Perceptions about risk for HIV/AIDS among adolescents in juvenile detention

Although progress has been made toward reducing risk-taking behavior among teens, adolescents confined in juvenile detention facilities and youths living in inner cities remain vulnerable. Reaching these populations with appropriate risk-reduction strategies continues to challenge health providers and educators. Crucial first steps in the design of relevant programs involve discovering how at-risk teens perceive risk and which risks and dangers within their communities occupy their attention. Participants in this study did not identify HIV/AIDS as a primary concern; instead, they described the dangers and risks they encountered in their home neighborhoods. Based on these findings, this discussion addresses the implications for the development of health education programs to empower teens for responsible behavior after release from detention.     

Prevalence of psychoactive substance use among male adolescents in Southwest Nigeria

Introduction: Substance use in the adolescent period is recognized as a growing problem in Nigeria. The problem is even more significant among male adolescents in southwest Nigeria with consequent legal and academic problems.

Objectives: The study aimed to describe the pattern of substance use among male secondary-school adolescents and identify sociodemographic correlates of substance use.

Methods:. A total sampling of male students in senior classes of secondary schools selected randomly from urban and semi-urban areas of Ibadan a city in Nigeria were approached for the study.

Results: The mean age of the respondents was 16.49 years (SD ±1.31). Lifetime use of any psychoactive substance was 54%. The most common substance ever used by respondents were non-amphetamine stimulants (39%) followed by alcohol (31%) while hallucinogens (1.0%) and cocaine (1.0%) were the least ever used. None of the respondents had never used an amphetamine-type stimulant. Seven of the respondents (2.9%) reported ever using a psychoactive substance though injection in the last 3 months.

Conclusion: This study reports a high prevalence of psychoactive substance use among male secondary-school adolescents in Ibadan southwest Nigeria. It showed that being in a higher class and engaging in paid work after school were factors significantly associated with substance use. The findings of this study have implications for adolescent mental health intervention in the field of addiction.     

Culturally protective parenting practices against substance use among adolescents in Mexico

Abuse of over-the-counter (OTC) medicines is an under-researched and neglected area within the field of substance abuse. The aim of this paper is to raise awareness of the issues surrounding this subject. The paucity of research makes it difficult to comment conclusively on the problem, but studies based on pharmacist perceptions indicate that middle-aged females are particularly affected by OTC medication abuse. The most problematic of the OTC medicines is currently perceived to be Nytolr`, the brand name for the sedative antihistamine diphenhydramine, and which is marketed as a sleep aid. Diphenhydramine is used as a case study to illustrate the type of drugs available OTC and the potentially harmful problems that can arise as a consequence of their unregulated use and supply.     

Stages of substance use among adolescents in Cape Town,South Africa

Objectives (1) To examine whether there is a developmental pattern of use of the following substances among high-school students in Cape Town, South Africa: tobacco, alcohol, cannabis, Mandrax, Ecstasy and crack cocaine. (2) If such a pattern is present, to investigate whether it is affected by gender or racial differences.

Study type Cross-sectional analytical study.

Sample Multistage cluster sample of 2930 students in Grades 8 and 11 at 39 schools in Cape Town, South Africa.

Data source Anonymous and confidential self completed questionnaire.

Results Lifetime usage prevalence rates were 42.1 % for cigarettes, 43.8% for alcohol, 12.3% for cannabis, and 3.6% for Mandrax, Ecstasy or crack. There was a significant ordering effect, which was consistent across gender but not race classification. For black and white students, the sequence was cigarettes or alcohol, followed by cannabis and then Mandrax, Ecstasy or crack. For coloured students (those deriving from Asian, European and African ancestry), the sequence was cigarettes, followed by alcohol, cannabis and then Mandrax, Ecstasy or crack.

Conclusions There is a developmental sequence of substance use in this population which is identical for males and females but not for different race classifications. Future research should elucidate the reasons for the developmental sequence.     

