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Selected AbstractsAre we becoming more alike?DRUG AND ALCOHOL REVIEW, Issue 5 20082004 national household surveys, Comparison of substance use in Australia, the United States as seen in the 199 Abstract Introduction. This paper reports the results of the 1995, 1998, 2001 and 2004 Australian and US household surveys, with emphasis on changes since 2001. Design and Methods. The US survey data were recalculated to match age groups in the Australian data. Statistically significant changes are reported. Differences in prevalence of use by gender within age group were tested for significance. Results. The past-year use of ,any illicit drug', cannabis, cocaine, tranquillisers and injecting drugs decreased between 2001 and 2004 in Australia, but remained stable for all these drugs except ecstasy between 2002 and 2004 in the United States. The use of hallucinogens decreased in both countries. Alcohol and use of many illicit drugs by teenage girls in both countries increased to rates similar to or higher than boys, and teens in both countries reported binge and heavy drinking in the past month. Australians in their 20s had the highest rates of use, but in the United States, past-year use of many drugs was highest among teenagers. Discussion. More treatment services are needed, particularly for people dependent upon non-opiate drugs. The changes in acceptability of use of different drugs and their perceived availability are related to changes in prevalence rates. Even with the similarities in levels of use, there are differences in patterns of use and preferences for certain drugs in each country, and geographic proximity to drug sources is a factor. [source] Hazardous alcohol consumption and other barriers to antiviral treatment among hepatitis C positive people receiving opioid maintenance treatmentDRUG AND ALCOHOL REVIEW, Issue 3 2007BIANCA WATSON Abstract Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study. [source] Drug-related behaviors independently associated with syphilis infection among female sex workers in two Mexico,US border citiesADDICTION, Issue 8 2010Oralia Loza ABSTRACT Aims To identify correlates of active syphilis infection among female sex workers (FSWs) in Tijuana and Ciudad Juarez. Design Cross-sectional analyses of baseline interview data. Correlates of active syphilis (antibody titers >1 : 8) were identified by logistic regression. Setting Tijuana and Ciudad Juarez, two Mexican cities on the US border that are situated on major drug trafficking routes and where prostitution is quasi-legal. Participants A total of 914 FSWs aged ,18 years without known human immunodeficiency virus (HIV) infection who had had recent unprotected sex with clients. Measurements Baseline interviews and testing for syphilis antibody using Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) tests. Findings Median age and duration in sex work were 32 and 4 years, respectively. Overall, 18.0% had ever injected drugs, 14.2% often or always used illegal drugs before or during sex in the past month, 31.4% had clients in the last 6 months who injected drugs, and 68.6% reported having clients from the United States. Prevalence of HIV and active syphilis were 5.9% and 10.3%, respectively. Factors independently associated with active syphilis included injecting drugs (AOR: 2.39; 95% CI: 1.40, 4.08), using illegal drugs before or during sex (AOR: 2.06; 95% CI: 1.16, 3.65) and having any US clients (AOR: 2.85; 95% CI: 1.43, 5.70). Conclusions Among female sex workers in Tijuana and Ciudad Juarez, drug-using behaviors were associated more closely with active syphilis than were sexual behaviors, suggesting the possibility of parenteral transmission of T. pallidum. Syphilis eradication programs should consider distributing sterile syringes to drug injectors and assisting FSWs with safer-sex negotiation in the context of drug use. [source] Problems experienced by community pharmacists delivering opioid substitution treatment in New South Wales and Victoria, AustraliaADDICTION, Issue 2 2010Adam R. Winstock ABSTRACT Aims To explore service provision and the range of problems that New South Wales (NSW) and Victoria (VIC) community pharmacists providing opioid substitution treatment (OST) have experienced with clients and prescribers. Design Cross-sectional postal survey. Setting All community pharmacies providing OST in NSW (n = 593) and VIC (n = 393), Australia. Participants Completed questionnaires were received from 669 pharmacists (68% response rate). Measurements The questionnaire addressed pharmacy characteristics, recent problems experienced with clients including refusal to dose, provision of credit for dispensing fees, termination of treatment, responses of pharmacists to problems experienced with clients, as well as problems experienced with OST prescribers. Findings In the preceding month, 41% of pharmacists had refused to dose a client for any reason, due most commonly to expired prescriptions (29%), or ,3 missed doses (23%). Terminating a client's treatment in the past month was reported among 14% of respondents, due most commonly to inappropriate behaviour and missed doses. Treatment termination was reported by a significantly higher proportion of pharmacists in VIC (P < 0.001). Treatment termination in last month was predicted having more clients (P < 0.001), the provision of buprenorphine