Drug Use Research Articles

The Effects of Substance Abuse and Youth Involvement in Property Crime in Nigeria

This study investigates the relationship between substance abuse and youth involvement in property crime in Yelwa area of Bauchi Metropolis, Nigeria. The objectives of this research is to examine the nature of substance abuse among youths, identify the causes leading to their involvement in property crime, assess the effects of substance abuse, explore factors influencing drug use, and provide solutions to combat the problem. The study provides insights in to the socio-economic factors driving substance abuse and its contribution to property crimes such as theft and burglary. The research adopts a quantitative approach, using a survey design. The population consists of 800 youths aged 18 to 35 in Yelwa, and a sample size of 334 was determined using the Taro Yamane formula. Data was collected through self-administered questionnaires, containing both demographic information and targeted questions to assess the relationship between substance abuse and crime. The findings revealed that substance abuse, particularly involving marijuana, alcohol, and inhalants, is prevalent among youths and closely linked to property crimes. The key contributing factors include peer pressure, unemployment, and socio-economic hardship. The study highlights the detrimental impact of substance abuse on both individuals and the community, with increased property crimes and insecurity in Yelwa. The study concludes that comprehensive interventions are needed, including community awareness programs, stronger law enforcement, and youth rehabilitation initiatives. The study recommended that implementation of family-based interventions, youth engagement programs, and greater policy focus on substance abuse prevention at local and national levels.

Systematic Review and Meta-analysis of the Effectiveness of Whole-school Interventions Promoting Mental Health and Preventing Risk Behaviours in Adolescence.

Adolescence is a vulnerable period for the onset of mental disorders and risk behaviours. Based on the Health-Promoting Schools Framework, whole-school interventions offer a promising strategy in this developmentally-sensitive cohort, through championing a systems-based approach to promotion and prevention that involves the key stakeholders in an adolescent's life. The evidence-base surrounding the effectiveness of whole-school interventions, however, remains inconclusive, partly due to the insufficient number of studies in previous meta-analyses. An updated systematic review and meta-analysis was thus conducted on the effectiveness of whole-school interventions promoting mental health and preventing risk behaviours in adolescence. From 12,897 search results, 28 studies reported in 58 publications were included. Study characteristics and implementation assessments were synthesized across studies, and quality appraisals and meta-analyses performed. Analyses identified a significant reduction in the odds of cyber-bullying by 25%, regular smoking by 31% and cyber-aggression by 37% in intervention participants compared to the control. Whole-school interventions thus offer substantial population health benefits through the reduction of these highly-prevalent issues affecting adolescents. The non-significant findings pertaining to the remaining eleven outcomes, including alcohol use, recreational drug use, anxiety, depression and positive mental health, are likely attributable to suboptimal translation of the Health-Promoting Schools Framework into practice and inadequate sensitivity to adolescents' local developmental needs. Given the ongoing challenges faced in the implementation and evaluation of these complex interventions, this study recommends that future evaluations assess the implementation of health-promoting activities in both intervention and control conditions and actively use this implementation data in the interpretation of evaluation findings.Preregistration: A pre-registered PROSPERO protocol (ID: CRD42023491619) informed this study.

Animal models of cocaine use: importance of social context and co-use.

Cocaine-use disorders (CUDs) continue to be a major public health problem that requires effective treatments. Despite decades of preclinical research, there are no FDA-approved pharmacotherapies for cocaine use. While there are numerous potential reasons why no efficacious treatments have been identified or approved for cocaine use, we discuss two possible reasons in this review: the low number of studies incorporating social variables and the overlooking of the clinical reality of polysubstance use. These variables impact drug use across the substance-use cycle, including vulnerability, maintenance, and treatment. Recent preclinical and clinical data suggest that cocaine users who engage in polysubstance use should be viewed as a distinct and more prevalent population who require unique behavioral and pharmacological approaches to reduce cocaine use. Therefore, to understand the neurobiology and eventual treatments for CUDs, both variables should be included in animal models.

Safer Stimulant Supply: Program Outcomes.

