1
|
Wu S, Magwood O, Dong Q, Wei X. Evaluating population-level interventions to reduce inappropriate antibiotic use in healthcare and community settings: A systematic review protocol. PLoS One 2024; 19:e0300780. [PMID: 38498514 PMCID: PMC10947694 DOI: 10.1371/journal.pone.0300780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Inappropriate antibiotic use contributes significantly to the global challenge of antimicrobial resistance. While government-initiated population-level interventions are fundamental in addressing this issue, their full potential remains to be explored. This systematic review aims to assess the effectiveness of such interventions in reducing inappropriate antibiotic use among antibiotic providers and users in healthcare and community settings. METHODS We will conduct a systematic literature search across multiple databases and grey literature sources. We will include studies which evaluate the effectiveness of population-level interventions to reduce inappropriate antibiotic use in healthcare and community settings in both high-income and low- and middle-income countries. This includes government-initiated measures targeting antibiotic use through education, restriction, incentivization, coercion, training, persuasion, context modification, behavior modeling, or barrier reduction. Two reviewers will independently perform screening to select eligible studies, followed by data extraction. The outcomes of interest are various measures of antibiotic prescription and consumption, such as Defined Daily Dose (DDD) or number of prescriptions per year. We anticipate including a broad range of study designs and outcome measures. Therefore, we will narratively synthesize results using the categories of the population-level policy interventions of the Behavior Change Wheel Framework. We will organize outcome data by economic contexts, target populations, and implementation settings. DISCUSSION This review will strengthen the evidence base for the use of population-level interventions to address inappropriate antibiotic use. Drawing lessons from global experiences, the findings will provide valuable guidance to health policymakers, public health authorities, and researchers on tailoring interventions to specific economic contexts, populations, and settings, thereby enhancing their capacity to drive substantial improvement in appropriate antibiotic use.
Collapse
Affiliation(s)
- Shishi Wu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Olivia Magwood
- Bruyère Research Institute, Ottawa, Ontario, Canada
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Quanfang Dong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Grimholt TK, Bonsaksen T, Heir T, Schou Bredal I, Skogstad L, Ekeberg Ø. Prevalence of suicide attempt and associations with deliberate self-harm, mental health problems, drug misuse and traumatic experiences - a cross sectional survey of the Norwegian population. BMC Psychiatry 2024; 24:164. [PMID: 38408936 PMCID: PMC10895832 DOI: 10.1186/s12888-024-05610-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Monitoring self-reported suicide attempts (SA) with nationally representative surveys is important to initiate suicide prevention strategies. The aim of the study was to assess the prevalence of SA and compare deliberate self-harm, (DSH), mental health, drug misuse and traumas between SA and non-suicide attempters (NSA). METHODS In this cross-sectional survey of a representative sample (N=1757) of the Norwegian population, we compared people with self-reported SA (n=54) to NSA (n=1703) regarding sociodemographic data, mental health problems, drug misuse and exposure to trauma. RESULTS The prevalence of SA was 3.1 %. There was a higher proportion of welfare recipients and more deliberate self-harm, mental health problems, drug misuse and traumas in the SA group compared to NSA. CONCLUSION This national study confirms the association between suicide attempt and deliberate self-harm, mental health problems, drug misuse and traumas.
Collapse
Affiliation(s)
- T K Grimholt
- Faculty of Health, VID Specialized University, Oslo, Norway.
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.
| | - T Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Sciences, VID Specialized University, Stavanger, Norway
| | - T Heir
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - I Schou Bredal
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - L Skogstad
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Ø Ekeberg
- Psychosomatic and Consultation-Liaison psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
3
|
Etami Y, Lildharrie C, Manza P, Wang GJ, Volkow ND. Neuroimaging in Adolescents: Post-Traumatic Stress Disorder and Risk for Substance Use Disorders. Genes (Basel) 2023; 14:2113. [PMID: 38136935 PMCID: PMC10743116 DOI: 10.3390/genes14122113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Trauma in childhood and adolescence has long-term negative consequences in brain development and behavior and increases the risk for psychiatric disorders. Among them, post-traumatic stress disorder (PTSD) during adolescence illustrates the connection between trauma and substance misuse, as adolescents may utilize substances to cope with PTSD. Drug misuse may in turn lead to neuroadaptations in learning processes that facilitate the consolidation of traumatic memories that perpetuate PTSD. This reflects, apart from common genetic and epigenetic modifications, overlapping neurocircuitry engagement triggered by stress and drug misuse that includes structural and functional changes in limbic brain regions and the salience, default-mode, and frontoparietal networks. Effective strategies to prevent PTSD are needed to limit the negative consequences associated with the later development of a substance use disorder (SUD). In this review, we will examine the link between PTSD and SUDs, along with the resulting effects on memory, focusing on the connection between the development of an SUD in individuals who struggled with PTSD in adolescence. Neuroimaging has emerged as a powerful tool to provide insight into the brain mechanisms underlying the connection of PTSD in adolescence and the development of SUDs.
Collapse
Affiliation(s)
| | | | | | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (Y.E.); (C.L.); (P.M.); (N.D.V.)
| | | |
Collapse
|
4
|
Lennard S, Henley W, McLean B, Thompson T, Jadav M, Laugharne R, Shankar R. Risk characteristics of alcohol and/or drug misuse in repeat emergency department attendees for seizures: a case-control study. J Neurol 2023; 270:4914-4921. [PMID: 37354269 DOI: 10.1007/s00415-023-11833-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND There is a bi-directional relationship between seizures and substance misuse, i.e., alcohol and recreational drugs. Seizures and substance misuse are recognised separately to influence increased emergency department (ED) admissions and early death. There is however no understanding of the cumulative influence of these matters on repeat ED attenders for seizures esp. as a third are likely to re-attend within the year. This case-control study compares the characteristics of people with substance misuse to those without substance misuse presenting recurrently with seizures to the ED. METHODS From a single ED serving a rural population in the Southwest of England, data of all people presenting more than once with a seizure over a 4-year period were examined. The diagnosis of alcohol or drug misuse, deaths, demographic characteristics, and service use were captured. RESULTS Of 450 repeat attenders, 95 had a recorded history of alcohol and/or drug problems. Those with substance misuse had double the mortality when adjusted for age and gender compared to those without. They were also more likely to be male, younger in age, have mental health issues, live in socially deprived neighborhoods, not take anti-seizure medications and not have had a specialist review in epilepsy services in the previous year. Nearly a quarter of those with addiction issues died in the 4-year period. DISCUSSION Service provision for this vulnerable group may need to be modelled along different lines to traditional approaches, such as an assertive outreach community-based service as provided for chronic psychiatric and addiction management.
Collapse
Affiliation(s)
- Sarah Lennard
- Department of Intellectual Disability Neuropsychiatry, Research Team, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK
- CIDER, University of Plymouth Peninsula School of Medicine, Truro, TR1 3QB, UK
| | - William Henley
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, EX1 2LU, UK
| | | | - Tom Thompson
- CIDER, University of Plymouth Peninsula School of Medicine, Truro, TR1 3QB, UK
| | - Mark Jadav
- Royal Cornwall Hospital NHS Trust, Truro, TR1 3HD, UK
| | - Richard Laugharne
- Department of Intellectual Disability Neuropsychiatry, Research Team, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK
- CIDER, University of Plymouth Peninsula School of Medicine, Truro, TR1 3QB, UK
| | - Rohit Shankar
- Department of Intellectual Disability Neuropsychiatry, Research Team, Cornwall Partnership NHS Foundation Trust, Truro, TR1 3QB, UK.
- CIDER, University of Plymouth Peninsula School of Medicine, Truro, TR1 3QB, UK.