treatment (P = 0.008), having a separate dosing area (P = 0.021), and being a female pharmacist (P = 0.013). Past month refusal to dose was predicted by the pharmacy being in VIC (P < 0.001) and having more clients (P < 0.001). Problems experienced most commonly in the past month with prescribers were difficulty contacting prescriber (21%) and provision of takeaway doses to clients considered unstable by the pharmacist (19%) (higher in VIC: both P < 0.001). Conclusions This study highlights the range of problems experienced by community pharmacists in the delivery of OST and the consequences for people in treatment. Particular attention should be focused upon considering number of clients per pharmacy and improving professional communication between pharmacists and prescribers. [source] Hostility, drinking pattern and mortalityADDICTION, Issue 1 2008Stephen H. Boyle ABSTRACT Aims This study examined the association of hostility to drinking pattern and whether this association mediated the relation of hostility to mortality. Participants and design Subjects were 3326 current drinkers from the Vietnam Experience Study cohort who were followed for vital status. Setting United States. Measurements Hostility was measured by an abbreviated version of the Cook,Medley Hostility Scale (ACM). The alcohol variables were total monthly intake of alcohol, drinking frequency, drinks per drinking day and drinking , 5 drinks on at least one occasion in the past month (i.e. heavy episodic drinking). Findings Regression analyses showed associations between the ACM and total monthly intake of alcohol (P < 0.0001), drinks per drinking day (P < 0.0001) and heavy episodic drinking (P < 0.0001), but not with frequency of drinking days. Hostility, drinks per drinking day, heavy episodic drinking and total monthly alcohol intake were also associated with all-cause mortality (all Ps < 0.0001). Further analyses showed that drinking pattern, particularly drinks per drinking day, may account partially for the relation of hostility to mortality. Conclusions High hostility is associated with elevated mortality and a deleterious drinking pattern characterized by relatively high intake per drinking occasion. Drinking pattern could help explain the relationships between hostility and health. [source] GP prescribing of nicotine replacement and bupropion to aid smoking cessation in England and WalesADDICTION, Issue 11 2004Andy McEwen ABSTRACT Aims Prescribing nicotine replacement therapy (NRT) or bupropion for smoking cessation is of considerable importance to public health but little is known about prescribing practices. This paper examines general practitioners' (GPs') prescribing patterns in Britain where these drugs are reimbursed. The results have implications for other health-care systems considering introducing reimbursement. Design, participants and setting Postal survey conducted in 2002 of a random sample of 1088 GPs in England and Wales, of whom 642 (59%) responded. Measures Number of requests GPs reported having received from patients for NRT and bupropion over the past month, the number of prescriptions they reported issuing and ratings of attitudes to these medications. Findings GPs reported receiving an average of 4.3 requests for NRT and 1.9 for bupropion in the previous month. They reported issuing 3.5 prescriptions for NRT and 1.2 for bupropion. Almost all GPs accepted that NRT (95%) and bupropion (97%) should be reimbursable on National Health Service (NHS) prescription. However, a significant minority of those who received requests for prescriptions did not issue any (8% for NRT and 26% for bupropion). This was related to whether they thought these products should be available on NHS prescription for both NRT and bupropion (OR = 0.66, P < 0.05), which in turn was related to beliefs about whether smokers should have to pay for treatment themselves, the cost-effectiveness of NRT/bupropion and the low priority they would give NRT/bupropion in the drug budget. For bupropion, concern about side-effects independently predicted not prescribing [odds ratio (OR) = 1.46, P < 0.03]. Conclusion In the British health-care system, which has a well-established system for technology assessment and professionally endorsed guidelines, a significant minority of GPs decline all patient requests for stop-smoking medicines. [source] Culture and the behavioural manifestations of traits: an application of the Act Frequency ApproachEUROPEAN JOURNAL OF PERSONALITY, Issue 4 2007A. Timothy Church Abstract The behavioural manifestations of Big Five traits were compared across cultures using the Act Frequency Approach. American (n,=,176) and Filipino (n,=,195) students completed a Big Five measure and act frequency ratings for behaviours performed during the past month. Acts for specific traits cohered to an equivalent degree across cultures. In both cultures, the structure of act composites resembled the Big Five and the strength of trait-behaviour relationships was very similar. Many acts were multidimensional and analyses revealed cultural commonalities and differences in the relevance and prevalence of acts for the Big Five traits. The results were more consistent with trait than cultural psychology perspectives, because traits predicted behaviour equally well, on average, in the two cultures. Copyright © 2007 John Wiley & Sons, Ltd. [source] Suicidal thoughts among elderly Taiwanese