A Comparison of Family Characteristics and Attitudes Toward After-school Care for Latchkey Children

A convenience sample of 20 families with employed parents and school-age children who attended a local after-school program was compared with a convenience sample of 20 families with employed parents whose school-age children did not attend the program. The groups were compared to examine the relationship between family characteristics and attitudes toward after-school programs and the use of such programs by families with employed parents. The presence of a sibling 13 years of age or older tended to influence a family's decision to use the program. In addition, although an after-school program was easily accessible in this community, 67 percent of children (mean age 8 years) who did not attend went home after school to an older sibling whose mean age was 11 years. In addition, 22 percent of children (mean age of 8 years) who did not attend came home alone or with younger siblings. These findings indicate important implications for public health and school nurses to find innovative methods in meeting the needs of this population at risk.     

Examining the Substance Use Patterns and Treatment Needs of Incarcerated Sex Offenders

Using data from a Bureau of Justice Statistics' national prison inmate survey, this paper analyzes alcohol and drug use and abuse patterns among men incarcerated in state prison for sex crimes. Of the 13,986 inmates in the sample, 11.5% were incarcerated for a sex offense. Two thirds were substance-involved, meaning that they were under the influence of alcohol or drugs at the time of their crime, had committed a crime to get money for drugs, had histories of regular illegal drug use, had received treatment for alcoholism, or shared some combination of these characteristics. The level and type of substance-involvement was related to age and race, to history of victimization, and to victim characteristics. We discuss the implications of these findings for correctional program interventions, including assessing drug and alcohol problems, availability of substance abuse treatment for sex offenders, and the conjunction of such treatment with other programs.     

Nonfatal overdose from alcohol and/or drugs among a sample of recreational drug users

Abstract

The purpose of this study was to examine nonfatal overdose events experienced among a sample of recreational drug users. We sought to determine predictors of nonfatal overdose from alcohol and/or drugs among a sample of recreational drug users. In addition, we examined the substance(s) used at the last overdose event. Methods: Participants were 637 recreational illicit drug users (had used illicit drugs other than marijuana, in a club or party setting), aged 19 or older, from Victoria or Vancouver, British Columbia, Canada. Data were obtained in structured interviews conducted from 2008 to 2012 as part of the Canadian Recreation Drug Use Survey (CRDUS). Results: In the 12 months prior to interview, 19.3% (n?=?123) of the participants had experienced an overdose. In multivariate analysis, younger age, unstable housing, and usually consuming eight or more drinks containing alcohol, when drinking, significantly increased overdose risk. In addition, polysubstance use was reported by 67.5% (n?=?83) participants at their last overdose event. Conclusions: Intervention and prevention measures seeking to reduce overdoses among recreational drug users should not only address illicit drug use but also alcohol and polysubstance use. In addition, measures may target those who usually consume high amounts of alcohol when drinking are younger and who experience housing instability.     

130例不良反应报告分析及合理用药建议

目的:对130例临床药物不良反应报告进行回顾性分析,得出我院不良反应发生的特点,并对合理用药进行建议,以减少我院不良反应发生率。方法:对130例不良反应从性别、年龄、给药途径、药物分类等方面进行统计分析。结果:我院不良反应特点是在老年人和儿童中发生率较高,分别为33.08%和16.15%;女性(66.15%)多于男性(33.85%);发生不良反应最高的药物种类依次为抗菌药物(38.46%)、中成药(37.69%)及营养药物(6.92%),发生率较高品种为阿奇霉素、头孢呋辛、血塞通、生脉、痰热清、热毒宁,且20岁以下抗菌药物不良反应发生率高(42.00%),育龄期妇女中成药不良反应发生率高(30.61%)。结论:在合理用药中,建议我院应重点监护儿童中抗菌药物使用,育龄期女性中成药使用,老年人中成药和抗菌药物使用,并对阿奇霉素、头孢呋辛、血塞通、生脉、热毒宁、痰热清、疏血通7个品种建立重点监测制度,降低不良反应发生率。     