- Chygovenck, Three Milestone Industrial Estate, Truro, TR4 9LD, Cornwall, UK.
| |
Collapse
|
5
|
Chang WCW, Hsu MC, Liao PC. Detection of emerging patterns of drug misuse in sports via wastewater monitoring: A mini-review and potential strategies. Environ Pollut 2023; 333:122087. [PMID: 37348696 DOI: 10.1016/j.envpol.2023.122087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
Biological testing is a key component of the current anti-doping programme implemented by the authorities to detect doping in sports. Strategies such as longitudinal individualised data analysis and sport-specific analysis have been developed to increase the comprehensiveness of the testing. However, the trends of drug misuse in sports might not be effectively captured through today's testing plan. Wastewater testing, assembling individual-level data of a designated group to produce population-level results in one single aggregated sample, can be employed to as a complementary strategy offering added value for doping control. This paper presents an updated summary of the status of anti-doping testing and analytical methodologies for wastewater. The available literature on wastewater-based analyses of drugs prohibited in sports is reviewed. Publications surrounding sporting activities or competitions and others relevant to sports doping are selected. We debate between potential strategies and major limitations of using wastewater monitoring in anti-doping. Knowledge gaps and research directions, specifically on metabolites, stability, sensitivity, and ethical and legal considerations, are discussed. Choosing different wastewater sampling sites allows target sub-population that involved competing athletes and potentially reveal sport-specific or athlete-level-specific behaviour. Sampling from on-board toilets or athlete villages could target international-level athletes, sampling from the dormitories of national training centres allows monitoring of national-level athletes on a daily basis, and sampling from sports stadiums provides a full picture of drug use in the general population during an event. Confounding occurs as (i) the presence of non-athlete composition and the difficulty of analyses to be completely selective to the athlete population; and (ii) the identification of compounds prescribed legitimately with Therapeutic Use Exemptions, only banned in-competition, and naturally occurring. The practicalities of the approach are contextualised in monitoring the non-threshold substances such as anabolic agents, selective androgen receptor modulators, metabolic modulators, and hypoxia-inducible factor activators.
Collapse
Affiliation(s)
- William Chih-Wei Chang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
| | - Mei-Chich Hsu
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
| | - Pao-Chi Liao
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan.
| |
Collapse
|
6
|
McGrath RE. World beliefs, character strengths, and hope for the future. PLoS One 2023; 18:e0286531. [PMID: 37384666 PMCID: PMC10309982 DOI: 10.1371/journal.pone.0286531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 05/17/2023] [Indexed: 07/01/2023] Open
Abstract
Research in recent years has revealed the rate of premature and avoidable deaths from suicide and drug/alcohol misuse is rising in the United States. These are sometimes referred to as deaths of despair based on evidence that they are concentrated in relatively poor communities with less access to social resources and low labor force participation. The pattern was first noted in middle-aged White men but seems to be gradually spreading to other ethnic groups. As a first step in establishing a psychological response to this public health issue, the present article summarizes two studies that compared psychological variables to demographics as predictors of hopefulness. A number of intriguing findings emerged. Despite concerns about American despair and conflict, U.S. residents proved the most hopeful among residents of eight countries. Low-income Americans are particularly hopeful except for low-income Whites. Positive character traits and primal beliefs about the world generally proved to be better predictors of hope than ethnicity, financial status, or their interaction. A number of relationships were found between psychological variables and community demographics. The findings as a group suggest hopefulness is driven more by psychological variables than by life circumstances. It is suggested that psychologists could play an important role in the study of this topic by implementing programs intended to enhance hopefulness in impoverished populations, and by encouraging an intentional communal focus on the importance of enhancing well-being.
Collapse
Affiliation(s)
- Robert E. McGrath
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ, United States of America
| |
Collapse
|
7
|
Browne FA, Gichane MW, Shangase N, Ndirangu J, Bonner CP, Wechsberg WM. Social Determinants of Alcohol and Other Drug Misuse Among Women Living with HIV in Economically Underserved Communities in Cape Town, South Africa: A Cross-Sectional Study. AIDS Behav 2023; 27:1329-1338. [PMID: 36344731 PMCID: PMC9640812 DOI: 10.1007/s10461-022-03869-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 11/09/2022]
Abstract
This study aimed to understand how social determinants-the economic and social factors that affect health and well-being-are associated with self-reported and biological alcohol and other drug misuse in South Africa among women living with HIV. Logistic regression analyses were performed using baseline data from an implementation science trial conducted from 2015 to 2018 with 480 Black and Coloured women who were living with HIV and reported recent alcohol or other drug misuse. Educational attainment, type of housing, access to running water, food insecurity, and housing instability were examined. Women with higher education had reduced odds of any drug misuse-both biological (aOR: 0.53; 95% CI: 0.33-0.84) and self-reported (aOR: 0.37; 95% CI: 0.22-0.64). Women living in formal housing had increased odds of a positive alcohol screening test (aOR: 1.92; 95% CI: 1.16-3.18) and women with housing instability had increased odds of self-reported alcohol misuse-daily (aOR: 1.99; 95% CI: 1.18-3.35) and weekly (aOR:1.91; 95% CI: 1.19-3.07). Food insecurity was associated with reduced odds of self-reported alcohol misuse (aOR: 0.40; 95% CI: 0.25-0.64) and increased odds of self-reported drug misuse (aOR: 2.05; 95% CI: 1.16-3.61). These findings indicate the complexity of the relationship between social determinants and alcohol and other drug misuse, and may have implications for addressing social and structural determinants as part of multilevel interventions focused on reducing alcohol and other drug misuse among key populations of women in South Africa.
Collapse
Affiliation(s)
- Felicia A Browne
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA.
- Health Behavior, University of North Carolina Gillings School of Global Public Health, 135 Dauer Drive, Chapel Hill, NC 27599, USA.
| | - Margaret W Gichane
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
- Department of Obstetrics, Gynecology & Reproductive Sciences, Advancing New Standards in Reproductive Health, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA
| | - Nosipho Shangase
- Epidemiology, University of North Carolina Gillings School of Global Public Health, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Jacqueline Ndirangu
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
| | - Courtney Peasant Bonner
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
- Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Wendee M Wechsberg
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
- Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, 135 Dauer Drive, Chapel Hill, NC 27599, USA
- Department of Psychology, North Carolina State University, 640 Poe Hall, Campus Box 7650, Raleigh, NC 27695, USA
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, 40 Duke Medicine Circle, Durham, NC 27710, USA
| |
Collapse
|
8
|
Maslat A, Al-Atoom N, Al-Najdawi M, Khaled Hassouneh L, Mashaal A, Alrashdan Y, Al-Rawashdeh NH, Elhamrawy M. DRUG MISUSE AND SELF-MEDICATION AMONG PHARMACY STUDENTS IN JORDAN. Pol Merkur Lekarski 2023; 51:464-474. [PMID: 38069846 DOI: 10.36740/merkur202305104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE Aim: To estimate risks and prevalence of self-medication and potential abuse risk among pharmacy students in Jordanian Universities. PATIENTS AND METHODS Materials and Methods: A cross-sectional study design was conducted with 450 students, selected using multistage sampling methods, from seven different universities. Data was collected by self-administrated questionnaires covering demographic and academic information, health-related information, use of self-medication, and pattern of self-medication among pharmacy students. RESULTS Results: Out of 394 students who answer the questions, 76.9% reported that they had usually treated themselves in case of simple cases without physician or pharmacist consultation. Most commonly used drugs among the surveyed students were Paracetamol 60%, multivitamins supplement 74.25%, and herbal products 37.2%, combination of NSAIDs and Paracetamol 20.6%, and laxatives 19.4%. Cold and flu 25.5%, headache 22.3%, abdominal pain 7.9%, gastric pain 7.9%, cold and flu, headache, abdominal pain, and gastric pain 14.9% were the main conditions which contribute to self-medication practice. It was also found that Pharmacy students were over-confident with the type of cases they could treat without referral to a specialist physician, despite knowing that some of the symptoms may be due to serious health problems. Misuse of analgesics and laxatives was clear, and there was a weakness in knowledge of the indications for the use of the most common drug. CONCLUSION Conclusions: The prevalence of self-medication among pharmacy students in Jordan is high, and medical teaching institutions need to educate students about the proper use of medicines. Strict legislation and more education on self-medication are necessary for effective use of medicines.
