This study used data from the National Survey on Drug Use and Health (NSDUH) to evaluate the performance of 3 alcohol consumption items (ie, frequency of drinking in the past year, quantity con- sumed per occasion, and heavy epi- sodic drinking (HED) frequency in the past month) as very brief (ie, single item) screens to identify youth, aged 12 to 18, with alcohol-related prob- lems. The 2 alcohol outcomes described above were used as standards against which the consumption items were tested. Based on previous research, the frequency of drinking in the past year ( “ frequency ” ) was hypothesized to show better overall screening performance than either quantity consumed per occasion ( “ quantity ” ) or frequency of HED ( “ HED frequency ” ) in relation to both outcomes, across age, and within age for each gender. We predicted that frequency of drinking may provide a more ef ﬁ cient screen than quantity or
10 Read more
Use disorders are an important risk of marijuana use. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) provides definitions of marijuana abuse and dependence, with diagnostic criteria including spending a great time using or getting marijuana, increasing tolerance, continued use despite physical or mental problems, and reduced time spent on important activities; with the notable exclusion of withdrawal symptoms, due to a lack of evidence at the time of publication (American Psychiatric Association, 2000; Hasin et al., 2013). Questions corresponding to these criteria have been asked by the National Survey on Drug Use and Health (NSDUH) for decades, allowing for the calculation of prevalence of cannabis abuse and/or dependence based on self-reported symptoms.
The need for a study such as MTF is clear. Substance use by young people in the U.S. has proven to be a rapidly changing phenomenon, requiring frequent assessments and reassessments. Since the mid-1960s, when it burgeoned in the general youth population, illicit drug use has remained a major concern for the nation. Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality during adolescence as well as later in life. How vigorously the nation responds to teenage substance use, how accurately it identifies the emerging substance abuse problems, and how well it comes to understand the effectiveness of policy and intervention efforts largely depend on the ongoing collection of valid and reliable data. MTF is uniquely designed to generate such data in order to provide an accurate picture of what is happening in this domain of behavior and why. The study has served this function well for the past 44 years. Policy discussions in the scientific literature and media, in government, education, public health institutions, and elsewhere have been informed by the ready availability of extensive and consistently accurate information from the study relating to a large and ever-growing number of substances. Similarly, MTF findings help to inform organizations and agencies that provide prevention and treatment services.
127 Read more
We found that a cross-sectional relationship exists between responsiveness to DTC and self-reported use of prescription, but not OTC, drugs. Because there was a trend towards poorer self-reported health and respon- siveness to DTC, is plausible that users of prescription medications represent a sicker population, and one that may be more attuned to the messages conveyed in DTC advertising. Alternatively, because DTC advertising lar- gely focuses on prescription medications, persons who are responsive to DTC may have approached their pre- scribers based on information in DTC, resulting in more prescription, rather than OTC, use. Bell and colleagues found that current users of prescription drugs were more likely to be influenced by DTC advertising, but did not quantify the number of prescriptions, and lim- ited their sample to one county in California.
Background: It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods: Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI), current suicidality (1 month prior to assessment), mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/ alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk.
“ Basic ” EHRs include 7 features: patient demographics, problem lists, prescrip- tion orders, ability to view laboratory results and images, medication lists, and clinical notes. “ Fully functional ” EHRs include “ basic ” features plus display of out-of-range laboratory results, medical history, laboratory or- ders, drug interaction warnings, radio- logy orders, electronic prescriptions to pharmacy, electronic images returned, laboratory orders sent electronically, radiology orders sent electronically, and guideline reminders. Pediatric- supportive EHRs were de ﬁ ned as “ fully functional ” EHRs that also support 5 fundamental features: tracking of well- child visits, anthropometric support (such as growth charts or percentile calculations), tracking of immunizations, immunization forecasting (in the form of calculating catch-up immunizations),
young people as a key priority because of the particular health and social risks. In order to provide more information on young people’s attitudes and potentially harmful behaviour, questions were included in the survey concerning where pupils drink, money spent on alcohol, the number of drinks consumed on a single occasion, occasions of drunkenness and particular behaviour resulting from drinking, such as fights or arguments. Questions were also included on the attitudes of parents towards their children’s drinking, including whether they were allowed to drink at home. These were based on questions already used about parents’ attitudes to smoking. In 2004, questions were added about who pupils were with when they drank alcohol and how many of their friends drank, also based on questions on smoking. Questions were also added on pupils’ recall and attitudes to alcohol advertising on television. A question used in 1998 and 2000, on the specific days on which alcohol had been drunk in the previous week, was also used in 2004.
