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Prevention Programmes (prevention + programme)
Selected AbstractsPREMATURE ADOPTION AND DISSEMINATION OF PREVENTION PROGRAMMESADDICTION, Issue 4 2010SVEN ANDRÉASSON No abstract is available for this article. [source] Uncovering sexual abuse: evaluation of the effectiveness of The Victims of Violence and Abuse Prevention ProgrammeJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2010J. DONOHOE bsc Accessible summary ,,Discusses factors inhibiting open talk around a client's history of abuse including gender, age and diagnosis. ,,Evaluates the helpfulness of a training course designed to reduce and overcome these factors. ,,Aim of the evaluation is to help replicate the training nationally, following the positive impact found. Abstract Despite the high prevalence of sexual abuse among users of mental health services, it appears that mental health professionals are frequently unaware of clients' abuse histories. In order to address this, a Mental Health Trusts Collaboration Project of nine trusts was formed, which piloted delivering the Department of Health's Victims of Violence & Abuse Prevention Programme one-day education and training course regarding enquiring about histories of sexual abuse to various mental health practitioners. This hoped to educate practitioners in factors associated with victims and offenders, improve confidence and competence in asking about client's history of abuse and to increase awareness of the importance of asking. The purpose of this paper is to describe the impact of this course on mental health professionals' practice and attitudes in one of these nine trusts. It was found that since the delivery of the course, 44% (n= x) of professionals had been asking about abuse in 75,100% of cases. Gender, age and diagnosis of both the service users and the practitioners were all identified as factors potentially affecting practitioners' willingness to ask about abuse. Most importantly, 93% (n= x) of participants were found to feel they have the skills and knowledge to enquire about abuse and respond to disclosure in the appropriate way and 77% (n= x) of participants felt that this training had changed their clinical practice. The aim of this evaluation is to prove the effectiveness of the Department of Health's education and training course, which will help towards replicating the project nationally. [source] Empirically evaluated treatments for body image disturbance: a reviewEUROPEAN EATING DISORDERS REVIEW, Issue 5 2006Clare Farrell Abstract Body image disturbance is both a risk factor for the development of disturbed eating and a central feature of clinical eating disorders. This review examines empirically tested interventions for people with high levels of body image disturbance. The most commonly used therapies with the most empirical support are cognitive-behavioural. The specificity of the body image interventions and the importance of individual components have not yet been established. Prevention programmes to address body image disturbance appear promising, although further research evidence is required. It is concluded that treatments for addressing body image disturbance are hindered by the lack of a clearly specified theoretical model of the maintenance of body image disturbance and that such an analysis is needed to increase the effectiveness of current interventions. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Early sexual debut and associated factors among in-school adolescents in eight African countriesACTA PAEDIATRICA, Issue 8 2010Karl PeltzerArticle first published online: 19 MAY 2010 Abstract Objective:, This report examines early sexual debut ( Trends in childhood mortality from 1969 to 2004 in FinlandACTA PAEDIATRICA, Issue 8 2008Marjo Lantto Abstract Aim: The aim was to evaluate the trends in childhood mortality in Finland from 1969 to 2004. We especially wanted to find out whether the decline in mortality is continuous and whether there are still deaths that could be prevented. Methods: We analyzed mortality data obtained from the official cause of death statistics in Finland from 1969 to 2004. Annual mortality rates were calculated in proportion to those at risk of dying. Comparison of cause specific mortality rates was conducted for neonatal group and children aged 1 month to 15 years. Results: Annual neonatal mortality declined from 11.13, in 1969 to 2.46, in 2004. The leading causes of death were perinatal disorders and congenital malformations. Mortality among children aged 1 month to 15 years declined from 0.67, in 1969 to 0.23, in 2004, with accidents the leading cause of death, although congenital malformations, tumours and haematological diseases, and infectious diseases were significant causes as well. There was a notable peak in total mortality in 2004, as 44 Finnish children died in the Asian tsunami in December of that year. Conclusion: Childhood mortality in Finland has decreased significantly during recent decades. Prevention programmes should be directed towards reducing mortality from accidents by promoting traffic safety and ensuring a safer environment. Even though child mortality is very low in Finland at present, continued reductions can still be achieved. [source] Effects of back care education in elementary schoolchildrenACTA PAEDIATRICA, Issue 8 2000G Cardon The purpose of this study was to investigate the effects of a back care education programme, consisting of six sessions of 1 h each, in fourth- and fifth-grade elementary schoolchildren. Testing consisted of a practical performance and a back care knowledge test. Forty-two subjects and 36 controls performed a pre-test and were tested within 1 wk after the programme. To monitor