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1.
East Mediterr Health J ; 26(2): 212-218, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32141600

RESUMO

Background: Parenting approach and early childhood experiences are thought to be two important factors in the initiation of substance use. Aims: We aimed to explore the nurse's role in the prevention of childhood addiction. Methods: In this qualitative study we conducted in-depth interviews with young men and women who were either in treatment for their addiction or were active drug users as well as with family members and nurses. The data analysis followed Strauss and Corbin's constant comparison method. Results: The data analysis revealed six categories: traumatic events during childhood, inappropriate parenting approach, Lack of knowledge and a tolerant attitude toward drug use, turning a blind eye on the threat of drug use, nurses' poor experience of drug use prevention, and the lack of a clear definition of the nurse's role in prevention of drug use. Conclusions: Nurses who work with young people and their families have a special opportunity for prevention, early detection and timely intervention for drug dependency.


Assuntos
Usuários de Drogas/psicologia , Papel do Profissional de Enfermagem , Transtornos Relacionados ao Uso de Substâncias/enfermagem , Adolescente , Adulto , Comportamento Aditivo/enfermagem , Comportamento Aditivo/prevenção & controle , Comportamento Aditivo/psicologia , Criança , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pesquisa Qualitativa , Estresse Psicológico/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/psicologia
3.
Postgrad Med ; 132(1): 17-27, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31591925

RESUMO

Health-care professionals are faced with a daunting task: balancing appropriate care for chronic pain with their responsibility to keep patients and others safe from treatment-related harm. Whereas opioids have historically been considered an effective tool in the analgesic armamentarium, the rise of opioid abuse has caused the pendulum to swing away from prescribing opioids to an emphasis on safety. This paradigm shift risks neglecting the very real consequences of untreated/undertreated pain. Using data from the medical literature, this review examines influences on the real and perceived benefit-to-risk ratio for opioids and provides clinicians with a practical approach to prescribing opioids that minimizes the risk for abuse/misuse. There is appreciable clinical trial and observational evidence of efficacy/effectiveness with opioids used for pain management over the short or long term when considered in the context of pharmacologic alternatives. Enhancing the relative safety and minimizing the risk for abuse/misuse may be achieved through proactive prescription practices that include careful patient selection, risk assessment, individualized and multimodal treatment plans with established goals, initiating opioid treatment cautiously with an exit plan in place, ongoing assessments of response to therapy, and routine patient monitoring. Additionally, prescribing opioids with a lower potential for abuse or misuse (e.g. abuse-deterrent formulations) may provide a benefit. Using a pragmatic approach to prescribing practices, we postulate that the balance between benefit and risk can be favorable for opioid therapy in select patients, even for long-term treatment of chronic pain.


Assuntos
Analgésicos Opioides/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Analgésicos Opioides/efeitos adversos , Dor Crônica/tratamento farmacológico , Humanos , Manejo da Dor , Uso Indevido de Medicamentos sob Prescrição/prevenção & controle , Medição de Risco
6.
Arch. argent. pediatr ; 117(6): S205-S242, dic. 2019. tab, graf
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1051592

RESUMO

La enfermedad cardiovascular secundaria a aterosclerosis es la principal causa de morbimortalidad en la población adulta a nivel mundial. Aunque las manifestaciones clínicas de aterosclerosis (enfermedad coronaria, accidente cerebrovascular y arteriopatía periférica) son excepcionales en la población pediátrica, la presencia de factores de riesgo para enfermedad cardiovascular, así como la adquisición de hábitos que favorecen su desarrollo, se observan ya desde edades tempranas. En el presente documento, se elaboraron recomendaciones, con dos objetivos principales: prevenir la aparición de factores de riesgo para enfermedad cardiovascular (prevención primordial) y detectar y tratar los que favorecen el desarrollo de aterosclerosis clínica (prevención primaria). Si bien las recomendaciones están dirigidas a la población pediátrica, el objetivo del trabajo conjunto de la Sociedad Argentina de Pediatría y la Sociedad Argentina de Cardiología es asegurar un abordaje integral y consensuado de la prevencion cardiovascular a lo largo de toda la vida, incluso, desde antes de la concepción.