Collapse
Affiliation(s)
- Ahmed Maslat
- DEPARTMENT OF PHARM-D, FACULTY OF PHARMACY, JADARA UNIVERSITY, AMMAN, JORDAN; DEPARTMENT OF BIOLOGICAL SCIENCES, FACULTY OF SCIENCE, YARMOUK UNIVERSITY, IRBID, JORDAN
| | - Nadia Al-Atoom
- DEPARTMENT OF BIOCHEMISTRY AND MOLECULAR BIOLOGY, SCHOOL OF MEDICINE, INDIANA UNIVERSITY, INDIANA, USA
| | - Manal Al-Najdawi
- DEPARTMENT OF APPLIED PHARMACEUTICAL SCIENCES AND CLINICAL PHARMACY, FACULTY OF PHARMACY, ISRA UNIVERSITY, AMMAN, JORDAN
| | - Loay Khaled Hassouneh
- DEPARTMENT OF RESPIRATORY THERAPY, FACULTY OF ALLIED MEDICAL SCIENCES, ISRA UNIVERSITY, AMMAN, JORDAN
| | - Ahmed Mashaal
- DEPARTMENT OF PHYSICAL THERAPY, FACULTY OF ALLIED MEDICAL SCIENCES, ISRA UNIVERSITY, AMMAN, JORDAN
| | - Yazan Alrashdan
- DEPARTMENT OF PHARMACY, FACULTY OF PHARMACY, AMMAN ARAB UNIVERSITY, AMMAN, JORDAN
| | | | - Mohammed Elhamrawy
- DEPARTMENT OF PHYSICAL THERAPY, FACULTY OF ALLIED MEDICAL SCIENCES, MIDDLE EAST UNIVERSITY, AMMAN, JORDAN
| |
Collapse
|
9
|
Cruz SL. Preface: Special Issue on Challenges and New Findings on Misused Psychoactive Drugs. Rev Invest Clin 2023; 75:91-92. [PMID: 37441767 DOI: 10.24875/ric.230001221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Silvia L Cruz
- Department of Pharmacobiology, Center for Research and Advanced Studies (Cinvestav), National Polytechnic Institute, Mexico City, Mexico
| |
Collapse
|
10
|
McCabe SE, Hughes TL, Fish JN, Hoak S, Kcomt L, Evans-Polce RJ, Engstrom C, Leary K, Veliz P, West BT, McCabe VV, Boyd CJ. Is it all in the family? Sexual identity differences in DSM-5 alcohol and other drug use disorders and associations with alcohol and other drug misuse history among parents, offspring, and other relatives. Subst Abus 2022; 43:1277-1285. [PMID: 35849748 PMCID: PMC10469272 DOI: 10.1080/08897077.2022.2095080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: The objectives of this study were to: (1) estimate the prevalence of family history of alcohol and other drug (AOD) misuse (positive family history [FH+]) in first- and second-degree relatives across sexual identity subgroups (i.e., lesbian, gay, bisexual, heterosexual); (2) compare AOD misuse among offspring of sexual minority and heterosexual parents; and (3) examine the relationships between FH+ and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol use disorder (AUD) and other drug use disorder (ODUD) across sexual identity subgroups. Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 36,309 non-institutionalized U.S. adults aged ≥ 18 years). Data collection occurred in households using structured diagnostic face-to-face interviews during 2012-2013. Results: The presence of FH+ in first- and second-degree relatives was most prevalent among bisexual women relative to all other sexual orientation subgroups. Multivariable regression analyses indicated that the odds of AUD and ODUD were higher among FH+ adults relative to negative family history (FH-) adults. Lesbian and bisexual women had higher odds of AUD compared to heterosexual women, controlling for any FH+; this sexual identity difference was not found for men. There were no significant differences in ODUD between heterosexual FH- men and gay FH- men. We found differences in AOD misuse among offspring of bisexual parents, but not gay or lesbian parents compared to heterosexual parents. Conclusions: Health professionals should consider the higher likelihood of a family history of AOD misuse among sexual minorities, especially bisexual women, when treating these individuals. The lack of differences in AOD misuse among offspring of gay or lesbian parents relative to heterosexual parents warrants attention for legal, policy, and clinical decisions.
Collapse
Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Tonda L. Hughes
- School of Nursing, Columbia University, New York, New York, USA
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Sebastian Hoak
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Curtiss Engstrom
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Kate Leary
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Philip Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Brady T. West
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, North Campus Research Complex, Ann Arbor, Michigan, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Vita V. McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol J. Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
11
|
Weiss NH, Schick MR, Contractor AA, Reyes ME, Suazo NC, Sullivan TP. Racial/Ethnic Differences in Alcohol and Drug Misuse Among IPV-Victimized Women: Exploring the Role of Difficulties Regulating Positive Emotions. J Interpers Violence 2022; 37:2826-2850. [PMID: 32697115 DOI: 10.1177/0886260520943735] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Alcohol and drug misuse is prevalent and problematic among women who experience intimate partner violence (IPV). Emotional dysfunction has been identified as a key mechanism in the etiology, maintenance, and treatment of alcohol and drug misuse. However, existing research has not considered the role of race/ethnicity in the relations between emotional dysfunction and alcohol and drug misuse. Furthermore, past research in this area has focused almost exclusively on emotional dysfunction stemming from negative (vs. positive) emotions. The goals of the current study were as follows: (a) to explore whether levels of difficulties regulating positive emotions differ among Latina, African American, and White IPV-victimized women, and (b) to examine the moderating role of race/ethnicity in the relations between difficulties regulating positive emotions and alcohol and drug misuse. Participants were 197 IPV-victimized women recruited through the criminal justice system (Mage = 36.14; 51.8% African American, 31.5% White, and 16.8% Latina). Difficulties regulating positive emotions did not differ as a function of race/ethnicity. However, relations among difficulties regulating positive emotions and alcohol and drug misuse were significant for Latina and White but not African American IPV-victimized women. Moreover, race/ethnicity moderated an association between difficulties regulating positive emotions and drug misuse; this relation was significant and positive for White (compared with African American) IPV-victimized women. While preliminary, these results may inform culturally sensitive interventions for alcohol and drug misuse that are tailored to the unique needs of Latina, African American, and White IPV-victimized women.