Parent–adolescent discrepancies in reports of adolescent tobacco and alcohol use associated with family relationships in Taiwan

This study assessed the discrepancies between reports from parents and adolescents concerning family relationships and the use of tobacco and alcohol by adolescents. Data were obtained from a sample of 2015 parent–adolescent dyads recruited from 30 junior high schools in Taipei City and Taouyun County, Taiwan, in 2010. The results indicated that more than 90% of parent–adolescent dyads agreed to no tobacco/alcohol use by adolescents. More than half (38 parents; 68%) of responding parents were unaware of the tobacco use that was reported by 56 adolescents in this study. A high percentage (133 parents; 93.7%) of the responding parents were unaware of the alcohol use reported by 142 adolescents in this study. Parents reported higher levels of parent–adolescent attachment, communication, monitoring and teaching than was reported by their adolescent children. Multivariate logistic regression results showed that lower ratings by adolescents on questions of family attachment, poor academic performance and delinquent behaviour were associated with parental unawareness of tobacco use. Likewise, low adolescent ratings of family communication and delinquent behaviour by adolescents could be used to predict parental unawareness of alcohol use by their adolescent children.     

Perceived risks of alcohol and illicit drugs: relation to prevalence of use on individual and country level

Background: Individual experience with substance use is considered as one of the principal factors influencing risk perception and attitudes of young people towards substance use. The aim of this article is to show the relationship between self‐reported prevalence and the subjectively perceived risks of substance use, both for individuals and at the country level.

Methodology: The relationships were analysed on a sample of students participating in the ESPAD survey in eight European countries. The sample of 22,899 students was divided into five groups: abstainers (9.3%), experimental alcohol consumers (52.0%), regular alcohol consumers (14.2%), experimental drug users (12.3%), and regular drug users (12.2%).

Findings: Significant differences were observed in the risk perception of use of selected substances among five types of users. The percentage of students perceiving moderate or great risks of substance use tends to fall across the groups with increasing prevalence of more risky patterns of substance use. Highest perceived risks of alcohol and illicit drugs use were found among abstainers and experimental alcohol consumers, while both experimental and regular drug users tend to perceive lower risks. Regular alcohol consumers perceive relatively high risks of illicit drug use, but they under‐estimate the risks of alcohol consumption. Country differences were observed in the level of perceived risks. These differences correspond to a different distribution of types of users and to the overall prevalence of substance use in individual countries.     

门诊处方不合理用药分析

目的：探讨本院门诊处方不合理用药情况。旨在促进和提高合理用药水平。方法：随机抽查本院2003年3～7月份门诊西药处方6780张，了解我院不合理用药情况。对处方中重复用药、联用增大毒性、联用降低药效、溶媒不合理、选药不合理、用法、用量不合理等不合理用药情况进行逐一展开全面分析。结果：不合理用药处方169张，占抽查处方总数的2．4％。其中重复用药的29张，占不合理用药处方的17．16％；增大毒性的34张，占不合理用药处方的20．12％；降低疗效的44张，占不合理用药处方的26．04％；溶媒不合理的22张．占不合理用药处方的13．02％，选药不合理的26张，占不合理用药处方的15．38％，用法、用量不合理的14张．占不合理用药处方的8，28％。结论：我院存在一定程度的不合理用药现象．不合理用药不仅造成经济上的浪费，还增加了药物不良反应和耐药性，导致药源性疾病发生，临床医师应提高合理用药水平，以便能更好地防治疾病，提高药物疗效，减少药品的毒副作用。     

The effect of personal use and family history on the attitudes of medical students toward alcohol and drug users

Objective: To investigate the effects of the personal exposure/usage of alcohol and drugs in medical students on their attitudes toward alcohol and drug users. Negative attitudes in health care practitioners about alcohol and drug users may lead to poor patient care. Personal experience on alcohol and drug use can influence the attitudes of health care professionals.