Drug and substance use in adolescents

This article provides an overview of adolescent drug and substance use, and includes prevalence and trends, commonly occurring comorbid conditions, clinical manifestations of drug and substance use, and evidence-based prevention and treatment principles. Risk and protective factors in five domains are also discussed in this article to provide guidance for assessment and care planning. A detailed table of the most prevalent drugs used by adolescents, including the drug's street names and the clinical manifestations of each drug's use, is offered to assist nurses in understanding their adolescent patients' language and to aid in teaching. Nurses are in varied and ideal positions to begin early screening (and to include families, peers, and other important influences in the adolescent's life), to provide continuity of care, and to advocate in the policy arena for development and funding of comprehensive and efficacious programs to help prevent or treat substance use in adolescents.     

Pregnancy resolution decisions in juvenile detention

A group of detained pregnant adolescents and expectant teenage fathers served as participants in a qualitative research project designed to describe how adolescents residing in a large metropolitan area juvenile detention facility make health- and pregnancy-related decisions. During the course of the study and clinical work with this population, it was found that although troubled and troublesome, these teenagers do not present as bleak and depressing a picture as might appear on the surface. Three primary themes emerged from the study findings: responsibility, reputation, and respect. These themes were bound to the important relationships in the teenagers' lives. The participants also presented some surprising strengths and resolutions for the future that psychiatric and liaison nurses working in the setting can use in program planning and clinical interventions.     

Perceptions of inner city substance abusers about their families

This study involved 12 in-depth interviews of inner city rehabilitating substance abusers. An exploration of their perception about their families of origin and their families of today was the purpose of this study. The topic outline, coding system, and qualitative analysis was guided by concepts of the framework of systemic organization. Common family characteristics were lack of togetherness, nonexistent or peripheral role of fathers, and underused or overused controlling power with victimization of the weakest. Regenerative strengths were seen in some families. Family integration of addicts seemed more difficult than anticipated by the subjects and demanded major changes in family processes.     

Perceptions of mental health among recently immigrated Mexican adolescents

Rates of anxiety, depression, and suicidal ideation are high among Latino adolescents in the U.S., many of whom are immigrants. Immigration during adolescence creates risk factors for mental health problems. The purpose of this study was to explore the health-related perceptions of Mexican-origin immigrant adolescents to inform the design of culturally and developmentally appropriate mental health services. This focused ethnography was guided by Bronfenbrenner's ecological framework and symbolic interactionism. Fourteen adolescents were recruited from two non-health-based community settings. Data from one-to-one semi-structured interviews and a visual narrative project were coded and analyzed inductively. Three thematic patterns were identified: "mentally healthy," "mentally unhealthy," and "health promotion." Increased awareness of cultural influences and immigration on Latino adolescents' mental health is needed. Mental health nurses are in a unique position to educate and to influence accessibility of services.     

School health nurses and substance use among adolescents - towards individual identification and early intervention

Adolescents' health is today threatened by the use of alcohol and other psychoactive substances. It is therefore important to develop interventions related to substance use in school health care. The aim of this study was to examine the empowering or risk background factors related to substance use among adolescents, and the ability of school nurses (PHN) to identify these factors and to provide needed individual early intervention. The data were collected by semistructured questionnaires completed by 14- to 18-year-old adolescents (n = 326, response rate 79) and PHNs (n = 10) in 2004. The adolescent questionnaire consisted of items related to the respondents' background and Adolescents' Substance Use Measurement (ADSUME). Following individual consent, adolescents' ADSUME responses were sent to the PHNs for intervention. The PHNs assessed the adolescents' empowering background factors and intervention using the questionnaire, and 70% (n = 228) of their answers matched the adolescents' answers. The data were analysed with the SPSS software using the chi-squared test, Fisher's exact test, kappa coefficient and agreement percentages. Substance use among adolescents was associated with parental support, mother's education and smoking, the adolescents' knowledge about substances, peer support and hobbies. The PHNs' assessments regarding supportive background were not in agreement with the assessments of adolescents who were using hazardous substances. One-fifth of the adolescents received the brief intervention, although many of them might have needed extra support and follow-up on the basis of their ADSUME results. The research findings can be generalized only for alcohol use, because only 3% of the study informants used substances other than alcohol. Further research is warranted concerning PHNs' ability to identify hazardous substance use and to ensure preventive early intervention and requisite support among substance-using adolescents in order to improve evidence-based health promotion.     

