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O'Donnell S, Scott-Storey K, Malcolm J, Vincent CD, Wuest J. Cumulative lifetime violence, social determinants of health, and cannabis use disorder post-cannabis legalization in a community sample of men: An intersectional perspective. Res Nurs Health 2024; 47:460-474. [PMID: 38722053 DOI: 10.1002/nur.22389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/30/2024] [Accepted: 04/27/2024] [Indexed: 07/11/2024]
Abstract
Despite Canada having the highest disease burden globally for cannabis use disorder (CUD) and violence being ubiquitous in men's lives, little is known about how intersections among social determinants of health (SDOH) and cumulative lifetime violence severity (CLVS) influence CUD in men post-cannabis legalization. Using data collected in a survey with a national community sample of 597 men who self-identified as having experienced violence, we conducted a latent profile analysis using 11 subscales of the CLVS-44 scale and explored differential associations between CLVS profiles and CUD considering SDOH covariates. Four profiles were distinguished by intersections among CLVS-44 subscale severity and roles as target and perpetrator. CLVS profiles were significantly associated with CUD in the unadjusted model and in the adjusted model where age, adverse housing, and education were significant covariate controls. In the adjusted model, CUD was differentially associated with CLVS profiles and significantly higher in Profile 4 (highest severity target and perpetrator) than in Profile 1 (lowest severity target, no perpetration). Chi-square tests showed significant intersection between adverse housing, younger age, Profile 4 CLVS, and moderate to severe CUD among cannabis users. These results reveal the importance of understanding simultaneous intersections among indicators of CLVS in determining profiles of lifetime violence. Also critical are intersections among CLVS profiles and significant covariates as a basis for trauma- and violence-informed care for CUD that prioritizes men most disadvantaged by this convergence and attends to individual and structural health disparities at practice and policy levels.
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Affiliation(s)
- Sue O'Donnell
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Kelly Scott-Storey
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Jeannie Malcolm
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Charlene D Vincent
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Judith Wuest
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
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Stephenson M, Barr P, Thomas N, Cooke M, Latvala A, Rose RJ, Kaprio J, Dick D, Salvatore JE. Patterns and predictors of alcohol misuse trajectories from adolescence through early midlife. Dev Psychopathol 2024:1-17. [PMID: 38465371 PMCID: PMC11387953 DOI: 10.1017/s0954579424000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
We took a multilevel developmental contextual approach and characterized trajectories of alcohol misuse from adolescence through early midlife, examined genetic and environmental contributions to individual differences in those trajectories, and identified adolescent and young adult factors associated with change in alcohol misuse. Data were from two longitudinal population-based studies. FinnTwin16 is a study of Finnish twins assessed at 16, 17, 18, 25, and 35 years (N = 5659; 52% female; 32% monozygotic). The National Longitudinal Study of Adolescent to Adult Health (Add Health) is a study of adolescents from the United States, who were assessed at five time points from 1994 to 2018 (N = 18026; 50% female; 64% White, 21% Black, 4% Native American, 7% Asian, 9% Other race/ethnicity). Alcohol misuse was measured as frequency of intoxication in FinnTwin16 and frequency of binge drinking in Add Health. In both samples, trajectories of alcohol misuse were best described by a quadratic growth curve: Alcohol misuse increased across adolescence, peaked in young adulthood, and declined into early midlife. Individual differences in these trajectories were primarily explained by environmental factors. Several adolescent and young adult correlates were related to the course of alcohol misuse, including other substance use, physical and mental health, and parenthood.
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Affiliation(s)
- Mallory Stephenson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Peter Barr
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Nathaniel Thomas
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Megan Cooke
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Antti Latvala
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland
| | - Richard J Rose
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Jaakko Kaprio
- Department of Public Health, Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Danielle Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Jessica E Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
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Schaefer JD, Nelson KM, Wilson S. The Effects of Adolescent Cannabis Use on Psychosocial Functioning: A Critical Review of the Evidence. Psychiatr Clin North Am 2023; 46:677-689. [PMID: 37879831 PMCID: PMC11113564 DOI: 10.1016/j.psc.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adult socioeconomic status, and legal consequences, mechanisms underlying these associations remain largely unclear. Cannabis use may have a deleterious causal effect on functioning, but it is also possible the association may be due to reverse causation or confounding by shared vulnerability factors that account for both cannabis use in adolescence and concurrent and subsequent psychosocial impairment. Causally informative studies that delineate these possibilities, including research using epidemiologic samples and quasi-experimental designs, are critical to move the field forward.
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Affiliation(s)
- Jonathan D Schaefer
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@JonSchaeferPhD
| | - Kayla M Nelson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@KaylaNeIson
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA.
