International Journal of Environmental Research and Public Health

Editorial

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7 pages, 272 KiB

Open AccessEditorial

Substance Abuse and Public Health: A Multilevel Perspective and Multiple Responses

by T. Wing Lo, Jerf W. K. Yeung and Cherry H. L. Tam

Int. J. Environ. Res. Public Health 2020, 17(7), 2610; https://doi.org/10.3390/ijerph17072610 - 10 Apr 2020

Cited by 28 | Viewed by 16960

Abstract

Substance abuse has been a thorny public health concern throughout human history. Manifestly, prevention and treatment are the two main strategies commonly adopted to tackle the problem of substance abuse. They are in fact cross-disciplinary, and they relate to the various domains of [...] Read more.

Substance abuse has been a thorny public health concern throughout human history. Manifestly, prevention and treatment are the two main strategies commonly adopted to tackle the problem of substance abuse. They are in fact cross-disciplinary, and they relate to the various domains of heredity, biology, psychology, cognitive science, family, social development and cultural structures. This special issue, “Substance Abuse, Environment and Public Health,” has published empirical studies from different regions and countries globally to enhance the international exchange of latest views and findings on the etiology, processes and influences of substance abuse across different domains, through which a multilevel perspective is considered more helpful for analyzing its complex nature, courses and consequences. This in turn suggests the possible need to employ multiple responses dynamically and integratively in the prevention and treatment of substance abuse. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

Research

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11 pages, 342 KiB

Open AccessArticle

Unnatural Death among Treatment Seeking Substance Users in Singapore: A Retrospective Study

by Asharani PV, Tan Jun Wen, Mohamed Zakir Karuvetil, Alvin Cheong, Christopher Cheok and Gomathinayagam Kandasami

Int. J. Environ. Res. Public Health 2019, 16(15), 2743; https://doi.org/10.3390/ijerph16152743 - 31 Jul 2019

Cited by 6 | Viewed by 3874

Abstract

Substance use carries a higher risk of unnatural death. A retrospective analysis of 42 treatment seekers between 2011–2015 was conducted through medical record review to understand the profile and circumstances leading to premature deaths. Ninety percent of the subjects were males. The mean [...] Read more.

Substance use carries a higher risk of unnatural death. A retrospective analysis of 42 treatment seekers between 2011–2015 was conducted through medical record review to understand the profile and circumstances leading to premature deaths. Ninety percent of the subjects were males. The mean age at death was 44.9 (SD ± 13.1). Opioids (52.4%), benzodiazepines (45.2%) and alcohol (35.7%) were the main substances used by the group. Suicide was the most common cause of death (n = 27, 64.3%) followed by accidents (n = 15; 35.7%). Among the suicide cases, alcohol was the main substance used (33.3%) followed by opioids (25.9%). A total of 58.5% (n = 24) deaths occurred within a year of their last visit while 41.5% (n = 17) were dead more than a year after their last visit. Of the total cases (n = 41), 63% had a history of mental illness with depressive disorder (53.8%) being the most common. History of suicide attempts were reported in 34.1% (n = 14) of cases and 50% of the subjects (n = 21) had a history of suicidal ideation. Drug related offences were reported in 57.1% of the subjects, of which 60% (n = 18) committed suicide. The findings support the need for appropriate treatment resources to reduce the untimely deaths among substance users. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

10 pages, 459 KiB

Open AccessArticle

Trajectory of Smoking and Incidence of Atherosclerotic Cardiovascular Disease among Korean Young Adult Men

by Yongho Jee, Jooeun Jeon, Joung Hwan Back, Mikyung Ryu and Sung-il Cho

Int. J. Environ. Res. Public Health 2019, 16(12), 2219; https://doi.org/10.3390/ijerph16122219 - 24 Jun 2019

Cited by 6 | Viewed by 3454

Abstract

Introduction: Smoking among young adults is associated with atherosclerotic cardiovascular disease (ASCVD) in middle age. Our aim was to analyze the trajectory of smoking in young adults and analyze the effects of the trajectory group on incident ASCVD. Methods: This study was [...] Read more.

