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1.
J Acquir Immune Defic Syndr ; 85(4): 475-482, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33136748

RESUMO

BACKGROUND: The spread of severe acute respiratory syndrome coronavirus 2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use, and treatment adherence among people living with HIV (PLWH) in Argentina. SETTING: PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database. METHODS: Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, and loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine. RESULTS: A total of 1336 PLWH aged 18-82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321) = 8.86, P = 0.003 and loneliness ΔF(1,1326) = 5.77, P = 0.016 was buffered by resilience. A 3-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325) = 4.76, P = 0.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown. DISCUSSION: The impact of COVID-stress and lockdown on emotional distress seemed mitigated by resilience coping strategies, and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Infecções por HIV/psicologia , Saúde Mental/tendências , Pneumonia Viral/psicologia , Transtornos de Estresse Traumático Agudo/psicologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Infecções por Coronavirus/complicações , Infecções por Coronavirus/economia , Infecções por Coronavirus/prevenção & controle , Feminino , Infecções por HIV/complicações , Humanos , Violência por Parceiro Íntimo/tendências , Análise dos Mínimos Quadrados , Modelos Logísticos , Solidão , Masculino , Serviços de Saúde Mental/normas , Pessoa de Meia-Idade , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/economia , Pneumonia Viral/prevenção & controle , Resiliência Psicológica , Fatores Sexuais , Isolamento Social/psicologia , Apoio Social , Transtornos de Estresse Traumático Agudo/etiologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento , Adulto Jovem
2.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32868471

RESUMO

BACKGROUND: Legal performance-enhancing substance(s) (PES) (eg, creatine) are widely used among adolescent boys and young men; however, little is known about their temporal associations with substance use behaviors. METHODS: We analyzed prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves I to IV (1994-2008). Logistic regressions were used to first assess adolescent substance use (Wave I) and use of legal PES (Wave III) and second to assess use of legal PES (Wave III) and subsequent substance use-associated risk behaviors (Wave IV), adjusting for potential confounders. RESULTS: Among the sample of 12 133 young adults aged 18 to 26 years, 16.1% of young men and 1.2% of young women reported using legal PES in the past year. Adolescent alcohol use was prospectively associated with legal PES use in young men (odds ratio 1.39; 95% confidence interval [CI] 1.13-1.70). Among young men, legal PES use was prospectively associated with higher odds of problematic alcohol use and drinking-related risk behaviors, including binge drinking (adjusted odds ratio [aOR] 1.35; 95% CI 1.07-1.71), injurious and risky behaviors (aOR 1.78; 95% CI 1.43-2.21), legal problems (aOR 1.52; 95% CI 1.08-2.13), cutting down on activities and socialization (aOR 1.91; 95% CI 1.36-2.78), and emotional or physical health problems (aOR 1.44; 95% CI 1.04-1.99). Among young women, legal PES use was prospectively associated with higher odds of emotional or physical health problems (aOR 3.00; 95% CI 1.20-7.44). CONCLUSIONS: Use of legal PES should be considered a gateway to future problematic alcohol use and drinking-related risk behaviors, particularly among young men.


Assuntos
Substâncias para Melhoria do Desempenho/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Intoxicação Alcoólica/complicações , Aminoácidos/efeitos adversos , Atletas/estatística & dados numéricos , Índice de Massa Corporal , Intervalos de Confiança , Creatina/efeitos adversos , Desidroepiandrosterona/efeitos adversos , Feminino , Humanos , Modelos Logísticos , Masculino , Fumar Maconha/efeitos adversos , Razão de Chances , Estudos Prospectivos , Assunção de Riscos , Fatores Sexuais , Fumar/efeitos adversos , Esteroides/efeitos adversos , Consumo de Álcool por Menores , Adulto Jovem
3.
PLoS One ; 15(7): e0236243, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32722721

