360 Soziale Probleme und Sozialdienste; Verbände
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Cannabis is the most commonly used illicit drug in the world. However, because of a changing legal landscape and rising interest in therapeutic utility, there is an increasing trend in (long-term) use and possibly cannabis impairment. Importantly, a growing body of evidence suggests that regular cannabis users develop tolerance to the impairing, as well as the rewarding, effects of the drug. However, the neuroadaptations that may underlie cannabis tolerance remain unclear. Therefore, this double-blind, randomized, placebo-controlled, cross-over study assessed the acute influence of cannabis on the brain and behavioral outcomes in two distinct cannabis user groups. Twelve occasional and 12 chronic cannabis users received acute doses of cannabis (300-μg/kg delta-9-tetrahydrocannabinol) and placebo and underwent ultrahigh field functional magnetic resonance imaging and magnetic resonance spectroscopy. In occasional users, cannabis induced significant neurometabolic alterations in reward circuitry, namely, decrements in functional connectivity and increments in striatal glutamate concentrations, which were associated with increases in subjective high and decreases in performance on a sustained attention task. Such changes were absent in chronic users. The finding that cannabis altered circuitry and distorted behavior in occasional, but not chronic users, suggests reduced responsiveness of the reward circuitry to cannabis intoxication in chronic users. Taken together, the results suggest a pharmacodynamic mechanism for the development of tolerance to cannabis impairment, of which is important to understand in the context of the long-term therapeutic use of cannabis-based medications, as well as in the context of public health and safety of cannabis use when performing day-to-day operations.
Cannabis is the most commonly used illicit drug in the world. However due to a changing legal landscape, and rising interest in therapeutic utility, there is an increasing trend in (long-term) use and possibly, cannabis impairment. Importantly, a growing body of evidence suggests regular cannabis users develop tolerance to the impairing, as well as the rewarding, effects of the drug. However, the neuroadaptations that may underlie cannabis tolerance remain unclear. Therefore, this double-blind, randomized, placebo controlled, cross-over study assessed the acute influence of cannabis on brain and behavioral outcomes in two distinct cannabis user groups. Twelve occasional (OUs) and 12 chronic (CUs) cannabis users received acute doses of cannabis (300 μg/kg THC) and placebo, and underwent ultra-high field functional magnetic resonance imaging (fMRI) and magnetic resonance spectroscopy (MRS). In OUs, cannabis induced significant neurometabolic alterations in reward circuitry, namely decrements in functional connectivity and increments in striatal glutamate concentrations, which were associated with increases in subjective high and decreases in performance on a sustained attention task. Such changes were absent in CUs. The finding that cannabis altered circuitry and distorted behavior in OUs, but not CUs, suggests reduced responsiveness of the reward circuitry to cannabis intoxication in chronic users Taken together, the results suggest a pharmacodynamic mechanism for the development of tolerance to cannabis impairment.
In a significant number of cases, clerical sex offenders impregnate their victims and force them into hiding, abortion, or adoption. This phenomenon is referred to in this paper as reproductive abuse. Clearly, most victims of reproductive abuse are adults, but even among minor victims of clerical child abuse, between 1 and 10 percent may have experienced reproductive abuse. On the basis of pertinent studies, this paper explores archival material on several dozen allegations of reproductive abuse in the context of clergy sexual abuse of minors in the US Catholic Church. Besides some tentative estimates of the general frequency of the phenomenon, this paper offers a distinction of three different types of reproductive abuse and an analysis of the interplay of clericalist and secular misogyny, which appears to be largely responsible for the silencing of victims as well as for the impunity of perpetrators and leads to the invisibility of this phenomenon, despite the high importance attributed to reproductive issues in the Catholic context.
In this article, we examine anti-refugee hate crime in the wake of the large influx of refugees to Germany in 2014 and 2015. By exploiting institutional features of the assignment of refugees to German regions, we estimate the impact of unexpected and sudden large-scale immigration on hate crime against refugees. Results indicate that it is not simply the size of local refugee inflows which drives the increase in hate crime, but rather the combination of refugee arrivals and latent anti-refugee sentiment. We show that ethnically homogeneous areas, areas which experienced hate crimes in the 1990s, and areas with high support for the Nazi party in the Weimar Republic, are more prone to respond to the arrival of refugees with incidents of hate crime against this group. Our results highlight the importance of regional anti-immigration sentiment in the analysis of the incumbent population’s reaction to immigration.
