pays much atten tion to the reality and is from the perspectives of females tells people the misery of women in the man's world and tells people that the domestic abuses are the result of a patriarchal society.展开更多
The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of whi...The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).展开更多
Social media platforms like Instagram have increasingly become venues for online abuse and offensive comments. This study aimed to enhance user security to create a safe online environment by eliminating hate speech a...Social media platforms like Instagram have increasingly become venues for online abuse and offensive comments. This study aimed to enhance user security to create a safe online environment by eliminating hate speech and abusive language. The proposed system employed a multifaceted approach to comment filtering, incorporating the multi-level filter theory. This involved developing a comprehensive list of words representing various types of offensive language, from slang to explicit abuse. Machine learning models were trained to identify abusive messages through sentiment analysis and contextual understanding. The system categorized comments as positive, negative, or abusive using sentiment analysis algorithms. Employing AI technology, it created a dynamic filtering mechanism that adapted to evolving online language and abusive behavior. Integrated with Instagram while adhering to ethical data collection principles, the platform sought to promote a clean and positive user experience, encouraging users to focus on non-abusive communication. Our machine-learned models, trained on a cleaned Arabic language dataset, demonstrated promising accuracy (75.8%) in classifying Arabic comments, potentially reducing abusive content significantly. This advancement aimed to provide users with a clean and positive online experience.展开更多
OBJECTIVE Over 30% of all new psychoactive substances identified by the UN Office on Drugs and Crime in 2016 were synthetic cannabinoids.The recent emergence of MAM-2201 on the illicit market is troubling because this...OBJECTIVE Over 30% of all new psychoactive substances identified by the UN Office on Drugs and Crime in 2016 were synthetic cannabinoids.The recent emergence of MAM-2201 on the illicit market is troubling because this drug has no precedent in either the scientific or patent literature,and appears to be a novel compound developed specifically as a "graymarket" drug of abuse bystructurally combining the known synthetic cannabinoids JWH-122 and AM-2201.There is currently no published information regarding the pharmacology of MAM-2201.METHODS The present studies characterized cannabinoid-like effects of MAM-2201 in vitro(interactions with cannabinoid type 1 receptors[CB1 Rs]) and in vivo(in mice and rats).RESULTS In a radioligand binding assay using [3 H]CP55,940 in HEK cell membranes transfected with the CB1 R,MAM-2201(K i=5.4 nmol·L^(-1)),had higher binding affinity than WIN 55,212-2(K i=80 nmol·L^(-1)),and D9-THC(K i=8.3 nmol·L^(-1)).The E max values for MAM-2201 and WIN 55,212-2 in an assay of agonist inhibition of forskolin-stimulated c AMP were 85%(EC50=0.45 nmol·L^(-1)) and 95%,respectively,as compared with the D9-THC E max of 74%.In mice,MAM-2201(0.003-1.0 mg·kg^(-1),IP) produced dose-dependent cannabimimetic effects which were both more potent and more effective than those of D9-THC.MAM-2201 and D9-THC dose-dependently produced hypothermia:ED50=0.287 and 25.4 mg·kg^(-1),analgesia:ED50=0.125 and 29.4 mg·kg^(-1),and catalepsy:ED50=0.301 and18.9 mg·kg^(-1) in adult male CD1 mice.Importantly,MAM-2201 also elicited convulsant effects at a dose of 1.0 mg·kg^(-1) in 8/8 murine subjects.In rats,MAM-2201 produced dose-dependent D9-THC-like interoceptive effects in subjects trained to discriminate 3.0 mg·kg^(-1)(IP) D9-THC from saline.CONCLUSION MAM-2201 binds CB1 Rs with high affinity and agonist efficacy,and functions as a potent cannabinoid agonist in vivo across several complementary measures of cannabinoid activity in two rodent species.展开更多
AIMTo evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT).METHODSFifteen eyes of 10 patients with abus...AIMTo evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT).METHODSFifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination.RESULTSAll patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco.CONCLUSIONAMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.展开更多
Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, mo...Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.展开更多