Cardiovascular disease secondary to atherosclerosis is the leading cause of morbimortality in the adult population worldwide. Although clinical manifestations of atherosclerosis (coronary heart disease, stroke and peripheral vascular disease) are extremely rare in the pediatric population, the presence of risk factors for cardiovascular disease and the development of health-behavior patterns that promote them are observed since early childhood.In this document, recommendations were developed addressing two main goals: prevention of the risk factors development for cardiovascular disease (primordial prevention) and early detection and treatment of the risk factors to prevent clinical atherosclerosis (primary prevention). Even though the recommendations are addressed to the pediatric population, the aim of the collaborative work between the Sociedad Argentina de Pediatría and the Sociedad Argentina de Cardiología is to ensure a comprehensive and consensual approach of lifetime cardiovascular prevention beginning even before conception.


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Prevenção Primária/métodos , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Exercício , Tabagismo/prevenção & controle , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Álcool/prevenção & controle , Síndrome Metabólica , Diabetes Mellitus Tipo 2 , Dislipidemias/diagnóstico , Dislipidemias/tratamento farmacológico , Sobrepeso/prevenção & controle , Comportamento Sedentário , Alimentos, Dieta e Nutrição , Hipertensão/diagnóstico , Hipertensão/prevenção & controle , Hipertensão/terapia , Anamnese , Obesidade/prevenção & controle
7.
Global Health ; 15(1): 80, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31847875

RESUMO

BACKGROUND: The increase in problematic substance use is a major problem in Canada and elsewhere, placing a heavy burden on health and justice system resources given a spike in drug-related offences. Thus, achievement of Sustainable Development Goal (SDG) Target 3.5 to 'Strengthen the prevention and treatment of substance abuse' is important for Canada's overall realization of the SDGs, including SDG 3 (Good Health and Wellbeing). Since 2008, Vancouver's Downtown Community Court (DCC) has pioneered an innovative partnership among the justice, health and social service systems to address individuals' needs and circumstances leading to criminal behaviour. While researchers have examined the DCC's impact on reducing recidivism, with Canada's SDG health commitments in mind, we set out to examine the ways health and the social determinants of health (SDH) are engaged and framed externally with regard to DCC functioning, as well as internally by DCC actors. We employed a multi-pronged approach analyzing (1) publicly available DCC documents, (2) print media coverage, and (3) health-related discourse and references in DCC hearings. RESULTS: The documentary analysis showed that health and the SDH are framed by the DCC as instrumental for reducing drug-related offences and improving public safety. The observation data indicate that judges use health and SDH in providing context, understanding triggers for offences and offering rationale for sentencing and management plans that connect individuals to healthcare, social and cultural services. CONCLUSIONS: Our study contributes new insights on the effectiveness of the DCC as a means to integrate justice, health and social services for improved health and community safety. The development of such community court interventions, and their impact on health and the SDH, should be reported on by Canada and other countries as a key contribution to SDG 3 achievement, as well as the fulfillment of other targets under the SDG framework that contain the SDH. Consideration should be given by Canada as to how to capture and integrate the important data generated by the DCC and other problem-solving courts into SDG reporting metrics. Certainly, the DCC advances the SDGs' underlying Leave No One Behind principle in a high-income country context.


Assuntos
Crime/legislação & jurisprudência , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Desenvolvimento Sustentável , Canadá , Humanos
8.
S Afr Med J ; 109(12): 971-977, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31865961