264 Read more
The result showed significant socio-economic in- equity exists in utilisation of 4 + ANC in both years. Therefore, the economically better off mothers were utilising 4 + ANC more compared to poor mothers. The concentration index also showed wealth-related inequity in 4 + ANC utilisation were higher in 2014 (Concentration index = 0.253) compared to 2011 (Concentration index = 0.227). Earlier studies showed such inequity in overall utilisation of ANC was de- creased over time (1994–2011) [36–39]. To under- stand the reason behind this slight increment of inequity between 2011 and 2014 further decompos- ition analysis of inequity is required. Bangladesh has already been entitled as a nation providing “Good health services at low cost ” even though majority of the poor women failed to utilise recommended num- bers of 4 + ANC .
In workers with OA, reductions in work productivity, including presenteeism, appear to be associated with increased patient-reported OA severity , yet data on the contribution of OA pain to work productivity and other outcomes in an employed population are limited. A study by White et al.  estimated the economic burden of patients with OA who were receiving pain pharmacotherapy, but the relative impact of pain on costs was not addressed. A more direct effect of OA pain was demonstrated in an analysis of data from the Longitudinal Examination of Arthritis Pain (LEAP) study . Results from LEAP suggested that weekly fluctuations in OA pain were associated with changes in levels of daily activities/functioning, work absenteeism, sleep interference, and healthcare resource use. In an analysis of four measures of presenteeism (the Health and Labor Questionnaire [HLQ]; the Work Limitations Questionnaire [WLQ]; the World Health Organization’s Health and Work Performance Questionnaire [HPQ]; and the Work Productivity and Activity Impairment Questionnaire [WPAI]), Zhang et al.  observed a sig- nificant association between pain and the risk of presen- teeism, but only weak associations between pain severity and hours lost. Another study implicated acute pain exacerbations as a factor in lost productivity in a popu- lation of employed adults with arthritis, however, the type of arthritis was not specified . In that study, the magnitude of lost productivity was mediated by the pro- portion of workers who lost work time rather than the
It adopted a multistage cluster sampling design in all countries, two-stage sampling in rural areas and three-stage sampling in urban areas. The SAGE collected data using standardized questionnaires (country specific adaptions) in- cluding self-reported and objective health measures (per- formance tests, anthropometry, and biomarkers). SAGE collected information on self-reported morbidities and health conditions based on interviews, anthropometric and health measurements, and blood tests. SAGE surveys inter- viewed 30,376 adults (18 years and above) including 4335 adults in the Russian Federation, 11,230 in India, and 14, 811 in China . Since we excluded adults whose an- thropometric measurements are not available in SAGE, our analytical sample sizes are 3692, 10,914 and 13,827 adults in the Russian Federation, India, and China respectively.
10 Read more
Opioid misuse is an epidemic in the United States (Centers for Disease Control and Prevention, 2011). Yet, little is known about the rate of opioid abuse, nor protective and risk factors, in college populations. For this study, opioid misuse was defined as use of heroin, or non-medical use of prescription opioids (NMUOPD), such as OxyContin, Percocet, or Vicodin, or concurrent use of heroin and NMUOPD. This study sought to develop a profile of students who misuse opioids by exploring the following research question using a large, national dataset: What individual, social, and institutional characteristics predict student opioid misuse? Potential predictor variables were identified in individual, social, and institutional domains. The current study provided an epidemiological foundation to inform evidence-based prevention and intervention approaches specific to the unique needs of higher education settings. Based on limited previous research, it was hypothesized that misuse would be greater among white students, students with lower GPAs, and sorority and fraternity members (Dart et al., 2014; McCabe, 2008; McCabe, Teter, Boyd, et al., 2005). Prior research has been mixed regarding whether or not athletes and males are at greater risk (Ford, 2008; Veliz et al., 2014).