aboriginal womenINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2008Cheng-Sheng Chen Abstract Objectives The aims of this study were to investigate prevalence of suicidal thoughts among a population of elderly aboriginal women in Taiwan over a 1-month period and to examine the risk factors for suicidal thinking in terms of individual (self-perceived health, disability and financial difficulty), family (marital discord) and social (medical accessibility) aspects. The mediating effects of depression on the above risk factors were also investigated. Furthermore, we examined the buffer effect on suicidal ideation of emotional social support for dealing with marital discord. Methods One thousand three hundred and forty-seven elderly Taiwanese aboriginal women were enrolled. Suicide thoughts within the past month, demographic data, adverse life events, emotional social support and depressive state were assessed. The 1-month prevalence of suicide thoughts was calculated. The risks of suicide thought based on individual, family and community aspects were estimated. Results The 1-month prevalence of suicidal thoughts among the community-dwelling aboriginal elderly women was 17.8%. Those subjects with poorer self-perceived health, difficulty in accessing medical resources, or experiencing marital discord were at higher risk of having suicidal thoughts. After controlling for depression, the odds ratio of self-perceived health and marital discord remained statistically significant. The odds ratio of interaction of marital discord and emotional social support was 0.41. Conclusion Suicidal thoughts are common among the community-dwelling aboriginal elderly women in Taiwan. Risk factors for suicidal thoughts comprise individual (depression and physical condition), family (marital discord) and community (medical resources) aspects. Better emotional social support can effectively buffer the effect of marital discord. Copyright © 2008 John Wiley & Sons, Ltd. [source] Suicidal ideation among elderly homecare patientsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2007Patrick J. Raue Abstract Objectives To identify the prevalence, correlates, and one-year naturalistic course of suicidal ideation in a representative sample of elderly adults newly admitted to visiting nurse homecare. Method Five hundred and thirty-nine participants (aged ,65), newly initiating homecare for skilled nursing services, were interviewed with the Structured Clinical Interview for DSM-IV (SCID-IV) and measures of depression severity, medical comorbidity, functional status, and social support. Participants were classified as having no suicidal ideation in the past month, passive ideation, active ideation, or active ideation with poor impulse control or suicide plan. Results Fifty-seven participants (10.6%) reported passive and six (1.2%) reported active suicidal ideation. Higher depression severity, greater medical comorbidity, and lower subjective social support were independently associated with the presence of any level of suicidal ideation. At one year, suicidal ideation persisted for 36.7% of those with ideation at baseline, and the incidence of suicide ideation was 5.4% Conclusions The high prevalence, persistence, and incidence of suicidal ideation in medically ill home healthcare patients underscore the relevance of this population for suicide prevention efforts. The clinical and psychosocial factors associated with suicidal ideation in this underserved, high-risk population are potentially modifiable, and thus useful targets for suicide prevention interventions. Copyright © 2006 John Wiley & Sons, Ltd. [source] Assessment of health, well-being and social connections: A survey of women living in Western SydneyINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2007Rhonda Griffiths RN CM B.Ed(Nursing) M.Sc(Hons) DrPH Strengthening the physical and social environment has been shown to support health and strengthen community action for health. In an attempt to improve the social factors that influence the health of individuals and the community, community interventions increasingly include strategies to build networks and social capital and develop resilience. This study was undertaken to identify the most appropriate strategies to strengthen friendships and the social support networks for women aged 18,39 years living in Villawood, an area of high disadvantage in South Western Sydney, Australia. Although the majority reported positively on their health, one-third reported feeling isolated, experienced low energy levels and felt unhappy and anxious over the past month. Women who described themselves as unemployed felt more isolated than women in home duties. Women who were employed or engaged in home duties had more contact with neighbours, and had more in common with their neighbours. Those who reported more contact with their neighbours perceived their mental healthlevel as being higher. These results indicate that community development initiatives should include consultation with the community and consider the needs of socially isolated groups and those with the poorest health status. [source] Trends in Alcohol-Related Traffic Risk Behaviors Among College StudentsALCOHOLISM, Issue 8 2010Kenneth H. Beck Background:, Alcohol-impaired driving is a major public health problem. National studies indicate that about 25% of college students have driven while intoxicated