Search Results (75)

Studies analyzing the prevalence of associated substance use are limited. Currently, the World Health Organization (WHO) defines polydrug use as the concurrent (simultaneous use) or sequential (use of one drug followed by another) abuse of more than one drug or type of drug, with dependence on at least one. Associated drug consumption can exacerbate the adverse effects and complicate the clinical management of patients. This study aimed to investigate the prevalence of polydrug use, excluding tobacco, in patients presenting with acute intoxication in the Emergency Department (ED) of the Clinical University Hospital Virgen de la Arrixaca (Murcia, Spain) in the year 2023. To this end, a retrospective analysis of 2562 patients was conducted, examining demographic variables, substance use patterns, reasons for presenting to the ED, and the substances consumed by each patient. The study reveals an average patient age of 41 ± 0.5 (SD = 11.96) composed of predominantly male patients (74.4%). A high prevalence of benzodiazepines and cocaine use, often in combination, was observed. The main reasons for attendance included symptoms such as palpitations, dyspnea, vomiting, diarrhea, behavioral disturbances, and self-harm. Only 25.5% of patients admitted to consuming all substances detected in their analyses. Polydrug use is frequent in our environment, which can lead to added complexity in diagnosis and treatment. Consumption patterns show a profile strongly related to the age of the subject. Among the youngest subjects, tetrahydrocannabinol (THC) and benzodiazepines predominate, whilst among older subjects, alcohol and benzodiazepines, and sometimes cocaine, predominate. This study highlights the need to design specific intervention and prevention strategies to address patterns of substance abuse, the importance of family and community support, and the need to tackle challenges in identifying and treating cases of polysubstance abuse. Moreover, cooperation between the healthcare system and law enforcement is also important to obtain up-to-date knowledge of new drugs and their consumption patterns in an emergency context. Full article

Background: Adverse childhood experiences (ACEs) are potentially traumatic experiences that may promote poor mental health, including substance use and suicidality, as well as chronic pain. Telementoring may be used to provide education to school-based health center (SBHC) clinicians and other health professionals in the community to identify and support youth with ACEs. Methods: This study was an evaluation of the novel ACEs ECHO telementoring program, which incorporates didactics, case-based learning, and a community of practice to serve school-based health clinicians in New Mexico, a rural state with a high prevalence of ACEs. Results: In the program’s first two years, there were 704 unique participants, including SBHC clinicians from 25 of New Mexico’s 33 counties. The pre/post survey demonstrated that the participants reported increases in knowledge in identifying children that experienced ACEs (4.3 versus 3.7, p = 0.001) and confidence in supporting children who may be at high risk (4.1 versus 3.3, p = 0.001) compared with before they began attending the ACEs ECHO program. The participants also reported that they felt more hopeful that they could help youth with ACEs (4.2 versus 3.3, p = 0.001). Conclusions: The ACEs ECHO telementoring program may be considered for other rural states and globally as a capacity-building model to educate SBHC clinicians and other health professionals to identify youth at risk for adverse childhood experiences. Full article

Introduction. Bisphenols are chemicals widely used in industrial production, but they are also of significant concern due to their potential health effects. In particular, bisphenol A (BPA) is a documented endocrine disruptor. As a result, bisphenol S (BPS) and bisphenol F (BPF) are now frequently used as substitutes. However, evidence of endocrine-disrupting properties is also emerging for these substances. Methods. A new, simple, and rapid HPLC-MS/MS procedure for the urinary analysis of bisphenols was developed and validated. Results. The mean accuracy ranged from 83.3 to 119.2%, and precision values (CV%) ranged from 2.2 to 18.9%. The limit of detections (LODs) for BPA, BPS, and BPF, were 0.01, 0.001, and 0.07 µg/L. The pre-analytical step involved only enzymatic hydrolysis, followed by a liquid–liquid extraction, for the subsequent urine analysis of the three BPs. Chromatographic separation was achieved in 9 min, with high selectivity. Discussion. The procedure was applied to 36 urine samples of a male population attending a fertility center. Most of the subjects showed relevant exposure to BPs (BPS average level: 0.87 ± 3.03 µg/g creatinine; BPF average level: 0.14 ± 0.34 µg/g creatinine), particularly to BPA (average level 0.97 ± 1.27 µg/g creatinine). The procedure demonstrated high efficiency and was confirmed to be practical, fast, and accurate. Full article