116 Read more
A high mono-resistance rate facilitates the emergence of MDR-TB 31 ; emergence of MDR-TB facilitates extended drug resistance (XDR) (MDR-TB that is resistant to quinolones and also to any one of the injectable drugs; kanamycin, capreomycin, or amikacin). 32 to occur. In previously treated patients in DOTS implementing areas, MDR-TB could emerge in a sequential manner; i.e., initial resistance to INH or STM is amplified to double STM and INH resistance; initial resistance to INH or RMP is amplified to double INH and RMP resistance and so on and finally to MDR-TB and XDR-TB. 31,33 The rate of MDR-TB is increasing in spite of DOTS implementation in Ethiopia as can be seen from the figures specially acquired MDR-TB (Fig-1). In general resistance to the first line anti-tuberculosis is increasing with time as can be seen from the different studies done in Ethiopia. Patients with INH resistance receiving INH and EMB in the continuation phase will undergo EMB mono-therapy resulting in development of EMB resistance. EMB is a bacteriostatic drug with low efficacy that may not effectively prevent development of resistance to INH. Patients with INH resistance receiving INH and RMP in the continuation phase will undergo RMP mono-therapy resulting in development of RMP resistance that leads to MDR-TB.
10 Read more
ED utilization for nonurgent problems was also defined as a dichotomous variable. It measured whether a child had any non- urgent ED visits in 1997. Because MEPS does not provide direct information about whether an ED visit is for urgent or nonurgent problems, we used a variety of household-reported data sources to classify the visits. Households reported the type of care that a child received during the ED visit; categories include 1) diagnosis or treatment, 2) emergency, 3) psychotherapy or mental health counseling, 4) follow-up or postoperative visit, 5) immunization or shots, 6) pre/postmaternity care, and 7) other. When the type of care that a child received in the ED was designated as “emergen- cy,” the visit was considered urgent. Other visits that were not designated as “emergency” but were also considered urgent in- clude 1) visits that led to admission and 2) visits in which children received tests or procedures that were not immediately available in primary care offices and were needed for the diagnosis and treatment of some potential urgent problems. These tests or pro- cedures include radiography, computed tomographic scan or magnetic resonance imaging, electrocardiogram, electroencepha- logram, and any surgical procedures. The remaining visits were classified as nonurgent. On the basis of our criteria, 38.6% of the ED visits was classified as nonurgent. Because our focus was on nonurgent ED visits, we tried to identify ED visits that have a relatively high certainty of being nonurgent. We therefore used somewhat more relaxed criteria to classify urgent visits.
Our study has a number of strengths and limitations. The standardised methods used in DEGS1 ensure high quality data collection in a representative sample of the German population. However, the survey focus is on the community-dwelling population; excluding residents of institutions and those unable to visit the study centres who are more likely to be frail and therefore our findings may under-estimate frailty at the population level. We used Fried and colleagues’ criteria to classify frailty; how- ever, we made minor modifications to the original compo- nents due to data availability. We recognise complex relationships exist between BMI, obesity and frailty status and our methods of using BMI as a proxy for unintentional weight loss, although consistent with numerous others [9,13,14] may have resulted in misclassification of some older adults with obesity as not frail. Our results should be interpreted with caution as the absolute numbers of participants with frailty was low and restricted analyses. For example, we were unable to undertake more detailed sex-specific analyses. However, recognising the importance of age, sex and SES status from previous frailty studies [5,7,9] we performed restricted multinomial regression Table 3 Prevalence and associations between participants ’ characteristics and frailty status in unadjusted and adjusted multinomial regression models (Continued)
University (CASA), 2011). In addition, substance use in adolescence has been shown to be a risk factor for later psychopathology (Newcomb, Scheier, & Bentler, 1993). In addition to the personal risk to the adolescent, there is a huge financial burden on society as a whole, with the costs associated with underage drinking alone estimated at $68 billion a year in the United States (CASA, 2011). Risky sex (RS) behavior can also have dire consequences for adolescents. Americans aged 15-24 account for almost half of the 19 million new cases of STDs each year (Weinstock, Berman, &Cates, 2004) and nearly half a million teen girls aged 15-19 gave birth in the U.S in 2009 (Weinstock et al., 2004). There were also over 8,000 cases of HIV infection among young people from the ages of 13 to 24 reported to the Center for Disease Control (CDC) in 2009 (CDC, 2009).