Collapse
|
12
|
Shao Y, Wang Y, Yuan Y, Xie Y. A systematic review on antibiotics misuse in livestock and aquaculture and regulation implications in China. Sci Total Environ 2021; 798:149205. [PMID: 34375247 DOI: 10.1016/j.scitotenv.2021.149205] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 06/13/2023]
Abstract
China is one of the largest producers and consumers of antibiotics, and China is a larger producer of livestock farming and aquaculture in the world. The livestock farming and aquaculture industry is a major area of antibiotic misuse, which has caused serious antibiotic residues and environment pollution. The antibiotic residues exceeding the standard may lead to antibiotic resistances in animals or human bodies, which poses a threat to human health. In this context, this study tries to systematically review the current situation of antibiotic misuse in livestock and aquaculture in China, and put forward corresponding regulatiory measures for the central government. Based on the status quo of livestock farming and aquaculture in China, this study reviewed antibiotic misuse in livestock farming and aquaculture and antibiotic resistance in China, introduced China's current policies on antibiotic regulation and the gap between China and developed countries, and analyzed the implications of current regulatory policies on animal health and productivity. At last, we put forward suggestions for the future antibiotic regulation, including strictly implementing the relevant laws and regulations, formulating specific supporting measures, encouraging the research and development of antibiotic substitutes, introducing advanced technologies for supervision and regulation, strengthening the publicity of science popularization and enhancing the public's awareness of the rational use of antibiotics. If these policy recommendations can be implemented, they will significantly promote the regulation of antibiotic abuse.
Collapse
Affiliation(s)
- Yitian Shao
- The New Types Key Think Tank of Zhejiang Province "China Research Institute of Regulation and Public Policy", Zhejiang University of Finance & Economics, Hangzhou 310018, China; China Institute of Regulation Research, Zhejiang University of Finance & Economics, Hangzhou 310018, China
| | - Yiping Wang
- Hangzhou City Health Bureau, Hangzhou, 310005, China
| | - Yiwen Yuan
- China Institute of Regulation Research, Zhejiang University of Finance & Economics, Hangzhou 310018, China
| | - Yujing Xie
- The New Types Key Think Tank of Zhejiang Province "China Research Institute of Regulation and Public Policy", Zhejiang University of Finance & Economics, Hangzhou 310018, China; China Institute of Regulation Research, Zhejiang University of Finance & Economics, Hangzhou 310018, China.
| |
Collapse
|
13
|
Glei DA, Weinstein M. Mental health, pain, and risk of drug misuse: A nationwide cohort study. Addict Behav 2020; 109:106467. [PMID: 32485544 PMCID: PMC7299126 DOI: 10.1016/j.addbeh.2020.106467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 11/15/2022]
Abstract
Evidence suggests that rising drug misuse, particularly of prescription painkillers, is more closely linked with period increases in reported pain among Americans of the same age range than with deterioration in mental health, but it is unclear whether those cross-sectional associations reflect causal effects of pain and mental health on drug misuse. Using data from the 1995-96, 2004-05, and 2013-14 waves of a nationwide cohort study, we evaluate the effects of pain and mental health on subsequent misuse of prescription painkillers and sedatives. Logistic regression is applied to model drug misuse (separately for painkillers and sedatives) as a function of predictors measured at the previous wave; respondents who reported misuse of that drug type at the prior wave are excluded from the analysis. Mental health is an important predictor of both painkiller and sedative misuse, whereas pain plays a much bigger role in painkiller misuse. Frequency of joint aches and stiffness has the strongest effect on subsequent painkiller misuse, although mental health yields substantial incremental predictive ability above and beyond pain. Negative affect, positive affect, and psychological well-being have notable effects on sedative misuse, while pain (particularly backache) makes only a small incremental contribution to sedative misuse. We suspect that increases over time in pain levels may have played a bigger role than mental health in explaining the rise in prescription painkiller misuse and may have contributed to growing misuse of sedatives. In contrast, deteriorating mental health was probably more important in explaining the rise of sedative misuse.
Collapse
Affiliation(s)
- Dana A Glei
- Center for Population and Health, Georgetown University, 5985 San Aleso Court, Santa Rosa, CA 95409-3912, United States.
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, 312 Healy Hall, 37th & O Streets NW, Washington, DC 20057-1197, United States.
| |
Collapse
|
14
|
Helwig A, Smulders Y. [Toxicity of vitamin supplements]. Ned Tijdschr Geneeskd 2020; 164:D4762. [PMID: 33201626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Half of all Dutch people take nutritional supplements, vitamins amongst others. The fact that vitamins can be toxic when taken in overdose is not common knowledge. There is no evidence that taking vitamin supplements without medical indication improves the health of people with a varied diet. Many are seduced by health claims to use vitamin supplements, unaware of the fact that the evidence for effectiveness is lacking, let alone of the risks of overdosing. In this article, we describe the known toxic symptoms of each vitamin. Furthermore, the toxic doses were indexed against the available dosage, both through regular pharmacies and online. The doses reported to have toxic effects have not always been properly studied. Consequently, toxic doses may be higher or lower than the doses mentioned in this article. The vitamins for which no toxic effects have been described are not automatically safe in every dosis, considering the lack of systematic research into the potential toxicity of vitamins.
Collapse
Affiliation(s)
| | - Yvo Smulders
- Amsterdam UMC, locatie VUmc, afd. Interne Geneeskunde, Amsterdam
| |
Collapse
|
15
|
Sahker E, Sakata M, Toyomoto R, Hwang C, Yoshida K, Luo Y, Watanabe N, Furukawa TA. Efficacy of brief intervention for drug misuse in primary care facilities: systematic review and meta-analysis protocol. BMJ Open 2020; 10:e036633. [PMID: 32878757 PMCID: PMC7470504 DOI: 10.1136/bmjopen-2019-036633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Drug misuse is associated with significant global morbidity, mortality, economic costs and social costs. Many primary care facilities have integrated drug misuse screening and brief intervention (BI) into their usual care delivery. However, the efficacy of BI for drug misuse in primary care has not been substantiated through meta-analysis. The aim of this systematic review and meta-analysis is to determine the efficacy of BI for drug misuse in primary care settings. METHODS AND ANALYSIS We will include all randomised controlled trials comparing primary care-delivered BI for drug misuse with no intervention or minimal screening/assessment and usual care. Primary outcomes are (1) drug use frequency scores and (2) severity scores at intermediate follow-up (4-8 months). We will retrieve all studies through searches in CENTRAL, Embase, MEDLINE and PsycINFO until 31 May 2020. The reference list will be supplemented with searches in trial registries (eg, www.clinicaltrials.gov) and through relevant existing study reference lists identified in the literature. We will conduct a random-effect pairwise meta-analysis for primary and secondary outcomes. We will assess statistical heterogeneity though visual inspection of a forest plot and calculate I2 statistics. We will assess risk of bias using the Cochrane Risk of Bias Tool V.2 and evaluate the certainty of evidence through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Sensitivity analyses will account for studies with control group variations and studies with a high risk of bias. If heterogeneity is present, subgroup analyses will consider patient variables of age, sex/gender, race/ethnicity, per cent insured, baseline severity and primary drug misused. ETHICS AND DISSEMINATION This study will use published aggregate data and will not require ethical approval. Findings will be disseminated in a peer-reviewed journal.
