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[What are the epidemiological data on the consequences of smoking-related increased risk in pregnant women? Dermatological consequences].

Smoking has numerous effects on skin. Some of them are well established, others are more debatable. Smoking is a cofactor of skin aging after chronic sun exposure, as demonstrated by recent histological, biochemical and cutaneous relief studies. Smoking is a well established risk factor of cutaneous, mucous membrane cancers, and some gynecologic cancers as well, in some cases increased by pregnancy. However, published studies have included small numbers of subjects. Some skin affections are worsened by smoking, and others might be improved. However scientific data on smoking and skin or pregnancy are both scarce.

Female↗

[Perforation in Crohn's ileitis and its consequences in the natural history of disease. 2. Consequences of perforation in the peritoneal cavity: diffuse septic peritonitis, abscesses, external and internal fistulas].

Perforation of Crohn's ileitis occurring in the peritoneal cavity is always free perforation, but it causes usually a localized peritonitis, i.e. an abscess, and only in rare cases a diffuse septic peritonitis for the reasons expounded in the Part 1. Diffuse septic peritonitis has the common features of all perforative peritonitis; its surgical treatment must be ileocolic resection, simple suture of perforation being a serious mistake. Abscesses develop: as regards the ileum, about 30-45 cm from the ileo-caecal valve; as regards the abdominal cavity, in the right iliac fossa or in the pelvis, at a site where the ileum, weighed down by its chronic inflammation, rests. These abscesses have a wall like that of all abscesses, with no specific crohnian features. On operation, if technical considerations so require, part of the abscess wall may be left in place with no fear of recurrences or fistulas. Nowadays, most abscesses of the right iliac fossa are opened surgically; an enterocutaneous fistula follows. Most abscesses of the pelvis still open spontaneously into a hollow organ (sigma-rectum, urinary bladder), and rarely into the vagina or onto the perineum after penetrating through the levator any muscle and causing suppuration of the ischiorectal fossa.

Abdominal Abscess↗

Positive and negative consequences of alcohol consumption in college students.

While the negative consequences of alcohol use in college students are well known, less is known about the relationships of these consequences to alcohol consumption patterns. Further, almost no research has been conducted examining students' positive alcohol-related consequences. The current study examines the nature and frequency of positive and negative alcohol-related consequences, the relationship of these consequences to alcohol consumption patterns, and the impact of these consequences on subsequent drinking intentions. Findings indicate that college student drinking does indeed involve many negative consequences, some of which are quite serious, but that students also experience many positive consequences. In fact, they report their encounters with positive consequences as being more extreme and more frequent than their encounters with negative consequences. Further, consuming more alcohol is related to experiencing more positive and more negative consequences, as well as more extremely positive positive encounters, but not more extremely negative negative ones. Finally, participants reported that their positive and negative consequences would influence their future drinking decisions in a number of different ways. Future research directions and implications for interventions are discussed.

Adult↗

Negative consequences of intercollegiate athlete drinking: the role of drinking motives.

OBJECTIVE: Intercollegiate athletes consume more alcohol and experience more negative alcohol-related consequences than nonathletes. The purpose of this study was to determine if drinking motives accounted for variability among intercollegiate athletes in experiencing negative alcohol-related consequences, and to analyze how the strength and patterns of the relationship between individual drinking motives and negative consequences varied among the different consequences. METHOD: Self-report data were analyzed on 206 National Collegiate Athletic Association Division I athletes (55% female), selected from a large, midwestern university, who reported drinking alcohol in the past year. Participants completed the Drinking Motives Measure and the Core Alcohol and Drug Survey. RESULTS: Drinking motives accounted for variability in experiencing negative alcohol-related consequences. Drinking for coping reasons displayed the strongest relationship with most of the negative consequences, but for some consequences social and enhancement motives displayed relationships with the consequences that were either similar to or stronger than those of the coping motives. CONCLUSIONS: This research demonstrated that drinking motives in general are useful predictors of negative alcohol-related consequences among a yet unstudied population, intercollegiate athletes. The findings suggest that drinking for negatively reinforcing reasons (i.e., coping motives) is generally the strongest motivational predictor of alcohol-related consequences, although the relative strength of individual motives in predicting consequences can vary depending upon the content of an individual consequence.