RESUMO

BACKGROUND: Cannabis is one of the most widely used substances among vulnerable young people (<26 years of age) experiencing street entrenchment. Although previous research has documented the role cannabis can play in harm reduction, substance use and mental health treatment and pain management, this research has predominantly been quantitative and focused on adult drug-using populations. Little qualitative work has examined how young people who use drugs understand, experience, and engage with cannabis in the context of street entrenchment and drug use trajectories that include the use of other substances such as alcohol, opioids and crystal methamphetamine (meth). METHODS: Semi-structured, in-depth qualitative interviews were conducted between 2017 and 2019 with 56 young people recruited from a cohort of street-involved youth in Vancouver, Canada. We also conducted 13 interviews with 12 youth-focused care providers across the same time period. Interview data were triangulated by drawing on the findings of a program of anthropological research conducted by the senior author since 2008. Interviews were transcribed verbatim and thematic analysis was conducted. RESULTS: The vast majority of study participants engaged in daily, intensive cannabis use at the same time as they cycled on and off other substances that were perceived as much more harmful (primarily alcohol, fentanyl, heroin and meth). While most participants derived significant pleasure from the use of cannabis, no participants in our study described using cannabis for purely recreational purposes. A number of participants explicitly framed cannabis as a form of mental health and substance use treatment that was more effective and "healthier" than the long-term use of psychopharmaceuticals and medication-assisted substance use treatment (e.g., opioid agonist therapies). Cannabis use was also understood to ameliorate some of the harms of, or even facilitate transitions out of, periods of street-based homelessness. While the majority of our participants highlighted the positive effects of regular cannabis consumption, some described how intensive cannabis use could generate significant harms. CONCLUSION: In the context of the recent legalization of non-medical cannabis use in Canada and amid ongoing overdose and housing crises, it is imperative that future policy and programming interventions and provider education and training be responsive to the ways in which vulnerable youth in our setting are actively using cannabis to navigate their everyday lives and healthcare needs.


Assuntos
Usuários de Drogas/psicologia , Adolescente , Analgésicos Opioides/administração & dosagem , Feminino , Redução do Dano , Pessoas em Situação de Rua/psicologia , Humanos , Entrevistas como Assunto , Masculino , Saúde Mental , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adulto Jovem
4.
JMIR Public Health Surveill ; 6(3): e19630, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32589149

RESUMO

BACKGROUND: The international outbreak of coronavirus disease (COVID-19) has led many countries to enforce drastic containment measures. It has been suggested that this abrupt lockdown of populations will foster addiction-related habits such as caloric/salty food intake, screen use, and substance use. OBJECTIVE: Our aim was to assess the global changes and factors of increase in addiction-related habits during the early COVID-19 containment phase in France. METHODS: A web-based survey was provided from day 8 to day 13 of the containment and was completed by 11,391 participants. The questions explored sociodemographic features, psychiatric/addiction history, material conditions of lockdown, general stress, mental well-being, and reported changes in several addiction-related behaviors. Global changes were described and factors of increase were explored using population-weighted and adjusted logistic regression models, providing adjusted odds ratios (aORs) and their 95% confidence intervals. RESULTS: Overall, the respondents reported more increases in addiction-related habits than decreases, specifically 28.4% (caloric/salty food intake), 64.6% (screen use), 35.6% (tobacco use), 24.8% (alcohol use), and 31.2% (cannabis use). Reduced well-being scores and increased stress scores were general factors of increase in addiction-related habits (P<.001 for all habits). Factors of increase in caloric/salty food intake (n=10,771) were female gender (aOR 1.62, 95% CI 1.48-1.77), age less than 29 years (P<.001), having a partner (aOR 1.19, 95% CI 1.06-1.35), being locked down in a more confined space (per 1 square meter/person decrease: aOR 1.02, 95% CI 1.01-1.03), being locked down alone (aOR 1.29, 95% CI 1.11-1.49), and reporting current (aOR 1.94, 95% CI 1.62-2.31) or past (aOR 1.27, 95% CI 1.09-1.47) psychiatric treatment. Factors of increase in screen use (n=11,267) were female gender (aOR 1.31, 95% CI 1.21-1.43), age less than 29 years (P<.001), having no partner (aOR 1.18, 95% CI 1.06-1.32), being employed (P<.001), intermediate/high education level (P<.001), being locked down with no access to an outdoor space (aOR 1.16, 95% CI 1.05-1.29), being locked down alone (aOR 1.15, 95% CI 1.01-1.32), living in an urban environment (P<.01), and not working (P<.001). Factors of increase in tobacco use (n=2787) were female gender (aOR 1.31, 95% CI 1.11-1.55), having no partner (aOR 1.30, 95% CI 1.06-1.59), intermediate/low education level (P<.01), and still working in the workplace (aOR 1.47, 95% CI 1.17-1.86). Factors of increase in alcohol use (n=7108) were age 30-49 years (P<.05), a high level of education (P<.001), and current psychiatric treatment (aOR 1.44, 95% CI 1.10-1.88). The only significant factor of increase in cannabis use (n=620) was intermediate/low level of education (P<.001). CONCLUSIONS: The early phase of COVID-19 containment in France led to widespread increases in addiction-related habits in the general population. Reduced well-being and increased stress were universal factors of increase. More specific factors were associated with increases in each of the explored habits.