effects and follow-up effects on a larger sample, 82 different pupils were tested within 1 wk after the programme and 116 other children 3 mo after. Both larger samples were compared with one group of 129 controls. Interrater reliability for the test items of the practical assessment was high; intraclass correlation coefficients varied from 0.785 to 0.980. In the pre/post design study, interaction between time and condition was significant for the sum score of the practical assessment and for the knowledge test (p < 0.001), with higher scores for the intervention group (15% improvement for the knowledge test score, 31.6% for the practical sum score). Significantly higher sum scores for the knowledge test and for all practical assessment items were found in the intervention groups, tested within 1 wk and 3 mo after the programme, in comparison with the control group (p <0.001). Conclusion: The effectiveness of a primary educational prevention programme on back care principles was demonstrated in this study. Effectiveness, long-term outcomes and behavioural changes need further evaluation to optimize back care prevention programmes for elementary schoolchildren. [source] Effects of a community intervention to reduce the serving of alcohol to intoxicated patronsADDICTION, Issue 6 2010Katariina Warpenius ABSTRACT Aims To assess the effects of an alcohol prevention programme to reduce the serving of alcoholic beverages to intoxicated clients on licensed premises. Research design A controlled pre- (2004) and post-intervention study (2006) design. Intervention A community-based programme combining law enforcement, responsible beverage service training, information campaigns and policy initiatives in one Finnish town (Jyväskylä). Participants and measurements A male actor pretended to be clearly under the influence of alcohol and tried to buy a pint of beer at licensed premises. For the baseline measurement, every bar and nightclub was visited in the intervention and the control areas (94 licensed premises in total). Post-intervention data were gathered with the same principles (100 licensed premises in total). A researcher observed every visit and documented the results. Results In the post-intervention study there was a statistically significant increase in refusals to serve denials alcohol to the actor in the intervention area (from 23% to 42% of the licensed premises) compared to refusals in the control area (from 36% to 27% of the licensed premises). Conclusion Previous research has documented that multi-component community-based interventions can have a significant impact on over-serving of alcohol when training and house policies are combined with effective law enforcement. The present findings also demonstrate that comprehensive Responsible Beverage Service (RBS) interventions applied at a local community level can be effective in decreasing service to intoxicated clients in a Nordic context. [source] Predicting the life-time benefit of school-based smoking prevention programmesADDICTION, Issue 6 2010Mark Jit ABSTRACT Aim School-based smoking prevention programmes may delay the age of smoking initiation, but do not appear to achieve lasting reductions in smoking prevalence beyond school-leaving age. We explored whether delaying the age at which someone initiates smoking may have life-time benefits by increasing the likelihood of quitting in later life. Design and setting Data from the General Household Survey of Great Britain were used in a logistic regression model to examine the association between age at which someone initiates regular smoking and the probability that the person will quit smoking later in life. The effect of confounding variables (sex, ethnicity, socio-economic class, education and geographical location) was taken into account. The predicted relationship was used in a cohort model to estimate the life-time reduction in smoking prevalence and all-cause mortality of a school-based smoking prevention programme. Results Age of regular smoking initiation was associated strongly with the probability of quitting later in life (coefficient ,0.103, P < 0.001). The strength of the association was slightly reduced but still significant when confounding variables were included (coefficient ,0.075, P < 0.001). An intervention that delays smoking initiation without decreasing smoking prevalence at age 18 may reduce adult smoking prevalence by 0.13,0.32% (depending on age) and all-cause mortality by 0.09% over the life-time of the sample. Conclusion School-based smoking prevention programmes have potential for a beneficial effect over the life-time of the participants even if they have no apparent effect at school-leaving age. [source] Internet-based prevention for alcohol and cannabis use: final results of the Climate Schools courseADDICTION, Issue 4 2010Nicola C. Newton ABSTRACT Aims To establish the long-term efficacy of a universal internet-based alcohol and cannabis prevention programme in schools. Methods A cluster-randomized controlled trial was conducted to assess the effectiveness of the Climate Schools: Alcohol and Cannabis Course. The evidence-based course, aimed at reducing alcohol and cannabis use, is facilitated by the internet and consists of 12 novel and curriculum consistent lessons delivered over 6 months. Participants A total of 764 year 8 students (13 years) from 10 Australian secondary schools were allocated randomly to the internet-based prevention programme (n = 397, five schools), or to their usual health classes (n = 367, five schools). Measures Participants were assessed at baseline, immediately post, and 6 and 12 months following completion of the intervention, on measures of alcohol and cannabis knowledge, attitudes, use and related