With nearly 50,000 people having died since 2016 as a result of the unregulated toxic drug supply, novel approaches to care are needed. A small number of Safer Stimulant Supply programs have been piloted in Canada, which seek to provide a pharmaceutical-grade stimulant medication replacement for the toxic unregulated stimulant supply. In this paper, we describe the results of retrospective Safer Stimulant Supply program medical chart reviews. We extracted data from program intake and check-in forms collected on an ongoing basis by the clinical teams. In total, 28 medical charts were included in this evaluation. Data collected was reported using descriptive statistics. Chart reviews showed that over the course of the program, program participants reported an overall decrease in their unregulated stimulant use. Specifically, at program intake and check-in appointments, cocaine use went from a median of 10 points/day to 0 points/day, and crystal methamphetamine use went from a median of 1.5 points/day to 0 points/day. Chart reviews also showed that program participants reported increased access to primary care and infectious disease programs and improvements in housing status. Our research demonstrated that program participants found Safer Stimulant Supply programs to be impactful in addressing ongoing drug use. Safer Stimulant Supply programs remain an underutilized but important harm reduction tool to address the drug poisoning crisis.

Risk and protective factors of disease flare during pregnancy in systemic lupus erythematosus: a systematic review and meta-analysis.

To synthesize available evidence on predictive factors associated with systemic lupus erythematosus (SLE) flares during pregnancy, we systematically searched MEDLINE, Embase, and the Cochrane Library through January 2024 for observational studies on risk and protective factors of SLE flares during pregnancy. Odds ratios (OR) and mean differences (MD), as well as their 95% confidence intervals (CI) were used to quantify effect sizes. We employed fixed-effect or random-effect models based on heterogeneity assessments (I2 statistics). Sensitivity analyses were performed using the leave-one-out method, and publication bias was assessed through Egger's test. Thirty-two studies were included in the meta-analysis. Significant baseline SLE characteristics associated with higher risks for flares during pregnancy were identified: thrombocytopenia (with OR [95%CI], 2.29 [1.14-4.58]), hypocomplementemia (1.70 [1.28-2.27]), anti-dsDNA positivity (1.43 [1.16-1.77]), and a history of lupus nephritis (2.34 [1.70-3.21]). Protective factors included achieving remission before pregnancy (0.32 [0.20-0.49]) and antimalarial use at baseline (0.71 [0.55-0.92]) and during pregnancy (0.44 [0.33-0.58]). Additional risk factors included baseline glucocorticoid usage (1.51 [1.17-1.94]), glucocorticoid administration during pregnancy (3.39 [1.90-6.06]), use of other immunosuppressive drugs at baseline (1.46 [1.00-2.12]), and hypertension (2.16 [1.45-3.23]). Furthermore, individuals in the flare group were younger, had higher baseline disease activity, and lower C3/C4 levels compared to the non-flare group. This study highlighted the critical role of managing SLE disease activity prior to pregnancy to minimize flare risks, and identified significant risk and protective factors associated with flares. These evidences facilitate better clinical management strategies for pregnant women with SLE. Key Points • Synthesizes existing evidence on the risk and protective factors associated with SLE flares during pregnancy. • Highlights the critical importance of effectively managing disease activity prior to conception. • Provides insights to enhance risk stratification and management strategies for pregnancies in patients with SLE.

Risk of Cancers According to the Use of Biological Agents in Patients With Radiographic Axial Spondyloarthritis: A Nationwide Population-Based Cohort Study.