Assuntos
Comportamento Aditivo/epidemiologia , Infecções por Coronavirus , Dieta , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral , Tempo de Tela , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Comportamento Alimentar , Feminino , França/epidemiologia , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Razão de Chances , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Prevalência , Cloreto de Sódio na Dieta/administração & dosagem , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adulto Jovem
5.
Traffic Inj Prev ; 21(5): 330-334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32363941

RESUMO

Objectives: To investigate the occurrence of signs of altered psychomotor capacity (SAPC) associated with the violation of the dry law at the exits of nightclubs in the city of São Paulo, Brazil.Methods: Data from drivers participating in the Balada com Ciência project were used. Alcohol dosages were measured with breathalyzer test. The use of other drugs was obtained by interviewees' self-report. SAPC (speech, walking, glazed eyes, and alcohol odor) were verified by the interviewers at the time of the interview and categorized as "no sign" or "at least one sign". All measurements were evaluated at the exit of the nightclubs. The population description considered the sample weighting. Logistic regression analysis evaluated the association between the occurrence of SAPC, alcohol and other drugs use, controlling for sociodemographic variables.Results: At nightclubs, the SAPC among drivers are about 8 times higher when the breath alcohol concentration is above 0.05 mg/L if compared with those who did not drink alcohol, and about 30 times higher when the alcohol concentration was ≥ 0.34 mg/L in exhaled air. This finding is not generally verified in the literature for those who report the use of drugs inside nightclubs, which is interesting, since 20.4% of the interviewed population reported using drugs in the places surveyed.Conclusion: This study suggests the potential of using the Perham (2007) physical test for alcohol intoxication in sobriety checkpoints at the exit of nightclubs. However, the verification of these signs is not enough for the identification of drug use by drivers.


Assuntos
Intoxicação Alcoólica/epidemiologia , Atividades de Lazer/psicologia , Transtornos Psicomotores/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Idoso , Intoxicação Alcoólica/etiologia , Brasil/epidemiologia , Dirigir sob a Influência/estatística & dados numéricos , Feminino , Humanos , Atividades de Lazer/classificação , Masculino , Pessoa de Meia-Idade , Transtornos Psicomotores/etiologia , Desempenho Psicomotor , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adulto Jovem
6.
Spine Deform ; 8(5): 965-973, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32378042

RESUMO

STUDY DESIGN: Retrospective review. OBJECTIVE: To identify national trends in postoperative opioid prescribing practices after posterior spinal fusion (PSF) in patients with adolescent idiopathic scoliosis (AIS). Opioids are an important component of pain management after PSF for AIS. Given the national opioid crisis, it is important to understand opioid prescribing practices in these patients. METHODS: Using a commercial prescription drug claims database, we identified AIS patients who underwent PSF from 2010 to 2016 and who were prescribed opioids postoperatively. An initial prescription at hospital discharge of ≥ 90 morphine milligram equivalents daily (MMED) was used to identify patients at risk of overdose according to the US Centers for Disease Control and Prevention (CDC) guidelines. Prescriptions for skeletal muscle relaxants were also identified. α = 0.05. RESULTS: We included 3762 patients (75% female) with a mean (± standard deviation) age of 15 ± 2.1 years. 56% of patients filled only 1 opioid prescription after discharge, and 44% had ≥ 1 refills. 91% of opioid prescriptions were for hydrocodone (median strength, 43 MMED; mean strength, 65 ± 270 MMED) or oxycodone formulations (median strength, 60 MMED; mean strength, 79 ± 174 MMED). 82% of prescriptions complied with CDC guidelines (< 90 MMED). Overall, 612 patients (16%) filled ≥ 1 prescription for skeletal muscle relaxants, the most common being cyclobenzaprine (45%) and methocarbamol (29%). The percentage of patients filling > 1 prescription declined from 54% in 2010 to 31% in 2016 (p < 0.001). The proportion of patients receiving prescriptions for ≥ 90 MMED was highest in the West (29%) and lowest in the South (16%) (p < 0.001). CONCLUSION: Most opioid prescriptions after PSF in patients with AIS comply with CDC guidelines. Temporal and geographic variations show an opportunity for standardizing opioid prescribing practices in these patients. LEVEL OF EVIDENCE: III.