RESUMO

BACKGROUND: Alcohol, tobacco and unregulated substance use contributes to the global burden of disease. Admission to hospital provides an opportunity to screen patients for substance use and offer interventions. OBJECTIVES: To determine the prevalence and nature of substance use and treatment as well as interest in harm reduction among inpatients from four hospitals in the City of Tshwane, South Africa. METHODS: In a cross-sectional study, sociodemographic and substance use data were collected from 401 patients using the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test. Demographic characteristics were analysed using descriptive statistics. Bivariate and multivariate analyses of moderate- to high-risk tobacco and unregulated substance use in relation to demographic characteristics were also done. RESULTS: Most patients were South African (88%) and black African (79%), over half were female (57%), and they were relatively young (median age 38 years). Most (82%) lived in formal housing. Over half (56%) had completed high school, and 33% were formally employed. Bivariate analysis found substance use-related admission to be higher where scores for tobacco and unregulated substance use were moderate to high (13% v. 0.3%, p<0.05). A notably higher (p<0.1) proportion of participants with no/low tobacco and unregulated substance use had completed high school, were employed and were cohabiting/married compared with those with moderate to high scores. Across the hospitals, 32% (129/401) of the participants had moderate- to high-risk use of at least one substance: tobacco (28%, 111/401), alcohol (10%, 40/401), cannabis (7%, 28/401), opioids (2%, 9/401) and sedatives (2%, 9/401). Of these 129 participants, 10% had accessed professional help, many (67%, 78/129) wanted to learn more about harm reduction, and most (84%, 108/129) said that they were willing to participate in a community-based harm reduction programme. Multivariate analysis found moderate- to high-risk tobacco and unregulated substance use to be positively associated with male sex (adjusted odds ratio (aOR) 7.9, 95% confidence interval (CI) 2.9 - 21.5), age <38 years (aOR 3.3, 95% CI 1.2 - 8.9), moderate- to high-risk alcohol use (aOR 3.1, 95% CI 1.1 - 8.4; p=0.027) and being admitted to Tshwane District Hospital (aOR 3.6, 95% CI 1.1 - 12.2). It was negatively associated with employment (aOR 0.2, 95% CI 0.1 - 0.6). CONCLUSIONS: Moderate- to high-risk substance use is an undetected, unattended comorbidity in the hospital setting in Tshwane, particularly among young, single, unemployed men. Clinicians should identify and respond to this need. Further research is required on the implementation of in-hospital substance use screening and treatment interventions.


Assuntos
Redução do Dano , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adulto , Alcoolismo/epidemiologia , Alcoolismo/prevenção & controle , Estudos Transversais , Escolaridade , Emprego , Feminino , Hospitais Públicos , Humanos , Masculino , Abuso de Maconha/epidemiologia , Abuso de Maconha/prevenção & controle , Estado Civil , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Admissão do Paciente , Prevalência , Fatores Sexuais , África do Sul/epidemiologia , Tabagismo/epidemiologia , Tabagismo/prevenção & controle
9.
AAPS PharmSciTech ; 21(1): 2, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31713019

RESUMO

The abuse of prescription opioid drugs is a well-documented and very serious problem. One of the typical first steps an abuser will take is to manipulate a tablet into to a fine powder. To deter this behavior, formulators use crush-resistant technologies like polyethylene oxide (PEO). When heat-treated, PEO creates a hard, flexible tablet that cannot be easily ground down into a fine powder. We investigated the effects of PEO molecular weight (MW), annealing temperature, and annealing time on tablet compression deformation behavior and fracture resistance. These tests were designed to represent an abuser's attempt to smash and grind a tablet, respectively. Annealing temperatures above the melting point of PEO showed the most improvement in mechanical properties compared with that in unannealed tablets. The minimum annealing time was dependent on the polymer MW and annealing temperature. Tablets were manipulated using a coffee grinder, and the particle size of the resulting powders was measured. The particle size correlated well with fracture toughness, demonstrating that increasing fracture toughness increases the manipulation resistance of a PEO tablet.