As the duration of use of biological disease-modifying antirheumatic drugs (bDMARDs) in patients with radiographic axial spondyloarthritis (r-axSpA) accumulates over time, long-term real-world safety data on cancer risk are needed. This study assessed the association between tumor necrosis factor inhibitors (TNFis) and interleukin 17 inhibitors (IL-17is) exposures and cancer risk in patients with r-axSpA. From the Korean nationwide database, we assembled 41,889 patients without prior history of cancer who were diagnosed with r-axSpA from 2010 onwards. Patients were followed up through 2021. Multivariable time-varying Cox models were performed to estimate the adjusted hazards ratios (aHRs) and 95% confidence intervals (CIs) of (1) overall cancers and (2) cancer subtypes according to TNFis exposure versus bDMARDs nonexposure, IL-17is exposure versus bDMARDs nonexposure, and IL-17is exposure versus TNFis exposure. The incident rates of overall cancers during bDMARDs nonexposure, TNFis exposure, and IL-17is exposure were 53.8, 37.6, and 67.3 per 10,000 person-years, respectively. TNFis exposure versus bDMARDs nonexposure was not associated with an increased risk of overall cancers (aHR = 0.9, 95% CI = 0.8-1.1). IL-17is exposure was not associated with an increased risk of overall cancers compared with bDMARDs nonexposure (aHR = 1.2, 95% CI = 0.5-3.0) or TNFis exposure (aHR = 1.3, 95% CI = 0.6-3.3). Similarly, no significant associations were observed between bDMARDs exposures and the risk of cancer subtypes. In patients with r-axSpA, there was no evidence of increased cancer risk with TNFis and IL-17is exposures compared with bDMARDs nonexposure, suggesting that the use of bDMARDs is safe with respect to cancer risk in patients with r-axSpA.

Dendritic Antifungal Peptides as Potent Agents against Drug-Resistant Candida albicans and Biofilm.

Candida albicans infection is a major public health problem, exacerbated by the emergence of drug-resistant fungi with the widespread use of antifungal drugs. Therefore, the development of novel antifungal drugs for drug-resistant C. albicans infections is crucial. We constructed a series of dendritic antifungal peptides (AFPs) with different chain lengths of fatty acids as hydrophobic ends and 2 or 3 protease-stable repeats (Arg-Pro) as dendritic peptide branches. Among them, C4-3RP exhibited excellent antidrug-resistant fungal and biofilm activity (GMall = 5.04 μM) and was nontoxic. Furthermore, C4-3RP demonstrated high protease stability and salt ion tolerance, making it highly effective in murine skin infection mediated by C. albicans. In addition, C4-3RP uses multiple mechanisms of action to achieve excellent antifungal effects. In conclusion, the construction of dendritic peptides holds substantial potential in the treatment of fungal infections and provides a broader perspective on the design of peptide-based antifungal drugs.

Factors Associated with Workplace Injuries Among Shift Work Nurses: A Cross-Sectional Study in an Ecuadorian Sample

Background/Objectives: Shift work schedules and mental and physical workloads affect the sleep homeostasis of nurses, increasing the risk of occupational injuries. This study aimed to investigate the relationship between sleep disturbances caused by shift schedules and the occurrence of needlestick and sharps injuries (NSIs) among nurses, considering significant worker and occupational factors. Methods: A total of 348 nurses from five hospitals of Santiago de Guayaquil, Ecuador, participated in this cross-sectional survey. Data on sociodemographic and occupational characteristics, work schedules, and NSI incidents during the previous six months were collected. Emotional status, sleepiness, and insomnia symptoms were assessed using validated questionnaires. Additionally, nurses with night shifts (fixed or rotating) were specifically assessed to estimate the relationship between NSIs and insomnia or sleepiness symptoms related to these types of shift work using logistic regression analyses. Results: Nurses whose schedule included night shifts showed a higher prevalence of NSIs than those with other shifts (33.2% vs. 29.0%; p < 0.05). High levels of depression, anxiety, and stress were associated with having had an NSI in the previous six months. Logistic regression showed that female sex (adjusted odds ratio, aOR 4.62, 95% CI: 1.65–12.97), less experience in the current clinical setting (aOR 3.12, 95% CI: 1.46–6.57), the use of psychotropic drugs (aOR 4.46, 95% CI: 1.51–13.17), and insomnia and sleepiness symptoms due to shift work (aOR 2.61, 95% CI: 1.15–5.91) increased NSI risk among nurses with night shifts. Conclusions: There is an acute need to explore the complex relationship between sleep troubles linked to shift work schedules, occupational factors, and the risk of occupational injuries and propose preventive strategies for enhancing nurses’ sleep health and workplace safety.