in the past month and an even greater percentage drive after drinking any alcohol and/or ride with an intoxicated driver. The purpose of this investigation was to examine the change in these various alcohol-related traffic risk behaviors as students progressed through their college experience. Methods:, A cohort of 1,253 first-time first-year students attending a large, mid-Atlantic university were interviewed annually for 4 years. Repeated measures analyses were performed using generalized estimating equations to evaluate age-related changes in prevalence and frequency of each behavior (i.e., ages 19 to 22). Results:, At age 19, 17%wt of students drove while intoxicated, 42%wt drove after drinking any alcohol, and 38%wt rode with an intoxicated driver. For all 3 driving behaviors, prevalence and frequency increased significantly at age 21. Males were more likely to engage in these behaviors than females. To understand the possible relationship of these behaviors to changes in drinking patterns, a post hoc analysis was conducted and revealed that while drinking frequency increased every year, frequency of drunkenness was stable for females, but increased for males. Conclusions:, Alcohol-related traffic risk behaviors are quite common among college students and take a significant upturn when students reach the age of 21. Prevention strategies targeted to the college population are needed to prevent serious consequences of these alcohol-related traffic risk behaviors. [source] Effectiveness of Structured Questionnaires for Screening Heavy Drinking in Middle-Aged WomenALCOHOLISM, Issue 11 2006Mauri Aalto Background: There is a need for an effective and feasible alcohol screening instrument. The aim of the study was to evaluate how the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire perform in comparison with the original AUDIT and what the optimal cutoffs are when screening for heavy drinking among women. Methods: All the 40-year-old women in the city of Tampere, Finland, are invited yearly for a health screening. From 1 year, data from 894 women (response rate 68.2%) invited for a health screening were utilized in the study. The original 10-item AUDIT, AUDIT-C, Five Shot, AUDIT-PC, AUDIT-3, AUDIT-QF, and CAGE were evaluated against the Timeline Followback. Consumption of at least 140 g of absolute ethanol per week on average during the past month was considered heavy drinking. Results: In the Timeline Followback, the mean±SD weekly reported alcohol consumption was 45±67 g (range 0,936 g) of absolute ethanol. Of the women, 6.2% (55/894) were heavy drinkers. The optimal combination of sensitivity and specificity was reached for the AUDIT with cutoff ,6, for the AUDIT-C with cutoff ,5, for the Five Shot with cutoff ,2.0, for the AUDIT-PC with cutoff ,4, and for the AUDIT-QF with cutoff ,4. When choosing the optimal cutoffs, the AUDIT-C, the Five Shot, the AUDIT-PC, and the AUDIT-QF performed as well as the 10-item AUDIT. With these cutoffs, sensitivities were 0.84 to 0.93 and specificities were 0.83 to 0.90. The AUDIT-3 and the CAGE did not perform as well as the other questionnaires. Conclusions: The 10-item AUDIT, AUDIT-C, Five Shot, AUDIT-PC, and AUDIT-QF seem to be equally effective tools in screening for heavy drinking among middle-aged women. However, their applicability is achieved only if the cutoffs are tailored according to gender. [source] Clinical trial: lansoprazole 15 or 30 mg once daily vs. placebo for treatment of frequent nighttime heartburn in self-treating subjectsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2009D. A. PEURA Summary Background, Frequent nighttime heartburn is common. Lansoprazole 15 mg is indicated for treatment of heartburn and other gastro-oesophageal reflux disease-related symptoms. Aim, To evaluate the efficacy and safety of lansoprazole in self-treating subjects with frequent nocturnal heartburn. Methods, A total of 864 subjects with heartburn on ,2 days/week over the past month were randomized to double-blind treatment with lansoprazole 15 or 30 mg or placebo each morning. Endpoints were percentage of nighttimes without heartburn (primary), percentage of 24-h days without heartburn and percentage of subjects without heartburn on day 1. Results, Mean percentage of nighttimes without heartburn was significantly greater with lansoprazole 15 mg (61.3%) or lansoprazole 30 mg (61.7%) vs. placebo (47.8%) over 14 days (P < 0.0001 vs. placebo for both doses). Percentage of 24-h days without heartburn and percentage of subjects without heartburn on day 1 were significantly greater with lansoprazole 15 or 30 mg vs. placebo. Conclusions, Both lansoprazole 15 and 30 mg were highly effective and well tolerated in reducing symptoms in subjects with frequent nighttime heartburn. The benefit of therapy on 24-h heartburn and nighttime heartburn on day 1 of treatment was also evident. Lansoprazole 15 mg is a suitable choice for management of frequent nighttime heartburn. [source] Urinary incontinence across the lifespanNEUROUROLOGY AND URODYNAMICS, Issue 6 2003Yvette D. Miller Abstract Aims The objectives of the current study were (1) to measure type and severity of urinary leakage and (2) to investigate the association between these factors and age-related life events and conditions in three groups of Australian women with a history of urinary leakage. Methods Five hundred participants were randomly