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Objective Substance use disorders (SUDs) have increased substantially across the globe, and has become one of the world’s most significant public health and socioeconomic challenge. This study examined the prevalence and patterns...
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Objective Substance use disorders (SUDs) have increased substantially across the globe, and has become one of the world’s most significant public health and socioeconomic challenge. This study examined the prevalence and patterns of substance use disorders among patients admitted to the main psychiatric hospital in Botswana, the Sbrana Psychiatric Hospital. Method This was a cross-sectional study of patients admitted to a major psychiatric hospital in Botswana. SUDs were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v13.0. Bivariate analysis was conducted to determine the association between socio-demographic characteristics and SUDs. Multivariate logistic regression was used to control for confounders. Results The final analysis involved 101 patients. Participants ranged in age from 18-60 years, and over half (59.4%) were male. The majority of participants (85.1%) had used potentially addicting substances at least once during their lifetime, with 63.4% having current substance use disorders. The most frequently used substances were tobacco, cannabis, alcohol, and cocaine at 58.4%, 42.6%, 34.7% and 12.8% respectively. SUDs were more common among participants who were male, ages 18–35 years, single, had a tertiary education, or were unemployed. Conclusions There is a high prevalence of substance use and SUDs among psychiatric patients in Botswana. Screening for and interventions to manage SUDs should be part of routine care at psychiatric health care facilities in this country. Consideration should be given to the screening of all patients admitted to psychiatric hospitals in Botswana for SUDs using the ASSIST.
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Vasculitis presents with a wide spectrum of clinical manifestations ranging from cutaneous vasculitis to systemic, multi-organ vasculitis. It occurs as a primary disorder or secondary to various medical conditions. The treatment o...
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Vasculitis presents with a wide spectrum of clinical manifestations ranging from cutaneous vasculitis to systemic, multi-organ vasculitis. It occurs as a primary disorder or secondary to various medical conditions. The treatment of cutaneous vasculitis is based on the severity and type of disease. Although cutaneous vasculitis is usually self-limiting and can often be managed by general measures, patients with more severe disease require pharmacological treatmen.
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This study investigates the effect of the unified theory of acceptance and use of technology (UTAUT) and DeLone and McLean information system success model (IS success model) on facets of system use for digital library systems. Th...
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This study investigates the effect of the unified theory of acceptance and use of technology (UTAUT) and DeLone and McLean information system success model (IS success model) on facets of system use for digital library systems. These facets include lean measures (e.g. frequency, duration, and intensity) and rich measures of system use (e.g. deep structure use and cognitive absorption use). The study overcomes the general description for some constructs, for instance facilitating conditions and quality, and assesses the effects of sub-constructs on system use facets, such as smart and traditional facilitating conditions. Data was collected through a cross-sectional survey in three universities. Component-based structural equation modeling software was used to analyze the data and assess the research model. The findings indicate that there is variance and consistency in the antecedents that influence the facets of system use. The lean measure was predicted by performance expectancy, traditional facilitating conditions, system quality, and behavioral intention, while the rich measure, particularly deep structure use, was influenced by performance expectancy, effort expectancy, traditional facilitating conditions, system quality, and behavioral intention. Furthermore, cognitive absorption use, a rich measure, was impacted by performance expectancy, service quality, system quality, and intention. This study provides a theoretical contribution and practical implications relevant to academics and practitioners in areas related to digital library systems.
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Objectives: Alcohol is among the most common psychoactive substances to be co-administered with a variety of other drugs. It is frequently used simultaneously (i.e. on the same occasion) with cocaine. The objectives of this qualit...
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Objectives: Alcohol is among the most common psychoactive substances to be co-administered with a variety of other drugs. It is frequently used simultaneously (i.e. on the same occasion) with cocaine. The objectives of this qualitative investigation are (1) to explore the functions and motivational factors underlying the simultaneous use of alcohol and cocaine, and (2) to explore the associated consequences. Methods: In-depth open-ended interviews with simultaneous alcohol and cocaine users were conducted at a residential treatment centre in Ontario, Canada (n 10). The interview transcripts were coded by two independent coders. A thorough content analysis of the transcripts was performed in order to identify themes. Findings: Respondents used cocaine and alcohol simultaneously to control cravings; to alter their state of consciousness; to manage their emotions; to enhance sexual, physical and social functioning; and to minimise financial costs. Negative consequences experienced from simultaneous use include psychological, physical, social and financial harms. These findings have been used to develop potential hypotheses for testing in future studies.