Marijuana use among middle-class adolescents

One hundred sixty-two adolescents being seen for sick or well visits at two suburban private pediatric practices completed an anonymous, written questionnaire about drug habits. The respondents' ages ranged from 14 to 17 years; all were white and from middle-class or upper-middle-class families. The adolescents reported high self-esteem, good general health, and few psychologic problems. The majority of respondents stated that they and their good friends never used drugs. Seven adolescents (4%), however, reported having used marijuana during the previous week, and 13 (8%) during the previous month. When asked about the frequency of marijuana use by their good friends, 13 respondents (8%) said their friends had smoked marijuana 51 to 100 times, and another ten (6%) replied 21 to 50 times. The most frequently cited source of drugs was another student at school, whereas places drugs were commonly used included parties, rock concerts, and friends' houses. Even among a population of middle-class adolescents having follow-up in a suburban pediatric practice, use of marijuana and other drugs may constitute a serious health and psychologic problem. Physicians caring for adolescents must be aware of patterns of drug availability and use in their community, and should be prepared to recognize and remediate drug-related problems occurring in their patients.     

Potential risk and protective factors of substance use among school adolescents in Morocco: A cross-sectional study

Background: Substance use among adolescents is responsible, in long term, for several chronic diseases, including cancer. In this study, we sought to assess the prevalence and correlates of substance use among students’ adolescents in Taza city, focusing on risk and protective factors to develop a health promotion intervention.

Methods: A school-based cross-sectional survey was conducted in Taza during 2016. The sample consisted of 800 students from 14 to 19 years old from randomly stratified cluster sampling. Data were collected using a Global School Health Survey questionnaire.

Results: Of 800 total students, 764 responded to the survey (response rate of 95.5%), with slightly more than half (53.3%) being girls. The survey showed current tobacco use of 16.2%, lifetime alcoholic drink of 6.8%, and lifetime drug use of 9.2%. Results from multivariate logistic regression analyses showed that substance use was significantly associated with older age, being male, poor hand hygiene, suicidal ideations, peer substance use, and absenteeism. Parental bonding represented a protective factor for illicit drug use.

Conclusions: We found a high prevalence of substance use among adolescents in Taza city, similar to rates reported at the national level. These findings suggest an urgent need to develop national health promotion programs for adolescents.     

Self-reported depression and its associated factors among male inpatients admitted for substance use disorders in Saudi Arabia

Abstract

Background: The association between depression and substance abuse is well established. However, uncertainties exist about the prevalence and comorbidity of substance use disorders and depression in Saudi Arabia.

Methods: Data were collected from December 2012 to March 2013 from 165 male inpatients admitted for substance use disorders to a public health hospital in Jeddah. Participants completed a self-administered questionnaire. Depression was assessed using the Arabic version of the Beck Depression Inventory (BDI).

Results: High BDI scores were reported by 95.2% of participants with more than two-thirds scoring severe (37%) or very severe (33.9%). Multivariate logistic regression indicated that those who had abused substances for more than 10 years were double the risk for depression compared to participants who had abused substances for less than 5 years (AOR?=?2.16; 95% CI: 1.09–9.11). Those abusing substances for a duration of 5–10 years were likely to have a threefold risk for depression relative to participants who had a substance abuse history of less than 5 years (AOR?=?3.08; 95% CI: 1.23–43.6).

Conclusion: There is high prevalence of depression among substance users in Saudi Arabia. Prevalence and comorbidity is significantly associated with duration of substance abuse. Such findings have implications for treatment and service development as patients with these co-morbidities will require complex management.     

Perceptions about complementary and alternative medicine use among Chinese immigrant parents of children with cancer

Purpose  

Research indicates complementary and alternative medicine (CAM) use among children with cancer is common and widespread. CAM use, particularly traditional Chinese medicine (TCM), is prevalent in the country of origin of Chinese immigrant families, yet little is known about its use after immigrating to Canada. This paper describes 25 Chinese immigrant parents’ perception about the use of CAM in their child with cancer in Canada.     