Collapse
Affiliation(s)
- Ethan Sahker
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
- Japan Society for the Promotion of Science (JSPS), Overseas Fellowship Division, Kojimachi, Chiyoda-ku, Tokyo, Japan
| | - Masatsugu Sakata
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Rie Toyomoto
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Chiyoung Hwang
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
- Japan Society for the Promotion of Science (JSPS), Research Fellowship Division, Kojimachi, Chiyoda-ku, Tokyo, Japan
| | - Kazufumi Yoshida
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Norio Watanabe
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| |
Collapse
|
16
|
Castilho I, Rocha É, Magalhães S, Vaz Z, Costa ALG. [Polypharmacy and the Use of Potentially Inappropriate Medication in the Elderly Aged 75 and Over: The Case of a Family Health Unit]. ACTA MEDICA PORT 2020; 33:632. [PMID: 32893783 DOI: 10.20344/amp.13320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 07/15/2020] [Indexed: 11/05/2023]
Affiliation(s)
- Inês Castilho
- Unidade de Saúde Familiar AlphaMouro. Sintra. Portugal
| | - Érica Rocha
- Unidade de Saúde Familiar Bombarral. Bombarral. Portugal
| | | | - Zélia Vaz
- Unidade de Saúde Familiar AlphaMouro. Sintra. Portugal
| | | |
Collapse
|
17
|
|
18
|
Christopher PP, Anderson B, Stein MD. Comparing views on civil commitment for drug misuse and for mental illness among persons with opioid use disorder. J Subst Abuse Treat 2020; 113:107998. [PMID: 32359671 PMCID: PMC7200755 DOI: 10.1016/j.jsat.2020.107998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/23/2020] [Accepted: 03/04/2020] [Indexed: 11/20/2022]
Abstract
Despite the growing use of civil commitment for drug use disorders, little is known about attitudes among individuals who might be subject to civil commitment. This study examined attitudes of persons with opioid use disorder toward civil commitment for drug misuse and for psychiatric illness. Consecutive persons entering a brief, inpatient opioid detoxification (n = 254) were surveyed regarding their attitudes about civil commitment for mental illness and for drug use, and responses were compared by commitment type and by individual history of being civilly committed for opioid misuse. Participants endorsed high support for civil commitment (both psychiatric and drug misuse-related) when used to address risk of harm to self, to others, and of criminal activity. Respondents were more likely to support civil commitment for psychiatric disorders than for drug misuse, expressing higher support for civil commitment in general, higher agreement with the criteria used to justify civil commitment, and greater perceived efficacy of commitment. Individuals previously committed for opioid misuse were less likely to support drug misuse-related commitment on the basis of its perceived efficacy. These results suggest individuals with opioid use disorder hold more favorable views toward civil commitment for mental health disorders than for drug misuse, and reinforce the need for more research on the procedures and outcomes related to civil commitment for drug misuse.
Collapse
Affiliation(s)
- Paul P Christopher
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University, United States of America.
| | - Bradley Anderson
- General Medicine Unit, Butler Hospital, Providence, RI, United States of America
| | - Michael D Stein
- Department of Health Law, Policy & Management, School of Public Health, Boston University, United States of America
| |
Collapse
|
19
|
Burns A, Goodlet KJ, Chapman A, Roberts EP. A case report of self-medication with over-the-counter fish antibiotic: Implications for pharmacists. J Am Pharm Assoc (2003) 2020; 60:e121-e123. [PMID: 32007363 DOI: 10.1016/j.japh.2019.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/23/2019] [Accepted: 12/30/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The human use of over-the-counter antibiotics intended for the treatment of pet animals has been recognized as a potential barrier to antibiotic stewardship efforts. The objective of this report is to describe a case of self-medication with a fish antibiotic resulting in delayed medical treatment and provide recommendations for pharmacists practicing in outpatient settings on how to best identify and manage nonprescription antibiotic use. CASE SUMMARY A 24-year-old man experienced dental pain and "flu-like" symptoms for which he attempted self-treatment with oral amoxicillin 250 mg daily purchased by a family member from a pet store. The amoxicillin was marketed for the treatment of bacterial infection in pet fish. After several days of increasing tooth pain despite the self-medication, the patient presented to an outpatient clinic where he was found to have a molar abscess requiring tooth extraction. The patient responded well to therapy and was counseled to discontinue antibiotic self-treatment. PRACTICE IMPLICATIONS Undocumented use of nonprescription antibiotics represents a threat to patient safety. Potential deleterious outcomes include resistance, adverse drug events, and delays in definitive infection treatment. Pharmacists should screen patients for nonprescription antibiotic use, provide them counseling on appropriate antibiotic use, and educate other health care professionals on underrecognized sources of nonprescription antibiotics to increase awareness of this growing issue. Furthermore, antibiotic resistance should be considered when recommending an antibiotic agent for the treatment of infections.
Collapse
|
20
|
Hagan JC. Atropine Eye Drops Inappropriately Used for Diplopia Following Cosmetic Botulinum A Toxin Injections. Mo Med 2020; 117:73-75. [PMID: 32158055 PMCID: PMC7023941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This is a first case report of atropine eye drops used inappropriately to treat diplopia that followed botulinum A toxin injections for a cosmetic indication. Also presented is a review of precautions on use of atropine eye drops by non-ophthalmic physicians.
Collapse
Affiliation(s)
- John C Hagan
- John C. Hagan, III, MD, FACS, FAAO, MSMA member since 1975, is a Kansas City, Missouri, ophthalmologist and Missouri Medicine Editor since 2000
| |
Collapse
|
21
|
Shastay A. Dangerous Abuse of a 40-Year-Old Over-the-Counter Medication, Loperamide. Home Healthc Now 2020; 38:167-168. [PMID: 32358446 DOI: 10.1097/nhh.0000000000000871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Ann Shastay
- Ann Shastay, MSN, RN, AOCN, is Managing Editor, Institute for Safe Medication Practices, Horsham, Pennsylvania
| |
Collapse
|
22
|
Abstract
PURPOSE This study measured levels of health literacy, drug knowledge, and drug misuse behavior and analyzed the relationship among major variables related to 137 North Korean refugees who could only receive limited medical benefits owing to cultural and linguistic barriers. METHOD The data were analyzed using descriptive statistics, t test, and the Pearson correlation coefficient using SPSS. RESULTS The subjects' health literacy and drug knowledge levels were low; however, drug misuse behavior was not high. The drug dosage was significant considering the health literacy of the subjects; notably, the functional health literacy of women was high. However, many drug misuse cases were identified among women in their 40s. Health literacy and drug knowledge levels showed a significant relationship. CONCLUSION It is necessary to provide community-based information to vulnerable groups to ensure safe use of medications and to develop a level-based and tailored educational program considering North Korean refugees' literacy levels and cultural characteristics.
Collapse
|
23
|
Goodman CW, Brett AS. Gabapentinoids for Pain: Potential Unintended Consequences. Am Fam Physician 2019; 100:672-675. [PMID: 31790179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | - Allan S Brett
- University of South Carolina School of Medicine, Columbia, SC, USA
| |
Collapse
|
24
|
Gillespie NA, Bates TC, Hickie IB, Medland SE, Verhulst B, Kirkpatrick RM, Kendler KS, Martin NG, Benotsch EG. Genetic and environmental risk factors in the non-medical use of over-the-counter or prescribed analgesics, and their relationship to major classes of licit and illicit substance use and misuse in a population-based sample of young adult twins. Addiction 2019; 114:2229-2240. [PMID: 31313399 PMCID: PMC6868294 DOI: 10.1111/add.14750] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/03/2018] [Accepted: 07/09/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS The non-medical use of over-the-counter or prescribed analgesics (NMUA) is a significant public health problem. Little is known about the genetic and environmental etiology of NMUA and how these risks relate to other classes of substance use and misuse. Our aims were to estimate the heritability NMUA and sources of genetic and environmental covariance with cannabis and nicotine use, cannabis and alcohol use disorders and nicotine dependence in Australian twins. DESIGN Biometrical genetic analyses or twin methods using structural equation univariate and multivariate modeling. SETTING Australia. PARTICIPANTS A total of 2007 young adult twins [66% female; μage = 25.9, standard deviation (SD) = 3.6, range = 18-38] from the Brisbane Longitudinal Twin Study retrospectively assessed between 2009 and 2016. MEASUREMENTS Self-reported NMUA (non-opioid or opioid-based), life-time nicotine, cannabis and opioid use, DSM-V cannabis and alcohol use disorders and the Fagerström Test for Nicotine Dependence. FINDINGS Life-time NMUA was reported by 19.4% of the sample. Univariate heritability explained 46% [95% confidence interval (CI) = 0.29-0.57] of the risks in NMUA. Multivariate analyses revealed that NMUA is moderately associated genetically with cannabis (rg = 0.41) and nicotine (rg = 0.45) use and nicotine dependence (rg = 0.34). In contrast, the genetic correlations with cannabis (rg = 0.15) and alcohol (rg = 0.07) use disorders are weak. CONCLUSIONS In young male and female adults in Australia, the non-medical use of over-the-counter or prescribed analgesics appears to have moderate heritability. NMUA is moderately associated with cannabis and nicotine use and nicotine dependence. Its genetic etiology is largely distinct from that of cannabis and alcohol use disorders.