Assuntos
Polietilenoglicóis/química , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Comprimidos , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/química , Composição de Medicamentos , Excipientes , Testes de Dureza , Temperatura Alta , Peso Molecular , Tamanho da Partícula , Solubilidade , Temperatura Ambiente
10.
J Opioid Manag ; 15(4): 295-306, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637682

RESUMO

OBJECTIVE: To understand the needs of Emergency Medical Service (EMS) providers caring for substance users in an urban setting. DESIGN: Qualitative interviews with EMS providers regarding perceptions of substance users and treatment programs. SETTING: Baltimore City. PARTICIPANTS: Twenty-two Baltimore City Fire Department EMS providers. INTERVENTIONS: Semistructured in-depth interviews were conducted with 22 EMS providers. Topics included experiences caring for substance-using patients and attitudes about local harm reduction approaches. MAIN OUTCOME MEASURE: Providers were asked their views on receiving training to deliver a brief motivational intervention to encourage patients to enter drug treatment. Interviews were transcribed and analyzed using constant comparison. RESULTS: Participants were mostly Male (68.2 percent), White (66.6 percent), and had Advanced Life Skills training (90.9 percent). Mean experience was 8.7 years. Many providers described EMS misusers as mostly male and middle-aged, although there were variations in substance use patterns among all races and income levels. Most stated that repeated care provision to a small number of substance-users negatively impacted care quality. Provider demands included departmental policies and resource limitations. Many expressed willingness to deliver motivational messages to substance-using patients to consider drug treatment. Other stated that behavioral interventions were beyond their job duties and most reported having little-to-no knowledge of local treatment programs. CONCLUSIONS: EMS providers may be uniquely positioned to deliver substance use treatment messages to substance users. This could be a life- and cost-saving improvement to EMS in Baltimore City with incentivized training. More research is needed to inform opioid use preparedness in urban settings, which remain at the center of the opioid epidemic.


Assuntos
Analgésicos Opioides , Serviços Médicos de Emergência , Auxiliares de Emergência/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias , Adulto , Baltimore , Serviços Médicos de Emergência/estatística & dados numéricos , Epidemias , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
11.
AANA J ; 87(1): 1-4, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31587748

RESUMO

Diversion in the workplace can adversely impact the safety of healthcare professionals and patients. The Anesthesia Patient Safety Foundation (APSF) believes that substance use disorder, diversion in the workplace, and their potential adverse effects on patient safety need to be addressed through open discussion, education, research, policy, and possible other interventions. To make progress in this area, the APSF convened a conference entitled "Drug Diversion in the Anesthesia Profession: How Can APSF Help Everyone Be Safe?" in Phoenix, Arizona, on September 7, 2017 (Supplemental Digital Content, Document, http://links.lww.com/AA/C616). It was comoderated by the authors.


Assuntos
Anestesiologia , Enfermeiras Anestesistas , Segurança do Paciente , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Fundações , Humanos
12.
Medicina (Kaunas) ; 55(10)2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31575011

RESUMO

Background and Objectives: The aims of this study are to: describe the sociodemographic characteristics and typology of drug addiction among people who use drugs that attend the Servizio per le Dipendenze (SerD), and evaluate the competence and ability of these rehabilitation services to improve their health status and wellness. Materials and Methods: A cross-sectional study was conducted from January to July 2017. Patients attending two selected SerD facilities in the city of Naples, Italy were interviewed with a questionnaire gathering information on sociodemographic data, characteristics of drug addiction, characteristics of enrolment at the SerD, self-reported health status and wellness, and reports of the discrimination suffered. Results: Among the 451 people interviewed, 72.3% had started taking drugs by the age of 20, and half of them have used drugs within the last year. 54.5% of responders attended SerD for more than 10 years, and the two main reasons for attendance were to get help and to get methadone. 79.4% were declared to have a good/very good/excellent health status at the time of interviewing. 53.7% reported suffering from discrimination. Conclusions: Based on our study, discrimination is higher in participants who attended SerD for more than one year, who were formerly in prison, or who were current drug users.


