Electronic interventions in primary care to address substance use: A systematic review.

The present systematic review aims to identify electronic interventions for addressing substance use and understand their effectiveness in primary care settings. A systematic search was carried out in the Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library. The search included the keywords "electronic intervention", "substance use", "primary care" and synonyms. To determine the quality and recommendation of the analyzed interventions, the efficacy results reported by the studies were considered, as well as the Mixed Methods Appraisal Tool (MMAT) assessment and the GRADE Evidence Assessment. Twenty-one electronic interventions in Primary Care were identified: internet, mobile or tablet applications, text messages, emails, automated telephone calls, or electronic self-reports. These interventions had diverse components, incorporating theories that have proven effective in face-to-face interventions as their theoretical frameworks. Some of them were complementary to in-person treatment, while others replaced it. Six interventions (28.5 %) displayed high quality: HealthCall, AB-CASI, Quit Genius, eCHECKUP-TOGO, CBI, and TES. Another nine interventions (42.8 %) were found to have moderate-high quality: Alcohol y Salud, IVR-BI, Program of Wallace et al., Let's Talk About Smoking, SMSalud, ESCAPE, AAC-ASPIRE, iQuit, and Programa VIH. One intervention (4.7 %) had moderate-low quality: Vive sin tabaco ¡Decídete! The remaining five interventions (23.8 %) were found to have very low quality: Connection to health, cSBI, Teen Well Check, the program of Helzer et al. (2008), and Down your drink. The programs with the highest recommendation for addressing alcohol-related issues are HealthCall and AB-CASI; for tobacco use, it is Quit Genius; for cannabis use, it is eCHECKUP-TOGO; for addressing both legal and illegal substances, it is CBI and TES. Finally, for specific illicit drug use, the only recommended program is CBI. This last intervention, CBI, is of the highest quality and, therefore, can be considered a model intervention for dissemination in the primary care setting.

Model of structural equations on the perception of aspects of school life and substance consumption as predictors of problem behavior in adolescents.

Introduction: Problematic behavior and drug use are behaviors of social concern, especially in adolescence. There are school factors that can contribute to their development or prevent them. The objective was to establish explanatory models of the relationship between various school variables with the consumption of alcohol, tobacco and cannabis; determining its direct and/or indirect relationship with problematic behaviors. Materials and methods: The study was cross-sectional with a sample of 346 students (Main Age=14.81; 54% women) from secondary education. Structural Equation Model (SEM) were carried to analyze the relationship between the dimensions of the Scale of perception of aspects of school life and alcohol, tobacco and cannabis consume with the presence of Problematic Behavior. Results: Problem behavior was predicted by alcohol, tobacco and cannabis consume, and binge drinking. Different aspects of school life differentially predicted problem behavior and drug use. Sense of challenge was observed as having a reciprocal predictive relationship with problem behavior. Perception of oneself at school predicts both alcohol and tobacco use; while the value given to school predicts binge drinking. Discussion: These findings suggests that, when addressing problem behavior and drug use that affect minors in school and have repercussions on class dynamics and academic outcomes, we should not focus exclusively on these problem areas, but rather take a more integrated approach that includes modifying different school-related aspects that act as risk factors for these types of problems.

Profiles and Risk Factors for Teen Dating Violence in Spain.

Teen dating violence (TDV) refers to a wide range of partner-directed harmful behaviors among adolescents. Since it was first documented in the 1980s, there is a growing interest in TDV due to its potentially devastating mid- and long-term consequences. Aiming at the early detection of TDV onset with prevention purposes, research has focused on the detection of typologies of perpetrators and/or victims as well as on identifying risk and protective factors for its occurrence. Research with Spanish adolescents, however, is very limited. To fill this gap, we recruited a total of 2,319 adolescents from different regions in Spain, out of which, 1,079 reported having had a romantic partner during the last year. These filled out measures of TDV (perpetration and victimization), school aggression, hostile and benevolent sexism, empathy, assertiveness, psychological inflexibility (general measures), and psychological inflexibility with prejudice thoughts. A cluster analysis revealed that adolescents could be divided into two clusters as a function of their TDV profile: Cluster 1, including close to 76% of the sample (boys and girls), presented low TDV perpetration and victimization; Cluster 2, including 24% of the sample (boys and girls), presented higher TDV perpetration and victimization. Regression analyses revealed that, as compared to those in Cluster 1, adolescents in Cluster 2 were more likely to be older boys who scored high in benevolent sexism, overt and relational school aggression, and personal distress, and low in behavior regulation skills, perspective taking, and practical personal ability. We discuss the implications of these findings for the design of evidence-based TDV prevention campaigns.

