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1.
Artigo em Inglês | MEDLINE | ID: mdl-34208466

RESUMO

Substance use is a public health problem that affects the normal physical, neurological, and psychological development of adolescents. Apparently, discrimination is an important variable for explaining the initiation and continued use of alcohol and marijuana. Since most research focused on discrimination based on factors, such as race, ethnicity, sexual orientation, or gender faced by minority groups, studies on discrimination faced by the general population remain scarce. This cross-sectional study described the relationship between everyday discrimination and alcohol and marijuana use-related behaviors among Chilean adolescents. It included 2330 students between 12 and 20 years of age from educational establishments in the city of Arica. To evaluate substance use, specifically alcohol and marijuana, the Child and Adolescent Evaluation System (SENA) was used. The Everyday Discrimination scale was used to evaluate discrimination. Age and everyday discrimination can predict up to 11% of the variance in substance use. Reducing the incidence of everyday discrimination may help reduce heavy alcohol and marijuana consumption among adolescents.


Assuntos
Comportamento do Adolescente , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
2.
Rev Bras Enferm ; 74(3): e20200829, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34287491

RESUMO

OBJECTIVES: to analyze, in the light of systemic thinking, the association between family dynamics and the use of alcohol, tobacco, and other drugs by adolescents throughout life. METHODS: a cross-sectional descriptive study was conducted in nine public schools in the city of Recife. Three hundred and sixty-four adolescents aged 14 to 19 years participated. We used three questionnaires: The Alcohol, Smoking, and Substance Involvement Screening Test, a reduced version of the Drug Use Screening Inventory; and a sociodemographic questionnaire. RESULTS: there was an association between parents/guardians ignoring what the child considers meaningful to him and the consumption of alcohol and tobacco by adolescents; we also verified an association between the occurrence of conflicting relationships and the consumption of illicit drugs by adolescents. CONCLUSIONS: it confirmed that disorganization in the family system, marked by impairments in emotional connections among members, and fragility in the sense of belonging are associated with the consumption of drugs in life by adolescents.


Assuntos
Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Estudos Transversais , Relações Familiares , Humanos , Masculino , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Tabaco
3.
Rev Bras Enferm ; 74(3): e20201244, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34287495

RESUMO

OBJECTIVES: to analyze the factors associated with the use of alcohol, tobacco and illicit drugs among Brazilian undergraduate students. METHODS: observational, cross-sectional study, with convenience sampling, conducted in 2014/2015, involving institutional data and a self-completed online questionnaire, analyzed using measures of frequency, central tendency/dispersion and logistic regression. RESULTS: among 126,326 students, 62.8% reported alcohol use; 11%, tobacco; and 7.5%, illicit drugs. Several academic factors-such as not residing with family (sororities [alcohol: aOR:2.38;95%CI:2.28-2.48; tobacco: AOR:2.20;95%CI:2.09-2.33; illicit drugs: AOR:2.53;95%CI:2.38-2.70]), acting in university movements (student [alcohol: AOR:1.74;95%CI:1.65-1.83; tobacco: AOR:1.97;95%CI:1.86-2.08; illicit drugs: AOR:2.43;95%CI:2.28-2.59] and religious [alcohol: AOR:0.28;95%CI:0.26-0.29; tobacco: AOR:0.23;95%CI:0.21-0.26; illicit drugs: AOR:0.18;95%CI:0.16-0.21]) and lack of discipline/study habit (alcohol: AOR:1.41;95%CI:1.37-1.45; tobacco: AOR:1.53;95%CI:1.46-1.59; illicit drugs: AOR:1.85;95%CI:1.76-1.94) - were associated with the use of the three categories of substances. CONCLUSIONS: we identified that a number of academic factors are associated with licit and illicit drug use. These findings may help in designing preventive strategies among college students.


