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Studies of Substance Abuse with Interventions for the Youth of Native American Indian Community #14

CHAPTER 2: Review of Related Literature

The recognition that substance use among American Indian youth often begins at an early age has resulted in a growing emphasis on prevention rather than treatment efforts. Research detailing epidemiology, etiology, and domains of risk and protection can provide the basis for developing prevention programs and identifying intervention targets. These preventive interventions are designed to reach children early and limit the initiation of substance use and/or the later development of substance abuse and related consequences.

Prevention services are widely characterized as primary, secondary, or tertiary (Caplan, 1964). Within the health field, primary prevention programs are aimed at reducing the incidence of a particular disorder or risk factor. Secondary prevention programs target early identification and treatment to reduce the prevalence of a particular problem. Tertiary prevention programs focus on reducing the severity or impact of an established condition. Because this framework assumes dichotomous categorization (i.e., present and absent), using this classification system often makes it difficult to distinguish between primary and secondary prevention. Instead, mental health and substance abuse problems tend to be conceptualized as spectrum disorders, with attention focused on the level and severity of functional impairment rather than the strict presence or absence of a disorder.

In 1994, the Institute of Medicine proposed a new model that divides the continuum of care into three categories: prevention, treatment, and maintenance. The prevention category distinguishes between three classifications of prevention programs: universal, selective, and indicated. In a universal program, specific individuals are not singled out for an intervention; rather, all individuals within a defined area or population are offered the service. Examples of this include high school health education classes and anti-smoking media campaigns. Selective prevention targets groups of individuals considered at higher than average risk because of the presence of one or more risk factors. A program designed for children of alcoholics or an after-school mentoring program for youth experiencing behavioral problems are examples of selective prevention. Indicated prevention programs are aimed at specific individuals who have already begun engaging in high-risk behaviors but who do not meet criteria for a substance use disorder. Examples of this kind of intervention might include youth screened for problems at school or a physician’s office, or those mandated to treatment. Selective and indicated preventions are also often referred to as forms of targeted prevention.

Universal and targeted prevention programs both have their advantages and disadvantages (Offord, 2000). Universal programs tend to cast a wider net and can, therefore, potentially influence more people. They also tend to be less stigmatizing, as no one individual is singled out for attention. However, they are often expensive usually have a smaller effect on any one person, and may have the greatest effect on those at lowest risk. Targeted programs have the potential advantage of efficiency, as available resources are directed only at the high-risk group. In addition, they tend to be more intensive and may have greater impact on an individual level. A common difficulty in indicated interventions, though, is the cost and commitment necessary to screen individuals to determine risk status. Furthermore, risk factors are usually fairly weak predictors of future pathology, so screening may not accurately target individuals in the most need. Finding the balance between sensitivity (the ability to accurately detect those who are at risk) and specificity (the ability to correctly identify those who are not at risk) often presents a challenge for clinicians and researchers.

Greece has become the epicenter of the worst crisis of capitalism since the interwar depression.

No Exit? Greece's Ongoing Crisis

When the New Year kicked off in Athens, a pall of smoke hung over the city. Steep hikes in fuel prices had pushed people to burn wood to stay warm, and even discarded Christmas trees were being fed into the fires. At the same time, a series of small explosions targeted the offices of the two major parties, New Democracy and Pasok, as well as the residences of several prominent journalists. Most shocking of all was a series of brutal beheadings across the capital that quickly became fodder for headlines, with the victims including a former central banker, a Dutch credit ratings executive and the CEO of a small debt collection agency. Well, not quite—the beheadings are described in Lixiprothesma daneia (Expiring Loans), the first novel in a new crisis trilogy by the leading Greek crime writer, Petros Markaris, whose detective hero, Inspector Costas Haritos, is as shrewd a reader of the mood in Athens as anyone. Greece is now sunk in its sixth straight year of recession, and with social and political disintegration reaching extremes not seen since World War II, it is no longer easy to separate fact from fiction.

Hard though it is to believe, around four years ago commentators and politicians were expressing relief that Greece, like the rest of Europe, had managed to escape the worst of the financial crisis. There were good reasons to be cautiously optimistic: the country’s ratio of debt to GDP had worsened a bit but not substantially, and levels of personal indebtedness were relatively low by international standards. There was no looming mortgage crisis on an American or even a Dutch or Irish scale. (The growth in housing prices in Greece between 1996 and 2008 was only 80 percent compared with 170 percent in Ireland, for instance.) Yet in the six months following the summer of 2009, everything unraveled with bewildering speed, catching the Greeks—and the rest of the world—by surprise. Following the elections that autumn, the incoming government of George Papandreou’s socialist Pasok party announced that the books had been cooked and the country’s plight far worse than anyone had foreseen. Then the credit ratings agencies piled in, downgrading Greek bonds and helping to send the government’s borrowing costs through the roof. As the panic spread, negotiations got under way among Greece, the European Union and the IMF, and the first in a series of bailouts was negotiated in exchange for the imposition of austerity.

Since then, Pasok has fallen from power and all but imploded. The government is now headed by the center-right party New Democracy; meanwhile Syriza, a coalition grouped around the old Euro-communist left (and once a happy member of the radical fringe), finds itself occupying the unaccustomed role of official opposition, and a thuggish neo-Nazi party called Golden Dawn sits third in the polls. Greece remains a member of the eurozone, but at an exorbitant cost: three years into the austerity regimen, the country’s unemployment is likely the highest in the EU at 27 percent, with youth unemployment exceeding 60 percent. Reports suggest that one out of three Greek households is living in poverty. Greece has become the epicenter of the worst crisis of capitalism since the interwar depression.
Rather in the spirit of Neville Chamberlain, who in 1938 expressed consternation at the prospect of a really important nation like Britain being plunged into a European war because of a “quarrel in a faraway country between people of whom we know nothing,” commentators outside Greece have been alarmed that the debt problems of a country whose GDP makes up less than 3 percent of the entire eurozone could become an international issue of such consequence. But how could they have been surprised? What’s happening in Greece is the dark side of the extreme globalization of finance that began in the 1990s and accelerated in Europe with the creation of the euro. Their surprise is part of a more profound ignorance exposed by the crisis: as financial globalization has accelerated, our knowledge of the world and its interlocking parts—political, financial, economic—has failed to keep pace.