Resting state fMRI has been employed to identify alterations in functional connectivity within or between brain regions following acute and chronic exposure to Δ9-tetrahydrocannabinol (THC), the psychoactive component in cannabis. Most studies focused a priori on a limited number of local brain areas or circuits, without considering the impact of cannabis on wholebrain network organization. The present study attempted to identify changes in the wholebrain human functional connectome as assessed with ultra-high field (7T) resting state scans of occasional (N=12) and chronic cannabis users (N=14) during placebo and following vaporization of cannabis. Two distinct data-driven methodologies, i.e. network-based statistics (NBS) and connICA, were used to identify changes in functional connectomes associated with acute cannabis intoxication and chronic cannabis use. Both methodologies revealed a broad state of hyperconnectivity within the entire range of major brain networks in chronic cannabis users compared to occasional cannabis users, which might be reflective of an adaptive network reorganization following prolonged cannabis exposure. The connICA methodology also extracted a distinct spatial connectivity pattern of hypoconnectivity involving the dorsal attention, limbic, subcortical and cerebellum networks and of hyperconnectivity between the default mode and ventral attention network, that was associated with the feeling of subjective high during THC intoxication across both user groups. Whole-brain network approaches identified spatial patterns in functional brain connectomes that distinguished acute from chronic cannabis use, and offer an important utility for probing the interplay between short and long-term alterations in functional brain dynamics when progressing from occasional to chronic use of cannabis.
Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally.
Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation.
Findings: We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well.
Interpretation: Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue.
Child sexual abuse has been discussed thoroughly; however, marginalized groups of victims such as victims of child sexual abuse in early childhood and victims of maternal sexual abuse have rarely been considered. This essay combines these two relevant perspectives in child protection and aims to pin out future directions in the field of child abuse and specifically maternal sexual abuse and its early prevention. In the course of the 7th Haruv International PhD Workshop on Child Maltreatment at the Hebrew University, Jerusalem, in 2019 the topics of maternal sexual abuse and early prevention of child maltreatment in Germany were discussed and intertwined. Problems concerning the specific research of maternal sexual abuse in early childhood and prevention were identified. Both, maternal sexual abuse as well as sexual abuse in early childhood, i.e. before the age of three, are underreported topics. Society still follows a “friendly mother illusion” while recent cases in German media as well as research findings indicate that the mother can be a perpetrator of child sexual abuse. Similarly, sexual abuse in early childhood, namely abuse before the age of three, is existent; although the recognition of it is difficult and young children are, in regards to their age and development especially vulnerable. They need protective adults in their environment, who are aware of sexual abuse in the first years of life. Raising awareness on marginalized or tabooed topics can be a form of prevention. An open dialog in research and practice about the so far marginalized topics of maternal sexual abuse and sexual abuse in early childhood is crucial.
Objective: Prisoners constitute a high-risk group for suicide, with suicide rates about 5 to 8 times higher than in the general population. The first weeks of imprisonment are a particularly vulnerable time, but there is limited knowledge about the risk factors for either early or late suicide events. Methods: Based on a national total sample of prison suicides in Germany between 2005 and 2017, suicides within the first 2 (4 and 8) weeks after reception into prison were matched by age and penalty length with cases that occurred later. Factors that potentially influence the timing of suicide were investigated. Results: The study has shown that 16.7% (31.5%) of all 390 suicides in German prisons occurred within the first two weeks (two months) of imprisonment. Factors that facilitate adaptation to the prison environment (e.g. prior prison experience) were negatively associated with early suicide events. Factors that hindered the adaptation process (e.g. withdrawal from illicit drugs) were observed more frequently in early suicide events than in late ones. These factors are active at different times of imprisonment. Conclusion: At reception, particular attention should be paid to the following factors associated with early suicide events: widowed marital status, lack of prison experience, and drug dependency.
This article addresses the continuing resilience of two post-Soviet governments – Azerbaijan and Lithuania – against community-based engagement and social protection of HIV-positive people by exploring the challenges of two social activists. The analysis shows how basic social and medical needs of people living with HIV/AIDS remain unmet, while stigmatisation informs the local health policies and manifests as a protective mechanism against contrary promotion effects. The findings call for urgent policy changes to prevent the further suffering of these people because of poor state strategies. The aim is to help further intervention practices and improve social care services for HIV-positive people in the two countries.
Garbage piles up in the capital of Cambodia; it lies around in corners, on streets, in fields. COVID-19, which has led to a global reduction in the production of greenhouse gases considered utopian, has had little if any significant impact within this country, where garbage is produced in the same amounts, likewise burned and buried, or dumped into the rivers. The smelly sewage channels of Phnom Penh run as brown as usual, patterned with flip-flops, shampoo packaging, diverse plastic particles, and undefinable fragments of rubbish, travelling south-eastwards into the morning glory fields; passing by buzzing, still active markets, passing urban poor areas, where children play in the thick mud, passing citizens in facemasks. On 10 April, the Cambodian government counted some 120 official cases of COVID-19 infection among its populace...