Assessing substance use among Iranian healthcare students

Aims : The strict measures used to prohibit the sale and use of unlawful substances has not changed the increasing trend of substance use in Iran. The aim of this study is to assess the rate of substance use among Iranian healthcare students. Participants : Students (346) were selected randomly; 43.9% were females and 56.1% were males. Measurements : A confidential questionnaire was distributed, completed by the students and collected in the same session. Findings : Of the participants, 34.7% admitted the use of substances now or in the past: cigarettes (28%) were the most frequently used substance. The other substances used were: alcohol (15%), opium (8.4%), cannabis (4.6%), heroin (0.9%) and LSD (0.6%). Only 6.9% of the students were still using substances regularly: cigarettes (5.5%), alcohol (1.7%), opium (1.4%), cannabis (1.2%), heroin (0.3%) and LSD (0.3%). Some had used or were using more than one substance. Conclusions : Use of substance was significantly related to gender (50% of males and 15.2% of females used substances, and 11.3% of males and 1.4% of females were current regular users). Pleasurable purposes were the most common motivations both for past and current use.     

Latent class analysis of substance use and predictors of latent class membership among adolescents in the Republic of Korea

Purpose: We aimed to investigate substance use patterns and identify predictors of homogeneous subgroups of adolescent substance users.

Methods: We analyzed nationally representative secondary data collected from Korean adolescents (N = 72,435). To investigate substance use patterns, we conducted latent class analysis using seven behaviors linked to alcohol, cigarette, and e-cigarette use. After choosing the best latent class model, we investigated predictors of latent class membership (LCM) for substance use, using demographics and mental health conditions.

Results: A four-latent class model best fit the data. Non-users (74%) had low likelihoods of reporting lifetime and current use of alcohol, cigarette, and e-cigarette. Experimenters (10%) had high likelihoods of reporting lifetime alcohol and cigarette use. Current drinkers (10%) had high likelihoods of reporting lifetime and current alcohol use. Multi-substance users (6%) had high likelihoods of reporting lifetime and current use of alcohol and cigarettes, lifetime e-cigarette use, and current binge drinking. Additionally, demographics (gender, grades, socioeconomic status, co-residence with family members, and grade point average) and mental health conditions (depression, suicidal ideation, and subjective unhappiness) successfully predicted LCM.

Conclusions: In developing interventions for addressing substance-related issues, health professionals should focus on adolescent substance use patterns and take into account factors predicting LCM.     

Predictors of condom use among Mexican adolescents

Mexican adolescents continue to be at increased risk for HIV infection due to inconsistent condom use. The purpose of this study was to identify predictors of condom use intentions and condom use among Mexican adolescents who participated in a randomized control trial designed to test a sexual-risk reduction intervention. Data from sexually active adolescents 17 to 21 years (n = 157) of age who were assigned to the control group were analyzed 48 months post intervention. Regression analysis showed that positive attitudes toward condoms, subjective norms, and control beliefs significantly explained intention to use condoms (R2 = .75, p < .001). Attitudes toward condoms (beta = .67, p <.001), technical skills (beta = .13, p = .01), and condom use self-efficacy (beta = .24, p < .001) were significant predictors of condom use intention. Compared to those who inconsistently used condoms, adolescents who used condoms consistently had greater intention to use condoms and greater impulse control. Findings suggest that attitudes and control beliefs should be further explored with Mexican adolescents in order to support consistent condom use.     

Relapse patterns among patients with substance use disorders

The aim of the study was to examine the time interval from treatment to relapse among patients with substance addiction. Some of the risk factors related to this interval were investigated. The sample (n?=?352) was recruited from 16 substance addiction treatment facilities in four Norwegian counties. The respondents replied to a questionnaire either at waiting lists, when starting treatment, upon treatment completion or 3–12 months after treatment. Among these respondents, 160 patients had experienced a relapse after their prior treatment. Cox regression models showed that the relapse risk peaked during the first months after treatment. Older and employed patients had lower probabilities of early relapses. Patients who had an addiction pattern dominated by stimulants or cannabis had lower probabilities of early relapses compared with those who used opiates or alcohol. Inpatient treatment of short and long durability was associated with a longer time interval from treatment to relapse. Aftercare should be intensified during the first months after treatment. Treatment follow-up should be individually differentiated and target patients with higher risk of relapse. Interventions could aim to target adolescents and facilitate occupational activities for the patients before they leave the facilities.