Method: This study used a quantitative cross-sectional methodology, utilizing a self-report survey on the personal use of alcohol and drug use, and the family history of alcohol and tobacco use. The “Substance Abuse Attitude Survey” (Chappel J. N., Veach, T. L., & Krug, R. S. (1985). The Substance Abuse Attitude Survey: An instrument for measuring attitudes. Journal of Studies on Alcohol, 46, 48–52.) measured attitudes (n = 417).

Results: The attitudes of medical students towards alcohol and drug users were weakly linked to their own personal use, and family history of alcohol and drug use. Increased use of alcohol was positively correlated with non-stereotyping. Length of time in medical school, number of years drinking alcohol, and high frequency of binge drinking were negatively correlated with non-moralism.

Conclusions: This study demonstrated that the attitudes of future medical professionals are fairly neutral toward alcohol and drug users. Given that alcohol and drug abuse are now considered medical illnesses health professionals themselves may attach fewer stigmas and stereotypes to the use and abuse of alcohol.     

Tobacco prevention in children and cessation in family members

PURPOSE: To examine the effects of a theory-driven tobacco prevention program in sixth-grade children with a family tobacco cessation component implemented by school nurses in conjunction with the initiation of a statewide toll-free Quit Line. DATA SOURCES: Self-report questionnaires completed by the sixth-grade children and their parents/guardians (N= 1024) representing largely rural southern school systems from disparate areas with high prevalence rates of tobacco use and lung cancer diagnoses. Pre- and posttest measures that evaluated the impact of both student and parent/guardian interventions were obtained over a 10-week period. Paired t-tests were used to examine differences between pre- and posttest scores for all student and parent/guardian variables. Repeated-measures analysis of variance was used to examine the effect of parent/guardian smoking on student pre- and posttest scores. CONCLUSIONS: The student program resulted in significant improvements in drug knowledge, refusal skills, attitudes, normative expectations, assertiveness, and anxiety reduction techniques. In addition, the effectiveness of several components of the tobacco prevention program for the children was impacted by the smoking status of their parents/guardians. Drug-use intentions and behaviors were lower at posttest for children from homes of nonsmokers versus children from homes of smokers. Parents/guardians consistently reported that smoking was detrimental to themselves, the public, and their children. Of those parents/guardians who identified themselves as smokers (26%) and received cessation materials, 46.4% indicated that the information motivated them to want to quit. IMPLICATIONS FOR PRACTICE: Tobacco use continues to be the leading cause of preventable death in the United States, with greater than 2000 new youth becoming regular smokers each day. School nurses and nurse practitioners are in various pivotal positions to address tobacco and its related health concerns through delivery of effective family interventions that target children for tobacco prevention and parent/guardian smokers for cessation.     

Effectiveness of a drinking-reduction program on drinking behavior,stages of change,drinking refusal self-efficacy,and resilience in Koreans with moderate alcohol use disorder

The purpose of this study was to examine the effects of a drinking-reduction program on drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in Koreans with moderate alcohol use disorder. This study used a quasi-experimental nonequivalent control design. This study was performed from March 2015 to July 2015. The drinking-reduction program was conducted once per week for 11?weeks. This program improved drinking behavior, stages of change, drinking refusal self-efficacy, and resilience in the experimental group compared to the control group (p?<?.05, n?=?34). The drinking-reduction program can be used as a nursing intervention for people with moderate alcohol use disorder.     

Factors in Childhood Drug and Alcohol Use: A Review of the Literature

TOPIC. Drug and alcohol use in children.
PURPOSE. To identify the prevalence of drug and alcohol use in children 12 and younger and the factors associated with this use.
SOURCE. A review of the literature.
CONCLUSIONS. The identified factors include: a) dijferences in use between boys and girls; b) influence of family members' drug and alcohol use; c) influence of peers; d) the child's self-esteem; and e) the child's knowledge about drug and alcohol use. Awareness by child psychiatric nurses of the identified factors is crucial to prevent, assess, and treat the problem of drug and alcohol use by children.     