Prevalence of problematic Internet use and problematic gaming in Spanish adolescents.

Epidemiological studies on problematic Internet use and problematic gaming conducted so far have mainly been carried out with unrepresentative and self-selected convenience samples, resulting in unreliable prevalence rates. This study estimates the prevalence of problematic Internet use and problematic gaming in a large sample of Spanish adolescents (N = 41,507) and identifies risk and protective factors for these risky behaviours. Data were collected online using the Adolescent Problem Internet Use Scale and the Adolescent Gaming Addiction Scale. Using a cut-off approach with measurement instruments inspired by the DSM-5 framework, we found a prevalence of 33% for problematic Internet use and 3.1% for problematic gaming. With a more conservative approach inspired by the ICD-11 framework, prevalence rates decreased to 2.98% for problematic Internet use and 1.8% for problematic gaming. Female gender, higher parents' education, elevated Internet connection time, reporting being online after midnight and using the mobile phone in class predicted problematic Internet use; whereas male gender, "living situation" where families do not have a traditional structure or stable environment, elevated Internet connection time and reporting using the mobile phone in class predicted problematic gaming. A cut-off approach involving scales that recycle substance use criteria (as in the DSM-5) over-pathologize Internet use and gaming behaviours. In contrast, the ICD-11 approach seems to provide more realistic and reliable prevalence rates.

Changes in tobacco and e-cigarette consumption in Spanish university students during the COVID-19 lockdown: Identification of vulnerable groups.

INTRODUCTION: The objective of this study was to determine the changes in tobacco consumption in Spanish university students during the lockdown in 2020, and to identify vulnerable groups based on gender, age, and living situation. METHODS: This was a cross-sectional descriptive study. From a sample of 1540 Spanish university students, 19.9% (n=306; 77.6% women; mean age=30.9 years; SD=8.3) reported having consumed tobacco. The frequency and average daily consumption of cigarettes and electronic nicotine delivery systems (ENDS) before the pandemic and during lockdown were analyzed. RESULTS: A total of 97.1% of students consumed only cigarettes, 2.9% only ENDS, and 3.3% were dual consumers. During lockdown, cigarette consumption was significantly reduced (5.3 before; 4.0 during; t(71)=3.6255; p<0.001) in the youngest group (aged 18-24 years). However, women daily users significantly increased their consumption (t(149)= -2.5461; p<0.05) and so did the 35-44 years age group (t(32)= -2.2285; p<0.05). Cigarette consumption significantly increased in those who were living alone (5.6 to 7.2; Z= -2.351; p<0.05) and with a partner (7.2 to 8.0; t(97)= -2.3771; p<0.05), but decreased in those who were living with their parents or other relatives (6.2 to 4.5; t(101)=3.4298; p<0.001). A total of 17.0% ceased consumption during lockdown, mainly women, younger students (aged 18-24 years), and those who lived with their parents. None of the people who used cigarettes daily during the pre-pandemic period stopped smoking during lockdown. CONCLUSIONS: Younger university students and those living with their parents decreased their tobacco use during the lockdown. Potentially vulnerable groups at risk of increasing their consumption were women who consumed tobacco daily before the pandemic and students aged 35-44 years who lived alone or with their partner.

Problematic Internet Use, Depressive Symptomatology and Suicidal Ideation in University Students During COVID-19 Confinement.