Dear Editor,The prevalence of drug abuse has diverted from traditional drugs such as opioid and cannabis to modern,synthetic and psychoactive drugs such as amphetamine groups,the amphetamine(AT)and methamphetamine[1]....Dear Editor,The prevalence of drug abuse has diverted from traditional drugs such as opioid and cannabis to modern,synthetic and psychoactive drugs such as amphetamine groups,the amphetamine(AT)and methamphetamine[1].Amphetamine is used medically to treat several disorders such as attention deficit hyperactivity disorder,narcolepsy,depression and minor obesity[2].However,AT has also gained展开更多
This study aims to identify details of the psychosocial characteristics of fathers who have abused children as they appear to public health nurses (PHNs). In this study a qualitative descriptive design was applied to ...This study aims to identify details of the psychosocial characteristics of fathers who have abused children as they appear to public health nurses (PHNs). In this study a qualitative descriptive design was applied to the data analysis. Interviewees were 10 public health nurses (PHNs), in charge of maternal and child health services for 5 or more years at public health centers. The study analyzed 13 cases reported in the PHNs interviews. The characteristics of the fathers who had abused children as seen by the PHNs were the psycho-social characteristics of ‘weak suppression and control of impulsiveness’, ‘cognitive dissonance in the fatherhood role’, ‘poor social sensitivity’, ‘unbalanced relationship with other members of the family’ and ‘weak relationships with people around the father’. The father’s impulsiveness and cognitive dissonances in the fatherhood role are associated with weaknesses in the family relationships and social adaptation. Conversely, the weakness in the strength of family relationships and social adaptation affects the father’s ability to control impulsiveness and give rise to the cognitive dissonance in the fatherhood role. These in turn interact to create a negative downward spiral, a steadily worsening situation. The findings of this study suggest the necessity for PHNs to focus on the background to the cognitive dissonance in the fatherhood role and to work to educate and guide the fathers.展开更多
文摘The Japanese movie“0.5mm”connects the life clips between the nursing-care helper Sawa and several old people in the form of a road movie,highlighting many thought-provoking social problems,and revealing how the elements of emotional abuse hidden between the old people and their relatives and friends affect people’s dignity and decency,and at the same time trying to offset the persecution from the emotional abuse with the warm kindness between the elderly and the care workers.The film’s implicit description of emotional abuse and explicit display of good deeds are blended in the quiet and mysterious narrative character,achieving the effect of synchronizing the artistic narrative rhythm with the flow of life,reflecting the unique aesthetic characteristics of Japanese films.
文摘Objective: Utilizing Mendelian Randomization, this study employs Single Nucleotide Polymorphisms (SNPs) as instrumental variables to explore the causal relationships between bibulosity, smoking, and Primary Open Angle Glaucoma (POAG). Methods: GWAS data for bibulosity, smoking, and POAG were obtained from the Social Science Genetic Association Consortium website and the IEU OpenGWAS Project website, respectively. Using a P-value threshold of −8, a linkage disequilibrium coefficient (r2) of 0.001, and a linkage disequilibrium region width of 10,000 kb, the data were aggregated, resulting in 6 SNPs for bibulosity and 253 SNPs for smoking. Three regression models, MR-Egger, Weighted Median Estimator (WME), and Random-Effects Inverse-Variance Weighted (IVW) were applied to analyze the causal impact of bibulosity and smoking on POAG. Results: The GWAS data for alcohol consumption and smoking were derived from European populations, while the GWAS data for Primary Open-Angle Glaucoma (POAG) were sourced from East Asian populations, with no gender restrictions. Analysis using three different regression models revealed that neither excessive alcohol consumption nor smoking significantly increased the risk of developing POAG. Specifically, the odds ratios with 95% confidence intervals for the alcohol consumption group were 0.854 (0.597 - 1.221) in MR-Egger regression, 0.922 (0.691 - 1.231) in WME regression, and 0.944 (0.711 - 1.252) in IVW regression. For the smoking group, the odds ratios were 1.146 (0.546 - 2.406) in MR-Egger regression, 0.850 (0.653 - 1.111) in WME regression, and 0.939 (0.780 - 1.131) in IVW regression. Given the significant heterogeneity in the SNPs associated with smoking, the focus was primarily on the results from the IVW regression model. Conclusion: Alcohol consumption and smoking are not significant risk factors for the development of POAG.
文摘Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.