harms. Results This paper reports the final results of the intervention trial, 12 months following the completion of the Climate Schools: Alcohol and Cannabis Course. The effectiveness of the course 6 months following the intervention has been reported previously. At the 12-month follow-up, compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge, a reduction in average weekly alcohol consumption and a reduction in frequency of drinking to excess. No differences between groups were found on alcohol expectancies, cannabis attitudes or alcohol- and cannabis-related harms. The course was found to be acceptable by teachers and students as a means of delivering drug education in schools. Conclusions Internet-based prevention programs for school-age children can improve student's knowledge about alcohol and cannabis, and may also reduce alcohol use twelve months after completion. [source] ,-thalassaemia carrier detection by ELISA: A simple screening strategy for developing countriesJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 1 2005M. Shyla Ravindran Abstract The frequency of ,-thalassaemia in India ranges from 3.5% to 15% in the general population and of the 100,000 children born with thalassaemia major in the world, 10,000 are in India alone. Affected children do not die immediately, but treatment by regular transfusion is costly and leads to iron overload and death. Therefore, health services in lower-economic countries can sustain patients only if the numbers can be limited. Detecting carrier couples by simple blood test can prevent thalassaemia and at-risk couples can be identified and informed of their genetic risk before having children. A prevention programme including population screening, counselling, and prenatal diagnosis will markedly reduce the birth prevalence of affected individuals. Hemoglobin A2 (HbA2) measurement in human hemolysates has great significance, since its level can indicate ,-thalassaemia carrier status in otherwise healthy individuals. We have developed a rapid, simple, and inexpensive enzyme linked immunosorbent assay (ELISA) for the quantitation of HbA2, which can be used in carrier screening programmes in developing countries like India. In a limited trial for ,-thalassaemia carrier screening, the results obtained with ELISAs were compared with those obtained with the microcolumn chromatography method (r=0.89). J. Clin. Lab. Anal. 19:22,25, 2005. © 2005 Wiley-Liss, Inc. [source] An integrative literature review of lifestyle interventions for the prevention of type II diabetes mellitusJOURNAL OF CLINICAL NURSING, Issue 17 2008Suzanne G Madden Aims and objectives., An integrative literature review was undertaken to determine what type II diabetes prevention programmes have been evaluated, what type of programme is the most effective and how adherent to lifestyle changes adults are after participating in a prevention programme. Background., Type II diabetes is important because the disease is affecting millions of people worldwide. Obesity and sedentary lifestyles are preventable risk factors for type II diabetes, leading many researchers from around the world to examine different programmes that are focussed on prevention of the disease. Design., Integrative literature review. Method., Search of electronic databases. Results., Diet, exercise, counselling and diet plus exercise were the types of prevention programmes, with the diet plus exercise being the most efficacious. Although many studies demonstrated excellent results initially, maintaining the effects of the lifestyle behaviour change proved to be difficult for participants, with only one study demonstrating the persistence of results after six years. Conclusion., Future research should focus on long-term maintenance programmes, rather than just short-term prevention programmes to determine the need for booster interventions or other means to ultimately decrease the incidence of type II diabetes. Relevance to clinical practice., As front-line healthcare providers working across a broad array of settings, nurses are particularly well-suited to play an integral part in future applications of diabetes prevention programmes. Lifestyle interventions are being delivered in a variety of settings and venues such as the workplace, the Internet and places of worship. In addition, at-risk populations also can be targeted, particularly overweight and obese persons, with at least one parent having type II diabetes or persons with gestational diabetes. [source] Heights of occupied patient beds: a possible risk factor for inpatient fallsJOURNAL OF CLINICAL NURSING, Issue 11 2008Huey-Ming Tzeng PhD Aims., The aim of this study was to ascertain the average height of occupied patient beds in a general medical ward and to investigate the relationship between staff working-height for patient beds, time and whether the patient was on fall precaution. Background., The height of occupied patient beds can be an overlooked contributor to inpatient falls. Better physical design of hospital equipment such as patient beds may reduce patient falls and injuries. Methods., This study took place in an acute medical ward of a Michigan medical center. One researcher collected all the data and used the same metric for all the measurements. Univariate analyses were performed. Results., The average staff working-height measurement taken at the weekend was significantly higher than that taken on weekdays. The average height of patient beds on fall precaution was significantly higher than of those not on fall precaution. Conclusions., A higher patient/nurse ratio at weekends than on weekdays may result in fewer bedside nursing hours and nurses being less conscientious about keeping beds in the low position