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Background: Substance use among youth is associated with a range of immediate and long-term health risks. The current study sought to characterize early patterns of illicit drug use among Canadian youth. Methods: Nationally repres...
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Background: Substance use among youth is associated with a range of immediate and long-term health risks. The current study sought to characterize early patterns of illicit drug use among Canadian youth. Methods: Nationally representative surveys were conducted in 2002 (n=11,757), 2004 (n=16,705), 2006 (n=27,030), and 2008 (n=24,752) with students in grades 7 to 9 as part of Health Canada's Youth Smoking Survey (YSS). In 2008, students in grades 10-12 were also included in the survey (n=20,673). Results: In 2008, approximately 21% of youth in grades 7-9 reported drinking at least once a month in the past year, 26% reported previous tobacco use, 17% reported trying cannabis, while 13% reported trying another substance, including glue, non-medical use of prescription drugs, hallucinogens, and amphetamines. Compared to 2006, the number of youth in grades 7-9 who reported ever trying glue decreased significantly in 2008, whereas those who reported ever trying MDMA and non-medical use of prescription drugs had increased. Males were significantly more likely to report use for most but not all substances across survey years. Conclusions: A considerable portion of Canadians aged 13 to 15 reported experimenting with illegal substances. The findings provide the most comprehensive national trends in substance use among young Canadians.
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Our aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, ...
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Our aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, but that do not quite meet full psychiatric diagnostic criteria. They have been associated with significant impairment and cost. The National Epidemiologic Survey on Alcohol and Related Conditions-III was a multistage, weighted, cross-sectional survey completed in the United States in 2013 comprising 36,309 noninstitutionalized adults. We report lifetime prevalence rates of 14 SPS related to mood, anxiety, trauma, eating, and personality disorders. We then evaluate associations with lifetime alcohol use disorders (AUD) and all substance use disorders (SUD) using logistic regression and adjusted odds ratios. SPS and psychiatric diagnoses were mutually exclusive (could not co-occur). Lifetime prevalence of having at least one of 14 SPS was 57% compared with 37% for the related psychiatric disorders. This was similar for males and females, in contrast to psychiatric disorders in which prevalence was 42% in females and 31% in males. Otherwise, overall SPS and disorders had similar prevalence patterns across sociodemographic characteristics. Subthreshold personality symptoms had the highest prevalence rates (schizotypal 21.3%, antisocial 18.3%, and borderline 17.6%), followed by posttraumatic stress (13.1%). Subthreshold bipolar and depression had lifetime prevalence rates of 2.7 and 8.5%, respectively. Prevalence rates of subthreshold anxiety symptoms ranged from 2.2% (agoraphobia) to 9.8% (specific phobia). Subthreshold eating disorder related symptoms had the lowest prevalence rates (anorexia 1.5% and bulimia 1.7%). Half (seven) of the SPS had significantly increased odds of lifetime AUD. This number increased to 12 for all SUD. Subthreshold antisocial personality symptoms had the highest odds of AUD (2.2; 95% CI 2.00–2.37) and SUD (3.5; 95% CI 3.22–3.81). We found high lifetime SPS prevalence rates and significant associations with AUD and SUD. To our knowledge, this is the first published study evaluating a broad number of SPS. This indicates possible opportunities for early intervention and prevention but requires additional research and development of infrastructure and guidelines to better understand and manage patients who experience SPS.
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Prior research suggests that substance use disorders (SUDs) are associated with risk of suicide mortality, but most previous work has been conducted among Veterans Health Administration patients. Few studies have examined the rela...