Assuntos
Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Brasil/epidemiologia , Estudos Transversais , Humanos , Estudantes , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tabaco
4.
Artigo em Inglês | MEDLINE | ID: mdl-34198520

RESUMO

Virtually no studies appraised the co-use of alcohol, tobacco, and other drug (ATOD) among Finn undergraduates. We assessed the associations between sociodemographic, health, academic, policy, and lifestyle characteristics (independent variables); and individual, multiple and increasing ATOD use (dependent variables) using regression analyses. Data were collected by online questionnaire at the University of Turku, Finland (1177 students). Roughly 22% of the sample smoked, 21% ever used illicit drug/s, 41% were high frequency drinkers, and 31.4%, 16.3%, and 6.7% reported 1, 2, or 3 ATOD behaviors respectively. Individual ATOD use was significantly positively associated with the use of the other two substances [adjusted odds ratio (Adj OR range 1.893-3.311)]. Multiple ATOD use was negatively associated with being single (p = 0.021) or agreeing with total smoking or alcohol ban policy on campus (p < 0.0001 for each); but positively associated with not living with parents (p = 0.004). Increasing ATOD behaviors were significantly less likely among those agreeing with total smoking or alcohol ban policy on campus (p range 0.024 to <0.0001). Demographics significant to either individual, multiple, or increasing ATOD use included males, being single, not living with their parents during semesters, and to some extent, religiosity. Age, depressive symptoms, perceived stress, self-rated health, health awareness, income sufficiency, and academic variables were not associated with individual, multiple, or increasing ATOD use. Education and prevention efforts need to reinforce abstinence from ATOD, highlight their harmful outcomes, and target risk groups highlighted above. University strategies should be part of the wider country-wide successful ATOD control policies.


Assuntos
Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Consumo de Bebidas Alcoólicas/epidemiologia , Finlândia/epidemiologia , Humanos , Masculino , Prevalência , Estudantes , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Tabaco , Universidades
5.
Medicina (Kaunas) ; 57(6)2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34207966

RESUMO

Childhood onset bipolar disorder (CO-BD) presents a panoply of difficulties associated with early recognition and treatment. CO-BD is associated with a variety of precursors and comorbidities that have been inadequately studied, so treatment remains obscure. The earlier the onset, the longer is the delay to first treatment, and both early onset and treatment delay are associated with more depressive episodes and a poor prognosis in adulthood. Ultra-rapid and ultradian cycling, consistent with a diagnosis of BP-NOS, are highly prevalent in the youngest children and take long periods of time and complex treatment regimens to achieve euthymia. Lithium and atypical antipsychotics are effective in mania, but treatment of depression remains obscure, with the exception of lurasidone, for children ages 10-17. Treatment of the common comorbid anxiety disorders, oppositional defiant disorders, pathological habits, and substance abuse are all poorly studied and are off-label. Cognitive dysfunction after a first manic hospitalization improves over the next year only on the condition that no further episodes occur. Yet comprehensive expert treatment after an initial manic hospitalization results in many fewer relapses than traditional treatment as usual, emphasizing the need for combined pharmacological, psychosocial, and psycho-educational approaches to this difficult and highly recurrent illness.


Assuntos
Antipsicóticos , Transtorno Bipolar , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Transtorno Bipolar/complicações , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Criança , Comorbidade , Humanos , Lítio/uso terapêutico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
9.
J Consult Clin Psychol ; 89(6): 483-498, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34264697