Assuntos
Analgésicos Opioides/administração & dosagem , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Padrões de Prática Médica/estatística & dados numéricos , Padrões de Prática Médica/tendências , Escoliose/cirurgia , Fusão Vertebral/métodos , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Analgésicos Opioides/efeitos adversos , Feminino , Humanos , Prescrição Inadequada/efeitos adversos , Prescrição Inadequada/prevenção & controle , Prescrição Inadequada/estatística & dados numéricos , Masculino , Fármacos Neuromusculares/administração & dosagem , Fármacos Neuromusculares/efeitos adversos , Manejo da Dor , Risco , Transtornos Relacionados ao Uso de Substâncias/etiologia
7.
Med Clin North Am ; 104(3): 561-572, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32312415

RESUMO

Burnout is common in physicians who care for patients with serious illness, with rates greater than 60% in some studies. Risk factors for burnout include working on small teams and/or in small organizations, working longer hours and weekends, being younger than 50 years, burdensome documentation requirements, and regulatory issues. Personal factors that can protect against burnout include mindfulness, exercise, healthy sleep patterns, avoiding substance abuse, and having adequate leisure time. Institutional and work factors that can buffer against burnout include working on adequately staffed teams, having a manageable workload, and minimally burdensome electronic health record documentation.


Assuntos
Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Médicos/psicologia , Adulto , Esgotamento Profissional/economia , Esgotamento Profissional/epidemiologia , Depressão/etiologia , Empatia/fisiologia , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Plena/métodos , Cuidados Paliativos/métodos , Cuidados Paliativos/estatística & dados numéricos , Qualidade de Vida , Fatores de Risco , Autocuidado/métodos , Sono/fisiologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologia , Carga de Trabalho
8.
Medicina (B Aires) ; 80 Suppl 2: 76-79, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150719

RESUMO

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental alteration of biological basis that started in childhood may persist during adolescence-youth and, despite what was believed until not many years ago, also in adulthood up to 50-60% of those affected, producing a significant clinical and psychosocial deterioration. In spite of being a syndrome easily identifiable by the triad: inattention, hyperactivity and impulsivity that characterizes it, in clinical practice there are different circumstances that hinder and complicate its diagnosis and treatment. One of the most significant is the presence, both in childhood and adulthood, of other comorbid mental disorders. It is from adolescence-youth when together with ADHD we can detect the presence of personality, mood and anxiety disorders and especially the use of several substances. The evidences existing until now show how the comorbidity of ADHD and substance use disorder influence the evolutionary course of both, complicating the approach, the treatment and, therefore, aggravating the final prognosis. The difficulties in their approach and the scarcity of treatment options make us underline the importance of preventive treatment in the infantile stage, starting from psychoeducation programs focused on the vulnerability of these patients to substances and the consequences associated with consumption.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto Jovem
9.
PLoS One ; 15(3): e0227044, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32203565

RESUMO

Under paradigms of combined intravenous cocaine and ethanol self-administration, the effects on behavior have been poorly explored. Numerous studies have found sex differences in amino acids profile and behavioral responses to each drug, yet few have focused on the interactions between cocaine and ethanol. The main objective of this work was to explore the acquisition and maintenance of intravenous self-administration behavior with a combination of cocaine and ethanol in male and female young adult rats. Likewise, the amino acids profile in blood plasma was quantified 48 hours after the last self-administration session. Male and female 52 days old Wistar rats were randomly assigned to one of 3 groups: i) saline control, ii) cocaine (1 mg/kg bodyweight/injection) and iii) cocaine and ethanol (1 mg + 133 mg/kg bodyweight/ injection). After 24 self-administration sessions carried out on a fixed-ratio-1 schedule, with a limit of 15 doses per session, 14 plasma amino acids were quantified by mean Capillary Electrophoresis technique. The curve of cocaine and ethanol combined self-administration was similar to that associated with cocaine administration alone, with females acquiring self-administration criterion before males. The self-administration of cocaine and ethanol altered the plasma concentration and relative ratios of the amino acid L-Tyrosine. In our intravenous self-administration model, females appeared more vulnerable to acquire abusive consumption of the cocaine and ethanol combination, which altered plasma L-Tyrosine levels.