selected from women in the young (aged 18,22 in 1996), mid-age (45,50), and older (70,75) cohorts of the Australian Longitudinal Study of Women's Health (ALSWH) who had reported leaking urine in the 1996 baseline survey. Details about leaking urine (frequency, severity, situations) and associated factors (pregnancy, childbirth, body mass index [BMI]) were sought through self-report mailed follow-up surveys in 1999. Results & Conclusions Response rates were 50, 83, and 80% in the young, mid-age, and older women, respectively. Most women confirmed that they had leaked urine in the past month, and the majority of these were cases of "mixed" incontinence. Incontinence severity tended to increase with BMI for women of all ages, and increased severity scores were associated with having urine that burns or stings. Additional independent risk factors for increasing incontinence severity were heavy smoking in young women, past or present use of hormone replacement therapy in older women, and BMI and history of hysterectomy in mid-age women. Neurourol. Urodynam. 22:550,557, 2003. © 2003 Wiley-Liss, Inc. [source] Modafinil and Zolpidem Use by Emergency Medicine ResidentsACADEMIC EMERGENCY MEDICINE, Issue 12 2009Brian D. McBeth MD Abstract Objectives:, The objective was to assess the prevalence and patterns of modafinil and zolpidem use among emergency medicine (EM) residents and describe side effects resulting from use. Methods:, A voluntary, anonymous survey was distributed in February 2006 to EM residents nationally in the context of the national American Board of Emergency Medicine in-training examination. Data regarding frequency and timing of modafinil and zolpidem use were collected, as well as demographic information, reasons for use, side effects, and perceived dependence. Results:, A total of 133 of 134 residency programs distributed the surveys (99%). The response rate was 56% of the total number of EM residents who took the in-training examination (2,397/4,281). Past modafinil use was reported by 2.4% (57/2,372) of EM residents, with 66.7% (38/57) of those using modafinil having initiated their use during residency. Past zolpidem use was reported by 21.8% (516/2,367) of EM residents, with 15.3% (362/2,367) reporting use in the past year and 9.3% (221/2,367) in the past month. A total of 324 of 516 (62.8%) of zolpidem users initiated use during residency. Side effects were commonly reported by modafinil users (31.0%),most frequent were palpitations, insomnia, agitation, and restlessness. Zolpidem users reported side effects (22.6%) including drowsiness, dizziness, headache, hallucinations, depression/mood lability, and amnesia. Conclusions:, Zolpidem use is common among EM residents, with most users initiating use during residency. Modafinil use is relatively uncommon, although most residents using have also initiated use during residency. Side effects are commonly reported for both of these agents, and long-term safety remains unclear. [source] Young adolescents' use of medicine for headache: sources of supply, availability and accessibility at home,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008Bjørn E. Holstein Mag. Abstract Objective Use of medicines for headache is common among young adolescents but little is known about their sources of supply and access to medicines. The purpose was to describe sources of supply, availability and accessibility at home and to examine if supply, availability and accessibility were associated with medicine use. Methods Cross-sectional study in eight schools where all fifth and seventh grade students (11- and 13-year-olds) answered a questionnaire about socio-demographic factors, health and medicine use. Response rate: 84.0%, n,=,595. Results The reported prevalence of headache at least monthly was 45.0%, and 42.5% had used medicines for headache during the past month. 68.2% reported that medicines for headache were always available at home, and 22.2% were allowed to use these without asking for permission. Most pupils received medicine from their parents (73.1%) and physicians (25.4%). Smaller proportions had received medicine from school nurses, teachers, friends and others; 11.6% mentioned at least three sources of supply. Pupils with frequent episodes of headache reported more sources of supply and higher availability and accessibility at home. OR for medicine use among children who mentioned three or more sources of supply was 4.53 (95% CI 2.63,7.83) in a multivariate model controlled for sex, age and prevalence of headache. Use of medicine was also associated with availability at home (OR,=,1.51, 1.01,2.27) and accessibility (OR,=,2.49, 1.57,3.93). Conclusion Medicine use for headache among children and young adolescents is common and control of access may be the key issue for safe medicine use. Copyright © 2008 John Wiley & Sons, Ltd. [source] Self-rated health as predictor of medicine use in adolescence,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2008Bjørn E. Holstein Mag Scient Soc Abstract Purpose To examine the association between self-rated health (SRH) and medicine use for four common complaints: headache, stomach-ache, difficulties in getting to sleep and nervousness, in a nationally representative sample of adolescents. Methods The study population comprised of all students in the fifth, seventh and ninth grade (mean ages 11.6, 13.6 and 15.6 years) in a random sample