Trajectories of adolescent substance use development and the influence of healthy leisure: A growth mixture modeling approach

Considerable heterogeneity exists in adolescent substance use development. To most effectively prevent use, distinct trajectories of use must be identified as well as differential associations with predictors of use, such as leisure experience. The current study used a person-centered approach to identify distinct substance use trajectories and how leisure is associated with trajectory classes. Data came from a larger efficacy trial of 2.249 South African high school students who reported substance use at any time across 8 waves. Growth mixture modeling was used to identify developmental trajectories of substance use and the influence of healthy leisure. Results identified three increasing and one stable substance use trajectory and subjective healthy leisure served to protect against use. This study is the first of its kind to focus on a sample of South African adolescents and serves to develop a richer understanding of substance use development and the role of healthy leisure.     

Realizing or Relinquishing Rights? Homeless Youth,Their Life on the Streets and Their Knowledge and Experience of Health and Social Services in Hillbrow,South Africa

Poverty and youth unemployment are critical issues in South Africa with homeless persons begging at traffic light intersections in all major cities. Support services represent one way of empowering homeless youth. The study therefore examined the experiences of 10 homeless young adult males in Hillbrow, Johannesburg and whether they were aware of local health and social services. Qualitative interviews revealed that participants experienced poor health, addiction, physical violence, psychological trauma, and public hostility. Despite limited education, they were aware of and utilized local health and social services. Findings are discussed in terms of their implications for social work.     

Material Deprivation Affects High Sexual Risk Behavior among Young People in Urban Slums,South Africa

Young people in urban slums adopt HIV risk behaviors influenced by their neighborhood factors. Three critical factors in urban slums of Southern and Eastern Africa—the region most affected by the HIV epidemic in the world—are unmet needs of housing, food, and health care, which are associated with HIV sexual risks. Yet, there has been limited attention on how the combination of unmet needs of housing, food, and health care—i.e., material deprivation—relates to sexual risk behavior among young people in urban slums. Cross-sectional data were extracted from the LoveLife survey in South African four provinces—KwaZulu Natal, Mpumalanga, Eastern Cape, and Gauteng, to examine the association between material deprivation and sexual risk behavior among young people aged 18–23 years (263 males, 267 females) in urban slums. Adjusted logistic regression models showed that material deprivation was significantly associated with increased odds of high sexual risk taking for young men (adjusted OR = 1.20; 95 % CI = 1.10, 5.58) and young women (adjusted OR = 1.43; 95 % CI = 1.35, 3.28). Financial difficulty—a proxy for other deprivations—was the most salient influence on young women’s high sexual risk taking (adjusted OR = 2.11; 95 % CI = 1.66, 2.70). Localized behavioral HIV prevention interventions should target young people in deprived households.     

Beliefs about fetal alcohol spectrum disorder among men and women at alcohol serving establishments in South Africa

Background: South Africa has one of the highest rates of fetal alcohol spectrum disorder (FASD) in the world. However, little is known about what men and women who attend alcohol serving establishments believe about alcohol use during pregnancy and how these beliefs may be related to alcohol use. Objectives: To understand FASD beliefs and related behaviors among men and women attending alcohol-serving establishments. Methods: We surveyed 1047 men (n?=?565) and women (n?=?482) -including pregnant women and men with pregnant partners- attending alcohol serving establishments in a township located in Cape Town, South Africa. Results: Among both pregnant (n?=?53) and non-pregnant (n?=?429) women, 54% reported drinking alcohol at least 2–4 times per month, and 57% reported having at least 3–4 alcohol drinks during a typical drinking session. Pregnant women were less likely to believe that they should not drink alcohol and that alcohol can harm a fetus when compared to non-pregnant women. Similar findings were observed between men with pregnant partners compared to men without pregnant partners. Among women, beliefs about how much alcohol pregnant women can safely drink were associated with self-reported alcohol use. Conclusions: Efforts to address FASD need to focus on understanding how men and women perceive alcohol use during pregnancy and situational factors that contribute to alcohol consumption among pregnant women attending alcohol serving establishments. Structural and individual-level interventions targeting women at alcohol serving establishments should be prioritized to mitigate alcohol use during pregnancy.     