Implementation of intraoperative procedures to prevent anastomotic leak in low anterior rectal resections: a pilot study for a novel technique to evaluate anastomotic vascularization.

Altered vascular microcirculation is recognized as a risk factor for anastomotic leakage (AL) in colorectal surgery. However, few studies evaluated its impact on AL using different devices, with heterogeneous results. The present study reported the initial experience measuring gut microcirculatory density and flow with the aid of incidence dark-field (IDF) videomicroscopy (Cytocam, Braedius, Amsterdam, The Netherlands) comparing its operative outcome using a propensity score matching (PSM) model based on age, gender, and Charlson Comorbidity Index (CCI). Videos from 5 different sites (at least 10s/site) were recorded from both the mucosal and serosal site of the left colon end after the colonic resection. Total vessel density (TVD), Perfused Vessel Density (PVD), De Backer score, Proportion of Perfused Vessels (PPV), and Microvascular Flow Index (MFI) were analyzed. At each recording, noninvasive measurements of blood pressure, heart rate, temperature, use of vasoactive drugs, and peripheral oxygen saturation were simultaneously recorded. The association between postoperative outcomes and microcirculation evaluation was investigated using PSM analyses. Ninety-nine patients were included in the Cytocam group. The mean TVD small was 8.9 ± 2.8mm/mm2, the PPV small % was 100 in all patients but 1, while the MFI was 3 in all patients. The mean PVD small was 8.76 ± 2.8mm/mm2 and the mean De Becker score was 4.4 ± 1.3. In 2 patients (10.5%), the finding of altered vascularization resulted in the change of the operative strategy with an extension of the resection point. AL occurred in 2 patients of the No Cytocam group (p = 0.811). Thistype of anastomotic evaluation has shown to be feasible, safe, and useful in easily detecting any alteration of the resected colon before anastomotic construction.Moreover, this technology couldoffera more cost-effective manner than other devices.

Optimizing the role of pharmacists at the primary healthcare centres in Indonesia through an integrated information system

IntroductionThe role of pharmacists at primary healthcare centers (PHCs) in Indonesia still needs long-term improvement. Enhancing interprofessional collaboration through data-driven collaboration is essential to strengthening cooperation. This study aimed to identify the need for an integrated information system to enhance the role of pharmacists at PHCs in Indonesia.MethodsA desk review was applied as the initial step to analyze the role of pharmacists at the PHCs in Indonesia. Furthermore, a qualitative study was conducted using Walt and Gilson’s health policy analysis framework. Semi-structured interviews were conducted in four sections (context, content, process, and actors) with consideration of selected key respondents. All interviews were transcribed verbatim and then analyzed using Braun and Clarke’s thematic analyses, ensuring a comprehensive understanding of the situation.ResultsWe identified two significant challenges in optimizing the use of integrated systems at the PHCs to increase the role of pharmacists. Considering context-content-process-actors, implementing integrated pharmaceutical care standards relies significantly on human resources and infrastructures. Key challenges related to human resources are a limited number of human resources, a high workload, and insufficient use of working tools. We found several challenges regarding infrastructure, such as network connectivity issues, non-integrated systems or applications, and suboptimal benefits from the current systems.ConclusionVarious systems or applications in PHC involve reporting to the Ministry of Health, but detailed integration of these systems needs to be achieved immediately. According to informants, the criteria for desired applications are crucial to optimizing the integrated system, using it, and streamlining tasks for pharmacists at PHCs. Common expectations include an integrated system for monitoring drug usage and orders. Apart from usefulness, network connectivity must be assured for accessibility by all parties.

Sexual identity, sexual behavior, and drug use behaviors among people who use drugs in the rural U.S.