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El Haddad R, Meneton P, Melchior M, Wiernik E, Zins M, Airagnes G. Changes in alcohol consumption according to the duration of unemployment: prospective findings from the French CONSTANCES cohort. BMJ Open 2023; 13:e077255. [PMID: 37984957 PMCID: PMC10660887 DOI: 10.1136/bmjopen-2023-077255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/19/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To prospectively examine the association between the duration of unemployment among job seekers and changes in alcohol use in a year. DESIGN A prospective study. SETTING French population-based CONSTANCES cohort. PARTICIPANTS We selected 84 943 participants from the CONSTANCES cohort included between 2012 and 2019 who, at baseline and 1-year follow-up, were either employed or job-seeking. OUTCOME MEASURES Multinomial logistic regression models computed the odds of reporting continuous no alcohol use, at-risk alcohol use, increased or decreased alcohol use compared with being continuously at low risk and according to employment status. The duration of unemployment was self-reported at baseline; thus, the employment status at 1-year follow-up was categorised as follows: (1) employed, (2) return to employment since less than a year, (3) unemployed for less than 1 year, (4) unemployed for 1 to 3 years and (5) unemployed for 3 years or more. Analyses were adjusted for age, gender, education, household monthly income, marital status, self-rated health, smoking status and depressive state. RESULTS Compared with being continuously at low risk (ie, ≤10 drinks per week), the unemployment categories were associated in a dose-dependent manner with an increased likelihood of reporting continuous no alcohol use (OR: 1.74-2.50), being continuously at-risk (OR: 1.21-1.83), experiencing an increase in alcohol use (OR: 1.21-1.51) and a decrease in alcohol use (OR: 1.17-1.84). CONCLUSION Although our results suggested an association between the duration of unemployment and a decrease in alcohol use, they also revealed associations between at-risk and increased alcohol use. Thus, screening for alcohol use among unemployed job seekers must be reinforced, especially among those with long-term unemployment.
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Affiliation(s)
- Rita El Haddad
- Population-based Epidemiological Cohorts Unit, UMS011, INSERM, Villejuif, France
| | - Pierre Meneton
- INSERM U1142 LIMICS, UMRS 1142, Sorbonne Universities, UPMC University of Paris 06, University of Paris 13, Paris, France
| | - Maria Melchior
- Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, INSERM UMR_S 1136, Sorbonne Université, Paris, France
| | - Emmanuel Wiernik
- Population-based Epidemiological Cohorts Unit, UMS011, INSERM, Villejuif, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, UMS011, INSERM, Villejuif, France
| | - Guillaume Airagnes
- Centre Ambulatoire d'Addictologie, AP-HP, Centre-Université Paris Cité, Paris, France
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Duckworth JC, Graupensperger S, Schultz NR, Gilson MS, Fairlie AM, Patrick ME, Lee CM. Alcohol and marijuana use predicting next-day absenteeism and engagement at school and work: A daily study of young adults. Addict Behav 2023; 142:107670. [PMID: 36878183 PMCID: PMC10281488 DOI: 10.1016/j.addbeh.2023.107670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/13/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
This study examined effects of alcohol and marijuana use on next-day absenteeism and engagement at work and school among young adults (18-25 years old) who reported past-month alcohol use and simultaneous alcohol and marijuana use. Participants completed twice daily surveys for five, 14-day bursts. The analytic sample was 409 [64 % were enrolled in university (N = 263) and 95 % were employed (N = 387) in at least one burst]. Daily measures included: any alcohol or marijuana use, quantity of alcohol or marijuana use (i.e., number of drinks, number of hours high), attendance at work or school, and engagement (i.e., attentiveness, productivity) at school or work. Multilevel models examined between- and within-person associations between alcohol and marijuana use and next-day absenteeism and engagement at school or work. Between-persons, the proportion of days of alcohol use days was positively associated with next-day absence from school, consuming more drinks was positively associated with next-day absence from work, and the proportion of days of marijuana use was positively associated with next-day engagement at work. At the daily-level, when individuals consumed any alcohol and when they consumed more drinks than average, they reported lower next-day engagement during school and work. When individuals used marijuana and when they were high for more hours than average, they reported lower next-day engagement during school. Findings suggest alcohol and marijuana use consequences include next-day absence and decrements in next-day engagement at school and work, which could be included in interventions aimed at ameliorating harmful impacts of substance use among young adults.