文摘This essay will reexamine research on the relationship between human memory and addiction. This paper will review several studies that discussed how memory systems in the human brain are involved in the acquisition of behavior that is learned and is associated with the development of drug addiction and drug relapse. Additional information reveals that when individuals make the transition from recreational drug or impulsive use to compulsive drug abuse, which may result in a neuroanatomical change in areas of the brain from cognitive control guided by the hippocampus/dorsomedial striatum towards conditioned control of behavior managed by the dorsolateral striatum (DLS) [1]. This review also looked at studies that involved experiments with humans and lower animals, which suggested that the hippocampus mediates a cognitive/spatial type of memory, while the dorsal striatum manages stimulus-response (S-R) habit memory, and the amygdala governs the classical conditioning form of learning and stimulus-affective-associative relationships [1]. Overall, these studies utilize the hypothesis of the memory systems view of addiction, and the involvement of learning and memory in the context of drug addiction, which was proposed by them [2]. This theory has been proposed in response to drug addiction research and includes alcohol, amphetamine, and cocaine [1]. The research also explains how stress and anxiety can play a role in how strong emotional excitement can lead to dependent habit memory in rodents and humans [1]. .
基金the National Science Centre,Poland(Grant No.:2020/04/X/NZ9/01281).
文摘The direct coupling of solid-phase microextraction(SPME)to mass spectrometry(MS)(SPME-MS)has proven to be an effective method for the fast screening and quantitative analysis of compounds in complex matrices such as blood and plasma.In recent years,our lab has developed three novel SPME-MS techniques:SPME-microfluidic open interface-MS(SPME-MOI-MS),coated blade spray-MS(CBS-MS),and SPME-probe electrospray ionization-MS(SPME-PESI-MS).The fast and high-throughput nature of these SPME-MS technologies makes them attractive options for point-of-care analysis and anti-doping testing.However,all these three techniques utilize different SPME geometries and were tested with different MS instruments.Lack of comparative data makes it difficult to determine which of these methodologies is the best option for any given application.This work fills this gap by making a comprehensive comparison of these three technologies with different SPME devices including SPME fibers,CBS blades,and SPME-PESI probes and SPME-liquid chromatography-MS(SPME-LC-MS)for the analysis of drugs of abuse using the same MS instrument.Furthermore,for the first time,we developed different desorption chambers for MOI-MS for coupling with SPME fibers,CBS blades,and SPME-PESI probes,thus illustrating the universality of this approach.In total,eight analytical methods were developed,with the experimental data showing that all the SPME-based methods provided good analytical performance with R^(2)of linearities larger than 0.9925,accuracies between 81%and 118%,and good precision with an RSD%≤13%.
基金Funding for this research has been provided by the Office of Naval Research(ONR)under the Grant N00014-20-1-2227(Program Manager:Dr.Maria Medeiros and Dr.Corey Love).
文摘Abuse of Lithium-ion batteries,both physical and electrochemical,can lead to significantly reduced operational capabilities.In some instances,abuse can cause catastrophic failure,including thermal runaway,combustion,and explosion.Many different test standards that include abuse conditions have been developed,but these generally consider only one condition at a time and only provide go/no-go criteria.In this work,different types of cell abuse are implemented concurrently to determine the extent to which simultaneous abuse conditions aggravate cell degradation and failure.Vibrational loading is chosen to be the consistent type of physical abuse,and the first group of cells is cycled at different vibrational frequencies.The next group of cells is cycled at the same frequencies,with multiple charge pulses occurring during each discharge.The final group of cells is cycled at the same frequencies,with a partial nail puncture occurring near the beginning of cycling.The results show that abusing cells with vibrational loading or vibrational loading with current pulses does not cause a significant decrease in operational capabilities while abusing cells with vibrational loading and a nail puncture drastically reduces operational capabilities.The cells with vibration only experience an increase in internal resistance by a factor of 1.09–1.26,the cells with vibration and current pulses experience an increase in internal resistance by a factor of 1.16–1.23,and all cells from each group reach their rated lifetime of 500 cycles without reaching their end-of-life capacity.However,the cells with vibration and nail puncture experience an increase in internal resistance by a factor of 6.83–22.1,and each cell reaches its end-of-life capacity within 50 cycles.Overall,the results show that testing multiple abuse conditions simultaneously provides a better representation of the extreme limitations of cell operation and should be considered for inclusion in reference test standards.