RESUMO

OBJECTIVE: Justice-involved youth report high rates of adverse childhood experiences (ACEs; abuse, neglect, household dysfunction) and are at high risk for elevated behavioral health needs (i.e., substance use, psychiatric symptoms). Research with broad samples of adolescents shows ACEs predict behavioral health outcomes, yet most research on the impact of ACEs among justice-involved youth focuses on recidivism. The present study addresses this gap by examining the prospective association between ACEs and psychiatric symptoms, substance use, and substance-related problems (i.e., consequences of use) among first-time justice-involved youth. METHOD: First-time justice-involved youth (n = 271; 54.3% male; M age = 14.5 years; 43.5% Latinx; non-Latinx: 34.2% White, 8.6% Black, 7.1% Other, 6.7% Multiracial) and their caregivers were assessed at youth's first court contact and 4- and 12-month follow-ups. Youth and caregivers reported youth's exposure to ACEs through a series of instruments at baseline and 4-months (e.g., Childhood Trauma Questionnaire Short-Form; Traumatic Life Events Inventory). Primary outcomes included youth alcohol and cannabis use (Adolescent Risk Behavior Assessment), consequences of use (Brief Young Adult Alcohol Consequences Questionnaire; Brief Marijuana Consequences Scale), and psychiatric symptoms (Behavior Assessment System for Children; National Stressful Events Survey PTSD Short Scale). RESULTS: Youth were exposed to three ACEs, on average, prior to first justice contact (M = 3). Exposure to more ACEs, particularly abuse, predicted substance use and psychiatric outcomes. Gender differences emerged for cannabis use and internalizing symptoms. CONCLUSIONS: Implications for trauma-responsive juvenile justice reform are discussed, including screening for ACEs and their sequelae at first court contact and considering the role of masculine norms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Saúde Mental , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Cuidadores , Maus-Tratos Infantis/estatística & dados numéricos , Feminino , Humanos , Masculino , Abuso de Maconha/epidemiologia , Estudos Prospectivos , Inquéritos e Questionários
10.
Artigo em Inglês | MEDLINE | ID: mdl-34207964

RESUMO

BACKGROUND: Lockdown measures because of COVID-19 are likely to result in deteriorating physical and mental health. In this study, our aim was to assess the impact of media exposure on increases in substance use during the COVID-19 pandemic. METHODS: A nationally representative online survey of 1264 adults was collected during the pandemic in the United States. Logistic regression was used to explore the association between an increase in substance use since the beginning of the COVID-19 pandemic and exposure to cable news or social media together with COVID-19 knowledge, while controlling for covariates. RESULTS: In the multivariable-adjusted models, participants with the highest exposure to social media (at least daily) and low knowledge of COVID-19 were 9.9 times more likely to experience an increase in substance use since the pandemic began (OR = 9.90, 95% CI = 4.27-23.06). Participants with the highest exposure to cable news and low knowledge of COVID-19 were over 11 times more likely to experience an increase in substance use (OR = 11.64, 95% CI = 4.01-24.45). CONCLUSION: Based on our findings, we recommend that media organizations should aim to reduce uncertainty and also provide positive coverage to counter the negative information associated with pandemics.


Assuntos
COVID-19 , Mídias Sociais , Transtornos Relacionados ao Uso de Substâncias , Adulto , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2 , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Estados Unidos/epidemiologia
11.
Medicina (Kaunas) ; 57(6)2021 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-34204131

RESUMO

Background and Objectives: Over the past twenty years a large number of new psychoactive substances (NPS) have entered and modified the recreational drug scene. Their intake has been associated with health-related risks, especially so for vulnerable populations such as people with severe mental illness, who might be at higher risk of suicidality or self-injurious behavior. This paper aims at providing an overview of NPS abuse and the effects on mental health and suicidality issues, by performing a literature review of the current related knowledge, thereby identifying those substances that, more than others, are linked to suicidal behaviors. Materials and Methods: A comprehensive and updated overview of the literature regarding suicidality and NPS categories has been undertaken. An electronic search was performed, including all papers published up to March 2021, using the following keywords "NPS" OR "new psychoactive substances" OR "novel psychoactive substances" OR "synthetic cannabinoids" OR "phenethylamines" OR "synthetic cathinones" OR "tryptamines" OR "piperazines" OR "new synthetic opioids" OR "designer benzodiazepines" AND ("suicide" OR "suicidality") NOT review NOT animal on the PubMed, Cochrane Library, and Web of Science online databases. Results: Suicidality and self-injurious behavior appear to be frequently associated with some NPS such as cathinones, synthetic cannabinoids, and new synthetic opioids. The results are organized according to the substances recorded. Conclusion: The growing use of NPS has become a significant clinical issue, causing increasing concern and challenges for clinicians working in both mental health and emergency departments. Thus, considering the associations between NPS and suicidality or self-injurious behaviors, areas where suicide-prevention efforts and strategies might be focused are the early detection, monitoring, and restriction of NPS.