Collapse
Affiliation(s)
- Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, VA, USA
- QIMR Berghofer Medical Research Institute, QLD, Australia
| | | | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, NSW, Australia
| | | | - Brad Verhulst
- Psychology Department, Michigan State University, MI, USA
| | - Robert M Kirkpatrick
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, VA, USA
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, VA, USA
| | | | - Eric G Benotsch
- Psychology Department, Virginia Commonwealth University, VA, USA
| |
Collapse
|
25
|
Coll S, Monfort N, Alechaga É, Matabosch X, Pérez-Mañá C, Ventura R. Additional studies on triamcinolone acetonide use and misuse in sports: Elimination profile after intranasal and high-dose intramuscular administrations. Steroids 2019; 151:108464. [PMID: 31344406 DOI: 10.1016/j.steroids.2019.108464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 12/16/2022]
Abstract
Triamcinolone acetonide (TA) is a glucocorticoid (GC) widely used in sports medicine. GCs are prohibited in sports competitions by oral, intramuscular (IM), intravenous and rectal administrations, and they are allowed by other routes considered of local action such as intranasal administration (INT). We examined the urinary profiles of TA and its metabolites after INT and high-dose IM administrations. We also measured concentrations of TA and cortisol (CORT) in plasma following IM administration. TA was administered to healthy volunteers using INT route (220 μg/day for 3 days, n = 4 males and 4 females) or IM route (single dose of 40 mg, n = 4 males and 4 females and single dose 80 mg, n = 4 males). Urine and plasma samples were collected before and after administration at different time periods, and were analysed by liquid chromatography-tandem mass spectrometry. TA concentrations in urine were constant during 23 days after IM injection (range 1.4-129.0 ng/mL), and were very low after INT administration (range 0.0-3.5 ng/mL). For 6β-hydroxy-triamcinolone, the main TA metabolite, higher concentrations were detected (0.0-93.7 ng/mL and 15.7-973.9 ng/mL after INT and IM administrations, respectively). On the other hand, TA was detected in all plasma samples collected during 23 days after IM administration (range 0.2-5.7 ng/mL). CORT levels were largely suppressed after IM injection, and were recovered in a dose-dependent manner. In view of the results obtained, we propose a reporting level of 5 ng/mL for TA to distinguish forbidden from allowed TA administrations in sports. We also suggest that other GCs with faster urinary elimination from the body should be considered for IM therapies in out-of-competition rather than TA, in order to reduce the possibility of reporting false adverse analytical findings.
Collapse
Affiliation(s)
- Sergi Coll
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Monfort
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Élida Alechaga
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Xavier Matabosch
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain
| | - Clara Pérez-Mañá
- Hospital Universitari Germans Trias i Pujol (HUGTP-IGTP), Department of Clinical Pharmacology, Badalona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain; IMIM (Hospital del Mar Medical Research Institute), Human Pharmacology and Clinical Neurosciences Research Group, Barcelona, Spain
| | - Rosa Ventura
- IMIM (Hospital del Mar Medical Research Institute), Doping Control Research Group, Catalonian Antidoping Laboratory, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| |
Collapse
|
26
|
Sarfati S, Nakdimon I, Tsodyks J, Assa A, Gordon B. Success Rates at an Air Force Pilot Academy and Its Relation to Methylphenidate Use. Aerosp Med Hum Perform 2019; 90:788-791. [PMID: 31426894 DOI: 10.3357/amhp.5335.2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a chronic neurological disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity. The most common treatment for this disorder is methylphenidate, which is a disqualifying medication for flight. Candidates with previous use of methylphenidate are not necessarily disqualified from the Israeli Air Force (IAF) flight academy.METHODS: Flight cadets from 12 consecutive flight courses who have used methylphenidate at least once in the past were identified according to their medical records. The graduation ratio of cadets with previous use of methylphenidate was compared with that of the rest of the cadets. A comparison was also made with regard to the causes of disqualification from the flight course. Statistical significance was assessed using the Fischer Test.RESULTS: Among the 90 flight cadets who have used methylphenidate, only 2 (2.2%) successfully graduated from the IAF flight academy. Among the 2983 flight cadets who have no history of methylphenidate use, 461 (15.4%) successfully graduated. We found no significant differences in the disqualification causes between the two groups.CONCLUSION: The IAF flight academy graduation rate was meaningfully and significantly lower among cadets who reported previous use of methylphenidate. The study design, however, limits the inference of causal relationship.Sarfati S, Nakdimon I, Tsodyks J, Assa A, Gordon B. Success rates at an air force pilot academy and its relation to methylphenidate use. Aerosp Med Hum Perform. 2019; 90(9):788-791.
Collapse
|
27
|
Choisy M, Van Cuong N, Bao TD, Kiet BT, Hien BV, Thu HV, Chansiripornchai N, Setyawan E, Thwaites G, Rushton J, Carrique-Mas J. Assessing antimicrobial misuse in small-scale chicken farms in Vietnam from an observational study. BMC Vet Res 2019; 15:206. [PMID: 31221155 PMCID: PMC6585117 DOI: 10.1186/s12917-019-1947-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 06/04/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Antimicrobials are used by poultry farmers in Vietnam as a tool to treat and prevent infectious diseases. We aimed to determine the fraction of disease episodes likely to remain untreated due to the administration of antimicrobials on non-susceptible pathogens in chicken flocks in the Mekong Delta of Vietnam. Weekly data on antimicrobial use and clinical signs were collected from 88 randomly chosen chicken flocks over 124 full production cycles (i.e. time between restocking flocks with day-old chicks and sale for slaughter). A naïve Bayes model was trained to infer the probabilities of disease episodes having been caused by each of 24 pathogens, given the observed clinical sign profile, and expert knowledge on their relative incidence. RESULTS A total of 224 disease episodes were observed, of which 44.8% were attributed to viruses (95% CI 31.1-58.4%), 54.6% (CI 40.4-68.7%) to bacteria, and 0.6% (CI 0-1.7%) to a protozoan (Eimeria spp.). Antimicrobials were more frequently administered on weeks with disease than on weeks without disease (43.3% vs. 17.8%; p < 0.001). A median of 2 [IQR 0-4] antimicrobials were used by episode. The choice of specific antimicrobials was independent on whether the flocks had disease clinical signs or not. Antimicrobials were not used in 30.3% of the episodes. The overall probability that episodes were not effectively treated was 74.2, and 53.7% when discounting cases where the inferred aetiology is viral. Considering only episodes where antimicrobials were given, these probabilities were 57.4 and 23.8% respectively. CONCLUSIONS This study highlights untargeted use of antimicrobials on small-scale Vietnamese chicken farms, as well as the limitations of antimicrobials as effective tools to control infectious diseases.