Differences in personal,cognitive, psychological,and social factors associated with drug and alcohol use and nonuse by homeless women

The purpose of this study was to compare differences in personal, cognitive, behavioral, psychological, and social variables among homeless women who were current drug or alcohol users, or both, past drug or alcohol users, or both, and those who never used drugs or alcohol. The sample consisted of 1,013 women residing in 73 Los Angeles homeless shelters. Depression, anxiety, hostility, emotion-focused coping, lower self-esteem, and less social support were more prevalent among homeless women who continued to use drugs and alcohol than among past users or those who never used. AIDS knowledge was higher among past users. The results contribute important knowledge regarding the pattern of cognitive, psychological, and social differences between users and nonusers. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21:525–532, 1998     

Alcohol and other drug use among adolescent detainees

This paper seeks to describe alcohol and other drug use among a sample of 2280 male and female adolescent detainees at two state juvenile justice facilities. Substance use was explored by age of initiation, race/ethnicity, gender, delinquent behaviours, and recidivism. Results indicated that alcohol and marijuana were the substances of choice, followed by powder cocaine and ecstasy and other designer drugs. Alcohol use also preceded marijuana use for both males and females. Males engaged in more alcohol and other drug use than females, and they engaged in marijuana use at a younger age. White adolescents reported more alcohol use than adolescents in all other racial/ethnic categories, while there were no differences in marijuana use. White adolescents, however, were younger when they began using marijuana. Finally, adolescents who engaged in alcohol and other drug use reported more delinquent activities and were more likely to have been detained previously. The results of this study are discussed in the context of other studies examining substance use in the general adolescent population and in at‐risk and detained adolescents.     

PS1-01: Alcohol and Drug Use Among Chronic Opioid Therapy Patients

Background/Aims Opioid misuse and abuse is a significant public health problem, and there is a need to better identify at-risk individuals. Study aims were to examine patient characteristics associated with alcohol and other drug (AOD) use and aberrant drug related behaviors in chronic opioid therapy (COT) patients. Methods We conducted a telephone survey of a random sample of 972 COT patients in an integrated health care delivery system in 2009. Measures included weekly alcohol use and any illicit drug use in the last three months, and a composite measure of alcohol-only use, drug-only use, both alcohol and drug use, and tobacco only use. We conducted weighted multivariate logistic regressions models of AOD use and of aberrant drug-related behavior. Results Fourteen percent were weekly alcohol users (134/972), 16% used illicit drugs (157/972), 9% (83/972) used both alcohol and drugs, 8% used only drugs (74/972), 34% (334/491) used only alcohol, and 50% (481/972) did not use any substances. Multivariate models indicated illicit drug use was associated with a higher likelihood for weekly alcohol use, while being female, a higher daily opioid dose, and greater pain severity was associate with a lower likelihood of weekly alcohol use. Tobacco use, weekly alcohol use, depression symptoms, being male, and middle age was associated with a higher likelihood of illicit drug use. For aberrant drug related behaviors, drug-only use and both alcohol and drug use (compared to no AOD use) were associated with a higher likelihood of receiving opioids from friends or family in the last year, as were postive depressive symptoms and younger age. Both AOD use and depression symptoms were associated with a higher likelihood of giving opioids to others, while a high daily dose was associated with a lower likelihood of giving opioids to others, compared to the lowest dosage. Polysubstance use gender, and depression were risk factors in this sample. Post hoc analyses of primary care utilization indicated that those with high dosage opioids were more likely to have a certain threshold of primary care visits in the last year, suggesting there is an opportunity to manage these high risk patients.     