Assuntos
Drogas Ilícitas , Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Suicídio , Analgésicos Opioides , Humanos , Psicotrópicos/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
12.
Clin Ter ; 172(4): 271-272, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34247209

RESUMO

Abstract: Currently, the world is facing an unprecedent change of everyday life, due to the Covid-19 pandemic that has been affecting all the nations for more than one year. The public health systems were restructured in all the countries as a response to the constant emergency status, ne-glecting some services like toxicological analyses. In this scenario, the current spread of the New Psychoactive Substances is less controlled than before and the data on its expected mutation come from seizures analyses. Where the global distribution of drugs of abuse was affected by the restriction, fentanyl seizures did not drop during the pandemic. Moreover, new synthesis of fentanyl analogues resulted in new toxic adulterants as by products. Furthermore, diversion of benzodiazepines and new designer benzodiazepines were reported during the pandemic period. In this scenario, the scientific community and the international agencies should tighten their collaboration in order to monitor the emerging of new unknown substances.


Assuntos
Benzodiazepinas/efeitos adversos , COVID-19/epidemiologia , Contaminação de Medicamentos/estatística & dados numéricos , Fentanila/efeitos adversos , Psicotrópicos/efeitos adversos , Saúde Pública/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Humanos , Pandemias , SARS-CoV-2
13.
Eur. j. psychol. appl. legal context (Internet) ; 13(1): 29-36, ene.-jun. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-201546

RESUMO

Drugs are sold on both dark web services and on social media, but research investigating these drug purchases online is still emerging. The aim of this study is to analyze risk factors associated with buying drugs online. Utilizing theories of criminology and addiction research, it was hypothesized that social bonds, low levels of self-control, and poor mental health are associated with buying drugs online. Additionally, it was predicted that purchases of drugs online would mediate the relationship between low self-control and regular drug use. Participants of this nationwide study were 15 to 25 years old living in the United States (N = 1,212) and Spain (N = 1,212). Measures of impulsivity, a sense of mastery, social belonging, psychological distress, excessive behaviors (drinking, gambling and internet use) were utilized to predict purchasing drugs online. Two percent of the U.S. and Spanish respondents reported buying drugs online with 77% of them utilizing social media services to buy drugs. Results from multinomial logistic regression, penalized maximum-likelihood logistic regression, and binary mediation regression models indicated that buying drugs online was associated with lower self-control, higher psychological distress, and excessive gambling behavior and excessive Internet use. Having online friends was not a risk factor, but having strong social bonds with offline friends served as a protective factor. Additionally, buying drugs online mediated the relationship between low self-control and regular use of drugs. Results indicate that more focus should be placed on mainstream social media services as sources of drug acquisition as online drug buyers have multiple self-control and mental health problems


Las drogas se venden en páginas web oscuras y en las redes sociales, aunque la investigación de estas adquisiciones online está aún en sus comienzos. Este estudio tiene como objetivo examinar los factores de riesgo vinculados a la compra de drogas online. De acuerdo con las teorías de la criminología y la investigación sobre adicciones, se planteó la hipótesis de que los vínculos sociales, el bajo nivel de autocontrol y los problemas de salud mental están relacionados con la compra online de drogas. Además, se postuló que la adquisición online de drogas estaría mediada por la relación entre el bajo autocontrol y el consumo frecuente de drogas. Participaron en el estudio un total de 2,424 jóvenes residentes en Estados Unidos (N = 1,212) y en España (N = 1,212), que fueron evaluados en impulsividad, sensación de dominio, pertenencia social, malestar psicológico, comportamientos abusivos (bebida, juego y utilización de internet) , con el objetivo de predecir la compra online de drogas. El 2% de los participantes de EE UU y España dijeron que compraban drogas online, de los cuales el 77% utilizaba servicios de redes sociales para tal fin. Los resultados de una regresión logística multinomial, regresión logística de máxima verosimilitud penalizada y modelos de regresión de mediación binaria mostraron que la adquisición online de drogas se relaciona con un menor autocontrol y un mayor malestar emocional y abuso del juego, y del uso de internet. El hecho de tener amigos por internet no constituía un factor de riesgo y tener vínculos sociales estrechos con amigos fuera de internet constituía un factor protector. A su vez, la compra online de drogas es un factor que media la relación entre bajo autocontrol y uso habitual de drogas. Los resultados sugieren que debería prestarse mayor atención a las redes sociales como medio habitual de adquisición de drogas, dado que los compradores online de drogas tienen múltiples problemas de salud mental y autocontrol