Assuntos
Comportamento Animal/efeitos dos fármacos , Cocaína/efeitos adversos , Etanol/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/etiologia , Animais , Cocaína/administração & dosagem , Modelos Animais de Doenças , Etanol/administração & dosagem , Feminino , Humanos , Infusões Intravenosas , Masculino , Ratos , Reforço Psicológico , Autoadministração/efeitos adversos , Autoadministração/psicologia , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/sangue , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tirosina/sangue
11.
J Am Acad Orthop Surg ; 28(20): e917-e922, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32091422

RESUMO

INTRODUCTION: Opioids remain the most prescribed medication after total hip arthroplasty (THA) despite the potential for abuse and adverse effects. Given the high rates of opioid abuse and potential adverse effects, the reporting of controlled substances is now mandatory in many statewide databases. This study aimed to use a mandatory statewide database to analyze opioid prescription patterns in postoperative THA patients and identify independent risk factors for those patients who need a second prescription and/or require prolonged use (>6 months). METHODS: We retrospectively reviewed a consecutive series of 619 primary THAs. Demographic and comorbidity information were collected for all patients. Narcotic prescription data (converted to morphine milligram equivalents) as well as prescription data for sedatives, benzodiazepines, and stimulants were collected from the State's Controlled Substance Monitoring websites 6 months before and 9 months after the index procedure. Bivariate and multivariate analyses were done for second prescription and continued use. RESULTS: Of the 619 patients who underwent THA, 34.9% (216/619) used preoperative opioids, 36.2% (224/619) filled a second opioid prescription, and 10.5% (65/619) had continued use past 6 months. Patients with preoperative opioids were at an approximately 4-fold increased odds of requiring a second script and 12 times odds of continued opioid use. In the multivariate analysis, independent risk factors for requiring a second prescription, in descending order of magnitude, included the use of any sedative or sleep aid prescription and preoperative narcotic use. Independent risk factors for continued narcotic use longer than 6 months after THA included preoperative narcotic use and increased length of stay. DISCUSSION: Several risk factors and their relative weight have been identified for continued narcotic consumption after THA. It is important for surgeons to consider these predisposing factors preoperatively during the informed consent process and for managing postoperative pain expectations.


Assuntos
Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Artroplastia de Quadril , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Manejo da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Padrões de Prática Médica/estatística & dados numéricos , Programas de Monitoramento de Prescrição de Medicamentos , Medicamentos sob Prescrição/administração & dosagem , Medicamentos sob Prescrição/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Artroplastia do Joelho , Feminino , Humanos , Consentimento Livre e Esclarecido , Masculino , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/etiologia , Cuidados Pré-Operatórios , Estudos Retrospectivos , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/etiologia
12.
PLoS One ; 15(1): e0227051, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31967998

RESUMO

BACKGROUND: Cyberbullying is a global public health concern with tremendous negative impacts, not only on the physical and mental health of students but also on their well-being and academic performance. However, there are very few studies on cyberbullying among university students, especially in Myanmar. This study aims to determine the percentage of university students who suffered cyberbullying victimization in the last 12 months, and the association between students' socio-demographic characteristics, adverse events following cyberbullying and cyberbullying victimization. METHODS: A cross-sectional study was conducted among university students aged 18 years and older at one medical university in Magway, Myanmar. A total of 412 students (277 males and 135 females) participated in the study. Data were collected from August to September, 2018 using a self-administered questionnaire. Multiple logistic regression analyses (models I and II) were performed to estimate the unadjusted (UOR) and adjusted odds ratios (AOR), and 95% confidence intervals (CI). RESULTS: In total, 40.8% of males and 51.1% of females in the study had suffered cyberbullying victimization in the past 12 months. In model I, students who had been studying at the university for 3 years or less (AOR = 1.81; 95% CI 1.14-2.85), and who had witnessed psychological, physical or sexual violence, or cyberbullying in their neighborhoods, (AOR = 2.95; 95% CI 1.48-5.91) were more likely to have suffered cyberbullying victimization in the past 12 months. In model II, being a victim of cyberbullying was associated with difficulties in concentrating and understanding lectures (AOR = 3.96; 95% CI 1.72-9.11), and substance abuse (AOR = 2.37; 95% CI 1.02-5.49). Non-resident students were at a higher risk of being cyberbullying victims than their resident peers (AOR = 1.86; 95% CI 1.04-3.34). CONCLUSION: Two out of five students had suffered cyberbullying victimization in the past 12 months, and only half of the victims discussed their experience(s) with someone else. Students who suffered cyberbullying victimization faced academic difficulties and started or increased smoking, betel chewing or alcohol drinking. Counter measures to prevent and mitigate the adverse events related to cyberbullying victimization are urgently needed among university students in Myanmar. Periodic screening for cyberbullying, counseling services, cyber-safety educational programs, and awareness raising campaigns should be implemented.