Introduction: Smoking among young adults is associated with atherosclerotic cardiovascular disease (ASCVD) in middle age. Our aim was to analyze the trajectory of smoking in young adults and analyze the effects of the trajectory group on incident ASCVD. Methods: This study was conducted among 60,709 young adult men aged 20–29 years who received health screening every two years from 1992–2004. Trajectory analysis was performed through smoking survey data measured 7 times during this period. ASCVD, including ischemic heart disease (IHD) and stroke events were confirmed from 2005–2015. The association between the trajectory group and ASCVD risk was analyzed using Cox proportional hazard models, controlling for covariates and mediators. Results: Trajectory analysis showed that smoking categorized into five groups as follows: Group 1 (28.3%), low steady; Group 2 (14.7%), lowering; Group 3 (17.3%), high steady; Group 4 (15.6%), rise and fall; and Group 5 (24.2%), very high steady. The model performance of the trajectory model (Akaike information criterion; AIC = 51,670.78) with mediators was better than the model (AIC = 51,847.85) without mediators. Group 5 showed a 49% higher risk of ASCVD than Group 1. The risk of IHD was 1.63-times higher for Group 5 and 1.31-times higher for Group 4, compared to Group 1. Compared to Group 1, Group 5 had a 1.36- and 1.58-times higher risk for total stroke and ischemic stroke, respectively. Conclusions: In young adult men, the multiple measured trajectory model with mediators was far more informative than one-time smoking for explaining the association with cardiovascular disease. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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17 pages, 478 KiB

Open AccessArticle

Intrinsic Motivation and Psychological Connectedness to Drug Abuse and Rehabilitation: The Perspective of Self-Determination

by Gloria H. Y. Chan, T. Wing Lo, Cherry H. L. Tam and Gabriel K. W. Lee

Int. J. Environ. Res. Public Health 2019, 16(11), 1934; https://doi.org/10.3390/ijerph16111934 - 31 May 2019

Cited by 22 | Viewed by 10167

Abstract

This study adopts the perspective of the Self-Determination Theory to look at the psychological experience of drug users and their decisions to take drugs or not, with particular emphasis on the concept of relatedness. To achieve this objective, a qualitative methodology was employed [...] Read more.

This study adopts the perspective of the Self-Determination Theory to look at the psychological experience of drug users and their decisions to take drugs or not, with particular emphasis on the concept of relatedness. To achieve this objective, a qualitative methodology was employed to explore the experiences of these drug users regarding how they take drugs and/or relapse. Theory-driven thematic analysis was employed to identify themes related to this topic. Results show that one’s psychological need for relatedness is an important determinant of whether one will take drugs or not, via the interaction mechanisms that exist in dimensions of affiliation and intimacy. While drug taking is a result of the modeling behavior existing in affiliated relationships, it is also a coping strategy for the ultimate satisfaction of psychological needs when human relatedness disappears. The implication is that significant others can develop unconditionally warm, caring, and empathetic supportive relationships with drug users, so as to enhance their fulfillment of psychological needs and reduce the risk of drug relapse. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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16 pages, 330 KiB

Open AccessArticle

Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status

by Shervin Assari, James Smith, Ritesh Mistry, Mehdi Farokhnia and Mohsen Bazargan

Int. J. Environ. Res. Public Health 2019, 16(10), 1826; https://doi.org/10.3390/ijerph16101826 - 23 May 2019

Cited by 31 | Viewed by 5842

Abstract

Purpose. This study investigated the effects of objective and subjective socioeconomic status (SES) indicators on two health behaviors, cigarette smoking and alcohol drinking, among African American older adults. Methods. This community-based study recruited 619 economically disadvantaged African American older adults (age ≥ [...] Read more.