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Tráfico de Drogas/tendências , Comércio Eletrônico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Rede Social , Estados Unidos/epidemiologia , Espanha/epidemiologia , Controle de Medicamentos e Entorpecentes/tendências
14.
Subst Use Misuse ; 56(10): 1476-1482, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34130597

RESUMO

INTRODUCTION: COVID-19 has resulted in extraordinary adversities. Mandates such as distancing and variations to treatment services were implemented to slow transmission of the virus, but created new challenges for persons with Substance Use Disorder (SUD). To better understand this phenomenon, we surveyed healthcare professionals on how they believe COVID-19 has impacted persons with SUD and what needs to occur to effectively treat this vulnerable population. Methods: Attending physicians, residents, nurses, medical and nursing students, and other healthcare professionals were asked to respond to three open-ended questions related to the impact of COVID-19 on persons with SUD. Two independent coders reviewed the comments utilizing constant comparative analysis to develop themes. Results: Common themes of concern were found from the respective participants (n = 205) including: lack of access to treatment, feelings of isolation, negative impacts on mental health, and the possibility of relapse. Healthcare strategies to effectively treat and help persons with SUD included increasing access to treatment including telehealth, development of peer support groups, availability of mental health resources, development of enhanced communication channels between providers and patients, and systematic changes. Conclusion: During the COVID-19 pandemic, overdose deaths have dramatically increased. As the short-term and long-term effects of the pandemic become more apparent, swift and comprehensive responses and policies must be enacted. This study provides insight from healthcare providers on the effects of the pandemic for persons with SUD. Many preexisting issues remain unresolved (e.g. stigma and healthcare disparities), and now the pandemic has presented new obstacles as noted by the providers. The findings from this study provide implications for important discussion regarding the development of strategies for substance use treatment and harm reduction.


Assuntos
COVID-19 , Transtornos Relacionados ao Uso de Substâncias , Atenção à Saúde , Pessoal de Saúde , Humanos , Pandemias , SARS-CoV-2 , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia
15.
Drug Alcohol Depend ; 225: 108760, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34102507

RESUMO

BACKGROUND: The impact of the COVID-19 pandemic on alcohol and substance use has been a topic of concern. Pregnant women are currently experiencing elevated anxiety and depression symptoms, which may increase risk of substance use, and potentially result in poor perinatal and neurodevelopmental outcomes for children. METHODS: Survey results were analyzed from an ongoing study of 7470 pregnant individuals in Canada: Pregnancy during the COVID-19 Pandemic. Participants were asked about current use of alcohol and substances, symptoms of depression and anxiety, and COVID-19 concerns: how much they worry about COVID-19 threatening their baby's life, threatening their own life, care for themselves or the baby, feelings of social isolation, and financial difficulties. RESULTS: The percentage of participants who reported use during pregnancy was 6.7 % for alcohol, 4.3 % for cannabis, 4.9 % for tobacco, and 0.3 % for illicit drugs; 2.6 % were using multiple substances. Higher depression symptoms and financial difficulties were associated with more cannabis and/or tobacco use as well as the co-use of substances. There were no associations between alcohol use and mental health or COVID-19 concerns. CONCLUSIONS: Self-reported rates of use and co-use were lower or comparable to previous research, perhaps reflecting pandemic-related circumstances or the demographics of this sample. Depression symptoms and pandemic-related financial difficulties were associated with more tobacco use, cannabis use, and substance co-use. It remains important to maintain access to perinatal, mental health, and financial supports during the pandemic to mitigate prenatal alcohol and substance use and prevent poor perinatal and long-term neurodevelopmental outcomes for children.