Assuntos
Vítimas de Crime/psicologia , Cyberbullying , Universidades , Desempenho Acadêmico , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Mianmar , Fatores de Risco , Estresse Psicológico/etiologia , Estudantes , Transtornos Relacionados ao Uso de Substâncias/etiologia , Inquéritos e Questionários , Adulto Jovem
13.
Lancet Diabetes Endocrinol ; 8(3): 239-248, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31958403

RESUMO

As the prevalence of type 1 and type 2 diabetes increases and population-level patterns of alcohol and illicit drug use evolve, clinicians will continue to encounter people with diabetes whose substance use is affecting health outcomes. Substance use contributes substantially to the population-level prevalence of cardiovascular events, cerebrovascular events, cancers, mental health conditions, road trauma, and domestic violence. Alcohol and drug use also have a measurable effect on diabetes incidence and the development of both acute and chronic diabetes-related complications. In this Review, we examine the effect of alcohol and illicit drug use on people with type 1 or type 2 diabetes. We describe evidence for substance use as a risk factor for new-onset diabetes, prevalence of use in people with diabetes, evidence linking substance use with diabetes-related health outcomes, and evidence on the management of these co-occurring conditions.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Complicações do Diabetes/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Drogas Ilícitas/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Idoso , Austrália/epidemiologia , Complicações do Diabetes/etiologia , Complicações do Diabetes/psicologia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Incidência , Masculino , Prognóstico , Fatores de Risco , Fumar/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
14.
Rev. psicol. clín. niños adolesc ; 7(1): 59-64, ene. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194423

RESUMO

Teens tend to identify with social groups that characterize their lifestyles, interest in different musical styles and preference in specific activities. Previous studies conclude that group identification is a significant prospective predictor of drug use and other problematic behaviors but may not operate the same way in all cultures. There are no such studies that have been conducted in Spanish adolescents. This study examines the prevalence of self-identified group name research among Spanish adolescents, and its relationship between substance use and psychosocial constructs. The sample consisted of 791 Spanish adolescents from six secondary schools, aged between 14 to 18 years (M = 15.03; SD = 1.01). The results support the existence of group self-identification by youth. The High risk group reported significantly higher monthly cigarette and alcohol use, and the Others group reported higher monthly marijuana use. Regarding psychosocial correlates, youth with higher drug use report greater sensation seeking preference and higher levels of depression. Group self-identification is a consistent phenomenon among teens in different countries but, contrary to previous work, those youth not falling into a clearly defined group ("Others") were the most likely to use marijuana


Los adolescentes tienden a identificarse con diferentes grupos sociales que caracterizan sus estilos de vida. Estudios previos concluyen que la identificación grupal es un predictor del consumo de drogas y otros comportamientos problemáticos, pero puede no funcionar de la misma manera en todos los países y en España no existen estudios al respecto con adolescentes. Este estudio examina la prevalencia de grupos de referencia entre los adolescentes españoles y su relación con el consumo de sustancias y otras variables psicológicas. La muestra estuvo compuesta por 791 adolescentes de nueve centros de educación secundaria, con edades comprendidas entre los 14 y 19 años (M = 15,03; DT = 1,01). Los resultados apoyan la existencia de grupos de identificación grupal por parte de los jóvenes. El grupo de alto riesgo informó de un consumo mensual significativamente mayor de cigarros y alcohol, y el grupo Otros informó de un consumo mensual más elevado de marihuana, en comparación con los otros grupos. En cuanto a las variables psicológicas, los jóvenes con mayor consumo de drogas informan de una mayor preferencia por la búsqueda de sensaciones y niveles más altos de depresión. La autoidentificación grupal es un fenómeno constante en los adolescentes entre los diferentes países, pero, contrariamente a lo encontrado en estudios previos, los jóvenes que no pertenecen claramente a un grupo definido son los más propensos al consumo de cannabis