Adolescent↗

Negative consequences and cognitions about drinking and driving.

OBJECTIVE: Drinking and driving has been found to be a highly persistent behavior, even after experiencing negative consequences, such as arrest. This study tested the association between consequences of drinking and driving and cognitions related to drinking and driving (e.g., attitudes, normative beliefs). We tested whether exposure to negative consequences was associated with perceptions of risk associated with drinking and driving. METHOD: Participants were 938 college students. The sample was 57% female and primarily white (86%). Questionnaire measures were used to assess alcohol use, drinking and driving behaviors, drinking and driving cognitions, and lifetime drinking and driving consequences. RESULTS: Results indicated that participants who had experienced consequences of drinking and driving (either as a driver or rider) reported more current drinking and driving and greater alcohol consumption. Analyses indicated that most cognition measures differentiated those reporting lifetime consequences from the rest of the sample, with the consequence groups reporting more risky cognitions. However, experiencing a personal consequence of drinking and driving was associated with perceiving negative consequences of drinking and driving to be more likely. CONCLUSIONS: These results provide evidence that most cognitive risk factors for drinking and driving remain high even after experiencing a negative consequence. This may contribute to the persistence of drinking and driving in prior offenders. The finding that the perception of negative consequences may be influenced by experiencing consequences may have implications for intervention and treatment efforts.

Adult↗

Risk functions for frequency of alcohol-related negative consequences: New Zealand survey data.

AIMS: To examine the dose-response relationship between self-reported alcohol consumption and levels of self-reported negative consequences of drinking. DESIGN: Data from 10 general population random sample surveys over the years 1990-1997 were combined and responses were plotted and subjected to regression analysis. SETTING: Auckland, a city of approximately 1 million people in the North Island of New Zealand. Participants were interviewed in their homes using a computer-assisted telephone interviewing system. PARTICIPANTS: General population sample of 11,817 aged 14-65 years, representative of the Auckland population. MEASUREMENTS: Frequency of experience of 14 negative consequences; annual volume of alcohol consumed; frequency of drinking larger quantities of alcohol. RESULTS: Three different patterns of relationship between consequences and consumption were found for different consequences. These differed between the prevalence and the frequency of consequences but were similar for two different measures of consumption, annual volume and larger quantity drinking. Analysis of the frequency of experienced consequences found that the risk curves for the most common consequences approximated a straight line and the effects at low volume intake were due to those drinking larger quantities. Three less common consequences clearly showed a concave curve suggesting a threshold effect, with effects beginning at about 20 litres per annum of absolute alcohol. CONCLUSION: The different relationships between consumption and consequences imply that some consequences occur only once a very heavy volume of drinking is reached, while others show a direct relationship with consumption, reflecting that volume of alcohol consumed is closely related to the quantities consumed.

Adolescent↗

The physical, behavioral, and psychosocial consequences of Internet use in college students.

The purposes of this study were to identify the physical, behavioral, and psychosocial consequences of Internet use in undergraduate college students; and to evaluate whether time, social norms, and adopter category predict the consequences of Internet use. Rogers' model for studying consequences of innovation was adapted for this study. A descriptive, correlational design was used. Convenience sampling yielded 293 undergraduate students who answered the online survey. Consequences of Internet use were assessed with the researcher-developed instrument, the Internet Consequences Scale (ICONS). Mean scores on the behavioral and psychosocial subscales of the ICONS indicated positive consequences of Internet use, while the physical consequences subscale revealed negative consequences. Multiple regression analyses revealed a small, but significant, amount of variance in consequences of Internet use that could be explained by time, social norms, and adopter category, thus supporting the adapted model for the study of consequences of Internet use in college students.