People who use drugs (PWUD) are at risk of HIV infection, but the frequency and distribution of transmission-associated behaviors within rural communities is not well understood. Further, while interventions designed to more explicitly affirm individuals' sexual orientation and behaviors may be more effective, descriptions of behavior variability by orientation are lacking. We sought to describe how disease transmission behaviors and overdose risk vary by sexual orientation and activity among rural PWUD. From 01/2018-03/2020, rural PWUD participating in the Rural Opioid Initiative were surveyed across 8 sites. Collected data included: demographics; experiences with drug use, overdose, and healthcare; stigma; gender identity; and sexual orientation and partners. Participants were categorized as: monosexual by orientation and behavior (Mono-only), monosexual by orientation but behaviorally bisexual (Mono/Bi), and bisexual by orientation (Bi+). Analyses included descriptive summaries, bivariate examination (chi-square), and logistic regression (relative risk [RR] and 95 % confidence interval [CI]). The 1455 participants were 84.8 % Mono-only, 3.2 % Mono/Bi, and 12.0 % Bi+. Compared to Mono-only men, Mono/Bi and Bi+ men had greater risk of transactional sex (RR = 9.71, CI = 6.66-14.2 and RR = 5.09, CI = 2.79-9.27, respectively) and sharing syringes for injection (RR = 1.58, CI = 1.06-2.35 and RR = 1.85, CI = 1.38-2.47). Compared to Mono-only women, Mono-Bi and Bi+ women had greater risk of transactional sex (RR = 4.47, CI = 2.68-7.47 and RR = 2.63, CI = 1.81-3.81); and Bi+ women had greater risk of sharing syringes for injection (RR = 1.49, CI = 1.23-1.81), sharing syringes to mix drugs (RR = 1.44, CI = 1.23-1.69), and experiencing an overdose (RR = 1.32, CI = 1.12-1.56). Bi+ men and women both more frequently reported selling sex as a source of income (versus Mono-only, both p < 0.050) and measures of perceived stigma (all p < 0.050). Rural PWUD who are bisexual by orientation or behavior are significantly more likely to engage in behaviors associated with infectious disease transmission and to experience stigma and drug overdose. Given the growing recognition of bisexuality as a distinct orientation that warrants individualized consideration, interventions that are specifically acknowledging and affirming to the circumstances of this group are needed.

The influence of religious institutional logic in frontline work

AbstractThis research analyses the influence of religion—as an institutional logic—on the work of frontline workers (FLWs) in hybrid public policy implementation contexts. We conducted semi‐structured interviews and used vignettes with 37 therapeutic communities (TCs) in the state of São Paulo, Brazil, which provide care for individuals with problematic drug use. Through our analysis, we discovered variations in how FLWs from faith‐based and secular organisations categorise their clients and provide them with alternative services. These differences were evident in their perceptions of problematic drug use, desired outcomes for clients, and the methods they utilise to achieve these goals. In practice, faith‐based TCs prioritise behavioural categories and emphasise support from family and work as treatment alternatives, whereas secular TCs employ professional language and offer alternatives based on psychological and medical support. This study enhances the understanding of religion as an institutional logic and underscores the significance of analysing institutional logics to comprehend the actions of FLWs in cases of hybridity, particularly the role of faith‐based organisations in service delivery.Points for practitioners The religion of organisations can have an impact on the work of frontline workers (FLWs). This impact becomes especially clear in the categorisation process, as it shapes FLWs’ understanding of their work and the referrals they make based on that understanding.

Antiretroviral Use for HIV Prevention During Pregnancy: The Need to Strengthen Regulatory and Surveillance Systems in Africa.

HIV-prevention efforts focusing on women of child-bearing potential are needed to end the HIV epidemic in the African region. The use of antiretroviral drugs as pre-exposure prophylaxis (PrEP) is a critical HIV prevention tool. However, safety data on new antiretrovirals during pregnancy are often limited because pregnant people are excluded from drug development studies. Calls from communities, healthcare professionals, and regulators to improve the information supporting decision-making around the use of medical products during pregnancy have been increasing. Post-marketing safety surveillance is an essential tool for detecting adverse outcomes and evaluating real-world, longer-term effects of drugs. Detecting and evaluating uncommon pregnancy outcomes requires large sample sizes, highlighting the benefits of and need for safety surveillance. Surveillance systems vary widely across Africa, and the need for enhanced surveillance of PrEP use during pregnancy highlights the limitations of current regulatory and surveillance systems. Challenges include weak regulation and insufficient resources. Pooling of resources and regulatory harmonization could address resource challenges. The African Medicines Agency, as a specialized agency of the African Union, has the potential to improve African medical product regulation, including post-marketing safety surveillance. This can strengthen regulation and ensure that market authorization holders meet their responsibility to invest in post-marketing surveillance systems, such as pregnancy registries. At the same time, independent post-marketing studies are needed to ensure generation of essential safety data. The Forum for Collaborative Research has initiated a project to facilitate interactions between regulators in Africa, the USA, and Europe, as well as other stakeholders, and to work toward consensus on safety data generation from PrEP during pregnancy before and after marketing authorization.