Purpose. This study investigated the effects of objective and subjective socioeconomic status (SES) indicators on two health behaviors, cigarette smoking and alcohol drinking, among African American older adults. Methods. This community-based study recruited 619 economically disadvantaged African American older adults (age ≥ 65 years) residing in South Los Angeles. Structured face-to-face interviews were conducted to collect data. Data on demographic factors (age and gender), subjective SES (financial difficulties), objective SES (educational attainment), living arrangement, marital status, healthcare access (insurance), and health (number of chronic medical conditions, self-rated health, sick days, depression, and chronic pain) and health behaviors (cigarette smoking and alcohol drinking) were collected from participants. Logistic regressions were used to analyze the data. Results. High financial difficulties were associated with higher odds of smoking cigarettes and drinking alcohol, independent of covariates. Educational attainment did not correlate with our outcomes. Similar patterns emerged for cigarette smoking and alcohol drinking. Conclusion. Subjective SES indicators such as financial difficulties may be more relevant than objective SES indicators such as educational attainment to health risk behaviors such as cigarette smoking and alcohol drinking among African American older adults in economically constrain urban environments. Smoking and drinking may serve as coping mechanisms with financial difficulty, especially among African American older adults. In line with the minorities’ diminished returns (MDR) theory, and probably due to discrimination against racial minorities, educational attainment has a smaller protective effect among economically disadvantaged African American individuals against health risk behaviors. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

17 pages, 939 KiB

Open AccessArticle

The Association between Substance Abuse and Sexual Misconduct among Macau Youths

by T. Wing Lo, John W. L. Tse, Christopher H. K. Cheng and Gloria H. Y. Chan

Int. J. Environ. Res. Public Health 2019, 16(9), 1643; https://doi.org/10.3390/ijerph16091643 - 11 May 2019

Cited by 10 | Viewed by 6273

Abstract

This study investigates how peer influence, school attachment, and substance abuse are related to sexual behavior, with particular interest in exploring the relationship between substance abuse and sexual misconduct, while using a stratified random sample of adolescents in Macau. Mediation analyses were employed. [...] Read more.

This study investigates how peer influence, school attachment, and substance abuse are related to sexual behavior, with particular interest in exploring the relationship between substance abuse and sexual misconduct, while using a stratified random sample of adolescents in Macau. Mediation analyses were employed. The results show that substance abuse, apart from susceptibility to peer influence and school attachment/commitment, was significantly related to sexual misconduct. Substance abuse was the best predictor of sexual misconduct, and it significantly mediated the relationship between susceptibility to peer influence, as well as school attachment and sexual misconduct. This reflects that the use of substances, including drugs, alcohol, and cigarettes, can be viewed as a catalyst for triggering engagement in sexual misconduct. The implications of this study involve taking measures to reduce the rate of substance abuse as a way of decreasing sexual misconduct in adolescents. Future research directions in exploring the relationship between adolescent substance abuse and risky sexual behavior are discussed. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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8 pages, 302 KiB

Open AccessArticle

The Misconception of Antibiotic Equal to an Anti-Inflammatory Drug Promoting Antibiotic Misuse among Chinese University Students

by Weiyi Wang, Xiaomin Wang, Yanhong Jessika Hu, Dan Wu, Jingjing Lu, Yannan Xu, Chenhui Sun and Xudong Zhou

Int. J. Environ. Res. Public Health 2019, 16(3), 335; https://doi.org/10.3390/ijerph16030335 - 25 Jan 2019

Cited by 11 | Viewed by 4381

Abstract

Massive misuse of antibiotics is one of the most important reasons for antimicrobial resistance (AMR). Misconceptions of antibiotics contribute to antibiotic misuse behaviors. This study aims to examine whether university students hold the misconception that Antibiotic is a Xiaoyanyao (literally means anti-inflammatory drug [...] Read more.