Assuntos
Alcoolismo/epidemiologia , COVID-19/psicologia , Pandemias , Gestantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , COVID-19/epidemiologia , Canadá/epidemiologia , Feminino , Humanos , Gravidez , Inquéritos e Questionários
16.
J Abnorm Psychol ; 130(4): 333-345, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34180699

RESUMO

Cannabis use is linked to symptoms of depression and anxiety, particularly among sexual minorities. This study examines the relationships between cannabis, and depression and anxiety symptoms at 13, 15, and 17 years using cross-lagged models in a predominantly White (n = 1,430; 92%) subsample of 1,548 participants from the Quebec Longitudinal study of Child Development. Multigroup analyses were conducted to examine the models according to sexual orientation. Demographic covariates were included as control variables, as well as alcohol, cigarette, and other drug use to examine cannabis specificity. The full sample revealed small bidirectional associations, which remained significant once control variables were included in the model: cannabis at 13 and 15 years predicted anxiety symptoms at 15 and 17 years respectively, and depression symptoms at 15 years predicted cannabis at 17 years. The initial association between cannabis at 13 years and depression symptoms at 15 years was accounted for by other drug use at 13 years. Substantial differences were found between heterosexual participants and sexual minorities: LGB participants presented a substantially larger positive association between depression symptoms at 15 years and cannabis at 17 years, as well as a negative association between anxiety symptoms at 15 years and cannabis at 17 years. Both of these relationships remained significant when accounting for control variables. These results suggest that the relationships between cannabis, and depression and anxiety symptoms are bidirectional across adolescence, albeit small. Sexual minorities present particularly large associations that may represent self-medication efforts for depressive symptoms between 15 and 17 years. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Ansiedade/epidemiologia , Cannabis , Depressão/epidemiologia , Heterossexualidade/psicologia , Minorias Sexuais e de Gênero/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Feminino , Heterossexualidade/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Quebeque/epidemiologia , Minorias Sexuais e de Gênero/estatística & dados numéricos
17.
Am J Gastroenterol ; 116(6): 1248-1255, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074828

RESUMO

INTRODUCTION: We assessed the performance of direct-acting antivirals (DAAs) in hepatitis C virus (HCV)-infected people who use drugs (PWUDs) in terms of sustained virological response (SVR) and adherence rates in comparison to a location-matched cohort of non-PWUD HCV patients. METHODS: All consecutive HCV RNA-positive PWUDs were enrolled between 2015 and 2019. All subjects underwent DAA treatment according to international guidelines and then followed, at least, up to 12 weeks after the end of treatment (SVR12). The SVR and adherence to treatment was compared with that of non-PWUD HCV patients observed at hepatological units of the CLEO platform. Intention-to-treat analysis was performed. RESULTS: A total of 1,786 PWUDs who were followed up were available for assessment. Most PWUDs (85.4%) were managed inside the specialized outpatient addiction clinics (SerDs). The overall SVR rate was 95.4%. The SerDs group achieved an SVR rate of 96.2% compared with 91.6% of the non-SerDs group (P < 0.001). Comparison with the non-SerDs group and the control HCV group showed a significant difference in the dropout rate (0.6% in the SerDs group versus 2.8% in the non-SerDs group and 1.2% in the control group; P < 0.001). At multivariate analysis, factors independently associated with SVR were use of the most recent regimens (elbasvir/grazoprevir, glecaprevir/pibrentasvir, and sofosbuvir/velpatasvir; odds ratio: 3.126; P = 0.000) and belonging to the SerDs group (odds ratio: 2.356; P = 0.002). DISCUSSION: The performance of DAAs in PWUD is excellent, if 2 conditions are met: (i) that the latest generation drugs are used and (ii) that the patients are managed within the SerDs.