Trailblazer Tepezza for thyroid

Dear Editor, Teprotumumab is a human monoclonal antibody that blocks the insulin-like growth factor-1 receptor (IGF- 1R). Approved by the Food and Drug Administration (FDA) on January 21st, 2020, under the brand name Tepezza, to be used as the treatment for Graves eye disease in adults based on its landmark success in the randomised double-blind clinical trials named OPTIC study. [1] A meta-analysis published in the International Journal of Clinical Practice in 2023 stated that at week 24 of treatment, Teprotumumab had been shown to significantly improve proptosis in 71.86% participants, diplopia in 73.65% of participants and decrease tissue inflammation, as measured by the clinical activity score to zero or one, thus improving the overall quality of life. [2] Even though the drug has adverse effects namely alopecia, fatigue and headache, the risk of these occurring was the same as the placebo group. Other potential side effects included nausea, dry skin and muscle spasms which were deemed mild.[3] One manageable side effect reported was hypoglycaemia, especially in individuals already diagnosed with diabetes, which could be corrected by adjusting their anti-diabetic medication. Importantly, this drug should be avoided in pregnancy due to its prospective teratogenic effects [2]. The promising statistics outweigh the risks associated with the drug and make teprotumumab a game-changer for thyroid eye disease patients. Pakistan has a 2% prevalence of hyperthyroidism, with a major (90%) contribution from Graves’ disease. [4] Although this 2% seems insignificant, yet it amounts up to 4.2 million people. Unfortunately, this drug has not reached Pakistan yet and we still resort to using conventional treatments namely lubricants and steroids despite their worrying side effects and contraindications in patients having other comorbid conditions which majority of the people of Pakistan suffer from such as diabetes, hypertension, osteoporosis and hepatic dysfunction. [5] The government should subsidize the use of this novel drug in TED patients by incentivizing its availability and training physicians to monitor the patients taking the infusions. The patients will need to be educated about the adverse profile and danger signs when to report their symptoms to the doctor. Teprotumumab is not just a treatment, it is a cure for most patients. Should we not switch from using the current harmful conventional drugs to the more contemporary ones with better outcomes?

Laboratory animals anesthesia recommendations for biomedical research purposes

Anesthesia is widely used in experimental biomedical research to anesthetize and immobilize laboratory animals during surgical interventions and experimental procedures. In contrast to clinical and veterinary anesthesiology, an important aspect of anesthesia in laboratory animals is to minimize the effect of anesthetics on the results of the study. On November 19, 2022, the IV Scientific and Practical Conference “Experimental Surgery, Anesthesiology and Reanimatology of Laboratory Animals” was held in Moscow, where the community of specialists in the field of laboratory animal science, experimental surgery, pathophysiology, veterinary medicine, clinical and veterinary anesthesiology discussed various aspects of anesthesia in laboratory animals. This review is based on the conference proceedings and is devoted to general issues of animal anesthesia, its technological aspects (methods, equipment and consumables), consideration of advantages and disadvantages of the most commonly used inhalation and injection anesthetics.The advantages and schemes of modern combined anesthesia are substantiated, in particular, the need for adequate intraoperative analgesia and the possibility of regional anesthesia. The use of obsolete and non-recommended drugs is also discussed. The review and recommendations have a practical orientation and are intended for biomedical researchers who use laboratory animals in basic, translational and regulated preclinical studies.