文摘Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days after delivery. Long term separation and less attractive, less responsive appearance of preterm infants also make it difficult to build mother-child relationships. In addition, the mothers of preterm infants are likely to have mood disorders such as depression, anxiety, and stress-related disorders. The mothers’ psychiatric illnesses affect the psychosocial development of preterm infants and are often regarded as a risk factor for child abuse and maltreatment in later life. Child abuse and maltreatment are also prevalent among preterm infants than the full term infants. Intervention from the early period of preterm birth is an important issue for both preterm infants and their mothers. Medical and co-medical professionals should pay attention to developmental outcome of preterm as well as psychosocial conditions of their mothers for the improvement of their mental health.
文摘Karst aquifers occur worldwide and exhibit groundwater flow responses that differ considerably from aquifers lacking fractures, bedding planes, and other karst conduits where significant and rapid groundwater flow can occur. The regional, karst Floridan aquifer system underlies the United States (US) Southeastern Coastal Plain Physiographic Region and exhibits hydrologic interconnections with overlying surficial aquifers and throughout other zones of the aquifer system, as is characteristic of other karst aquifer systems. Anthropogenic groundwater declines in this regional karst aquifer system have been documented in published literature for decades, but the impacts of those declines in this coastal plain region and the embedded ecosystems that provide essential and critical habitat for native, endemic, and federally endangered and threatened species have not been considered previously. Those anthropogenic groundwater declines reduce surfacewater levels and flows due to the capture of both groundwater and overland flow of surfacewater, resulting in induced recharge through semi-confining zones and interbasin flow through fractures and other karst conduits. This case study identifies examples from the Greater Okefenokee Swamp Basin study area and comparison areas of how those declines result in loss of historic base flow to surface waters and other capture of surface waters, ultimately increasing saltwater intrusion. Those results alter and degrade the physical, chemical, and biological integrity of the nation’s waters, in violation of the US Clean Water Act (CWA) of 1972. Historic groundwater declines from mining and other anthropogenic groundwater withdrawals from this regional karst aquifer system already threaten the survival and recovery of federally endangered and threatened species, as well as existing and proposed critical habitat for those species within this regional extent, in violation of the Endangered Species Act (ESA) of 1973. This case study and its companion publication (Part 2) appear to be the first to provide scientific support for this regional karst aquifer system as the unifying factor in habitat responses to irreversible groundwater impacts on aquatic and marine ecosystems. These adverse impacts strongly suggest that the extent of the regional Floridan aquifer system should be designated as the Southeastern Coastal Plain Ecoregion for the purpose of managing natural resources. Mining activities continue to expand in our study area, which is the Greater Okefenokee Swamp Basin. Despite that fact, no comprehensive Areawide Environmental Impact Statement (AEIS), similar to the AEIS required for phosphate mining within the Central Florida Phosphate District (CFPD) approximately a decade ago has been conducted for any of the numerous mining projects that are occurring and are proposed within the Greater Okefenokee Swamp Basin. This case study also provides examples of why a comprehensive AEIS is essential to consider all of the adverse direct, indirect, and cumulative impacts of those mining activities to the CWA, the ESA, and the irreversible losses to local economies, because federal agencies responsible for considering those adverse impacts rely on public comments to identify those adverse impacts. The mining activities authorized throughout the regional Floridan aquifer system under Category 44 Nationwide Permits (NWP) result in the same type of adverse impacts as the mining activities evaluated under Individual Permits in that region. Therefore, those Category 44 NWP mining activities also should be required to obtain Individual Permits and be evaluated under an AEIS in the Greater Okefenokee Swamp Basin. This case study also describes how Florida’s assumption of the CWA Section 404 regulatory authority in 2020 severs four sub-basins within the Greater Okefenokee Swamp Basin study area at the state line between Florida and Georgia.
文摘The present article will provide an overview of use of dried blood sampling method for analysis of drug of abuse. Relatively short half life and instability in blood, calls for alternative sampling method for determination of drugs of abuse. Dried blood spot (DBS) method has many advantages over the conventional sampling methods. The available method for DBS sample collection, storage and transport are described here. The techniques involved in and the factors that may influence the accuracy and reproducibility of the DBS methods for determination of drugs of abuse are presented. The DBS sampling has the potential to be a useful technique to detect drugs of abuse. The use of DBS for any drug should be judged against the potential error involved with the method.