Massive misuse of antibiotics is one of the most important reasons for antimicrobial resistance (AMR). Misconceptions of antibiotics contribute to antibiotic misuse behaviors. This study aims to examine whether university students hold the misconception that Antibiotic is a Xiaoyanyao (literally means anti-inflammatory drug in Chinese), and association between this misconception and antibiotic misuse behaviors. A cross-sectional study was conducted among university students using the cluster random sampling method in six universities of six regions in China (one university per region). The Chi-square test was used to assess the relationship between the misconception and antibiotic misuse behaviors. Logistic regression was conducted to identify the risk factors for antibiotic misuse behaviors. 11,192 of university students completed the entire questionnaire. There were 3882 (34.7%) students who were considered to have the misconception. Female students were more likely to have the misconception compared with males (36.7% vs. 32.6%, P < 0.001). Those students with a background of social science/humanities were more likely to have the misconception compared with those from science and medicine (44.1% vs. 30.3% vs. 20.1%, P < 0.001). Students came from rural areas compared with those from urban areas (37.5% vs. 32.5%, P < 0.001) were more likely to have the misconception. Students who had the misconception were 1.51 (95% CI 1.21–1.89, P < 0.001) times, 1.34 (95% CI 1.21–1.48, P < 0.001) times, and 1.36 (95% CI 1.24–1.50, P < 0.001) times more likely to report self-medication, request to obtain antibiotics, and take antibiotics prophylactically than those who did not have this misconception, respectively. The high proportion of university students’ misconception on Antibiotic is a Xiaoyanyao is worth more attention. Effective health education and interventions need to be promoted among university students and the whole population. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

13 pages, 810 KiB

Open AccessArticle

Primary Reason for Drinking Among Current, Former, and Never Flushing College Students

by Sarah Soyeon Oh, Yeong Jun Ju, San Lee and Eun-Cheol Park

Int. J. Environ. Res. Public Health 2019, 16(2), 211; https://doi.org/10.3390/ijerph16020211 - 13 Jan 2019

Cited by 8 | Viewed by 5048

Abstract

Alcohol consumption among individuals who experience a flushing response (reddening of the face, nausea, dizziness, headache, anxiety, and increased heartbeat) can result in serious health problems. However, studies on reasons for drinking among flushers, especially in the college context, are limited. Thus, this [...] Read more.

Alcohol consumption among individuals who experience a flushing response (reddening of the face, nausea, dizziness, headache, anxiety, and increased heartbeat) can result in serious health problems. However, studies on reasons for drinking among flushers, especially in the college context, are limited. Thus, this study investigated the association between primary reason for drinking and alcohol use among a nationally representative sample of current, former, and never flushing college students. The aim was to measure whether college students with current or former experience of facial flushing have different primary reasons for drinking compared to students with no experience of facial flushing. We surveyed and analyzed the data of 4590 students in a nationally representative sample of 82 colleges in South Korea. Multiple regression analysis was used to identify the association between primary reason for drinking and alcohol intake. Alcohol intake was measured using the Alcohol Use Disorders Identification Test (AUDIT). Among 1537 current (33.5%), 152 former (3.3%), and 2901 (63.2%) never flushers, mean AUDIT scores were 7.715 ± 5.434, 11.039 ± 6.405, and 10.465 ± 5.779, respectively. Current flushers had significantly higher AUDIT scores when drinking for pleasure (β = 2.696, p < 0.0001) or stress/depression (β = 2.578, p < 0.0001). Primary reasons for drinking were not associated with alcohol intake for former flushers. Never flushers had significantly higher AUDIT scores when drinking for pleasure (β = 2.696, p < 0.0001), stress/depression (β = 2.578, p < 0.0001), or boredom (β = 0.740, p = 0.029) than peer pressure. Our results suggest that former and never flushers consume higher amounts of alcohol on average than never flushers. For current flushers, drinking for pleasure or stress/depression may increase alcohol intake, while for never flushers, drinking for pleasure, stress/depression, as well as boredom may have the same effect. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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15 pages, 1022 KiB

Open AccessArticle

Inmates with Harmful Substance Use Increase Both Exercise and Nicotine Use Under Incarceration

by Ashley Elizabeth Muller, Ingrid Amalia Havnes, Eline Borger Rognli and Anne Bukten

Int. J. Environ. Res. Public Health 2018, 15(12), 2663; https://doi.org/10.3390/ijerph15122663 - 27 Nov 2018

Cited by 12 | Viewed by 6072

Abstract

Exercise is increasingly understood as an important resource for people who engage in harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. This cross-sectional study analyzed self-reports from 1464 inmates in [...] Read more.