Assuntos
Disparidades em Assistência à Saúde , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Estudos Transversais , Demografia , Feminino , Nível de Saúde , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
14.
Metas enferm ; 22(8): 14-20, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184994

RESUMO

Objetivo: analizar el consumo de distintas sustancias adictivas en jóvenes universitarios de la Comunidad Valenciana en función de distintas características sociodemográficas y académicas. Método: estudio descriptivo transversal realizado en 2016 en ocho universidades valencianas (n= 26.529). El grupo de investigación NECOPSED de la Universidad CEU Cardenal Herrera diseñó un cuestionario ad hoc a través de un grupo focal en el que se incluyeron variables sociodemográficas (sexo, edad), académicas (titulación, curso) y de frecuencia de consumo de sustancias (de 1 nunca a 7 consumo diario), entre otras, que se administró en aulas seleccionadas por conveniencia. Se realizaron análisis uni y bivariantes. Resultados: en la muestra (n= 520) hubo un 61,2% de mujeres y la media de edad fue de 20,73 años. Las drogas más consumidas fueron alcohol (= 4,91), tabaco (= 3,17) y el cannabis (= 2,06). Se encontró un mayor consumo de todas las sustancias en los hombres, así como un aumento del mismo paralelo a la edad, con superioridad estadísticamente significativa en varias de ellas (p≤ 0,05). No hubo diferencias entre estudiantes de titulaciones relacionadas con la salud y el resto (p> 0,05). Conclusión: las sustancias más consumidas son el alcohol, el tabaco y el cannabis. El consumo de sustancias se asoció con el sexo y la edad, pero no con la titulación académica


Objective: to analyze the use of different addictive substances in young university students from the Valencian Community, according to different sociodemographical and academic characteristics. Method: a descriptive cross-sectional study conducted in 2016 in eight Valencian universities (n= 26.529). The NECOPSED Research Team from the Universidad CEU Cardenal Herrera designed an ad hoc questionnaire through a focus group, including the following variables: sociodemographical (gender, age), academic (career, year), and frequency of substance use (from 1= never to 7= daily use), among others, which was administered in classrooms selected by convenience. Univariate and bivariate analyses were conducted. Results: the sample (n= 520) included 61.2% of women, and the mean age was 20.73 years. The most common drugs used were alcohol (= 4.91), tobacco (= 3.17) and cannabis (= 2.06). A higher use of all substances was found in men, as well as an increase parallel to age, with statistically significant superiority in some of them (p≤ 0.05). There were no differences between students from careers associated with health and the rest (p> 0.05). Conclusion: the substances more used were alcohol, tobacco and cannabis. Substance use was associated with gender and age, but not with academic grade


Assuntos
Humanos , Masculino , Feminino , Adulto , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Abuso de Maconha/prevenção & controle , Tabagismo/prevenção & controle , Alcoolismo/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estudos Transversais , Inquéritos e Questionários
15.
Rev Med Suisse ; 15(663): 1661-1665, 2019 Sep 18.
Artigo em Francês | MEDLINE | ID: mdl-31532117

RESUMO

Substance use in adolescence can have a negative impact in the short and long terms. Fighting the deleterious effects of substance abuse is a public health issue. All adults who supervise adolescents, both specialized and not specialized professionals, can be involved in preventive actions. Young people at risk must be identified early enough and referred to appropriate care. It is therefore crucial that first-line professionals should be able to detect nascent problems and to understand signs of appeal. Professionals must be willing to raise drug consumption topics in their interviews and, thereafter, seek advice and guidance from specialized organizations. One such organization is DEPART which offers an intervention model for adolescents and their families as well as for professionals by offering them support and training.


Assuntos
Saúde Pública , Transtornos Relacionados ao Uso de Substâncias , Humanos , Modelos Teóricos , Saúde Pública/métodos , Saúde Pública/tendências , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/terapia
17.
BMC Public Health ; 19(1): 1276, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533671