36 Read more
In this study, health was captured through the variable self-rated oral health, an indicator of subjective oral health status. In the NSAOH, the self-rated question read: “How would you rate your own dental health?” In the CHMS, the question used was “In general, would you say the health of your mouth is…” The NZOHS asked “How would you describe the health of your teeth or mouth?” In NHANES, the question was “How would you describe the condition of your teeth?” All surveys used the following ordinal response options: ‘Excellent’ , ‘Very good’ , ‘Good’ , ‘Fair’ or ‘Poor’. The responses were dichotomized into ‘excellent, very good or good’ and ‘fair or poor’. Disease was assessed through clinical examin- ation by registered and calibrated dental examiners by using a standard oral epidemiological method /the examination protocol - the U.S. National Institute of Dental Research (National Institute of Dental Research 1987) , as untreated tooth decay (% DT > 0) and the mean number of decayed teeth (mean DT). All analyses were based on 28 teeth, excluding third molars.
Regular use of marijuana also exerts a negative effect on short-term memory, learning, and attention span. Three methodologically strong studies pre- sented compelling evidence that these functions were impaired in frequent users of marijuana (de- fined as using 20 to 30 days per month), even up to 6 weeks after discontinuation of use, 52 and noticeable
In this context, the National Institute of Mental Health (NIMH) and FDA hosted a workshop in Oc- tober 2000 to discuss the need to investigate the effects of psychotropic medications in young chil- dren, examine current obstacles to research in this area, and identify possible approaches to future ac- tivities. The meeting gathered researchers and clini- cians involved in the diagnosis and treatment of young children with behavioral and emotional dis- turbances, researchers in animal and clinical phar- macology, ethicists, patient and family representa- tives, and representatives of the American Academy of Pediatrics, American Academy of Child and Ad- olescent Psychiatry, American Academy of Family Physicians, and pharmaceutical industry, in addition to staff from the National Institutes of Health (NIH) and the FDA. For the purposes of this meeting, the term young children refers to prepubertal participants, with special emphasis on preschool-aged children, and the term psychotropic medications to pharmaco- logic agents used to treat behavioral and emotional disturbances. The discussion revolved around 2 main sets of questions:
issues during the research development process. The provid- ers objected to the high costs of, and the appropriateness of, positive reinforcement for addiction treatment; some believed that it could be counterproductive to provide incentives. Their concern regarding the cost of the incentives stemmed in part from the fixed level of reimbursement provided by third-party payers for the care of substance use disorders. Incentive payments were unlikely to be added to the reimbursement if clinically implemented, and were too costly to be supported by the provider alone. 25,26 The CTN therefore modified the
In NHANES 2005–2006, dietary supplement use data were self-reported and recorded by interviewers using Computer- Assisted Personal Interview technology. Survey participants were asked whether they had taken any vitamins, minerals or other dietary supplements, including prescription and nonprescription supplements, in the past 30 days. Those reported using any dietary supplements were asked to provide the containers of all the products used. NHANES interviewer recorded the name and manufacturer of each supplement as they appeared on the label of the supplement container. If the participant could not provide the container (12% of the time), the interviewer asked for the exact name of the product or, if not known, the supplement type, for example, multivitamin, vitamin C. Up to 20 supplements could be recorded. For the purpose of quality assurance, data extracted from the dietary supplement use questionnaire were routinely examined by trained nutritionists for discrepancies and erroneous entries. Efforts were made to ensure as much accuracy as possible in finding the label information for the exact product taken, and providing exact ingredient information for this product.
10 Read more