scholarly journals MON-615 Retrospective Analysis of the Contribution of Cannabis Usage to Diabetic Ketoacidosis at an Urban Teaching Hospital

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Christine K Kha ◽  
Ellyn Phan ◽  
Nicole Simon
Keyword(s):  
Diabetic Ketoacidosis ◽  
Retrospective Analysis ◽  
Teaching Hospital ◽  
Hospital Admissions ◽  
The Self ◽  
Urban Teaching ◽  
Drug Usage ◽  
The Us ◽  
Toxicology Screening ◽  
The Relationship

Abstract Diabetic ketoacidosis (DKA) is an acute life-threatening complication of diabetes mellitus. It is responsible for greater than 100,000 hospital admissions per year in the US (1). There are few studies regarding the relationship between drug usage and acute diabetic complications (2). Since 2001, cannabis usage among US adults have more than doubled, as state legal restrictions have eased and attitudes towards cannabis have become more permissive. Cannabis is the most commonly used illicit drug in the US (3). Some studies suggested cannabis usage was associated with improvement in insulin sensitivity and pancreatic beta cell function. Other research demonstrated cannabis usage may contribute to diabetes-related hospitalizations. A retrospective analysis was performed at an urban teaching hospital to examine the relationship between cannabis usage and risk for DKA upon presentation. From March 2017 to February 2019, all non-pregnant patients aged 18 years and older, and who met criteria for DKA admission upon medical records review, were included in the study. Demographics, vitals, biochemistry, and toxicology were evaluated. Overall, 188 admissions for DKA were identified in a total of 130 patients, and 43% (81/188) were readmissions by 23 patients. Illicit substance usage was addressed by history in 72% (135/188) of all admissions, among which 24% (33/135) reported cannabis usage. 36% (67/188) of all admissions, 73% (24/33) of the self-reported cannabis usage group, and 46% (37/81) of the readmissions, underwent general toxicology screening that did not include detection for cannabis. 11% (20/188) of all admissions, 24% (8/33) of the self-reported cannabis usage group, and 16% (13/81) of the readmissions, completed toxicology screening specifically for cannabis. All of the self-reported cannabis usage admissions (33/33) and readmissions (81/81) presented with additional aggravating factors for DKA such as medication noncompliance, polysubstance abuse, and infection. Finally, 20 of the overall 130 patients admitted during this timeframe presented with new onset DKA, where none reported cannabis usage, 20% (4/20) completed general toxicology screening, and none underwent cannabis specific toxicology screening. From the observational retrospective analysis at this hospital, there is a need for awareness about substance abuse screening, especially in adults with a history of recurrent hospital admissions for DKA. Knowledge among health care providers and patient education regarding the effect of cannabis usage on metabolic factors and its diabetes complications, including diabetes self-management at time of drug usage, can be further explored in prospective studies. References: (1) Umpierrez (2006) Diabetes Care, 29(12), 2755-2757. (2) Brown et al., (2017) JAMA, 317(2), 207. (3) Haffajee et al., (2018) NEJM, 379(6), 501-504.

From Container to Claustrum: Projective Identification in Couples

2014 ◽  
Vol 4 (2) ◽  
Author(s):  
Tamara Feldman
Keyword(s):  
Psychological Health ◽  
Projective Identification ◽  
The Self ◽  
The Other ◽  
Intimate Partners ◽  
And Control ◽  
The Relationship ◽  
As If

This paper is a contribution to the growing literature on the role of projective identification in understanding couples' dynamics. Projective identification as a defence is well suited to couples, as intimate partners provide an ideal location to deposit unwanted parts of the self. This paper illustrates how projective identification functions differently depending on the psychological health of the couple. It elucidates how healthier couples use projective identification more as a form of communication, whereas disturbed couples are inclined to employ it to invade and control the other, as captured by Meltzer's concept of "intrusive identification". These different uses of projective identification affect couples' capacities to provide what Bion called "containment". In disturbed couples, partners serve as what Meltzer termed "claustrums" whereby projections are not contained, but imprisoned or entombed in the other. Applying the concept of claustrum helps illuminate common feelings these couples express, such as feeling suffocated, stifled, trapped, held hostage, or feeling as if the relationship is killing them. Finally, this paper presents treatment challenges in working with more disturbed couples.