Adherence to Guideline Recommendations on Psychotropic Drug Use for Challenging Behavior in Dementia.

Psychotropic drugs are frequently prescribed for challenging behavior in residents with dementia in nursing homes. Recommendations on psychotropic drug use for challenging behavior are described in the Dutch multidisciplinary guideline "Problem behavior in dementia." This study aimed to gain insight into the adherence to guideline recommendations on drug type and timing of evaluations of different types of psychotropic drugs for challenging behavior in a national sentinel network of Dutch nursing homes. Prospective observational study. Data on psychotropic drug use of residents in a sentinel network of 22 nursing homes across the Netherlands were collected during a 3-month measurement period in2021. Physicians completed registration forms integrated into the electronic health record after reporting on psychotropic drug use in progress notes. Prescribed drug type(s), type of drug intervention (start/stop/change in dosage/evaluation), and drug indications were recorded. Adherence to guideline recommendations on drug type was achieved if prescribed psychotropic drugs were recommended for the specified indication. Adherence to guideline recommendations on timing of evaluations was achieved if evaluations were reported within 7 days after starting. A total of 1279 forms on psychotropic drug use for specified challenging behaviors in 599 residents were collected. Recommended psychotropic drugs were used in 57% of all forms. The highest rate of recommended psychotropic drugs was for psychotic behavior (80%), followed by agitation (48%). Adherence was lowest for nighttime restlessness (22%). Of all newly started prescriptions, 17% were evaluated within the recommended 7 days after starting. Adherence to guideline recommendations on drug type was present in just over half of the cases. Frequently, evaluations were not reported or were performed after the recommended time frame. Further research is needed to determine the reasons for non-recommended psychotropic drug use, low evaluation reporting rates, and factors that influence adherence. The use of a sentinel network may increase awareness and adherence.

Predictors, patterns, and correlates of moderate-severe psychological distress among New York City College Students during Waves 2–4 of COVID-19

The COVID-19 pandemic may have exacerbated mental health conditions by introducing and/or modifying stressors, particularly in university populations. We examined longitudinal patterns, time-varying predictors, and contemporaneous correlates of moderate-severe psychological distress (MS-PD) among college students. During 2020–2021, participants completed self-administered questionnaires quarterly (T1 = 562, T2 = 334, T3 = 221, and T4 = 169). MS-PD reflected Kessler-6 scores ≥ 8. At T1 (baseline), most participants were cisgender women [96% vs. 4% transgender/gender non-conforming (TGNC)]. MS-PD prevalence was over 50% at all timepoints. MS-PD predictors included low self-rated health and perceptions of local pandemic control, verbal/physical violence experience, food insecurity, cohabitation dynamics, geographic location, and loneliness. Unique MS-PD correlates encompassed drug use and TGNC identity. Trajectories comprised Persistently (40%), Highly (24% MS-PD twice/thrice), Minimally (15% MS-PD once), and Never (21%) Distressed. Persistently Distressed students had low social support and self-rated health; high food insecurity, drug use, physical/verbal violence experience, need-based financial aid, and TGNC representation; and fluctuating self-rated health amid increasing COVID-19 symptomatology. In this sample, MS-PD prevalence was high, persistent, and associated with financial, behavioral, structural, experiential, and intra- and inter-personal factors. Given its complexity, improving and preserving college students’ mental health necessitates comprehensive, multi-component activities to change adjustable stressors while attenuating the adverse effects of immutable influences.