And some of our politicians want to lead us down this merry path ...

How Much Water Does It Take to Frack a Well? Infographic

Here’s a graphical view of one of the most controversial aspects of hydraulic fracturing: the enormous amount of water it uses.


Galactic baby boom took place earlier than thought

Cosmologists peering into distant, dust-enshrouded galaxies have found that they are far older and more numerous than previously thought.

Their findings, published Wednesday in the journal Nature, push back the birth of these massive star-creation engines and add more precision to the model of how our expanding universe evolved.

“It doesn’t say when the universe began,” said Joaquin Vieira, an observational cosmologist at Caltech and lead author of the paper. “What it does change is when the most massive galaxies in the universe were born. It pushed it back by a billion years.”

Dusty starburst galaxies are extremely difficult to observe, but astronomers can focus on faint radiation signatures with wavelengths of less than a millimeter. Much of that ability is owed to an antenna array in Chile, known as ALMA, the Atacama Large Millimeter Array.


Police Kill Man Who Was Wanted in NY Rampage

Assault weapons ban passed after heated Senate hearing

Source: Washington Post

The Senate Judiciary Committee approved a bill banning almost 160 specific military-style assault weapons Thursday after a heated exchange between senators about the scope of the Second Amendment.

The Democratic-controlled panel approved the bill on a party-line vote of 10 to eight — all Democrats voted yes, all Republicans voted no.

In the past week the committee has approved four Democratic-backed proposals to limit gun violence in America, all introduced in the wake of the mass shooting at the Sandy Hook Elementary School shooting in Newtown, Conn. that left 20 elementary school children dead — and occurred three months ago Thursday.

Debate over gun control now shifts to the Senate, where the chamber’s divide between liberal, urban-state Democrats and Republicans and moderate Democrats weary of infringing on the rights of gun owners makes passage of the four proposals more difficult

Read more: http://www.washingtonpost.com/blogs/post-politics/wp/2013/03/14/assault-weapons-ban-passed-after-heated-senate-hearing/?wprss=rss_election-2012

Minimum Wage Workers Working 40 Hours A Week Can’t Afford A Two-Bedroom Apartment Anywhere

During his State of the Union address, President Obama unexpectedly called for a hike in the minimum wage to $9.25 an hour, and Congressional Democrats are calling for an even higher hike to $10.10.

The importance of boosting the minimum wage was highlighted earlier this week when the National Low Income Housing Coalition (NLIHC) released a report showing how difficult it is for low-income Americans to get affordable housing.

The report notes that there is no state in the country where a minimum wage worker working 40 hours a week can afford a two-bedroom apartment for their family. In the cheapest state, a worker would have to work approximately 1.4 jobs to afford such an arrangement, and in Hawaii, a worker would have to work 4.4 jobs at the minimum wage.

The report then follows up with this shocking fact:



Like we didn't know this.

Man who taped Romney's 47% comments speaks out

A Florida man has come forward to say he secretly taped the video last year in which GOP presidential nominee Mitt Romney told donors that 47% of Americans are "dependent on the government" and "who believe they are victims."

The man's name will be revealed Wednesday night in an MSNBC interview. The Huffington Post also interviewed the bartender several times and agreed not to disclose his name until after the TV appearance.

The secretly taped video was posted online by Mother Jones magazine in the fall, several months after the May fundraiser in Boca Raton where Romney spoke. The video created a national uproar, as President Obama and his Democratic allies used Romney's words to illustrate how the Republican was out of touch.


The Scariest Climate Change Graph Just Got Scarier

Average global temperature over the last ~2,000 years. Note the massive uptick on the far right side. Courtesy Science/AAAS
Back in 1999, Penn State University climate scientist Michael Mann released the climate change movement's most potent symbol: The "hockey stick," a line graph of global temperature over the last 1,500 years that shows an unmistakable, massive uptick in the 20th century, when humans began to dump large amounts of greenhouse gases into the atmosphere. It's among the most compelling bits of proof out there that human beings are behind global warming, and as such has become a target on Mann's back for climate denialists looking to draw a bead on scientists.

Today, it's getting a makeover: A study published in Science reconstructs global temperatures further back than ever before—a full 11,300 years. The new analysis finds that the only problem with Mann's hockey stick was that its handle was about 9,000 years too short. The rate of warming over the last 100 years hasn't been seen for as far back as the advent of agriculture.


RECD = Really Existing Capitalist Democracy by Noam Chomsky

Will Capitalism Destroy Civilization?

There is “capitalism” and then there is “really existing capitalism.”

The term “capitalism” is commonly used to refer to the U.S. economic system, with substantial state intervention ranging from subsidies for creative innovation to the “too-big-to-fail” government insurance policy for banks.

The system is highly monopolized, further limiting reliance on the market, and increasingly so: In the past 20 years the share of profits of the 200 largest enterprises has risen sharply, reports scholar Robert W. McChesney in his new book “Digital Disconnect.”

“Capitalism” is a term now commonly used to describe systems in which there are no capitalists: for example, the worker-owned Mondragon conglomerate in the Basque region of Spain, or the worker-owned enterprises expanding in northern Ohio, often with conservative support – both are discussed in important work by the scholar Gar Alperovitz.

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