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Identificação Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Usuários de Drogas/psicologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Usuários de Drogas , Depressão/complicações , Comportamento do Adolescente/psicologia , Uso de Tabaco/psicologia , Consumo de Álcool por Menores/psicologia , Uso da Maconha/psicologia , Inquéritos e Questionários , Espanha
15.
Am J Addict ; 29(2): 97-104, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31898858

RESUMO

BACKGROUND AND OBJECTIVES: Substance use in community college students has been explored in only a handful of studies. Differences in population characteristics and substance use between 2- and 4-year students suggest that different factors may promote and thwart this behavior. Cumulative risk is a parsimonious methodology that provides better model stability and more statistical power, yet it has only been recently used in substance use research. The aim of this study is to investigate multiple aspects of substance use risk in a population in need of substance use prevention and intervention services. METHODS: We conducted a cross-sectional study of community college students (N = 288; 75% female) examining the relative contributions of different domains of cumulative risk (eg, life stressors, academic stressors, and mental health diagnoses) to develop different profiles of risk across substance use classes (ie, alcohol, cigarette, marijuana, and hard drug use). RESULTS: Cumulative risk analyses indicated that alcohol and tobacco use were associated with the domains of life stressors and peer/family substance use, marijuana use with peer/family substance use and stressful childhood experiences, and hard drug use with peer/family substance use, lack of social support, low access to care, and stressful childhood experiences. DISCUSSION AND CONCLUSIONS: Different strategies for prevention and intervention may be necessary to effectively address different forms of substance use in this population. SCIENTIFIC SIGNIFICANCE: The risk domain profiles related to specific drugs may lead to targeted interventions to reduce substance use in community college students. (Am J Addict 2020;29:97-104).


Assuntos
Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Autorrelato , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tennessee/epidemiologia , Universidades , Adulto Jovem
16.
Dev Med Child Neurol ; 62(2): 163-168, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31381150

RESUMO

AIM: To estimate the prevalence of mental illness in parents of children with cerebral palsy (CP). METHOD: This is a systematic review that follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols in the search for observational studies determining the prevalence of depression, anxiety, and substance abuse in parents of individuals with CP. The information sources used for this study were: PubMed, SciELO, Cochrane Library, Clinical Trials, and Biblioteca Virtual de Saúde. RESULTS: Fourteen articles were selected and included, investigating 1264 mothers and 105 fathers of children with CP. Data extracted for analysis were divided into three categories: study data, data about participants with CP, and data about parents. All studies included volunteer parents, of whom 95 per cent were female. INTERPRETATION: CP is related to a higher prevalence of symptoms of depression and anxiety in parents. Factors such as a child's degree of functionality and socioeconomic level may influence the frequency of mental disorders in parents. However, these studies have heterogeneous samples and applied different criteria to characterize their populations. WHAT THIS PAPER ADDS: Depression and anxiety are more prevalent for parents of children with cerebral palsy (CP) than parents of typically developing children. The child's illness severity is a risk factor for mental illness in parents of children with CP. The more time spent on child care, the higher the risk of mental illness among mothers of children with CP. There is a lack of reliable data in the literature on substance abuse in parents of children with CP.


Assuntos
Ansiedade/epidemiologia , Paralisia Cerebral , Depressão/epidemiologia , Pai/psicologia , Mães/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ansiedade/etiologia , Paralisia Cerebral/psicologia , Paralisia Cerebral/terapia , Criança , Depressão/etiologia , Feminino , Humanos , Masculino , Prevalência , Transtornos Relacionados ao Uso de Substâncias/etiologia
17.
Support Care Cancer ; 28(1): 5-8, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31650294