RESUMO

BACKGROUND: Effective leadership is vital in the struggle to decrease the behavioral health disparities between the US population and American Indian Alaska Native (AIAN) communities. AIAN communities have a pre-colonization history of highly effective leadership, yet some AIAN leadership traditions have been eradicated through decades of trauma and genocidal efforts. There is a paucity of research on AIAN public health leadership, and most existing research relies on samples of individuals holding leadership positions rather than individuals purposely selected because of their effectiveness. The aim of the study was to investigate the experiences of successful AIAN behavioral health leaders and present an emerging AIAN public health leadership model. METHODS: Thirty-eight public health leaders in the Substance Abuse and Mental Health Service Administration (SAMHSA) funded Circles of Care project were observed over the course of their three-year leadership role. Stringent criteria for successful community participatory leadership resulted in the selection of 11 of the 38 leaders for inclusion in the study. Ultimately eight leaders (21% of the population of observed leaders) participated in the study. Semi-structured, one-on-one qualitative interviews were conducted. The methods were informed by phenomenology and the data were analyzed using a thematic content analysis approach. RESULTS: The analysis resulted in ten themes: Hopeful Vision for the People, Cultural Humility, Awareness of Historical Context, Purpose Driven Work Behavior, Cultural and Bi-Cultural Knowledge, Trusting a Broader Process, Caring Orientation, Holistic Supervision, Community Centered, and Influence Through Education. Respondents were strongly motivated by a desire to help future generations. They described their success in terms of the application of traditional AIAN values such as cultural humility and community orientation, but also relied heavily on task orientation. An emerging AIAN leadership model is presented. CONCLUSIONS: It is important to encourage AIAN public health leaders to employ leadership research and models conducted or developed in the context of AIAN communities. The emerging model presented in this study could serve as an initial basis for AIAN leadership training. Given the challenging context of AIAN leadership, the lessons taught by these successful leaders could be adapted for use by leaders in non AIAN settings.


Assuntos
Nativos do Alasca/estatística & dados numéricos , Características Culturais , Índios Norte-Americanos/estatística & dados numéricos , Liderança , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adulto , Nativos do Alasca/psicologia , Participação da Comunidade/estatística & dados numéricos , Feminino , Humanos , Índios Norte-Americanos/psicologia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-31527470

RESUMO

BACKGROUND: This study aims to identify the association between parenting styles and behavioral changes among adolescents regarding the consumption of alcohol, tobacco, cannabis, cocaine/crack. METHODS: A group of ninety-nine adolescents (39 girls and 60 boys), aged 14 to 19 years (17.05 ± 1.51), who called in to a call center that provides counseling to substance users, was followed-up for 30 days. Data collection occurred between March 2009 and October 2015. The adolescents answered questions regarding parental responsiveness and demanding nature on a scale to assess parental styles and provided sociodemographic data, substance abuse consumption characteristics, and the Contemplation Ladder scale score. RESULTS: The parental styles most reported by the adolescents were authoritative (30%) and indulgent (28%). Children who perceived their mothers as having an indulgent style and who had absent fathers presented more difficulties in making behavioral changes to avoid alcohol and cocaine/crack consumption. CONCLUSION: The study found that parent-child relationships were associated with a lack of change in the adolescent regarding substance use behavior, particularly the consumption of alcohol and cocaine/crack.


Assuntos
Relações Pais-Filho , Poder Familiar , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Comportamento do Adolescente , Adulto , Consumo de Bebidas Alcoólicas , Brasil/epidemiologia , Cocaína Crack , Pai , Feminino , Humanos , Masculino , Mães , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
19.
Nat Commun ; 10(1): 3934, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477694

RESUMO

Drug addiction is a chronic relapsing disorder of compulsive drug use. Studies of the neurobehavioral factors that promote drug relapse have yet to produce an effective treatment. Here we take a different approach and examine the factors that suppress-rather than promote-relapse. Adapting Pavlovian procedures to suppress operant drug response, we determined the anti-relapse action of environmental cues that signal drug omission (unavailability) in rats. Under laboratory conditions linked to compulsive drug use and heightened relapse risk, drug omission cues suppressed three major modes of relapse-promotion (drug-predictive cues, stress, and drug exposure) for cocaine and alcohol. This relapse-suppression is, in part, driven by omission cue-reactive neurons, which constitute small subsets of glutamatergic and GABAergic cells, in the infralimbic cortex. Future studies of such neural activity-based cellular units (neuronal ensembles/memory engram cells) for relapse-suppression can be used to identify alternate targets for addiction medicine through functional characterization of anti-relapse mechanisms.