BACKGROUND: The aim was to estimate the rate of PIU in Spanish university students during the lockdown, taking sex and age into account, and to analyze its relationship with depression and suicidal ideation. METHOD: 921 university students (55% women) from 18 to 30 years old (M = 24.8 years; SD = 3) participated. RESULTS: The results showed that 21% of the participants presented PIU, 25.1% moderate depression, 2.1% severe depression, and 6.6% suicidal ideation. The 18 to 21-year-old age group presented the highest rate of PIU (37.8%). A positive correlation was observed between PIU and depression (r = .38; p (241.813) = -8.21; < d = .78) in university students with PIU (M = 9.8; SD = 5.1) than those without it (M = 6.4; SD = 4.1). The rate of severe depression was six times greater (χ2 (3) = 73.25; p < .001) in undergraduates with PIU (6.2%) than those without PIU (0.8%). Moreover, 3.6% of university students with PIU presented suicidal ideation. CONCLUSIONS: These findings establish the association between PIU and depression and suicidal ideation in the university population, providing novel contributions for prevention policies.

Depression, Suicidal Ideation, and Consumption of Psychotropic Drugs During Lockdown by COVID-19 According to Gender and Age.

The objective was to analyze the relationship between depression and suicidal ideation and psychotropic drugs use during COVID-19 lockdown in adult population considering gender and age. The method used is a descriptive and non-probabilistic study, with a convenience sampling of 3780 participants (70.1% female), aged 18-64 years (M = 37.8). 18.3% participants presented depression and 5.1% exhibited suicidal ideation. The depression rate for female was double (21.4%) than male and 5 times higher (30.2%) for the youngest participants (18-24 years old) compared to oldest (55-64 years old), being this rate triple in suicidal ideation (9%). Depression correlated positively with tranquilizers and sleeping pills' consumption; and suicidal ideation did so with tranquilizers and sedatives. The rate of tranquilizer users was 8 times higher for severe depression compared to those who did not present depression, 5 times higher for sleeping pills, and 6 times higher for sedatives. The rate of tranquilizer users exhibiting suicidal ideation was more than triple than those who did not present suicidal ideation, between 3 and 4 times higher for sleeping pills, and almost 7 times higher for sedatives. The higher the level of depression and suicidal ideation during lockdown, the greater the consumption of psychotropic drugs. The consumption of psychotropic drugs should be monitored in people with depression and suicidal ideation during periods of crisis.

Importance of nutritional assessment tools in the critically ill patient: A systematic review.

Background: Among the risks of the critically ill patient, one of the aspects to be taken into account is the high probability of occurrence of malnutrition risk (40-50%). This process leads to increased morbimortality and worsening. The use of assessment tools allows the individualization of care. Objective: To analyze the different nutritional assessment tools used during the admission of critically ill patients. Methods: Systematic review of the scientific literature related to the nutritional assessment of critically ill patients. Between January 2017 and February 2022, articles were rescued from the electronic databases "Pubmed," "Scopus," "CINAHL" and "The Cochrane Library"; which will analyze which instruments are used during nutritional assessment in the ICU, as well as their impact on mortality and comorbidity of patients. Results: The systematic review was made up of 14 scientific articles that met the selection criteria, obtained from seven different countries. The instruments described were: mNUTRIC, NRS 2002, NUTRIC, SGA, MUST and the ASPEN and ASPEN criteria. All the included studies demonstrated beneficial effects after nutritional risk assessment. mNUTRIC was the most widely used assessment instrument, with the best predictive validity for mortality and adverse outcomes. Conclusion: The use of nutritional assessment tools makes it possible to know the real situation of patients, and by objectifying situations, to allow different interventions to improve the nutritional level of patients. The best effectiveness has been achieved using tools such as mNUTRIC, NRS 2002 and SGA.

Age and Living Situation as Key Factors in Understanding Changes in Alcohol Use during COVID-19 Confinement.

(1) The aim of the present study was to evaluate and characterize changes in alcohol use during the COVID-19 confinement in a sample of Spanish adults, analyzing their age and living situation as defining life cycle variables. (2) Method: Data from 3779 individuals were collected through a set of online surveys. AUDIT-C was used to measure the frequency of consumption, the average daily consumption, intensive consumption, risky consumption, and Standard Drink Units. (3) Results: Although alcohol consumption during confinement showed a significant general decline, age revealed important differences, with the decline being more pronounced in adults from 18 to 29 years old. The living situation also showed significant differences. The largest decreases in alcohol consumption were found in those who lived with their parents or other relatives, whereas those who lived alone or with a partner even increased their level of consumption. In addition, the data show a significant interaction between these two variables and gender. (4) Conclusions: Age and cohabitation processes are key factors in understanding the life situation of each individual during confinement and, consequently, in explaining consumption patterns. The results obtained provide interesting recommendations for designing prevention policies in both normal and crisis circumstances, emphasizing the need to understand alcohol use from a psychosocial perspective.