Exercise is increasingly understood as an important resource for people who engage in harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. This cross-sectional study analyzed self-reports from 1464 inmates in Norwegian prisons in 2013–2014, compared them according to harmful substance use pre-incarceration, and explored changes in exercise and nicotine use during incarceration. Results were presented in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Inmates with harmful substance use reported higher rates of smoking, smokeless tobacco, and physical inactivity pre-incarceration than inmates without harmful use. However, inmates with harmful use also exhibited more behavioral changes: they adopted exercise, ceased smoking, and adopted smokeless tobacco at higher rates during incarceration than the non-harmful group, to the extent that inmates with harmful use exercised during incarceration more. Exercise is being taken up by a significant proportion of inmates, and may in particular be a replacement behavior for substance use. However, unhealthy behaviors also begin or are maintained. If prisons were used as an arena to facilitate healthy behaviors, the public health benefits to a marginalized group such as substance-using inmates could be substantial. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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12 pages, 316 KiB

Open AccessArticle

Associations Between the Dopamine D4 Receptor and DAT1 Dopamine Transporter Genes Polymorphisms and Personality Traits in Addicted Patients

by Jolanta Chmielowiec, Krzysztof Chmielowiec, Aleksandra Suchanecka, Grzegorz Trybek, Bożena Mroczek, Iwona Małecka and Anna Grzywacz

Int. J. Environ. Res. Public Health 2018, 15(10), 2076; https://doi.org/10.3390/ijerph15102076 - 21 Sep 2018

Cited by 17 | Viewed by 4058

Abstract

Many factors are involved in addiction. The dopaminergic system is thought to be the key element in this process. The mesolimbic dopamine system is a crucial element in the reward system. Changes in this system are thought to be leading to substance use [...] Read more.

Many factors are involved in addiction. The dopaminergic system is thought to be the key element in this process. The mesolimbic dopamine system is a crucial element in the reward system. Changes in this system are thought to be leading to substance use disorders and dependence. Therefore, for our study we chose an analysis of two polymorphisms in genes (Variable Number of Tandem Repeats in DRD4 and DAT1) responsible for dopaminergic transmission, which might be implicated in the scores of personality traits measured by the NEO-FFI test. The study group consisted of 600 male volunteers—299 addicted subjects and 301 controls. Both groups were recruited by psychiatrists; in the case group addiction was diagnosed; in the controls a mental illness was excluded. In both groups the same psychometric test and genotyping by the PCR VNTR method were performed. The results were investigated by a multivariate analysis of the main effects ANOVA. In the presented study no DRD4 main effects were found for any of the analyzed traits but the DRD4 main effects approximated to the statistical significance for the extraversion scale. However, no DAT1 main effects were found for any of the analyzed traits but the DAT1 main effects approximated to the statistical significance for the agreeability scale.These associations open new possibilities for addiction research. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

10 pages, 324 KiB

Open AccessArticle

Emergency and Mental Health Nurses’ Perceptions and Attitudes towards Alcoholics

by Jesús Molina-Mula, Antonio González-Trujillo and Margarita Simonet-Bennassar

Int. J. Environ. Res. Public Health 2018, 15(8), 1733; https://doi.org/10.3390/ijerph15081733 - 13 Aug 2018

Cited by 19 | Viewed by 9129

Abstract

Knowing professionals’ attitudes is the basis for the development of skills for dealing with drug dependence. These attitudes may affect patients’ clinical safety and the cost-benefit ratio of the interventions. The goal of this study was to assess emergency and mental health nurses’ [...] Read more.