文摘Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense committed with violence, coercion, threat or surprise on the person of others. It is a criminal act punishable by the laws in force in almost every country in the world. Study Objectives: 1) draw up an epidemiological profile of female victims of sexual abuse;2) develop the treatment protocol. Methodology: This is a 7-year descriptive retrospective study from January 1, 2010 to December 31, 2016 at the Center Hospitalier National de Pikine (Dakar). Included in this study were all of the patients admitted during our investigation period who were the victims of suspected or certain sexual abuse, with or without requisition. For each case, the following parameters were studied: the epidemiological characteristics (age, gestation, parity and place of residence), the circumstances of the attack (time and place), the characteristics of the aggressor (age, link with the victim, number of aggressor), the type of sexual contact, the possible lesions found during the physical examination (genital and extra-genital), the mode of admission, the delay of the consultation, the attitude after the sexual abuse, the gynecological and obstetrical status of the victim, the repercussions and psychological follow-up, the paraclinical assessment, the treatments administered. Data were collected using a survey form and analyzed with SPSS software. Results: During the study period, 183 victims of sexual abuse were received and treated at the level of our structure out of a total of 39,760 patients, representing a frequency of 0.46%. The age of the victims varied between 2 and 36 years with an average of 13 years. The 11 to 15 age group was the most represented. Students were the most represented among victims of sexual abuse (87.4%). Workers represented 9.3% of the victims. Infants made up 3.3% of the victims;the average age of the alleged attackers was 31 when they were known to their victim. Half of the victims (50.3%) were in the pre-pubertal stage. Among those who were in genital activity (91 cases or 49.7%), 16 cases of pregnancy were reported;which represented 8.7% of cases. Only 20.2% of victims had genital trauma. Prescription of emergency contraception was carried out for 47% of the victims who were in genital activity. After the clinical examination, 17% of the victims had received antibiotic prophylaxis. Conclusion: Sexual abuse is currently a real socio-cultural drama. Preventing them involves raising public awareness. Their management must be early and adapted in order to prevent sexually transmitted infections and psychological consequences.
文摘What should academic institutions be doing in order to benefit students,the community at large,and society in the new era?Particularly,as computing is impacting all aspects of human society,it also brings many challenges and opportunities for the academic departments of computer science.Some of these challenges include the increasing impact of software on society,issues involving privacy and data abuse,and ethical issues concerning AI.Towards addressing these challenges,the Korea Advanced Institute of Science and Technology(KAIST)leverages its position as an educator in order to train the future computing workforce to be more aware of these issues.To achieve this goal,KAIST mainly adopts three strategies:Combining science&technology and humanities together;putting academy and industry together;training software experts while making them understand people and the world.
文摘Dolores Claiborne is one of Stephen King's finest works.It gives a comprehensive and stunning view at the judiciary and social corruption on domestic violence issues.And it has been made into a movie.The movie precisely describes the life of an abused woman.Dolores,the main character,covers all the characteristics of a typical abused housewife.Even the child molesta tion and the domestic cold violence typical in a domestic abuse family are presented in the movie.This movie pays much atten tion to the reality and is from the perspectives of females tells people the misery of women in the man's world and tells people that the domestic abuses are the result of a patriarchal society.
文摘The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).
文摘Social media platforms like Instagram have increasingly become venues for online abuse and offensive comments. This study aimed to enhance user security to create a safe online environment by eliminating hate speech and abusive language. The proposed system employed a multifaceted approach to comment filtering, incorporating the multi-level filter theory. This involved developing a comprehensive list of words representing various types of offensive language, from slang to explicit abuse. Machine learning models were trained to identify abusive messages through sentiment analysis and contextual understanding. The system categorized comments as positive, negative, or abusive using sentiment analysis algorithms. Employing AI technology, it created a dynamic filtering mechanism that adapted to evolving online language and abusive behavior. Integrated with Instagram while adhering to ethical data collection principles, the platform sought to promote a clean and positive user experience, encouraging users to focus on non-abusive communication. Our machine-learned models, trained on a cleaned Arabic language dataset, demonstrated promising accuracy (75.8%) in classifying Arabic comments, potentially reducing abusive content significantly. This advancement aimed to provide users with a clean and positive online experience.