after treatments. In an effort to prevent high-fall-risk patients from falling, nurses may have consciously or unconsciously kept their beds in higher positions. Relevance to clinical practice., If the patient bed can be manually or automatically adjusted, nurses must lower the height of the bed to the lowest position after completing treatments or tasks. This after-procedure activity should be enforced and monitored regularly as part of a hospital's patient fall prevention programme. Low beds should be used for patients at high risk of falling. Future research should investigate patients' and staff's views on hospital equipment to provide evidence-based information for policy-makers determining the design-regulation standard for hospital bedframes. [source] Evaluation of a falls prevention programme in an acute tertiary care hospitalJOURNAL OF CLINICAL NURSING, Issue 2 2007M Hth Sci, PG Dip Clin Epi, Teresa A Williams BN Aims and objectives., To evaluate a systematic, coordinated approach to limit the severity and minimize the number of falls in an acute care hospital. Background., Patient falls are a significant cause of preventable injury and death, particularly in older patients. Best practice principles mandate that hospitals identify those patients at risk of falling and implement interventions to prevent or minimize them. Methods., A before and after design was used for the study. All patients admitted to three medical wards and a geriatric evaluation management unit were enrolled over a six-month period. Patients' risk of falling was assessed using a falls risk assessment tool and appropriate interventions implemented using a falls care plan. Data related to the number and severity of falls were obtained from the Australian Incident Monitoring System database used at the study site. Results., In this study, 1357 patient admissions were included. According to their risk category, 37% of patients (n = 496) were grouped as low risk (score = 1,10), 58% (n = 774) medium risk (score = 11,20) and 5% (n = 63) high risk (score = 21,33) for falls. The incidence of falls (per average occupied bed day) was eight per 1000 bed days for the study period. Compared with the same months in 2002/2003, there was a significant reduction in falls from 0·95 to 0·80 (95% CI for the difference ,0·14 to ,0·16, P < 0·001). Conclusion., We evaluated a systematic, coordinated approach to falls management that included a falls risk assessment tool and falls care plan in the acute care setting. Although a significant reduction in falls was found in this study, it could not be attributed to any specific interventions. Relevance to clinical practice., Preventing falls where possible is essential. Assessment of risk and use of appropriate interventions can reduce the incidence of falls. [source] A three-year prospective study of adult subjects with gingivitis II: microbiological parametersJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2007R. P. Teles Abstract Aim: To investigate whether the clinical benefits obtained with a periodontal prevention programme in subjects with periodontal health or minimal disease were accompanied by beneficial changes in the subgingival microbiota. Material and Methods: One hundred and twenty-four subjects completed the study. Subjects were clinically and microbiologically monitored at baseline, 1, 2 and 3 years. Subgingival plaque samples were taken from the mesiobuccal aspect of every tooth and were analysed for the levels of 40 bacterial species using checkerboard DNA,DNA hybridization (total samples=13,477). The mean counts of each of the 40 test species were calculated for each subject at each time point. Significance of differences over time was sought using the Friedman test. p values were adjusted for multiple comparisons. Results: All clinical parameters, at the microbiologically sampled sites, improved over time. The clinical changes were accompanied by statistically significant decreases in the mean counts of 35 of the 40 test species. Major reductions occurred by year 2 for Actinomyces, Capnocytophaga, Campylobacter, Fusobacterium and Prevotella species. At year 3, there was a modest re-growth of the majority of the species. Conclusions: The clinical improvements obtained through preventive measures were accompanied by a shift to a more host-compatible subgingival microbiota. [source] A cervical cancer prevention programme in rural Mexico: addressing women and their contextJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 5 2005Martha Givaudan Abstract This article reports on the development and administration of a programme in seven rural villages in the Mexican state of Oaxaca to address high rates of cervical cancer. The rationale and strategy are described on which the programme is based. The development and administration of the programme (to 1513 women) is presented, aimed at enabling women to take better care of themselves. Various additional activities that were added in the course of the programme in order to facilitate contextual factors are also described, including community campaigning, programmes with men and the training of health personnel. Effectiveness was evaluated in terms of both process and impact indices, showing high rates of attendance at programme sessions by enrolled women, an increase in knowledge and a substantial increase in the number of preventive diagnostic tests. The final section reflects on both the achievements, and the scope and the limitations of the programme. Copyright © 2005 John Wiley & Sons, Ltd. [source] Comparing money and labour payment in contingent valuation: the case of forest fire prevention in Vietnamese contextJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 2 2007Le Trong