Predicting bullying victimization among adolescents using the risk and protective factor framework: a large-scale machine learning approach

BackgroundBullying, encompassing physical, psychological, social, or educational harm, affects approximately 1 in 20 United States teens aged 12-18. The prevalence and impact of bullying, including online bullying, necessitate a deeper understanding of risk and protective factors to enhance prevention efforts. This study investigated the key risk and protective factors most highly associated with adolescent bullying victimization.MethodsData from the Student Health and Risk Prevention (SHARP) survey, collected from 345,506 student respondents in Utah from 2009 to 2021, were analyzed using a machine learning approach. The survey included 135 questions assessing demographics, health outcomes, and adolescent risk and protective factors. LightGBM was used to create the model, achieving 70% accuracy, and SHapley Additive exPlanations (SHAP) values were utilized to interpret model predictions and to identify risk and protective predictors most highly associated with bullying victimization.ResultsYounger grade levels, feeling left out, and family issues (severity and frequent arguments, family member insulting each other, and family drug use) are strongly associated with increased bullying victimization - whether in person or online. Gender analysis showed that for male and females, family issues and hating school were most highly predictive. Online bullying victimization was most highly associated with early onset of drinking.ConclusionsThis study provides a risk and protective factor profile for adolescent bullying victimization. Key risk and protective factors were identified across demographics with findings underscoring the important role of family relationships, social inclusion, and demographic variables in bullying victimization. These resulting risk and protective factor profiles emphasize the need for prevention programming that addresses family dynamics and social support. Future research should expand to diverse geographical areas and include longitudinal data to better understand causal relationships.

Evaluation of the effectiveness and tolerability of diacerein in patients with osteoarthritis of the knee and hip joints

Aim: to evaluate the effectiveness and tolerability of the domestic drug Diacerein-SZ in patients with osteoarthritis of the knee and hip joints.Patients and Methods. A single-center clinical prospective study was conducted, which included patients with osteoatritis and metabolic syndrome. 65 patient with OA of the knee and/or hip joints of stage II–III according to Kellgren–Lawrence with pain intensity &gt;30 mm on a visual analog scale, aged 40 to 71 years, was examined. The duration of therapy was 6 months: 1 month – taking the drug Diacerein-SZ at a dose of 50 mg/day, then 5 months at 50 mg 2 times a day. During each visit, pain syndrome (VAS, mm), BMI, and biochemical blood tests were assessed. Data on the use of additional drugs with anti-inflammatory effects, as well as adverse events, were analyzed.Results. The average age of patients was 55.5 [49.5; 58] years. A pronounced anti-inflammatory effect was noted in the form of a decrease in the level of VAS and CRP (p &lt;0.0001), which led to the complete abolition of NSAIDs by the end of the study in 67.7% of the subjects. A statistically significant decrease in uric acid and glycated hemoglobin was observed already by week 12 of the study (p = 0.011), (p = 0.0001), respectively. There were no significant differences in lipid profile and glucose levels (p &gt;0.05). Adverse events were recorded in 12.9% of patients.Conclusion. The use of the domestic drug Diacerein-SZ in patients with osteoarthritis led to a decrease in the need for NSAIDs, had a favorable effect profile on the level of uric acid and glycated hemoglobin, and was well tolerated.

Pre-injury narcotic drug use in isolated severe traumatic brain injury: effect on outcomes.

The aim of this study was to explore the association between pre-injury narcotic drug use (opioids, methadone, and/or oxycodone) and outcomes in isolated severe traumatic brain injury (TBI) patients. ACS TQIP study included adult trauma patients (≥ 16 years) with complete drug and alcohol screening. Isolated severe TBI was defined as head trauma with AIS 3-5 and without significant extracranial trauma. Exact matching was used to compare patients with isolated pre-injury narcotic drug use to those with no illicit drug or alcohol use. Patients were matched 1:1 based on the following matching criteria: age, gender, mechanism of injury, Injury Severity Score, systolic blood pressure, head AIS, and comorbidities. Of 1,846,630 patients, 141,058 had isolated severe head injuries with complete drug and alcohol screenings. After exact matching, 1,560 patients in each group were analyzed. There were no significant differences in hospital mortality, craniectomy rates, complication rates, or length of hospital stay. Patients that tested positive for narcotics had lower rates of mechanical ventilation (16.5% vs. 25.3%, p < 0.01) and shorter ICU stays [3 (2-4) days vs. 3 (2-6) days; p < 0.01]. Pre-injury narcotic drug use in isolated severe TBI is not associates with adverse outcomes. Further research is needed to understand the biochemical and physiological effects of narcotic drugs on TBI outcomes.