Knowing professionals’ attitudes is the basis for the development of skills for dealing with drug dependence. These attitudes may affect patients’ clinical safety and the cost-benefit ratio of the interventions. The goal of this study was to assess emergency and mental health nurses’ attitudes and perceptions towards alcoholics. A multicenter prospective descriptive study was conducted in six hospitals with 167 emergency and mental health nurses. Nurses classified alcoholics as sick individuals, although there was a tendency to feel uncomfortable working with them. Results indicated that these professionals had a rejecting attitude towards moderate alcohol consumption. It found that there was a significant association between the attitude of the nurse and gender, with the degree of rejection towards the alcoholic being higher in men than in women, and with less punitive attitudes in professionals with 0 to 11 years of professional experience. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

16 pages, 831 KiB

Open AccessArticle

Identification of Factors Associated with Potential Doping Behavior in Sports: A Cross-Sectional Analysis in High-Level Competitive Swimmers

by Sime Devcic, Jakob Bednarik, Dora Maric, Sime Versic, Damir Sekulic, Zvonimir Kutlesa, Antonino Bianco, Jelena Rodek and Silvester Liposek

Int. J. Environ. Res. Public Health 2018, 15(8), 1720; https://doi.org/10.3390/ijerph15081720 - 10 Aug 2018

Cited by 14 | Viewed by 6040

Abstract

Background: Doping behavior, including the misuse of performance-enhancing drugs, is currently a serious problem in sports, and the efficacy of preventive efforts directly depends on information regarding the associations among different precipitating factors (PF) and doping behavior. This study aimed to establish [...] Read more.

Background: Doping behavior, including the misuse of performance-enhancing drugs, is currently a serious problem in sports, and the efficacy of preventive efforts directly depends on information regarding the associations among different precipitating factors (PF) and doping behavior. This study aimed to establish the PF of potential doping behavior (PDB) in competitive swimmers. Methods: The study included 301 swimmers from Slovenia (153 females, 16.4 ± 2.4 years), tested during the 2017 National Championship. Variables were collected by previously validated questionnaires, which included questions on sociodemographics, sports-related factors, consumption of dietary supplements, knowledge of doping, factors of hesitation, and doping-related factors (i.e., number of doping tests, opinion about the presence of doping in sport). The PDB (positive, neutral, or negative intention toward doping) was observed as a criterion, while other variables were included as predictors in multinomial regression analyses (with “negative” as reference value), which additionally controlled for gender and age category (cadet-, junior-, and senior-level) as confounders. Results: The results confirmed higher susceptibility to doping in males (positive: odds ratio (OR): 2.77, 95% confidence interval (CI): 1.27–6.04), those swimmers who reported higher alcohol consumption (neutral: OR: 2.18, 95%CI: 1.06–4.16, positive: OR: 2.14, 95%CI: 1.05–4.37), and those regularly used dietary supplements (positive: OR: 3.62, 95%CI: 1.25–10.52). Competitive achievement in Olympic- (neutral: OR: 0.57, 95%CI: 0.41–0.81, positive: OR: 0.59, 95%CI: 0.39–0.88), and non-Olympic disciplines (positive: OR: 0.54, 95%CI: 0.35–0.83) was protective against PDB. Swimmers who were more concerned about the negative social consequences of doping behavior (i.e., condemnation by family and friends) were less likely to declare a positive intention toward the PDB (family condemnation: OR: 0.69, 95%CI: 0.56–0.86, friends’ condemnation: OR: 0.65, 95%CI: 0.52–0.80). Conclusions: The results of the study provide more precise insight into the specific factors associated with PDB in swimming. The established precipitating factors should be incorporated into targeted anti-doping campaigns in this sport. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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12 pages, 974 KiB

Open AccessArticle

A Prospective Study on the Influence of Scholastic Factors on the Prevalence and Initiation of Illicit Drug Misuse in Adolescence

by Zoran Zubak, Natasa Zenic, Ljerka Ostojic, Ivana Zubak and Haris Pojskic

Int. J. Environ. Res. Public Health 2018, 15(5), 874; https://doi.org/10.3390/ijerph15050874 - 27 Apr 2018

Cited by 8 | Viewed by 4365

Abstract

Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia and Herzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of [...] Read more.

Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia and Herzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of 16 years old at the beginning of the study (baseline). The participants were tested at baseline and follow-up (20 months later). The predictors included variables of scholastic-achievement (grade point average, school absences, unexcused absences and behavioral grade). The criteria were: (i) IDM at baseline; (ii) IDM at follow-up; and (iii) initiation of IDM over the study course. Results: Logistic regression indicated increased odds of IDM in adolescents who were more frequent absent from school (baseline: Odds Ratio (OR): 3.73, 95% Confidence Interval (CI): 2.12–6.57; follow-up: OR: 2.91, 95% CI: 1.90–4.65). The lower grade point average and more unexcused absences were evidenced for adolescents who consumed drugs on follow-up (OR: 1.67, 95% CI: 1.11–2.51; OR: 1.74, 95% CI: 1.30–2.32 for grade point average and unexcused absences, respectively). Initiation of IDM was predicted by frequent absences from school (OR: 2.2, 95% CI: 1.3–3.8), and lower behavioral grades (OR: 1.9, 95% CI: 1.2–3.3). Conclusions: The findings confirmed strong correlations between scholastic failure and IDM. Absences from school and lower behavioral grades at baseline were predictive of the initiation of IDM in older adolescents. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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13 pages, 326 KiB

Open AccessArticle

Keeping Antibiotics at Home Promotes Self-Medication with Antibiotics among Chinese University Students

by Xiaomin Wang, Leesa Lin, Ziming Xuan, Lu Li and Xudong Zhou

Int. J. Environ. Res. Public Health 2018, 15(4), 687; https://doi.org/10.3390/ijerph15040687 - 5 Apr 2018

Cited by 38 | Viewed by 6019

Abstract

Background: Inappropriate use of antibiotics has caused antimicrobial resistance, presenting a major health challenge to the world population. Self-medication with antibiotics (SMA) is currently at an alarming level in China. Objectives: To determine the sources of antibiotics leftover at home, the risk factors [...] Read more.

Background: Inappropriate use of antibiotics has caused antimicrobial resistance, presenting a major health challenge to the world population. Self-medication with antibiotics (SMA) is currently at an alarming level in China. Objectives: To determine the sources of antibiotics leftover at home, the risk factors of keeping antibiotics at home, and the associations between keeping antibiotics at home and SMA among Chinese university students. Methods: Six provinces were purposely selected from six regions of China, and one multi-disciplinary university was selected from each chosen province. A total of 11,192 university students were selected using cluster random sampling from the selected universities. Logistic regression was conducted to examine the relationship between keeping antibiotics at home and SMA. Results: Out of the 11,192 students surveyed, 7057 (63.1%) reported keeping antibiotics at home at the time they were surveyed. Of those who kept antibiotics in their home, 1965 (27.8%) reported that these antibiotics were left over from a previous prescription by a doctor and 4893 (69.3%), purchased antibiotics over the counter. Additionally, 29.6% (507/1711) of students self-medicated with antibiotics when ill during the month before the survey. Students keeping antibiotics at home were five times (95% CI 3.53, 7.05) more likely to engage in SMA when ill and 2.6 times (95% CI 2.34, 2.89) more likely to self-medicating with antibiotics for prophylaxis than the other students. Female students, those with a family background of higher education, and those who had a parent working in the medical field had a significantly higher chance of keeping antibiotics at home. Conclusions: The high prevalence of keeping antibiotics at home and SMA among young adults is a serious concern. Professional regulations and population-tailored health education are needed. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