Collapse
Affiliation(s)
- Marc Choisy
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- MIVEGEC, IRD, CNRS, University of Montpellier, Montpellier, France
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh city, Vietnam
- LMI “Drug Resistance in South-east Asia” (DRISA), Hanoi, Vietnam
| | | | - Truong Dinh Bao
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Ho Chi Minh city, Vietnam
| | - Bach Tuan Kiet
- Sub-Department of Animal Health and Production (SDAHP), Cao Lanh, Dong Thap Vietnam
| | - Bo Ve Hien
- Sub-Department of Animal Health and Production (SDAHP), Cao Lanh, Dong Thap Vietnam
| | | | | | - Erry Setyawan
- Food and Agriculture Organization of the United Nations, Jakarta, Indonesia
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Nuffield, Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| | - Jonathan Rushton
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Juan Carrique-Mas
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Nuffield, Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| |
Collapse
|
28
|
Kumar K, Sharma R. Over-the-counter Use of Glucocorticoids causing Severe Stunting in Siblings. Indian Pediatr 2019; 56:251. [PMID: 30955003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Ketan Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rajni Sharma
- Department of Pediatrics and Division of Pediatric Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
29
|
McDonnell E. Codeine Usage in Ireland- A Timely Discussion on an Imminent Epidemic. Ir Med J 2019; 112:899. [PMID: 31124348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- E McDonnell
- Graduate Entry Medical School, University of Limerick
| |
Collapse
|
30
|
Schifano F, Chiappini S. Is there such a thing as a 'lope' dope? Analysis of loperamide-related European Medicines Agency (EMA) pharmacovigilance database reports. PLoS One 2018; 13:e0204443. [PMID: 30286103 PMCID: PMC6171858 DOI: 10.1371/journal.pone.0204443] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/07/2018] [Indexed: 12/02/2022] Open
Abstract
Background Among over-the-counter (OTC) drugs, loperamide has recently emerged for its potential of misuse and cardiotoxicity issues. Hence, we aimed here at assessing the loperamide-related cases being reported to the EMA's EudraVigilance (EV) database. Methods All spontaneous EV reports relating to loperamide misuse/abuse/dependence/withdrawal and cardiotoxicity issues were here retrieved, performing a descriptive analysis. Findings During the years 2005–2017, EV collected a number of 1,983 (out of a total of 7,895; 25.11%) loperamide-related misuse/abuse/dependence/withdrawal adverse drug reaction (ADR) reports, with a progressively increasing trend since 2014. Most cases were classified as drug use disorder (37.4%) or intentional overdose (25.4%). Loperamide was used on its own in 41.9% of cases; remaining, polydrug, cases included antidepressants; benzodiazepines; and other OTCs. Some 1,085 (1,085/7,895 = 13.7%) cardiovascular ADRs were reported, being conduction abnormalities and EKG alterations the most frequently identified. Conclusions EV data may support the levels of concern relating to loperamide potential of abuse and associated cardiotoxicity issues.
Collapse
Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, United Kingdom
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, United Kingdom
- Casa di Cura Villa Rosa, Viterbo (VT), Italy
- * E-mail:
| |
Collapse
|
31
|
Griffith R. The Gosport inquiry and the principle of double effect. Br J Nurs 2018; 27:762-763. [PMID: 29995516 DOI: 10.12968/bjon.2018.27.13.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Richard Griffith, Senior Lecturer in Health Law at Swansea University, restates the requirements of the principle of double effect that seeks to ensure that patients in intractable pain receive the analgesia they require to manage it.
Collapse
|
32
|
Abstract
The threat from microorganisms is complex, and the approaches for reducing the challenges the world is facing are also multifaceted, but a combination approach including several simple steps can make a difference and reduce morbidity and mortality and the economic cost of fighting infectious diseases. This paper discusses the continually evolving infectious disease landscape, contributing factors in the rise of the threat, reasons for optimism, and the policies, technologies, actions, and institutions that might be harnessed to further reduce the dangers introduced by pathogens. It builds upon and updates the work of other authors that have recognized the dangers of emerging and re-emerging pathogens and have explored and documented potential solutions.
Collapse
|
33
|
Al-Shibani N, Hamed A, Labban N, Al-Kattan R, Al-Otaibi H, Alfadda S. Knowledge, attitude and practice of antibiotic use and misuse among adults in Riyadh, Saudi Arabia. Saudi Med J 2018; 38:1038-1044. [PMID: 28917069 PMCID: PMC5694638 DOI: 10.15537/smj.2017.10.19887] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objectives: To assess the knowledge, attitude, and practice of antibiotics (ABs) use and misuse among adults living in Riyadh, Saudi Arabia. Methods: In this cross-sectional study, a self-administered questionnaire was distributed to participants from March 2016 to January 2017 in the outpatient department of King Khalid University Hospital and Dental Hospital, King Saud University, Riyadh, Saudi Arabia. The questionnaire was divided into 4 sections. The first and second section inquired regarding demographic details and knowledge of ABs. The third section assessed practice of ABs and the fourth section assessed attitude of participants towards ABs use. Questionnaires were hand delivered to respondents using convenience sampling. Statistical analysis using frequency distributions and knowledge responses of AB resistance for ‘yes’ and ‘no’ were associated with participant characteristics using Chi-square test. Results: A total of 1966 questionnaires were completed (response rate: 93.5%). Sixty-seven percent of the respondents were unaware of the meaning of ABs resistance. Sixty-seven percent of respondents were unaware of ABs being harmful for children’s teeth and 64.9% unaware of ABs that develop allergy and death. Twenty-four percent believed that ABs worked on viruses, 31% on cold and 21% can cure cough. Almost 51% used ABs without physician prescription while 37.5% obtained ABs directly from pharmacists without physician’s prescription. Almost 42% participants discontinued ABs on alleviation of symptoms. There was significant difference in knowledge response of AB resistance and source of AB use (p=0.026), reason of AB use (p=0.038) and discontinuation of ABs (p=0.041). Conclusion: Adults showed insufficient knowledge and understanding regarding the safe use of ABs consumption among the population.
Collapse
Affiliation(s)
- Nouf Al-Shibani
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | | | |
Collapse
|
34
|
Bigeard É, Grabar N, Thiessard F. Typology of Drug Misuse Created from Information Available in Health Fora. Stud Health Technol Inform 2018; 247:351-355. [PMID: 29677981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Patients seldom report the misuse of drugs to their physicians. Hence, other sources of information are necessary for studying these issues. We assume that online health fora can provide such information and propose to exploit them for building a typology of drug misuses. The misuses detected are structured according to the goals of patients: we distinguished three types of non-intentional misuses and 14 types of intentional misuses. This work will be used to guide future task of automatic extraction of drug misuses.