Adult↗

The importance of prudent negative consequences for maintaining the appropriate behavior of hyperactive students.

Teachers use both positive and negative consequences to influence classroom behaviors. Four experiments were conducted to examine the differential affects of these two types of consequences on the maintenance of appropriate behaviors of hyperactive children. Results of Experiment 1 showed that the use of both positive and negative consequences (combined) was associated with high levels of on-task behaviors. Withdrawal of negative consequences caused a significant and dramatic decrease in on-task performance. The withdrawal of positive consequences produced no change in the rate of on-task behaviors. In Experiments 2, 3, and 4, the on-task results of Experiment 1 were replicated using a different teacher, different children, a counterbalanced design, longer phases, and different types of negative consequences. The withdrawal of negative consequences led to decreases in productivity in Experiment 2. The results of Experiment 3 also suggested that a prudent (e.g., calm, concrete, and consistent) approach to discipline was more effective than an imprudent (e.g., loud, emotional, and inconsistent) approach. Some level of mild negative consequences for inappropriate behavior is an important ingredient in effective classroom management, and qualitatively different negative consequences may have drastically different effects on the behavior of hyperactive students.

Achievement↗

Relation between executive cognitive functioning and the adverse consequences of alcohol use in social drinkers.

The purpose of this study was to assess the relation between Executive Cognitive Functioning (ECF) and the adverse consequences of alcohol consumption. ECF encompasses "higher order" cognitive abilities involved in goal-directed behavior, such as attentional control, mental flexibility, planning, and self-monitoring. Impaired ECF has been shown to result in a variety of negative consequences, including excessive drug and alcohol use. Subjects were 79 nonalcoholic male social drinkers between 17 to 30 years of age. ECF was measured using three neuropsychological tests: the Wisconsin Card Sorting Test (WCST), the Conditional Associative Learning Test (CAT), and the Sequential Matching Memory Test (SMMT). Adverse drinking consequences were measured using the Drinker Inventory of Consequences (DrInC). The DrInC assesses drinking consequences in five domains: Physical, Intrapersonal, Interpersonal, Social Responsibility, and Impulse Control. Scores from the neuropsychological tests were reduced into two latent variables: one representing the WCST and the other representing the CAT and SMMT. The results indicated that errors on the CAT/SMMT variable were positively related to adverse consequences in each domain, except for physical consequences. A similar association was found between the WCST variable and impulse control consequences. These findings indicate that performance on tests measuring ECF is related to the severity of drinking consequences. Therefore, prevention and treatment outcomes may be improved by incorporating cognitive habilitation into current interventions.

Adolescent↗

Types of unintended consequences related to computerized provider order entry.

OBJECTIVE: To identify types of clinical unintended adverse consequences resulting from computerized provider order entry (CPOE) implementation. DESIGN: An expert panel provided initial examples of adverse unintended consequences of CPOE. The authors, using qualitative methods, gathered and analyzed additional examples from five successful CPOE sites. METHODS: Using a card sort method, the authors developed a categorization scheme for the 79 unintended consequences initially identified and then iteratively modified the scheme to categorize 245 additional adverse consequences resulting from fieldwork. Because the focus centered on consequences requiring prevention or remedial action, the authors did not further analyze reported unintended beneficial (positive) consequences. RESULTS: Unintended adverse consequences (UACs) fell into nine major categories (in order of decreasing frequency): 1) more/new work for clinicians; 2) unfavorable workflow issues; 3) never ending system demands; 4) problems related to paper persistence; 5) untoward changes in communication patterns and practices; 6) negative emotions; 7) generation of new kinds of errors; 8) unexpected changes in the power structure; and 9) overdependence on the technology. Clinical decision support features introduced many of these unintended consequences. CONCLUSION: Identifying and understanding the types and in some instances the causes of unintended adverse consequences associated with CPOE will enable system developers and implementers to better manage implementation and maintenance of future CPOE projects.

Communication↗