of schools in Denmark 2002, participation rate 90.6%, n,=,4.824. The students reported health problems, medicine use, social and psychosocial conditions in an anonymous and standardized questionnaire. The outcome measure was self-reported medicine use during the past month and the determinant was SRH measured by one item. Results There was an association between poor/fair SRH and medicine use for headache and stomach-ache. The associations remained statistically significant even after adjustment for frequency of the complaint for which the medicine was used: OR (95%CI) for medicine use for headache was 1.54 (1.10,2.14) among boys with poor/fair SRH and 1.50 (1.12,2.03) among girls with poor/fair SRH. A similar association was found between poor SRH and medicine use for stomach-ache for both boys (OR,=,3.41 (2.09,5.55)) and girls (OR,=,1.90 (1.36,2.67). Further, there was an association between poor/fair SRH and medicine use for difficulties in getting to sleep among girls, OR,=,2.66 (1.26,5.63) but not among boys. There was no association between SRH and medicine use for nervousness. Conclusion Poor/fair SRH is associated with medicine use for aches among Danish adolescents. Copyright © 2007 John Wiley & Sons, Ltd. [source] Health Risk Behavior of Rural Low-Income Expectant FathersPUBLIC HEALTH NURSING, Issue 4 2006Kevin D. Everett ABSTRACT Objectives: To assess expectant fathers' health risk behaviors and attitudes about pregnancy-related health issues. Pregnancy may be viewed as a teachable moment: a time when women are receptive to health advice and take action to improve their health and the health of their babies. Pregnancy may also be a teachable moment for expectant fathers, although men's behaviors are rarely considered as part of prenatal care or in associated research. Design: Cross-sectional prevalence study. Sample: Rural low-income expectant fathers (N=138) whose pregnant partners had enrolled in a Medicaid managed care health plan. Measurement: A telephone survey measuring five health risk behaviors, sociodemographic variables, and pregnancy- and behavior change-related attitudes. Results: Analyses found the following: 49.3% smoked cigarettes; 30.4% engaged in hazardous drinking in the past month; 27.5% had very low physical activity levels; 94.9% had at-risk fruit/vegetable intake; and 42% had weight-related health risk (25.4% met body mass index [BMI] criteria for obesity). Further, 47.9% of the men engaged in three or more of five assessed health risk behaviors. Conclusions: This sample of expectant fathers engages in high rates of health risk behaviors. Failure to address the health risk behavior of men during prenatal care represents a missed opportunity to improve paternal, maternal, and family health. [source] Uses of Diverted Methadone and Buprenorphine by Opioid-Addicted Individuals in Baltimore, MarylandTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2009Shannon Gwin Mitchell PhD This study examined the uses of diverted methadone and buprenorphine among opiate-addicted individuals recruited from new admissions to methadone programs and from out-of-treatment individuals recruited from the streets. Self-report data regarding diversion were obtained from surveys and semi-structured qualitative interviews. Approximately 16% (n = 84) of the total sample (N = 515) reported using diverted (street) methadone two,three times per week for six months or more, and for an average of 7.8 days (SD = 10.3) within the past month. The group reporting lifetime use of diverted methadone as compared to the group that did not report such use was less likely to use heroin and cocaine in the 30 days prior to admission (ps < .01) and had lower ASI Drug Composite scores (p < .05). Participants in our qualitative sub-sample (n = 22) indicated that street methadone was more widely used than street buprenorphine and that both drugs were largely used as self-medication for detoxification and withdrawal symptoms. Participants reported using low dosages and no injection of either medication was reported. [source] Pubic Hair Removal among Women in the United States: Prevalence, Methods, and CharacteristicsTHE JOURNAL OF SEXUAL MEDICINE, Issue 10 2010Debra Herbenick PhD ABSTRACT Introduction., Although women's total removal of their pubic hair has been described as a "new norm," little is known about the pubic hair removal patterns of sexually active women in the United States. Aims., The purpose of this study was to assess pubic hair removal behavior among women in the United States and to examine the extent to which pubic hair removal methods are related to demographic, relational, and sexual characteristics, including female sexual function. Methods., A total of 2,451 women ages 18 to 68 years completed a cross-sectional Internet-based survey. Main Outcome Measures., Demographic items (e.g., age, education, sexual relationship status, sexual orientation), cunnilingus in the past 4 weeks, having looked closely at or examined their genitals in the past 4 weeks, extent and method of pubic hair removal over the past 4 weeks, the Female Genital Self-Image Scale (FGSIS) and the Female Sexual Function Index (FSFI). Results., Women reported a diverse range of pubic hair-grooming practices. Women's total removal of their pubic hair was associated with younger age, sexual orientation, sexual relationship status, having received cunnilingus in the