16 pages, 765 KiB

Open AccessArticle

Preventing Opioid Use Disorders among Fishing Industry Workers

by Angela Wangari Walter, Cesar Morocho, Lauren King, John Bartlett, Debra Kelsey, Monica DeSousa, Gretchen Biesecker and Laura Punnett

Int. J. Environ. Res. Public Health 2018, 15(4), 648; https://doi.org/10.3390/ijerph15040648 - 31 Mar 2018

Cited by 19 | Viewed by 8086

Abstract

Fishing industry workers are at high risk for work-related musculoskeletal disorders (MSDs) and injuries. Prescription opioids used to treat pain injuries may put these workers at increased risk for developing substance disorders. Using a Community-Based Participatory Research approach, formative research was conducted to [...] Read more.

Fishing industry workers are at high risk for work-related musculoskeletal disorders (MSDs) and injuries. Prescription opioids used to treat pain injuries may put these workers at increased risk for developing substance disorders. Using a Community-Based Participatory Research approach, formative research was conducted to inform the eventual development of relevant interventions to prevent and reduce opioid use disorders among fishing industry workers. Qualitative interviews (n = 21) were conducted to assess: knowledge and attitudes about opioid use disorders; features of fishing work that might affect use and/or access to treatment; and community and organizational capacity for prevention and treatment. Participants reported numerous pathways connecting commercial fishing with opioid use. The combination of high stress and physically tasking job duties requires comprehensive workplace interventions to prevent chronic pain and MSDs, in addition to tailored and culturally responsive treatment options to address opioid use disorders in this population. Public health programs must integrate workplace health and safety protection along with evidence-based primary, secondary, and tertiary interventions in order to address opioid use disorders, particularly among workers in strenuous jobs. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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10 pages, 335 KiB

Open AccessProtocol

A School-Based Educational Intervention for School-Aged Children and Caregivers about Rational Use of Antibiotics in Urban Areas of Shaanxi Province: A Study Protocol for a Randomized Controlled Research

by Yu Zhang, John Kabba, Jie Chang, Wenjing Ji, Shan Zhu, Jiale Yu, Sen Xu and Yu Fang

Int. J. Environ. Res. Public Health 2018, 15(9), 1912; https://doi.org/10.3390/ijerph15091912 - 3 Sep 2018

Cited by 8 | Viewed by 4208

Abstract

(1) Background: Antibiotic resistance is an imperative public health issue globally. Major factors that are resulting in this trend are the irrational and excessive use of antibiotics. Children account for a greater population of antibiotics use, therefore, an educational intervention on the rational [...] Read more.

(1) Background: Antibiotic resistance is an imperative public health issue globally. Major factors that are resulting in this trend are the irrational and excessive use of antibiotics. Children account for a greater population of antibiotics use, therefore, an educational intervention on the rational use of antibiotics for children and caregivers will be beneficial. (2) Methods: A randomized controlled and parallel group study of fifth grade children and their caregivers will be evaluated in four primary schools in Baoji and Weinan of the Shaanxi Province. Two primary schools will be randomly selected for the educational intervention and two schools will serve as a control group. In the intervention arm, educational interventions will be conducted among caregivers and their children. The intervention measures include interactive training sessions, booklets, and printed or electronic educational materials that will be given to the caregivers or the school-aged children. In the control arm, no interventions will be implemented. Baseline data collected from June, 2018 and the intervention will last for three months. Knowledge-Attitude-Practice (KAP) questionnaires will be used to evaluate the caregivers’ knowledge, their attitude, and their practice. Knowledge-Retention questionnaires will be used to assess the children’s knowledge about microbes, antibiotics, and hygiene. (3) Discussion: This study is a unique comprehensive intervention targeting both children and their caregivers. We hypothesize a decrease in the irrational use of antibiotics among the studied population. Hence, this result would provide evidence for policy makers and educational departments for the implementation of similar interventions on the rational use of antibiotics. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

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