Hung Abstract The contingent valuation method for valuing public goods is a relatively new method in Vietnam. In developed countries, payments are often requested in money, but the form of payment should be more flexible in developing countries that do not have extensive cash economies. Drawing on historical precedent in Vietnam, payment in working days was also used and accepted by the local people; payment in money was less acceptable for the firebreak establishment and maintenance programme. The household mean willingness to pay for the firebreak establishment and maintenance programme was five days a year. The contingent valuation method was found workable at least for a forest fire prevention programme in the Vietnamese context. The lessons learned from this study should be of interest to researchers and policy makers considering applying the contingent valuation method in newly emerging market economies. Copyright © 2006 John Wiley & Sons, Ltd. [source] Effects of back care education in elementary schoolchildrenACTA PAEDIATRICA, Issue 8 2000G Cardon The purpose of this study was to investigate the effects of a back care education programme, consisting of six sessions of 1 h each, in fourth- and fifth-grade elementary schoolchildren. Testing consisted of a practical performance and a back care knowledge test. Forty-two subjects and 36 controls performed a pre-test and were tested within 1 wk after the programme. To monitor effects and follow-up effects on a larger sample, 82 different pupils were tested within 1 wk after the programme and 116 other children 3 mo after. Both larger samples were compared with one group of 129 controls. Interrater reliability for the test items of the practical assessment was high; intraclass correlation coefficients varied from 0.785 to 0.980. In the pre/post design study, interaction between time and condition was significant for the sum score of the practical assessment and for the knowledge test (p < 0.001), with higher scores for the intervention group (15% improvement for the knowledge test score, 31.6% for the practical sum score). Significantly higher sum scores for the knowledge test and for all practical assessment items were found in the intervention groups, tested within 1 wk and 3 mo after the programme, in comparison with the control group (p <0.001). Conclusion: The effectiveness of a primary educational prevention programme on back care principles was demonstrated in this study. Effectiveness, long-term outcomes and behavioural changes need further evaluation to optimize back care prevention programmes for elementary schoolchildren. [source] OEESC-2005 , Summing up on the theme Irritants and Wet WorkCONTACT DERMATITIS, Issue 6 2006Mari-Ann Flyvholm The aim of this paper was to summarize the presentations and discussions on the theme Irritants and Wet Work at the second conference on Occupational and Environmental Exposures of Skin to Chemicals held in Stockholm June 2005 (OEESC-2005) to bring the focus points to a broader group of professionals and stimulate further discussions. Occupational skin diseases are common diseases with a huge potential for prevention. The risk factors are mostly well known, and the ongoing high occurrence of occupational skin diseases may be seen as a paradox problem. Although all mechanisms involved in occupational skin diseases are not shown throughout, much is known. The existing knowledge justifies the relevance of reducing exposure and introducing prevention programmes. The questions identified for further research included an internationally agreed-upon definition of wet work; better methods to assess the exposure to wet work; the effect of combined exposure to water and water-soluble irritants; the importance of wet work with frequent/short wet,dry cycles versus working longer periods with wet hands; testing skin protection and skin care products; long-term skin effects from alcohol-based hand disinfectants; workplace testing of evidence-based prevention programmes in prospective randomized, controlled intervention studies. [source] Increasing prevalence of diabetes mellitus in OmanDIABETIC MEDICINE, Issue 11 2002J. A. Al-Lawati Abstract Aims To determine the prevalence of diabetes mellitus and impairedfasting glucose by age, gender, and by region and compare resultswith the 1991 survey; and estimate previously undiagnosed diabetesmellitus in the Omani population. Methods Cross-sectional survey containing a probability random sample of5838 Omani adults aged , 20 years. Diabetesand impaired fasting glucose (IFG) were assessed by fasting venous plasmaglucose using 1999 World Health Organization's diagnosticcriteria (normoglycaemia < 6.1 mmol/l, IFG , 6.1 but < 7 mmol/l,and diabetes , 7 mmol/l). The 1991 surveywas reanalysed using the same diagnostic criteria, and results werecompared. Results In 2000, the age-adjusted prevalence of diabetes among Omanis aged30,64 years reached 16.1% (95% confidenceinterval (CI) 14.7,17.4) compared with 12.2% (95% CI11.0,13.4) in 1991. IFG was found among 7.1% (95% CI6.2,8.1) of males and 5.1% (95% CI 4.4,6.0)of females. Generally, diabetes was more common in urban then ruralregions. Only one-third of diabetic subjects knew that they haddiabetes. Nearly half of the study population had a body mass index > 25 kg/m2. Conclusions The prevalence of diabetes is high in Oman and has increasedover the past decade. The high rate of abnormal fasting glucosetogether with high rates of overweight and obesity in the population makeit likely that diabetes will continue to be a major health problem inOman. Primary prevention programmes are urgently needed to counteract majorrisk factors that promote the development of diabetes. Diabet. Med. 19, 954,957 (2002) [source] The size and mix of government spending on illicit drug policy in AustraliaDRUG AND ALCOHOL REVIEW, Issue 4 2008TIMOTHY J. MOORE Abstract Aim. To estimate how much governments in Australia spend on reducing and dealing with illicit drug problems. Methods. Government documents and supplementary information sources were used to estimate drug-related expenditure for the financial year 2002,03, in Australian dollars. Public sector expenditure on reducing drug problems (,proactive expenditure') was classified into four policy functions: prevention, treatment, harm reduction and enforcement. Expenditure related to the consequences of drug use (,reactive expenditure') was included as a separate category. Results. Spending by Australian governments in financial year 2002,03 on all drug-related activities was estimated to be $3.2 billion. Proactive expenditure was estimated to be $1.3 billion, comprising 55% on enforcement, 23% on prevention, 17% on treatment, 3% on harm reduction and 1% on activities that span several of these functions. Expenditure on dealing with the consequences of drug use was estimated to be $1.9 billion, with the majority the result of crime-related consequences. Conclusion. Several insights result from estimating these expenditures. First, law enforcement is the largest drug policy component, with Australian governments also spending significant amounts on treatment and prevention programmes. Secondly, apart from the prevention component, Australia's drug policy mix is strikingly similar to recent international estimates. Finally, expenditures associated with dealing with the consequences of illicit drugs are large and important for assessing drug-related public sector expenditure. [source] Reflections on 30 + years of smoking cessation research: from the individual to the worldDRUG AND ALCOHOL REVIEW, Issue 1 2006HARRY A. LANDO PhD Abstract This is a personal retrospective in which I describe my career as a smoking cessation researcher and place cessation into an overall perspective of tobacco reduction. I spent approximately the first 15 years focusing primarily upon small group approaches to cessation emphasising relatively intensive behavioural interventions. It became apparent, however, that these types of approaches in isolation, even if broadly disseminated, would have relatively minimal impact on overall tobacco use. In part because I became discouraged with the potential of group programmes to reduce overall smoking prevalence, I began to focus more on population-based studies, especially in the context of ,teachable moments' including pregnancy, hospitalisation, forced abstinence in the military and existing smoking-related disease. I became concerned especially with the fact that there has been relatively little work with hard-core medically compromised smokers. It also became apparent that promoting cessation would be most likely to be effective with a comprehensive evidence-based tobacco reduction strategy including school and community-based prevention programmes, enforcement of ordinances restricting minors' access to tobacco, restrictions on tobacco advertising and promotion, counter advertising and strong smoke-free policies. In recent years I have become very concerned about the overall global tobacco epidemic and the projections of dramatically increasing tobacco morbidity and mortality in developing countries. I am now devoting my primary career emphasis to global tobacco reduction initiatives, including cessation research in India and Indonesia, cessation as part of broader tobacco reduction strategies and networking to increase resources and emphasis devoted to global tobacco reduction. [source] Drug prevention programmes for young people: where have we been and where should we be going?ADDICTION, Issue 10 2010Richard Midford ABSTRACT Aim Substance use by young people has long been a concern of western society, but opinion is mixed as to which prevention approach offers the greatest benefit, and whether indeed there is any benefit at all. This paper reviews the nature of prevention programmes, the research evidence that underpins these programmes and the prevention objectives against which effectiveness is measured. The aim of this is to create better understanding of the elements that maximize programme effectiveness, what can be achieved by prevention programmes and how programmes can be improved. Findings There is a range of prevention approaches for which there is evidence of effectiveness. Some are classroom-based; some focus upon parenting; some have substantial whole-of-school and community elements; and some target risk and protective factors in early childhood. All, however, are based substantially on the social influence model. In an attempt to improve practice lists of effective programmes have been developed, but there are concerns about the science behind selection. On balance, there is consistent evidence that social influence prevention programmes do have a small, positive effect on drug use, but this then raises the question as to whether harm, rather than use, would be the more worthwhile target for prevention. Prevention that seeks to reduce harm has been demonstrably effective, but has found little support in some jurisdictions. Conclusion Research has created a progressively better understanding of how to optimize programme effectiveness and what can be achieved realistically by even the most effective programmes. However, further research is required to identify which, if any, particular approach offers greater promise. The effectiveness of harm reduction should be compared with more traditional abstinence and the additional effects of whole of school, parent and community elements need to be measured