四川大学华西第二医院2010年儿科门诊患儿超说明书用药情况调查

目的回顾性调查2010年四川大学华西第二医院儿科门诊患儿超说明书用药现状,分析相关危险因素,为了解我国儿科超说明书用药现状和制订超说明书用药政策提供基线数据。方法分层随机抽取该院2010年儿科门诊患儿的处方,依据药品说明书,判断其用药医嘱是否超说明书,分析各超说明书用药类型、各年龄段儿童各类药品超说明书用药情况以及超说明书用药与年龄、性别和基本药物、非处方药物分类的关系。结果共抽取门诊儿科处方2 640张,分析处方用药医嘱8 588条,涉及药品329种。按处方、用药医嘱与药品种类计,超说明书用药发生率分别为76.59%、40.88%、83.89%。超说明书用药类型主要包括未提及儿童用药信息(35.57%)、适应症(25.44%)和剂量(25.31%)3种。超说明书用药发生率居前2位的年龄段为新生儿(54.35%)和青少年(49.64%)。用药医嘱数居前4位的超说明书用药种类依次为:呼吸系统用药(48.12%)、中成药(48.12%)、消化和代谢系统用药(33.36%)、全身用抗感染药(16.27%)。全院门诊各年龄段患儿超说明书用药的风险无差异,基本药物、处方药物可能存在更高的超说明书用药风险。结论 2010年四川大学华西第二医院儿科门诊患儿超说明书用药情况普遍,并呈增长趋势。这一方面反映了药品说明书中儿科用药信息缺乏,另一方面也提示急需国家出台相关法律法规或指南,以规范我国可能日趋严重的超说明书用药行为,并通过促进儿童药物临床试验以提供更多用药证据,鼓励研发和生产儿童适用药品和剂型,建立我国儿童基本药物目录等多种手段,保障儿童用药安全和规避医师职业风险。     

四川大学华西第二医院2010年儿科住院患儿超说明书用药情况调查

目的回顾性调查2010年四川大学华西第二医院儿科住院患儿超说明书用药现状,分析可能的危险因素,为了解我国儿科超说明书用药现状和制订超说明书用药政策提供基线数据。方法分层随机抽取该院2010年儿科住院患儿的用药医嘱和出院带药医嘱,依据药品说明书,判断其用药医嘱是否超说明书,分析各超说明书用药类型、各年龄段儿童、各类药品、各科室超说明书用药情况以及超说明书用药与年龄、性别和医生级别的关系。结果共抽取住院患儿749例,分析用药医嘱14?374条,涉及药品385种。按患儿、用药医嘱与药品品种计,超说明书用药发生率分别为98.00%、78.96%和88.05%。超说明书用药类型主要包括:未提及儿童用药信息(29.41%)、适应症(18.35%)、剂量(17.61%)及剂量范围(±20%)(13.52%)4种。超说明书用药发生率居前两位的年龄段为青少年(83.56%)和儿童(80.58%)。用药医嘱数居前四位药品的超说明书用药为消化和代谢系统用药(82.28%)、系统用抗感染药(75.06%)、血液和造血系统用药(79.27%)及呼吸系统用药(58.27%)。超说明书用药发生率居前两位的科室为血液儿科(88.27%)与新生儿科(79.12%)。全院儿童和青少年患儿及男性患儿超说明书用药的风险较高,高级职称医师超说明书用药医嘱高于中级职称医生。结论四川大学华西第二医院儿科住院患儿超说明书用药较常见,一方面反映了药品说明书中儿科用药信息严重缺乏,需要药品研发、生产、审批、监管、使用各环节工作者共同努力、采取措施,促进和规范儿童药物临床试验,为儿童用药提供更多的证据,保障儿童用药安全;另一方面反映儿科医院超说明书用药的执业风险高,急需国家制订相关法律法规或指南规范超说明书用药行为,规避医师执业风险。     

122例儿童急性中毒临床分析

目的：探讨儿童急性中毒的原因及诊治。方法：回顾122例儿童急性中毒的临床资料诊断进行分析。结果；误服中毒66例占54％；学龄儿童轻生服毒28例占23％；其他中毒(一氧化碳、酒精、被人投毒、吸人等)28例占23％。误诊为中毒性脑病4例，重症肺炎4例，发病高峰年龄1～4岁58例，占47．5％，且年龄小，不能自述易误诊。结论：强调家长要妥善保管好农药、鼠药、药物等，以防孩子误服。要关心学龄儿童的情绪变化，及时给予心理指导早期干预。提高首诊诊断正确率，是获得抢救成功的关键。