Assuntos
Cocaína/farmacologia , Condicionamento Operante/efeitos dos fármacos , Sinais (Psicologia) , Neurônios/fisiologia , Córtex Pré-Frontal/efeitos dos fármacos , Alcoolismo/fisiopatologia , Alcoolismo/prevenção & controle , Animais , Cocaína/administração & dosagem , Comportamento Compulsivo/fisiopatologia , Comportamento Compulsivo/prevenção & controle , Condicionamento Operante/fisiologia , Inibidores da Captação de Dopamina/farmacologia , Masculino , Córtex Pré-Frontal/fisiopatologia , Ratos Long-Evans , Ratos Sprague-Dawley , Ratos Transgênicos , Recidiva , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
20.
PLoS Med ; 16(9): e1002890, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31479454

RESUMO

BACKGROUND: There has been a growing interest in understanding the effects of social networks on health-related behaviour, with a particular backdrop being the emerging prominence of complexity or systems science in public health. Social network interventions specifically use or alter the characteristics of social networks to generate, accelerate, or maintain health behaviours. We conducted a systematic review and meta-analysis to investigate health behaviour outcomes of social network interventions. METHODS AND FINDINGS: We searched eight databases and two trial registries from 1990 to May 28, 2019, for English-language reports of randomised controlled trials (RCTs) and before-and-after studies investigating social network interventions for health behaviours and outcomes. Trials that did not specifically use social networks or that did not include a comparator group were excluded. We screened studies and extracted data from published reports independently. The primary outcome of health behaviours or outcomes at ≤6 months was assessed by random-effects meta-analysis. Secondary outcomes included those measures at >6-12 months and >12 months. This study is registered with the International Prospective Register of Systematic Reviews, PROSPERO: CRD42015023541. We identified 26,503 reports; after exclusion, 37 studies, conducted between 1996 and 2018 from 11 countries, were eligible for analysis, with a total of 53,891 participants (mean age 32.4 years [SD 12.7]; 45.5% females). A range of study designs were included: 27 used RCT/cluster RCT designs, and 10 used other study designs. Eligible studies addressed a variety of health outcomes, in particular sexual health and substance use. Social network interventions showed a significant intervention effect compared with comparator groups for sexual health outcomes. The pooled odds ratio (OR) was 1.46 (95% confidence interval [CI] 1.01-2.11; I2 = 76%) for sexual health outcomes at ≤6 months and OR 1.51 (95% CI 1.27-1.81; I2 = 40%) for sexual health outcomes at >6-12 months. Intervention effects for drug risk outcomes at each time point were not significant. There were also significant intervention effects for some other health outcomes including alcohol misuse, well-being, change in haemoglobin A1c (HbA1c), and smoking cessation. Because of clinical and measurement heterogeneity, it was not appropriate to pool data on these other behaviours in a meta-analysis. For sexual health outcomes, prespecified subgroup analyses were significant for intervention approach (p < 0.001), mean age of participants (p = 0.002), and intervention length (p = 0.05). Overall, 22 of the 37 studies demonstrated a high risk of bias, as measured by the Cochrane Risk of Bias tool. The main study limitations identified were the inclusion of studies of variable quality; difficulty in isolating the effects of specific social network intervention components on health outcomes, as interventions included other active components; and reliance on self-reported outcomes, which have inherent recall and desirability biases. CONCLUSIONS: Our findings suggest that social network interventions can be effective in the short term (<6 months) and longer term (>6 months) for sexual health outcomes. Intervention effects for drug risk outcomes at each time point were not significant. There were also significant intervention effects for some other health outcomes including alcohol misuse, well-being, change in HbA1c, and smoking cessation.


Assuntos
Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Comportamento de Redução do Risco , Rede Social , Adolescente , Adulto , Biomarcadores/sangue , Criança , Feminino , Hemoglobina A Glicada/análise , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Abandono do Hábito de Fumar , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Fatores de Tempo , Sexo sem Proteção/prevenção & controle , Adulto Jovem
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