基金supported by Drug Enforcement Administration,National Center for Toxicological Research(protocol#E0763601)University of Arkansas for Medical Sciences
文摘OBJECTIVE Over 30% of all new psychoactive substances identified by the UN Office on Drugs and Crime in 2016 were synthetic cannabinoids.The recent emergence of MAM-2201 on the illicit market is troubling because this drug has no precedent in either the scientific or patent literature,and appears to be a novel compound developed specifically as a "graymarket" drug of abuse bystructurally combining the known synthetic cannabinoids JWH-122 and AM-2201.There is currently no published information regarding the pharmacology of MAM-2201.METHODS The present studies characterized cannabinoid-like effects of MAM-2201 in vitro(interactions with cannabinoid type 1 receptors[CB1 Rs]) and in vivo(in mice and rats).RESULTS In a radioligand binding assay using [3 H]CP55,940 in HEK cell membranes transfected with the CB1 R,MAM-2201(K i=5.4 nmol·L^(-1)),had higher binding affinity than WIN 55,212-2(K i=80 nmol·L^(-1)),and D9-THC(K i=8.3 nmol·L^(-1)).The E max values for MAM-2201 and WIN 55,212-2 in an assay of agonist inhibition of forskolin-stimulated c AMP were 85%(EC50=0.45 nmol·L^(-1)) and 95%,respectively,as compared with the D9-THC E max of 74%.In mice,MAM-2201(0.003-1.0 mg·kg^(-1),IP) produced dose-dependent cannabimimetic effects which were both more potent and more effective than those of D9-THC.MAM-2201 and D9-THC dose-dependently produced hypothermia:ED50=0.287 and 25.4 mg·kg^(-1),analgesia:ED50=0.125 and 29.4 mg·kg^(-1),and catalepsy:ED50=0.301 and18.9 mg·kg^(-1) in adult male CD1 mice.Importantly,MAM-2201 also elicited convulsant effects at a dose of 1.0 mg·kg^(-1) in 8/8 murine subjects.In rats,MAM-2201 produced dose-dependent D9-THC-like interoceptive effects in subjects trained to discriminate 3.0 mg·kg^(-1)(IP) D9-THC from saline.CONCLUSION MAM-2201 binds CB1 Rs with high affinity and agonist efficacy,and functions as a potent cannabinoid agonist in vivo across several complementary measures of cannabinoid activity in two rodent species.
文摘AIMTo evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT).METHODSFifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination.RESULTSAll patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco.CONCLUSIONAMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.
文摘Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.
基金supported by Uni SZA/NRGS/2013(RR057-1)grant from Malaysia Ministry of Higher Education
文摘Dear Editor,The prevalence of drug abuse has diverted from traditional drugs such as opioid and cannabis to modern,synthetic and psychoactive drugs such as amphetamine groups,the amphetamine(AT)and methamphetamine[1].Amphetamine is used medically to treat several disorders such as attention deficit hyperactivity disorder,narcolepsy,depression and minor obesity[2].However,AT has also gained
文摘This study aims to identify details of the psychosocial characteristics of fathers who have abused children as they appear to public health nurses (PHNs). In this study a qualitative descriptive design was applied to the data analysis. Interviewees were 10 public health nurses (PHNs), in charge of maternal and child health services for 5 or more years at public health centers. The study analyzed 13 cases reported in the PHNs interviews. The characteristics of the fathers who had abused children as seen by the PHNs were the psycho-social characteristics of ‘weak suppression and control of impulsiveness’, ‘cognitive dissonance in the fatherhood role’, ‘poor social sensitivity’, ‘unbalanced relationship with other members of the family’ and ‘weak relationships with people around the father’. The father’s impulsiveness and cognitive dissonances in the fatherhood role are associated with weaknesses in the family relationships and social adaptation. Conversely, the weakness in the strength of family relationships and social adaptation affects the father’s ability to control impulsiveness and give rise to the cognitive dissonance in the fatherhood role. These in turn interact to create a negative downward spiral, a steadily worsening situation. The findings of this study suggest the necessity for PHNs to focus on the background to the cognitive dissonance in the fatherhood role and to work to educate and guide the fathers.