The United States and the Iranian Nuclear Programme

2018 ◽  
Author(s):  
Steven Hurst
Keyword(s):  
United States ◽  
Decision Making ◽  
Domestic Politics ◽  
The United States ◽  
Nixon Administration ◽  
Comprehensive Plan ◽  
The Us ◽  
Nuclear Issue ◽  
The Relationship

The United States, Iran and the Bomb provides the first comprehensive analysis of the US-Iranian nuclear relationship from its origins through to the signing of the Joint Comprehensive Plan of Action (JCPOA) in 2015. Starting with the Nixon administration in the 1970s, it analyses the policies of successive US administrations toward the Iranian nuclear programme. Emphasizing the centrality of domestic politics to decision-making on both sides, it offers both an explanation of the evolution of the relationship and a critique of successive US administrations' efforts to halt the Iranian nuclear programme, with neither coercive measures nor inducements effectively applied. The book further argues that factional politics inside Iran played a crucial role in Iranian nuclear decision-making and that American policy tended to reinforce the position of Iranian hardliners and undermine that of those who were prepared to compromise on the nuclear issue. In the final chapter it demonstrates how President Obama's alterations to American strategy, accompanied by shifts in Iranian domestic politics, finally brought about the signing of the JCPOA in 2015.

The Relationship between Seeker and Spiritual Guide as portrayed in contemporary Western Sufi Autobiographies

2011 ◽  
Vol 5 (2) ◽  
pp. 297-332
Author(s):  
Kate Zebiri
Keyword(s):  
Life Writing ◽  
New Age ◽  
The Self ◽  
Individual Autonomy ◽  
Religious Authority ◽  
The Face ◽  
The Relationship ◽  
Insight Into ◽  
Continuity And Discontinuity

This article aims to explore the Shaykh-mur?d (disciple) or teacher-pupil relationship as portrayed in Western Sufi life writing in recent decades, observing elements of continuity and discontinuity with classical Sufism. Additionally, it traces the influence on the texts of certain developments in religiosity in contemporary Western societies, especially New Age understandings of religious authority. Studying these works will provide an insight into the diversity of expressions of contemporary Sufism, while shedding light on a phenomenon which seems to fly in the face of contemporary social and religious trends which deemphasize external authority and promote the authority of the self or individual autonomy.

Effect of Parental Modernity on Rejection Sensitivity and Self-Esteem of Adolescents

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Ritu ◽  
Madhu Anand
Keyword(s):  
Social Development ◽  
Rejection Sensitivity ◽  
Self Esteem ◽  
The Self ◽  
Negatively Associated ◽  
Individual Modernity ◽  
The Impact ◽  
The Relationship

Parental Modernity is an important aspect for the psycho-social development of the child. The present study aims to study the effect of parental modernity on rejection sensitivity and self-esteem of adolescents and the relationship between rejection sensitivity and self-esteem. The research is carried out on a sample of 240 parents (including 120 fathers and 120 mothers) and their 120 children. For observing the impact of modernity of parents on their children, Individual Modernity Scale was used and administered on father and mother. Rejection Sensitivity Questionnaire and Self-Esteem Inventory were used to measure the rejection sensitivity and self-esteem of children (age ranges from 14 to 19 years). The results suggest that parental modernity has an effect on the rejection sensitivity and personally perceived self of the self – esteem of adolescents. Furthermore, the rejection sensitivity has been found negatively associated with self-esteem.

Sign in / Sign up

Export Citation Format

Share Document