RESUMO

BACKGROUND: Gabapentinoid use for long-term cancer pain control may be problematic, given unclear mechanisms of action and increased concerns for physical dependence. The purpose of this report is to examine trends of gabapentinoid use among US adults with cancer from 2005 to 2015. METHODS: We conducted a serial, cross-sectional study using data from the Medical Expenditure Panel Survey (MEPS). We performed multiple logistic regression to examine the annual percentages of gabapentinoid users, which were adjusted for age, sex, and US region of residence. The amount of gabapentinoid prescriptions filled in 2015 was also estimated. RESULTS: The adjusted percentage of gabapentinoid users in 2015 was 5.60% (3.79%, 7.41%), 2.39 times greater than the percentage in 2005 (p < .001). By 2015, the number of gabapentinoid prescriptions had grown to approximately 3.52 million (2.40 million, 4.65 million). CONCLUSION: We observed greater than a twofold increase in the trend of gabapentinoid medication use among US adults with cancer. Investigations on the long-term efficacy of gabapentinoids for complex pain syndromes, and mitigation of risks, is essential to guide informed clinical management and keep patients safe.


Assuntos
Analgésicos/uso terapêutico , Dor do Câncer/tratamento farmacológico , Gabapentina/uso terapêutico , Neoplasias/tratamento farmacológico , Manejo da Dor/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor do Câncer/epidemiologia , Dor Crônica/tratamento farmacológico , Dor Crônica/epidemiologia , Estudos Transversais , Feminino , Gabapentina/análogos & derivados , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Cuidados Paliativos/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
18.
Rev. eletrônica enferm ; 22: 1-8, 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1119167

RESUMO

Este estudo objetiva analisar a estrutura das representações sociais de pessoas em situação de rua sobre drogas. Pesquisa qualitativa, com 158 pessoas em situação de rua, que responderam ao Teste de Associação Livre de Palavras, com o estímulo "drogas" de novembro/2017 a janeiro/2018. Os dados foram processados por dois softwares que permitiram análise fundamentada na Teoria das Representações Sociais. Nas representações gráficas geradas pelos softwares, os termos "destruição", "coisa ruim", "tristeza" sinalizam uma conotação negativa sobre as drogas em contraponto ao termo "curtição" que revela o uso como ação que promove prazer, sobrevivência, relacionada ao contexto da rua. Para o grupo investigado, as drogas representam elemento de sobrevivência, que podem potencializar outras vulnerabilidades. Destaca-se a importância da Estratégia de Redução de Danos no cuidado às pessoas em situação de rua, pela possibilidade desta considerar o sujeito, suas representações e especificidades.


This study aimed to analyze the structure of social representations of the homeless regarding drugs. It is a qualitative study, with 158 homeless people, who responded to a Word Association Test, with the stimulus "drugs", from November/2017 to January/2018. The data were processed using two types of software that enabled analysis based on the Social Representations Theory. In the graphic representations generated by the software, the terms "destruction", "bad thing", and "sadness" indicate a negative connotation in relation to drugs, in contrast to the term "fun", which revealed usage as an action to promote pleasure, or survival, related to the context of homelessness. For the investigated group, drugs represent an element of survival, which may enhance other vulnerabilities. The importance of a Damage Reduction Strategy in the care of the homeless stands out, as it considers the subject, their representations and specificities.


Assuntos
Humanos , Pessoas em Situação de Rua , Vulnerabilidade Social , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Usuários de Drogas
20.
PLoS One ; 14(12): e0225384, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31825955

RESUMO

One of the major goals of drug use prevention programs is to delay the age of onset of substance use. What is called early initiation, usually occurring in adolescents under the age of 15, is a salient predictor of Substance Use Disorders later in adulthood. The causes of early initiation are complex and multifaceted and this has led to the identification of a rich set of risk and protective factors that influence age of onset. Nonetheless, there is little knowledge about the interdependence of these factors in their impact on early initiation. This paper addresses this question by applying Multiple Correspondence Analysis to data on family, community and social risk and protective factors from over 1200 adolescents. We find that community and to a lesser extent social factors are the most clearly associated to early initiation and we compare our results to those obtained from linear regression analyses of the same data that do not incorporate interdependence and find opposite results. We discuss the differences between linear regressions and MCA to evaluate the interplay of risk and protective factors and the implications of our findings for health policy and the design of prevention interventions aimed at delaying age of onset.


Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas , Fumar Cigarros , Uso da Maconha , Meio Social , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Idade de Início , Criança , Feminino , Humanos , Masculino , Fatores de Proteção , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/etiologia , Inquéritos e Questionários , Adulto Jovem
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