Assuntos
Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Adesão à Medicação , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Feminino , Hepatite C Crônica/epidemiologia , Humanos , Análise de Intenção de Tratamento , Itália , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Resposta Viral Sustentada
18.
Addict Behav ; 121: 106985, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34087768

RESUMO

Many psychosocial factors have been implicated in the onset and escalation of substance use in adolescence and young adulthood. Typically, each factor explains a small amount of the variance in substance use outcomes, and effects are typically applied across a broad range of ages or computed from cross-sectional data. The current study evaluated the association of factors including social influence (e.g., peer substance use), cognitive features (e.g., alcohol expectancies), and personality and emotional characteristics (e.g., impulsivity and typical responses to stress) in substance use throughout adolescence and emerging adulthood (ages 13-25; N = 798). Mixed-effects models tailored for the accelerated longitudinal design employed in this study were constructed with psychosocial and developmental factors predicting alcohol and cannabis use. As most participants in the sample exhibited little or no substance use at baseline by design, we excluded baseline assessments and examined data from follow-up years 1, 2, 3, and 4. Interactions between age cohort, change in age, and psychosocial predictors of substance use revealed differing associations over the developmental window for alcohol and cannabis use. For example, positive alcohol expectancies and sensation seeking were most strongly associated with greater drinking after age 18, whereas sensation seeking was associated with increased cannabis use as early as age 15. Higher emotion regulation skills led to less cannabis use in younger ages (i.e., shallower slopes below age 17), but this protective effect diminished after age 17. Results highlight developmentally important factors that differentially contribute to substance use in adolescence and young adulthood. We also demonstrate the importance of developmentally sensitive analyses that maximize the value of data from accelerated longitudinal designs.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Consumo de Bebidas Alcoólicas , Estudos Transversais , Humanos , Comportamento Impulsivo , Estudos Longitudinais , Fatores de Proteção , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
19.
Rev Esp Salud Publica ; 952021 Jun 23.
Artigo em Espanhol | MEDLINE | ID: mdl-34159950

RESUMO

OBJECTIVE: The use of alcohol and other drugs in youth has adverse health effects, and it is also associated with unsafe sexual practices. For this reason, it is important to include prevention programs in universities regarding alcohol, drugs, and safe sexual practices, and it is essential to evaluate them to prove their effectiveness in the target population. The aim of the study was to evaluate "En Plenas Facultades", a prevention program of substance use and Sexual Risk Behaviours, analysing both the results obtained and the process, in the seven universities of Spain where it is implemented. METHODS: An evaluation of the process and results of "En plenas facultades" program has been carried out through different quasi-experimental designs in four academic years, from the 2016/2017 to the 2019/2020 academic year. Participants from each course and from the 7 universities who joined the program during these four academic years were included (average of 270 participants per academic year). To evaluate the results a pre-post quasi-experimental study was designed, where participants were asked to answer a questionnaire before and after their participation in the program. For the evaluation of the program implementation process, exhaustiveness, coverage, and training's satisfaction were analyzed. For data analysis, absolute and relative frequencies, and means with their confidence intervals were calculated. RESULTS: In seven Spanish universities, "En plenas facultades" trainings increased students' knowledge in the subject of drug abuse and risky sexual behaviors. People went from a score of 5.29 (95%CI: 5.02-5.57), out of 9, to 7.31 (95%CI 7.13-7.48) in the 2019/2020 academic year. Around 80% of participants ended up being health agents. In the 2019/2020 academic year, the score of global training's satisfaction was 4.24 (95%CI: 4.10-4.38) points out of 5. CONCLUSIONS: The preventive program "En plenas facultades" increases participants' knowledge in subjects of drug abuse and risky sexual behaviors. Moreover, a high proportion of participants become health agents when the training finishes.


Assuntos
Assunção de Riscos , Comportamento Sexual/psicologia , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Adulto , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Espanha/epidemiologia , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Universidades , Adulto Jovem
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