Understanding environmental issues such as biogeochemical cycles of substances on a local and global level is important in order to be able to act responsibly and sustainably. Inadequate teacher training has proven to be the main reason why environmental education has failed to reach its full potential. The aim of the present study is therefore to investigate students’ level of knowledge about biogeochemical cycles in relation to their secondary school achievements in chemistry, biology, and physics, their individual interest for learning these topics, and their self-esteem regarding cycles of substances on Earth. A total of 145 undergraduate pre-service primary school teachers attending their first or third year of an undergraduate teacher education program at the Faculty of Education, University of Ljubljana, in 2024 participated in this quantitative study, which uses the causal non-experimental method of pedagogical research. The data were collected using a three-tier achievement test and a paper–pencil questionnaire, which were both developed by the researchers. The results show that pre-service primary school teachers possess roughly adequate knowledge of the environmental topic of biogeochemical cycles. Their individual interest and self-esteem related to learning biogeochemical cycles were found to be significant predictors of their performance in an achievement test on biogeochemical cycles. Their final grade in biology may also be a significant predictor of their knowledge of this topic. Finally, pre-service primary school teachers’ misconceptions related to the topic of biogeochemical cycles were determined. Although the number of their misconceptions on this topic is low, teachers’ environmental education nevertheless needs to be improved in order to optimize their work in the classroom and help environmental education reach its full potential. Full article

Background: Drugged driving is associated with an increased risk of road accidents worldwide. In Italy, driving under the influence (DUI) of alcohol and drugs is a reason for driving disqualification or revocation of the driving license. Drivers charged with driving under the influence of alcohol and drugs must attend a Local Medical Commission (LMC) to undergo mandatory examinations to regain the suspended license. Our study mainly aims to report on the analysis performed on hair samples collected from 7560 drivers who had their licenses suspended for drugged or drunk driving between January 2019 and June 2024. Methods: A rapid, sensitive, and selective method for the determination of ethyl glucuronide in hair by UPLC/MS-MS was developed and fully validated. Results: The most frequently detected substances were cocaine (ecgonine methyl ester, norcocaine, and benzoylecgonine) and cannabinoids (Δ9-tetrahydrocannabinol, cannabidiol, and cannabinol), followed by opiates (codeine, morphine, and 6-MAM), methadone (EDDP), and amphetamines (amphetamine, methamphetamine, MDA, MDMA, and MDEA). To perform a more in-depth analysis, we also compared hair color with the drug classes that tested positive. The results showed a significant prevalence of dark hair that tested positive for one or more substances, followed by gray/white hair and light hair. Conclusions: Our study provides an interesting and alarming insight into drug exposure in the general population with serious public health threats, discussing the main aspects of hair matrix analysis and focusing on its advantages and reliability in the interpretation of results. Full article

Substance use is a growing problem among young people in sub-Saharan Africa who increasingly adopt the habit of smoking cigarettes. The aim was to analyse prevalence rates and identify predictors for cigarette smoking among school-attending adolescents in Bissau, Guinea-Bissau. In June 2017, a survey questionnaire was implemented in 16 schools in a class-based, random sample of 2039 adolescents aged 14–19 (52% girls). The chi-square (p < 0.05) and odds ratios (OR) were calculated with 95% confidence intervals (CI). Potential explanatory variables for the dependent variables were introduced into a multinomial logistic regression model, and p-values were transformed to LogWorth values. The prevalence rate for lifetime smoking experience was 14.8%, 4.0% for occasional smoking (<30 days), and 2.4% for daily smoking. The most significant predictors for cigarette smoking included having friends who smoke, being a boy, attending a private school, smoking initiation at a young age, other substance use, and violent behaviour. It is imperative to initiate preventive actions against smoking and other use of tobacco in Guinea-Bissau. Considering the significant impact of the peer group, policymakers need to engage young people in developing primary prevention strategies to curb the use of tobacco and other substances. Full article

The practise of geophagy is common amongst women of childbearing age from different geographic locations, including South Africa, regardless of their social and economic status such as their level of education, race, marital status, income or occupation. This study aimed to examine the women of childbearing age in Tshwane District, Gauteng Province, South Africa. An experimental study was conducted at the laboratory to examine the chemical composition of clay soil ingested by geophagic women of childbearing age. Thirty-nine clay soil samples were collected from study participants attending antenatal care services and family planning at public healthcare facilities of Tshwane District, Gauteng Province, and subjected to geochemical analysis. The concentrations of vanadium, manganese, chromium, and barium were detected in quantities exceeding 100 mg/kg in almost all samples. Cadmium, mercury and silver were detected in low concentrations below 1 mg/kg in all samples. The practice of geophagy amongst women of childbearing age has been reported to be associated with detrimental health outcomes and risks such as iron deficiency anaemia, constipation, shortness of breath, maternal and childhood mortalities and morbidities, neurological and central nervous system disorder, death, appendicitis, cancers, teratogenic risks, and ulcers. The chemical composition of clay soil eaten by geophagic women of childbearing age contains potentially harmful substances, thus the practise of geophagy is toxic and should be discouraged to protect public health. Full article