more accurately. Contemporary social influence prevention programmes are flawed, but the approach is still the best way of influencing drug use behaviour in young people as a whole. Evidence-based refinement is the best option for greater benefit. [source] Drug Policy and the Public Good: a summary of the bookADDICTION, Issue 7 2010Drugs, Public Policy Group ABSTRACT Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence. [source] Predicting the life-time benefit of school-based smoking prevention programmesADDICTION, Issue 6 2010Mark Jit ABSTRACT Aim School-based smoking prevention programmes may delay the age of smoking initiation, but do not appear to achieve lasting reductions in smoking prevalence beyond school-leaving age. We explored whether delaying the age at which someone initiates smoking may have life-time benefits by increasing the likelihood of quitting in later life. Design and setting Data from the General Household Survey of Great Britain were used in a logistic regression model to examine the association between age at which someone initiates regular smoking and the probability that the person will quit smoking later in life. The effect of confounding variables (sex, ethnicity, socio-economic class, education and geographical location) was taken into account. The predicted relationship was used in a cohort model to estimate the life-time reduction in smoking prevalence and all-cause mortality of a school-based smoking prevention programme. Results Age of regular smoking initiation was associated strongly with the probability of quitting later in life (coefficient ,0.103, P < 0.001). The strength of the association was slightly reduced but still significant when confounding variables were included (coefficient ,0.075, P < 0.001). An intervention that delays smoking initiation without decreasing smoking prevalence at age 18 may reduce adult smoking prevalence by 0.13,0.32% (depending on age) and all-cause mortality by 0.09% over the life-time of the sample. Conclusion School-based smoking prevention programmes have potential for a beneficial effect over the life-time of the participants even if they have no apparent effect at school-leaving age. [source] Predicting life-time and regular cannabis use during adolescence; the roles of temperament and peer substance use: the TRAILS studyADDICTION, Issue 4 2010Hanneke E. Creemers ABSTRACT Aims The aim of the present study was to determine the mediating role of affiliation with cannabis-using peers in the pathways from various dimensions of temperament to life-time cannabis use, and to determine if these associations also contributed to the development of regular cannabis use. Methods Objectives were studied using data from 1300 participants of the Tracking Adolescents' Individual Lives Survey (TRAILS), a large, general population study of Dutch adolescents. We used parent-reports on the Early Adolescent Temperament Questionnaire to assess the dimensions of high-intensity pleasure, shyness, fearfulness, frustration and effortful control at age 10,12 years. By means of self-reports, life-time and regular cannabis use were determined at age 15,18 years, and proportion of substance-using peers was determined at ages 12,15 and 15,18 years. Models were adjusted for age, sex, intelligence and parental cannabis use. Results High-intensity pleasure [odds ratio (OR) = 1.09, 95% confidence interval (CI) = 1.05,1.13] and effortful control (OR = 0.92, 95% CI = 0.89,0.96) affected the risk for life-time cannabis use through their influence on affiliation with cannabis-using peers. Shyness affected this risk independently from peer cannabis use. Only the pathway from effortful control was associated additionally with the development of regular cannabis use (OR = 0.93, 95% CI = 0.89,0.98). Conclusions Peer cannabis use and, to a lesser extent, certain temperamental characteristics affect an adolescent's risk of cannabis use, and should be considered in prevention programmes. We recommend future research to focus upon factors that potentially modify the association between temperament, affiliation with cannabis-using peers and cannabis use. [source] Does opioid substitution treatment in prisons reduce injecting-related HIV risk behaviours?ADDICTION, Issue 2 2010A systematic review ABSTRACT Objectives To review systematically the evidence on opioid substitution treatment (OST) in prisons in reducing injecting-related human immunodeficiency virus (HIV) risk behaviours. Methods Systematic review in accordance with guidelines of the Cochrane Collaboration. Electronic databases were searched to identify studies of prison-based opioid substitution treatment programmes that included assessment of effects of prison OST on injecting drug use, sharing of needles and syringes and HIV incidence. Published data were used to calculate risk ratios for outcomes of interest. Risk ratios were not pooled due to the low number of studies and differences in study designs. Results Five studies were included in the review. Poor follow-up rates were reported in two studies, and representativeness of the sample was uncertain in the remaining three studies. Compared to inmates in control conditions, for treated inmates the risk of injecting drug use was reduced by 55,75% and risk of needle and syringe sharing was reduced by 47,73%. No study reported a direct effect of prison OST on HIV incidence. Conclusions There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required. OST should be implemented in prisons as part of comprehensive HIV prevention programmes that also provide condoms and sterile injecting and tattooing equipment. [source] Associations of cohort and socio-demographic correlates with transitions from alcohol use to disorders