past 4 weeks, and higher scores on the FGSIS and FSFI (with the exception of the orgasm subscale). Conclusion., Findings suggest that pubic hair styles are diverse and that it is more common than not for women to have at least some pubic hair on their genitals. In addition, total pubic hair removal was associated with younger age, being partnered (rather than single or married), having looked closely at one's own genitals in the previous month, cunnilingus in the past month, and more positive genital self-image and sexual function. Herbenick D, Schick V, Reece M, Sanders S, and Fortenberry JD. Pubic hair removal among women in the United States: Prevalence, methods and characteristics. J Sex Med 2010;7:3322,3330. [source] Denuded subchondral bone and knee pain in persons with knee osteoarthritisARTHRITIS & RHEUMATISM, Issue 12 2009Kirsten Moisio Objective It is unclear how articular cartilage loss contributes to pain in patients with knee osteoarthritis (OA). Full-thickness cartilage defects expose the subchondral bone plate. The relationship between denuded bone and pain has not been examined. The aim of this study was to investigate whether the percent of denuded bone is associated with moderate-to-severe knee pain or frequent knee pain and longitudinally with frequent knee pain 2 years after the baseline evaluation. Methods We studied 182 persons with knee OA (305 knees). Applying specialized magnetic resonance imaging techniques, manual segmentation was used to compute cartilage-covered and denuded bone areas for each surface. Moderate-to-severe knee pain was defined as a score of ,40 mm on a knee-specific 100-mm visual analog scale, and frequent knee pain was defined as pain on most days during the past month. Logistic regression and generalized estimating equations were used in analyses, adjusting for age, sex, body mass index, and bone marrow lesions. Results Cross-sectional analyses revealed that moderate-to-severe knee pain was associated with percent denuded bone in the medial compartment (adjusted odds ratio [OR] 3.90, 95% confidence interval [95% CI] 1.33,11.47), in the medial and patellar surfaces together, and in the lateral and patellar surfaces. Frequent knee pain was associated with percent denuded bone in the patellar surface (adjusted OR 3.11, 95% CI 1.24,7.81), in the medial and patellar surfaces, and in the lateral and patellar surfaces. Longitudinal analyses (in 168 knees without frequent knee pain at baseline) revealed that percent denuded bone in the medial and patellar surfaces was associated with frequent incident knee pain (adjusted OR 4.19, 95% CI 1.56,11.22). Conclusion These results support a relationship between subchondral bone plate exposure and prevalent and incident knee pain in patients with knee OA. [source] Adjunctive antidepressant use and its clinical correlates in patients with schizophrenia: an East Asia multicenter comparative prescribing auditASIA-PACIFIC PSYCHIATRY, Issue 1 2010FAMS, Kang Sim MBBS, MMed (Psychiatry) Abstract Aims: Previous pharmacoepidemiological studies have highlighted considerable rates of adjunctive psychotropic medication prescriptions in patients with schizophrenia, including the use of adjunctive antidepressants, but this has not previously been studied in East Asia. This study examined the frequency of adjunctive antidepressant prescriptions in patients with schizophrenia and their clinical correlates in six East Asian countries and territories. Methods: Co-prescription of antidepressants for a sample of 2,136 patients with schizophrenia from six countries and territories (China, Hong Kong, Korea, Japan, Taiwan, Singapore) were evaluated in 2004 using a standardized protocol. Results: Adjunctive antidepressant prescriptions were found in 6.5% (n=139) of the patients with some intercountry differences. Co-prescription of antidepressants was significantly associated with younger age, shorter duration of index admission, electroconvulsive therapy in the past month, less likelihood of manifesting disorganized speech, and prescription of first generation antipsychotic drugs. Concomitant antidepressant prescription was associated with greater weight and increased number of adverse events including constipation, sedation and sexual dysfunction. On multivariate analysis, it was found that country, younger age and history of electroconvulsive therapy for the past month were significantly associated with adjunctive antidepressant use. Discussion: Adjunctive antidepressant use for schizophrenia in East Asia was associated with a number of demographic, clinical, and treatment variables. The association with greater weight and more adverse events reinforces the notion that prescription of adjunctive psychotropic medication is not without its costs. The challenge for the clinician is to constantly reevaluate the risk benefit ratio in the process of understanding the patient in a holistic context and to optimize the treatment regimes for patients with schizophrenia. [source] Fruit consumption among people living in a high deprivation New Zealand neighbourhoodAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2009Sara R. Jaeger Abstract Objective: To investigate fruit consumption in a high deprivation population in New Zealand. Method: In 2007, 99 door-to-door interviews were conducted in a high deprivation neighbourhood in Auckland with a focus on measuring self-reported fruit