Pharmaceutical and personal care products as emerging environmental contaminants in Nigeria: A systematic review

The increasingly broad and massive use of pharmaceuticals (human, veterinary) and personal care products in industrially developing nations makes their uncontrolled environmental and ecological impact a true concern. Focusing on Nigeria, this systematic literature search (databases: PubMed, ScienceDirect, Google Scholar, EMBASE, Scopus, Cochrane library and African Journals Online) aims to increase visibility to the issue. Among 275 articles identified, 7 were included in this systematic review. Studies indicated the presence of 11 personal care products (15.94 %) and 58 pharmaceutical products (84.06 %) in surface and ground water, leachates, runoffs, sludge, and sediments. The 42.86% (3/7) of reviewed studies reported 17 analgesics; 71.42 % (5/7) reported 16 antibiotics; 28.57 % (2/7) reported 5 lipid lowering drugs; 28.57% reported anti-malaria and fungal drugs; 14.29 % (1/7) reported estrogen drugs. Different studies report on sunscreen products, hormone, phytosterol, insect repellent, and β1 receptor. Gemfibrozil (<4–730 ng/L), Triclosan (55.1–297.7 ng/L), Triclocarban (35.6–232.4 ng/L), Trimethoprim (<1–388 ng/L) and Tramadol (<2–883 ng/L) had the highest range of concentrations. Findings confirm the need of i) legislation for environmental monitoring, including biota, ii) toxicological profiling of new market products, and iii) sensitization on appropriate use and disposal of pharmaceuticals and personal care products.     

Prévalence et facteurs déterminants de l’épaisseur intima-media carotidienne élevée dans une population de 1203 hypertendus noirs africains

ObjectivesTo evaluate the prevalence and determinants of increased carotid intima-media thickness (IMT) in a population of black hypertensive patients and it influence of on the assessment of their overall cardiovascular risk.Patients and methodsThis was a 16-month, cross-sectional study conducted in the outpatient unit of the cardiology department of the Campus teaching hospital of Lome, and included 1203 hypertensive patients, both sexes, aged 35 years and more. Each patient benefited from a carotid IMT measure. Carotid IMT was increased if it was > 0.9 mm and the plaque was defined as a carotid IMT > 1.2 mm.ResultsThe mean age of our patients was 53.3 ± 10.4 years with a sex ratio of 1.6 in favor of women. The duration of hypertension was less than 5 years in 56.7% and hypertension was grade 1 in 47.7% of cases. The mean carotid IMT was 0.89 mm ± 0.20. The prevalence of the increased carotid IMT was 45.8% and that of an atheroma plaque was 15.8%. Carotid IMT was correlated with age (P ˂ 0.0001), duration of arterial hypertension (P = 0.01), history of stroke (P ˂ 0.0001), and presence of left ventricular hypertrophy to cardiac ultrasound (P = 0.01). The overall cardiovascular risk was modified after taking into account the carotid IMT. An increase in cardiovascular risk was observed in 30.5% of hypertensive patients.ConclusionIncreased carotid intima-media thickness is frequent in Togolese hypertension. The determining factors are age, duration of arterial hypertension, left ventricular hypertrophy and stroke. The systematic measurement of the carotid intima-media thickness would better evaluate the overall cardiovascular risk for our patients.     

Philtrum reconstruction in unilateral cleft lip repair

The philtrum is an important aesthetic structure in the midface. A number of philtrum reconstruction techniques have been advocated for secondary cleft lip revision procedures. Conventional surgical management involves end-to-end orbicularis oris muscle approximation during primary cleft lip repair, often resulting in a flat lip appearance that requires secondary revision surgery at a later stage. A novel modification of the approximation of the orbicularis oris muscle is described that may be implemented with any cleft lip technique in order to create an accentuated philtrum column for a natural looking philtrum. The muscle roll technique results in eversion of the orbicularis oris muscle, successfully recapturing the philtrum column topography. This is achieved by utilizing two inverted horizontal sutures, with an additional philtrum takedown suture placed in the region of the dimple to accentuate the philtrum anatomy and three-dimensional profile. This novel technique in unilateral cleft lip repair addresses philtrum architecture during primary surgery, which may reduce the requirement for secondary surgical intervention. Its application may be particularly suitable in outreach programmes where postoperative follow-up may be compromised.