Substance use self-stigma is a barrier to treatment and can negatively impact individuals’ well-being and treatment engagement. Given the mixed findings in previous research and the limited specific investigation into the concept of self-stigma within the context of opioid misuse, examining factors associated with self-stigma in the context of opioid use disorder (OUD) is warranted. The current study examines the influence of individual-level factors (race, sex, urban/rural status, support group attendance) on self-stigma and willingness to disclose opioid use. Data for this study were from a larger study of OUD-related stigma among adults in Pennsylvania, U.S. The current study included participants who indicated a personal past or current history with OUD were included (n = 84). Exploratory factor analysis and multiple indicators, multiple causes (MIMIC) model were used to explore the associations between demographic factors (i.e., sex, age, race/ethnicity, urban/rural status), attendance at mutual support groups, and self-stigma factors. Results indicated that sex and attendance at mutual support groups significantly predicted levels of self-stigma. Women and individuals with no previous experience attending mutual support groups endorsed lower levels of self-stigma. Additionally, attendance at mutual support groups predicted willingness to self-disclose past and present opioid use. Individuals who reported no history of attending mutual support groups demonstrated less willingness to disclose past and present OUD use compared to participants who were support group attendees. The current research findings enhance the understanding of OUD-related self-stigma by examining its relationship with individual-level factors, disclosure, and attendance to mutual support groups. The results offer insights into the influence of sex and support group attendance on self-stigma and disclosure. These findings have significant clinical implications for developing future interventions and promoting health policy changes. Full article

Background: Surveys conducted in different regions of the world show that the prevalence rates of health risk behaviors (HRBs) in university students are sometimes higher than those found in non-university populations. This study aims to identify the prevalence rates and demographic and academic environment correlates associated with HRBs among Brazilian university students. Methods: In a cross-sectional epidemiological study, a random sample of 5310 university students answered an online questionnaire, with demographic (sex, age, skin color, marital status, and paid work) and academic setting information (housing type, size of campus, year, and shift of study), as well as items clustered in four HRB domains: personal safety and violence, sexual behavior and contraception, addictive substance use, eating habits, physical activity, and sleep. The data were analyzed statistically using bivariate analysis and hierarchical multiple regression. Results: The highest prevalence rates occurred in HRBs clustered in the domain of eating habits, physical activity, and sleep (>60%), while HRBs for personal security and violence were less prevalent (<15%). From 15% to 35% of university students assumed HRBs regarding addictive substance use, and approximately 50% reported risky sexual behavior. The university students most susceptible to HRBs were men, aged ≥ 22 years, living far from their family, studying on larger campuses, attending night classes, and with two or more years of study at the university. Conclusion: The findings suggest that policies and interventions in the university context aimed at students’ readiness to engage in a healthy lifestyle should target specific correlates associated with HRBs. Full article

The occupational requirements of full-time non-administrative firefighters include shift-work schedules and chronic exposure to alerting emergency alarms, hazardous working conditions, and psychologically traumatic events that they must attend and respond to. These compiling and enduring aspects of the career increase the firefighter’s risk for insomnia and mental health conditions compared to the general population. Poor sleep quality and mental health impairments are known to coincide with and contribute to the symptom severity of one another. Thus, it is important to determine approaches that may improve sleep and/or mental health specifically for firefighters, as their occupation varies in many aspects from any other occupation. This review will discuss symptoms of insomnia and mental health conditions such as PTSD, anxiety, depression, substance abuse, and suicide in firefighters. The influencing factors of sleep and mental health will be examined including anxiety sensitivity, emotional regulation, and distress tolerance. Current sleep and mental health interventions specific to full-time firefighters are limited in number; however, the existing experimental studies will be outlined. Lastly, this review will provide support for exploring exercise as a possible intervention that may benefit the sleep and mental health of this population. Full article

Background: Substance use disorders pose unique challenges, affecting individuals physiologically and socially. This study addresses the fundamental question of how adherence to exercise programs impacts those with substance use disorders, examining both in-person and online interventions. Methods: A 12-week analysis involving 26 participants assessed physical fitness, strength, and quality of life. Participants were categorized into in-person and online exercise groups, with their adherence tracked through attendance and a dedicated app. Results: The in-person group exhibited higher adherence rates and significant improvements, in contrast to the challenges encountered by the online groups, particularly in substance use disorder cohorts. Statistical analyses highlighted these differences, emphasizing the pivotal role of the exercise program delivery format. Conclusions: This research advocates for hybrid models, blending professional supervision with online flexibility, recognizing the distinct challenges of substance use disorders. Insights from this study will contribute to shaping more effective, personalized interventions in the complex landscape of substance use disorders, offering guidance for advancing treatment strategies. Full article