Changes in Alcohol Consumption Pattern Based on Gender during COVID-19 Confinement in Spain.

(1) The goal of this study was to analyze the prevalence and pattern of alcohol consumption (frequency of consumption, average daily consumption, and risky consumption) before and during confinement due to the coronavirus disease (COVID-19) in the adult population and based on gender. (2) Methods: Data from 3779 individuals were collected via a set of online surveys. The AUDIT alcohol consumption questions (AUDIT-C) were used to measure the frequency of consumption, the average daily consumption, intensive consumption, risky consumption, and standard drink units. (3) Results: During confinement, the prevalence of alcohol consumption declined in both males and females, but only intensive consumption showed significant differences, with a greater reduction in males. The number of females who consumed alcohol four or more times per week doubled, whereas the number of males who did so was multiplied by a factor of 1.5; in both females and males, the percentage who presented intensive consumption doubled. The percentage of females with risky consumption was higher than that of males both before and during confinement. In addition to gender, the interaction between age and the employment situation explain consumption before and during confinement. (4) Conclusions: During confinement due to COVID-19, alcohol consumption declined in both sexes, but alcohol-risk consumers increased their frequency of use. The interaction between gender, age, and employment situation was related to these changes. These findings are relevant for guiding public health and health-risk management policies related to alcohol consumption in environmental situations similar to COVID-19.

Cognitive and personality differences between adolescents with and without attention deficit/hyperactivity disorder.

BACKGROUND: The relationships between cognitive and personality profile in teenagers with and without ADHD were assessed. METHOD: Two groups of teenagers, one with ADHD (N = 135; mean age = 13.93) and another group without ADHD (N = 199, mean age = 14.29) were evaluated using the K-BIT and 16PF-APQ tests. RESULTS: In cognitive variables, the results revealed that the ADHD group returned higher scores in the Matrices subtest and the IQ test. In personality variables, the group with ADHD exhibited higher scores in Tough-Mindedness and lower scores in Self-Control than the group without the disorder. The canonical correlation analysis applied to each group revealed a differing pattern of interrelationships between the cognitive-personality variables in the two groups. In adolescents with ADHD, we observed that higher scores in cognitive variables were associated with a more extroverted personality and less self-control, while in adolescents without ADHD, higher scores in cognitive variables were associated with less tough-mindedness and lower levels of self-control. CONCLUSIONS: The cognitive and personality variables of adolescents with and without ADHD differ. These results will be useful for establishing a cognitive and personality profile for this section of the population. The educational implications of the study are under discussion.

Psychological Flexibility With Prejudices Increases Empathy and Decreases Distress Among Adolescents: A Spanish Validation of the Acceptance and Action Questionnaire-Stigma.

Empathy is an emotional response that may facilitate prosocial behavior and inhibit aggression by increasing empathic concern for others. But the vicarious experience of other's feelings may also turn into personal distress when the person has poor regulation skills and holds stigmatizing beliefs. In thinking about the processes that may trigger the experience of personal distress or empathic concern, research on the influence of psychological flexibility and inflexibility on stigma is showing promising results. Both processes are assessed with the Acceptance and Action Questionnaire-Stigma (AAQ-S). The current study sought to carry out a validity study of a Spanish version of the AAQ-S with a sample of adolescents aged 11-17 years. The study included an expanded test of its predictive validity with measures at three times to evaluate the role of psychological flexibility and inflexibility as risk or protective variables for the development of personal distress and/or empathic concern in the stigmatizer. Statistical analyses confirmed a two-correlated-factor solution, the adequate reliability of both factors, and their construct and predictive validity in the expected direction. The stigmatizer's inflexible reaction to their stigmatizing thoughts predicted the occurrence of personal distress, whereas the stigmatizer's flexible reaction to their stigmatizing thoughts predicted the occurrence of empathic concern for others. These findings confirm the importance of considering the role of regulatory skills in the experience of empathic concern or personal distress in the presence of stigmatizing thoughts, with possible implications for the promotion of prosocial behavior and the reduction of aggressive behavior among adolescents.