consumption. Results: On average, participants reported eating a serving of fresh fruit five to six times per week. At the time of the interview, more than a third of participants (38%) did not have any fresh fruit in the house and 60% of respondents reported that in the past month they had thrown out fruit between one to four times per week because it was considered to be past its best in terms of eating quality. Fruit juice was consumed on average one to two times per week. Self-efficacy for fruit consumption was positively associated with consumption. Relative to participants with lower levels of self-efficacy for fruit consumption, those with higher levels of self-efficacy were more likely to achieve the target of consuming two or more servings of fruit daily. Conclusion: Strategies that aim to increase self-efficacy beliefs for fruit consumption may contribute to improving compliance with the recommended two or more servings daily. Together with strategies that give consideration to the social and cultural context and community level interventions (involving schools, churches and local community groups) they represent a holistic approach that is likely to be necessary for improving fruit consumption in high deprivation populations. [source] Crime, drugs and distress: patterns of drug use and harm among criminally involved injecting drug users in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Stuart A. Kinner Abstract Objective: Explore demographic characteristics, patterns of drug use and psychological distress among regular injecting drug users (IDUs) in Australia, as a function of recent criminal activity. Methods: Structured, face-to-face interviews with 909 regular IDUs recruited from every capital city in Australia, between June and August 2007, as part of the annual Illicit Drug Reporting System (IDRS). Criminal activity in the past month was assessed using the Opiate Treatment Index (OTI); psychological distress was assessed using the Kessler psychological distress scale (K10). Results: Forty-three per cent of IDUs reported recent (past month) criminal activity. Those who had committed crime recently were younger, exhibited riskier patterns of drug use, reported more drug-related problems and were more likely to exhibit significant psychological distress. In a multivariate model the most important correlates of recent criminal activity were use of more than three drug types recently (OR=2.66, 95% CI 1.96-3.61), initiation to injecting before age 18 (OR=1.93, 95% CI 1.42-2.61) and daily drug injection (OR=1.55, 95% CI 1.13-2.13). Conclusions and Implications: Criminal activity among regular IDUs in Australia is not restricted to a particular demographic group, and is a marker for riskier patterns of drug use, greater drug-related harm and psychological distress. Contact between IDUs and the criminal justice system provides opportunities for the delivery of targeted harm reduction messages, and for screening and diversion into appropriate treatment services. [source] How do trends in smoking prevalence among Indigenous and non-Indigenous Australian secondary students between 1996 and 2005 compare?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2009Victoria White Abstract Objective: To compare trends in smoking prevalence between 1996 and 2005 among Indigenous and non-Indigenous secondary students across Australia. Methods: Representative random samples of secondary students aged 12-17 years completed self-report anonymous surveys. Questionnaires assessed any cigarette smoking in lifetime, and smoking in past month, week and on at least three of the previous seven days. Intention to smoke in the next 12 months was assessed on a 7-point scale. Students self-identified as being of Aboriginal or Torres Strait Islander descent. Results: Three to four per cent of students identified as being Indigenous at each survey. Smoking was more common among Indigenous than non-Indigenous students. Between 1996 and 2005, the proportion of smoking declined among both Indigenous and non-Indigenous students. However, among 12-15 year olds, the rate of decline was different for the two groups. Among non-Indigenous students in this age group, prevalence decreased steadily between 1996 and 2005. Among Indigenous students, the decrease mainly occurred between 1999 and 2002. Smoking intention was higher for Indigenous than non-Indigenous students. The mean intention decreased between 1996 and 2005 among both student groups. Conclusions: Smoking prevalence decreased among both Indigenous and non-Indigenous students between 1996 and 2005. Implications: Reductions in Indigenous students' tobacco use and intentions coincided with a period of increased tobacco control activity, suggesting that these activities may positively influence smoking behaviours. [source] From Blair to Brown: The Condition of British GovernmentTHE POLITICAL QUARTERLY, Issue 3 2007PETER HENNESSY Peter Hennessy examines the conduct of central government since 1997, especially Cabinet processes during the build-up to the Iraq war of 2003. He discusses the degree to which both Blair and Brown over the past months have appeared to run against aspects of the governing style of the administrations they have jointly dominated. He assesses what Gordon Brown's floated idea of a written constitution might mean in practical terms and makes a particular case for a War Powers Act. [source] |