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Prior research suggests that substance use disorders (SUDs) are associated with risk of suicide mortality, but most previous work has been conducted among Veterans Health Administration patients. Few studies have examined the relationship between SUDs and suicide mortality in general populations. Our study estimates the association of SUDs with suicide mortality in a general US population of men and women who receive care across eight integrated health systems. We conducted a case–control study using electronic health records and claims data from eight integrated health systems of the Mental Health Research Network. Participants were 2674 men and women who died by suicide between 2000–2013 and 267,400 matched controls. The main outcome was suicide mortality, assessed using data from the health systems and confirmed by state death data systems. Demographic and diagnostic data on substance use disorders and other health conditions were obtained from each health system. First, we compared descriptive statistics for cases and controls, including age, gender, income, and education. Next, we compared the rate of each substance use disorder category for cases and controls. Finally, we used conditional logistic regression models to estimate unadjusted and adjusted odds of suicide associated with each substance use disorder category. All categories of substance use disorders were associated with increased risk of suicide mortality. Adjusted odds ratios ranged from 2.0 (CI 1.7, 2.3) for patients with tobacco use disorder only to 11.2 (CI 8.0, 15.6) for patients with multiple alcohol, drug, and tobacco use disorders. Substance use disorders were associated with increased relative risk of suicide for both women and men across all categories, but the relative risk was more pronounced in women. Substance use disorders are associated with significant risk of suicide mortality, especially for women, even after controlling for other important risk factors. Experiencing multiple substance use disorders is particularly risky. These findings suggest increased suicide risk screening and prevention efforts for individuals with substance use disorders are needed.
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Background: Understanding geographic variation in youth drug use is important for both identifying etiologic factors and planning prevention interventions. However, little research has examined Spatial clustering of drug use among...
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Background: Understanding geographic variation in youth drug use is important for both identifying etiologic factors and planning prevention interventions. However, little research has examined Spatial clustering of drug use among youths by using rigorous statistical methods. Objectives: The purpose of this study was to examine spatial clustering of youth use of tobacco, alcohol, and marijuana. Methods! Responses on, tobacco, alcohol, and Marijuana use from 1,292 high school students ages 13-19 who provided complete residential addresses were drawn from the 2008 Boston Youth Survey Geospatial Dataset. Response options on past month use included "none," "1-2," "3-9," and "10 or more." The response rate for each substance was approximately 94%. Spatial clustering Of youth drug use was assessed using the spatial Bernoulli model in. the SatScan (TM) Software package. Results Approximately 12%, 3:6%, and 18% of youth reported any past-month use of tobacco, alcohol, and/or Marijuana, respectively. Two clusters of elevated past tobacco use among: Boston youths were generated, one of which was statistically significant. This cluster, located in the South Boston neighborhood, had a relative risk of 5:37 with,a p-Value of 0.00014. There was no significant localized spatial clustering in youth past alcohol or marijuana use in either the unadjusted or adjusted. Models. Conclusion: Significant Spatial-clustering in youth tobacco use was-found.. Finding a significant cluster in the South Boston neighborhood provides reason for further investigation into neighborhood characteristics that may shape adolescents' substance use behaviors. This type of research can be used to evaluate the underlying reasons behind spatial clustering of youth substance and to target local drug abuse prevention interventions and use.
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The substance use normalization thesis predicts that adolescent substance users are less likely to report substance use risk factors in high than in low prevalence countries. This study tests whether national population-level alco...
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The substance use normalization thesis predicts that adolescent substance users are less likely to report substance use risk factors in high than in low prevalence countries. This study tests whether national population-level alcohol, cigarette and cannabis prevalence rates moderate the strength of the relationship between individual level social and behavioral risk factors and individual level alcohol, cigarette and cannabis use. Data from 2009/2010 Health Behaviour in School-Aged Children Study (N=68,045, age=15) from 35 countries was analyzed using logistic Hierarchical Linear Modeling. As expected based on low cannabis prevalence rates in all countries studied, no evidence of normalization was found for recent cannabis use. Also in line with the normalization thesis, results show that for substance use that reaches above 40% in at least some of the countries studied (drunkenness, alcohol and cigarette use), adolescents who reported use are less likely to report social and behavioral risk factors in high prevalence countries than in low prevalence countries. However, support for the normalization thesis was only partial in that results show that in models where evidence for normalization was found, there are risk factors that predict substance use to an equal degree regardless of country level prevalence rates. The current research shows that the normalization thesis is a useful framework for understanding the contextual aspects of adolescent alcohol, tobacco, and cannabis use. The study has implications for drug prevention as it suggests that selective prevention efforts may be particularly useful in low prevalence countries where screening based on risk factors may usefully identify adolescents at most risk for developing drug use problems. This approach may be less useful in high prevalence countries where screening based on risk factors is less likely to satisfactorily identify those at risk for developing drug use problems.
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