Collapse
Affiliation(s)
- Élise Bigeard
- Univ. Lille, CNRS, UMR 8163 - STL - Savoirs Textes Langage, F-59000 Lille, France
| | - Natalia Grabar
- Univ. Lille, CNRS, UMR 8163 - STL - Savoirs Textes Langage, F-59000 Lille, France
| | - Frantz Thiessard
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team ERIAS, UMR 1219, F-33000 Bordeaux, France
| |
Collapse
|
35
|
Hajjar W, Alnassar S, Al-Khelb S, Al-Mutairi S, Al-Refayi N, Meo SA. Antibiotics use and misuse in upper respiratory tract infection patients: Knowledge, attitude and practice analysis in University Hospital, Saudi Arabia. J PAK MED ASSOC 2017; 67:1387-1392. [PMID: 28924280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the awareness and causes of antibiotics use and misuse in patients with upper respiratory tract infections. METHODS This cross-sectional study was conducted at King Saud University, Riyadh, Saudi Arabia, from January 2014 to December 2015, and comprised patients suffering from upper respiratory tract infections. A well-established, self-administrated questionnaire was randomly distributed to the patients. The questionnaire consisted of 3 parts: demographic variables, knowledge, and beliefs, and behaviour towards antibiotic use and misuse. SPSS 21 was used for data analysis. RESULTS Of the 400 participants, 193(48.25%) were males and 207(51.75%) were females. Besides, 182(45.5%) participants used antibiotics without prescription (p=0.050) and 43(10.8%) used the mover a pharmacist's advice (p=0.030). Also, 69(17.3%) participants forced the physicians to prescribe antibiotic (p=0.014), and 207(51.7%) patients stopped taking antibiotics when they felt better (p=0.007). Moreover, 180(45%) had the antibiotic stocks at home in case of emergencies. In addition, 67(16.8%) were ignoring the instructions when taking antibiotics (p=0.004). Furthermore, 48(12%) participants denied that an antibiotic could cause an allergic reaction (p=0.054) and the same number of participants believed that the effectiveness of the treatment would not be affected if a full course of antibiotic was not completed (p=0.029). In addition, 29(7.3%) participants with high educational level believed that all antibiotics did not have side-effects (p=0.002) and 71(17.8%) of them believed that if symptoms were improving the antibiotic course could be interrupted without completing (p=0.037). CONCLUSIONS Misconceptions existed about the use and indications of antibiotics.
Collapse
Affiliation(s)
- Waseem Hajjar
- Department of Thoracic Surgery, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sami Alnassar
- Department of Thoracic Surgery, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sara Al-Khelb
- College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sarah Al-Mutairi
- College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Norah Al-Refayi
- College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sultan Ayoub Meo
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
36
|
|
37
|
Briskman I, Shelef A, Berger U, Baruch Y, Bar G, Asherov J, Lvovski A, Apter A, Barak Y. Deliberate Self-Harm in Older Adults: A General Hospital Emergency Department Survey. Isr Med Assoc J 2017; 19:160-163. [PMID: 28457093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Deliberate self-harm (DSH) increases the danger of future suicide death and the risk increases with age. Self-harm in older adults is often associated with greater suicidal intent and lethality. OBJECTIVES To investigate clinical and psychosocial variables of older patients (age ≥ 65 years) assessed due to DSH, compared with younger adults. METHODS Patients admitted to the Emergency Department following DSH during an 8 year period were included. RESULTS Of 1149 participants, 187 (16.6%) were older adults (age ≥ 65) and 962 (83.4%) were younger adults (< 65). The older adults reported DSH closer to mid-day (P < 0.01) and suffered more frequently from adjustment disorder and depression. Personality disorders and schizophrenia were less commonly diagnosed (P < 0.001). Prescription medication (sedatives and hypnotics) were a more frequent means (88% vs. 71%) of DSH among older patients. Younger patients with DSH used over-the-counter medications (21.9% vs. 6.4%) three times more than did the older patients (P < 0.01). Past DSH was significantly more frequent in younger adults. Following DSH the older patients were frequently admitted for further general hospitalization (P < 0.001). CONCLUSIONS Older adults with DSH are a unique group with different clinical characteristics. There is a need for targeted prevention strategies and education of caregivers regarding DSH in older adults.
Collapse
Affiliation(s)
- Irina Briskman
- Emergency Department, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assaf Shelef
- Abarbanel Mental Health Center, Bat Yam, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Berger
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Yehuda Baruch
- Abarbanel Mental Health Center, Bat Yam, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gali Bar
- Emergency Department, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jack Asherov
- Emergency Department, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Artur Lvovski
- Emergency Department, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alan Apter
- Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoram Barak
- Abarbanel Mental Health Center, Bat Yam, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
38
|
Heeren N, Farver D. You Abused What? Getting High with Unique Medications. S D Med 2017; 70:38-39. [PMID: 28810101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Debra Farver
- College of Pharmacy, South Dakota State University
| |
Collapse
|
39
|
Whittaker A, Williams N, Chandler A, Cunningham-Burley S, McGorm K, Mathews G. The burden of care: a focus group study of healthcare practitioners in Scotland talking about parental drug misuse. Health Soc Care Community 2016; 24:e72-e80. [PMID: 25939770 DOI: 10.1111/hsc.12249] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 06/04/2023]
Abstract
Parenting and family support are key prevention and intervention strategies for improving outcomes for children and families affected by parental drug misuse. However, little is known about the delivery of parenting support for drug-dependent parents, particularly within universal healthcare services. This study aimed to explore the way healthcare practitioners engage with this challenging agenda. Four multidisciplinary focus groups involving a purposive sample of 18 experienced healthcare professionals were conducted in Scotland. Participants included general practitioners, midwives, public health nurses and addiction staff who work together to provide care for vulnerable families. A focus group topic guide was developed to explore the views and experiences of these healthcare professionals in relation to providing parenting support for drug-using parents, predominantly those receiving opioid substitution therapy. Data were analysed using a constant comparison method and thematic approach. The overarching narrative which united the focus group discussions was about the 'burden of care' that these families pose for frontline healthcare professionals. Recurring themes centred on three key issues: the problematic nature of drug-using parents themselves; clinical challenges in living up to the ideals of professional practice; and the wider context in which current practice is governed. Professionals expressed ambivalence over their parenting support role; anxiety over responsibility for intervening with this 'hard-to-engage' population; and concern over 'dwindling' resources and lack of organisational support. Nevertheless, strategies and opportunities for providing parenting support were acknowledged and there was consensus about the need for further skills training. Despite a proliferation of policy and good practice guidance on the delivery of parenting support for drug-dependent parents, the findings of this study suggest that significant challenges remain. Notably, our findings raise questions about whose role it is to provide parenting support to drug-using mothers and fathers, especially those who are not involved in the child protection system.
Collapse
Affiliation(s)
- Anne Whittaker
- Substance Misuse Directorate, NHS Lothian, Astley Ainslie Hospital, Edinburgh, UK
| | | | - Amy Chandler
- Centre for Research on Families and Relationships, University of Edinburgh, Edinburgh, UK
| | | | - Kelly McGorm
- Division of Women Youth and Children Community Health Programs, ACT Health, Canberra, Australian Capital Territory, Australia
| | | |
Collapse
|
40
|
Leyden-Duval C. Primum Non Nocere: A More Proactive Workplace Drug Testing Regime for Australian Medical Practitioners? J Law Med 2016; 24:398-418. [PMID: 30137712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article considers whether Australian medical practitioners should be subject to a more proactive workplace drug testing regime in order to minimise the risk of harm to patients. It first canvasses the history of workplace drug testing in the United States, the United Kingdom and Australia, before exploring whether there is a need for more proactive drug testing of Australian medical practitioners. It then considers whether workplace drug testing adequately addresses drug-related risks to patient safety, and discusses some of the privacy issues associated with workplace drug testing regimes. The article concludes that although an argument can be advanced in favour of a more proactive workplace drug testing regime for all Australian medical practitioners, the implementation of such a regime would be costly and complicated. As a result, it should only apply to practitioners assessed as working in “high-risk” roles.
Collapse
|
41
|
McSherry B, Tellez JJ. Current Challenges for the Regulation of Chemical Restraint in Health Care Settings. J Law Med 2016; 24:15-19. [PMID: 30136770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Various forms of restraint may be used in a variety of health care settings to control behaviour. Laws and policies regulate the use of physical and mechanical restraint across health care settings, but there is a gap in relation to the regulation of chemical restraint. This may partly be because of problems in defining the term and partly because of a lack of information as to the extent of the use of drugs aimed at controlling behaviour rather than ameliorating a medical condition. This column provides an overview of current definitions and argues that there is a need for national guidance as to what constitutes chemical restraint in order to reduce its use.
Collapse
|