The marketing of sweetened and flavoured tobacco in the early 1990s resulted in an upsurge in waterpipe smoking (WPS), mainly among young people and women. Here, we estimate prevalence rates among school-attending adolescents aged 14–19 (girls 52%) for a lifetime experience of WPS and within the last 30 days (WPS < 30 days) and identify influential factors for such smoking in Bissau, Guinea-Bissau. A random sample (N = 2039) was drawn from a class-based register created for 16 schools in Bissau; attending students in June 2017 were invited to respond to a locally adapted Planet Youth questionnaire. Descriptive statistics, odds ratio with 95% confidence interval, and multinomial logistic regression analysis were used to identify influential factors for WPS. The prevalence rates for a lifetime experience of WPS and within < 30 days were high, 17.7% and 15.0%, respectively, with no significant gender difference. For both groups, a multinomial logistic regression analysis identified attending higher grades in school, use of alcohol and being a victim of sexual violence as significant, influential factors. The overlapping of influential factors suggests preventive work against substance abuse should focus on less stigmatising behaviour, such as WPS and firmer implementation of the Framework Convention of Tobacco Control (FCTC). Full article

The Teens Linked to Care (TLC) pilot program utilized a youth-led integrated strategy to prevent substance use and risky sexual behavior among school-attending youth at disproportionate risk, including sexual and gender minority youth (SGMY). The program developed a framework to address human immunodeficiency virus (HIV), sexually transmitted diseases (STDs), teen pregnancy, and high-risk substance use within schools. Strategies included education, primary prevention, and early detection screening. High schools in two rural counties served as pilot sites and successfully implemented strategies to encourage youth to engage in healthier sexual practices and avoid harmful substance use. An evaluation of TLC demonstrated its effectiveness in developing youth-friendly resources, promoting connectedness, and building resiliency among students and staff. This program used the results of two iterations of the Youth Risk Behavior Survey (YRBS) to understand the situations of youth, including SGMY. YRBS results helped tailor program activities for SGMY populations. By focusing on education, access to care, and supportive environments, schools can utilize the TLC model to combat youth substance abuse and risky sexual practices. Full article

This article reports on the findings of a study of the relationship between transnational experiences in the United States (US) and the use of alcohol, tobacco, and marijuana among 7th grade students (n = 1418). The study was guided by a cross-national framework for research on immigrant health and assessed the accumulation of risk factors for transnational adolescents. Data came from a survey conducted in 2017 in Nogales, Mexico. In this study, the last 30-day prevalence of use of alcohol, tobacco, and marijuana among students was 21.7%, 8.3%, and 2.4%, respectively. Most students were born in Nogales (69.6%), while 10.5% were born in the US, 7.5% attended school in the US, and 3.6% engaged in health-related risk behaviors while living in or visiting the US. Students with transnational experiences, such as attending school in the US, reported the highest 30-day prevalence of tobacco (13.3%) and marijuana (9.5%) use. After adjusting for family, school, access to substances and neighborhood violence variables, students who engaged in health-related risk behavior in the US had significantly increased odds of alcohol and marijuana use while later attending school in Mexico. The article discusses the findings from a prevention science perspective and provides implications for policy, practice, and future research on the Mexico-US border region. Full article

Aporophobia or aversion to the poor is a discriminatory phenomenon that causes a serious problem to the person with consequences related to damage, injury and physical and/or psychological sequelae. This paper describes the creation of the first aporophobia risk assessment tool, developed through a bibliometric review and expert opinion. This article presents the results obtained in the first phase of the design of this instrument for the detection of victimisation suffered by people in extreme poverty or at risk of poverty due to discrimination or aversion. Initially, a bibliometric review was carried out to identify the risk factors present in aporophobic situations and victimisations related to discrimination or rejection of people living in poverty. For the development of this aporophobic victimisation detection tool, the methodology of structured judgment by means of a panel of experts was used. After identifying the risk factors present in aporophobic victimisation, the panel of experts was formed with the participation of 26 academic professionals and those who work with these people in situations of social exclusion. Using expert methodology and the Delphi technique, they identified the most appropriate variables for inclusion in the detection instrument currently being designed, distinguishing between individual, social and relational factors and, finally, the most influential environmental factors for being victims of aporophobia. The results of the panel of experts highlight some of the following variables, for example, substance use and/or possible undiagnosed mental illness related to individual dimensions, in the case of variables related to one’s social level, among others, a lack of community ties and/or social participation and, finally, among the variables within a context called victim opportunity, the routine of staying overnight on the street or in enclosed spaces at street level by homeless people is highlighted. The experts who made up the panel highlighted the usefulness of this type of instrument for the professionals who attend to these people with different resources; the first version of this instrument is a protocol that evaluates all possible areas of the people of interest in order to detect these invisible situations. Full article