and remission in metropolitan ChinaADDICTION, Issue 8 2009Sing Lee ABSTRACT Aims To examine socio-demographic associations of transitions from alcohol use to disorders and of remission from disorders in metropolitan China. Design and setting Face-to-face interviewing by trained lay-interviewers on a multi-staged, clustered sample from the general population of Beijing and Shanghai, China. Participants A total of 5201 adults aged 18,70 years and with household registration. Measurements World Mental Health version of Composite International Diagnostic Interview. Findings Lifetime prevalence estimates for alcohol use, regular use (at least 12 drinks in a year), DSM-IV abuse and dependence with abuse were 65.4%, 39.5% (60.4% of ever-drinkers), 4.6% (11.6% of regular users) and 0.9% (20.4% of lifetime alcohol abusers), respectively. These estimates were higher among respondents from the recent cohort; 64.3% and 36.9% respondents with a history of lifetime abuse and dependence respectively had remitted. The number of socio-demographic associations for the onset of each transitional stage decreased from alcohol use to alcohol dependence. Onset of ever-use was more common in respondents who were male, 18,50 years of age, with middle education level and never married, but less common among the previously married and students. First onset of regular use among those with ever-use was more common in respondents who were male, less than 50 years of age and never married, but less common in students. Being male and less than 50 years of age was associated with more alcohol abusers among regular users. Conclusion This study was the first to reveal in a Chinese population that qualitatively different risk factors might operate during the different stages of progression from alcohol use to disorders. Further research is needed to clarify the mechanisms underlying these differences in order to guide prevention programmes. [source] Disruptiveness, peer experiences and adolescent smoking: a long-term longitudinal approachADDICTION, Issue 4 2009Roy Otten ABSTRACT Aims This study examined links of peer experiences (i.e. social status and affiliation with disruptive peers) throughout childhood with respect to adolescent smoking trajectories, after controlling for childhood disruptiveness. Specifically, we tested four models regarding links of peer experiences and deviant behaviours. Design Prospective community sample. Participants A total of 312 children, aged 6.17 years at baseline. Measurements Growth parameters of own disruptive behaviour, disruptive behaviour of friends and social status measured at ages 7,12 years as predictors of smoking assessed at ages 13,15 years, while controlling for own disruptive behaviour at age 6 years. Findings We found three groups with distinct profiles of smoking. One group displayed hardly any or no smoking at all; a second group showed a trajectory of increased smoking; and a third group that showed high smoking rates initially and increased in smoking intensity over time. Results support the assumption of the selection model that the link between disruptive peers and smoking is spurious and due to shared variances with own early disruptiveness. Moreover, support was found for the popularity,socialization model supporting the assumption that age-related increases in social status are associated with smoking. Conclusions The findings emphasize that early disruptiveness is predictive of later smoking. In addition, it was shown that smoking becomes less deviant over time, in line with group norms. Future prevention programmes should emphasize the need to change these norms. [source] Assessing the value of environmental prevention programmes in reducing driving under the influence (DUI) among college studentsADDICTION, Issue 3 2005Drug Driving Consultant, ROB TUNBRIDGE Alcohol No abstract is available for this article. [source] Perceived peer smoking prevalence and its association with smoking behaviours and intentions in Hong Kong Chinese adolescentsADDICTION, Issue 9 2004Man Kin Lai ABSTRACT Background Among the many personal, social and environmental risk factors of adolescence smoking, normative beliefs stand out for their potential to be modified with factual information on smoking prevalence. Aims To study the perceived peer smoking prevalence and its association with smoking behaviours in Hong Kong Chinese adolescents. Design and setting Cross-sectional territorial-wide school-based survey conducted in 64 randomly selected secondary schools in Hong Kong. Participants A total of 13 280 forms 1,3 students (equivalent to grades 7,9 in the United States) aged 12,16 years. Measurements Perceived peer smoking prevalence, smoking status, intention to smoke in future, other smoking-related factors and demographic information. Findings Overestimation of peer smoking prevalence was observed regardless of gender and smoking status, and was more common in girls (69.4%) than boys (61.0%), and in experimental (74.3%) and current smokers (85.4%) than in never smokers (60.7%). Boys who overestimated and grossly overestimated (over two times) peer smoking were more likely to be current smokers, with adjusted odds ratios and 95% confidence intervals (95% CI) of 1.95 (1.24,3.07) and 3.52 (2.37,5.24) (P for trend <0.001). Similarly, boys who grossly overestimated peer smoking were 76% (95% CI: 41,120%) more likely to have ever smoked. Conclusion Overestimation of peer smoking prevalence was common in Hong Kong Chinese boys and girls, and was associated with current and ever smoking in boys. These findings have important implications on normative education in adolescence smoking prevention programmes. [source]
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