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Affiliation(s)
- Jennifer C Duckworth
- Department of Human Development, Washington State University, Johnson Tower 516, Pullman, WA 99163, United States.
| | - Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Nicole R Schultz
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Michael S Gilson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Tanveer S, Schluter PJ, Beaglehole B, Porter RJ, Boden J, Sulaiman-Hill R, Scarf D, Dean S, Assad F, Hasnat MA, Bell C. The COVID Psychosocial Impacts Scale: A Reliable and Valid Tool to Examine the Psychosocial Impacts of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5990. [PMID: 37297593 PMCID: PMC10252202 DOI: 10.3390/ijerph20115990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/05/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
This paper reports on the development and validation of the COVID Psychosocial Impacts Scale (CPIS), a self-report measure that comprehensively examines both positive and negative psychosocial impacts from the COVID-19 pandemic. This is the first part of the program of work in which the CPIS was administered and compared with a measure of psychological distress (Kessler Psychological Distress Scale, K-10) and wellbeing (World Health Organization Well-Being Index, WHO-5). The data were obtained online in 2020 and 2022 at two distinct time points to capture different exposures to the pandemic in the New Zealand population to a non-representative sample of 663 and 687 adults, respectively. Two hundred seventy-one participants took part in both surveys. Findings indicate a unidimensional structure within CPIS subscales and inter-relatedness among CPIS stress-related subscales. The scatter plots and correlation matrix indicate CPIS having a positive moderate correlation with K10 and a negative moderate correlation with WHO-5, indicative of construct validity. The paper outlines contextual factors surrounding CPIS development and makes suggestions for future iterations of CPIS. Further work will examine its psychometric properties across cultures.
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Affiliation(s)
- Sandila Tanveer
- Department of Psychological Medicine, Christchurch Campus, University of Otago, Christchurch 8011, New Zealand
| | - Philip J. Schluter
- Te Kaupeka Oranga|Faculty of Health, Te Whare Wānanga o Waitaha|University of Canterbury, Christchurch 8041, New Zealand
- School of Clinical Medicine, Primary Care Clinical Unit, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Ben Beaglehole
- Department of Psychological Medicine, Christchurch Campus, University of Otago, Christchurch 8011, New Zealand
| | - Richard J. Porter
- Department of Psychological Medicine, Christchurch Campus, University of Otago, Christchurch 8011, New Zealand
| | - Joseph Boden
- Department of Psychological Medicine, Christchurch Campus, University of Otago, Christchurch 8011, New Zealand
| | - Ruqayya Sulaiman-Hill
- Department of Psychological Medicine, Christchurch Campus, University of Otago, Christchurch 8011, New Zealand
| | - Damian Scarf
- Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - Shaystah Dean
- Department of Psychological Medicine, Wellington Campus, University of Otago, Wellington 6021, New Zealand
| | - Fatima Assad
- Department of Psychiatry, HITEC Institute of Medical Sciences, Taxila 47078, Pakistan
| | | | - Caroline Bell
- Department of Psychological Medicine, Christchurch Campus, University of Otago, Christchurch 8011, New Zealand
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Schaefer JD, Nelson KM, Wilson S. The Effects of Adolescent Cannabis Use on Psychosocial Functioning: A Critical Review of the Evidence. Child Adolesc Psychiatr Clin N Am 2023; 32:43-55. [PMID: 36410905 DOI: 10.1016/j.chc.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adult socioeconomic status, and legal consequences, mechanisms underlying these associations remain largely unclear. Cannabis use may have a deleterious causal effect on functioning, but it is also possible the association may be due to reverse causation or confounding by shared vulnerability factors that account for both cannabis use in adolescence and concurrent and subsequent psychosocial impairment. Causally informative studies that delineate these possibilities, including research using epidemiologic samples and quasi-experimental designs, are critical to move the field forward.
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Affiliation(s)
- Jonathan D Schaefer
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@JonSchaeferPhD
| | - Kayla M Nelson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA. https://twitter.com/@KaylaNeIson
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455, USA.
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Mangot-Sala L, Smidt N, Liefbroer AC. Disentangling the association between alcohol consumption and employment status: causation, selection or confounding? Eur J Public Health 2022; 32:926-932. [PMID: 36215662 PMCID: PMC9713390 DOI: 10.1093/eurpub/ckac141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Alcohol use constitutes a major health risk and is related to unemployment. However, the direction of this relationship is unclear: unemployment may change drinking patterns (causation), but heavy drinkers may also be more prone to lose their job (selection). We simultaneously examined selection and causation, and assessed the role of residual confounding. Moreover, we paid attention to the subgroup of abstainers and occupationally disabled, often disregarded in the literature. METHODS Longitudinal data (three waves collected between 2006 and 2018) of the Lifelines Cohort study from the Netherlands were used (138 875 observations of 55 415 individuals, aged 18-60 at baseline). Alcohol use was categorized as 'abstaining', 'moderate drinking' and 'binge drinking' (≥5 drinks/occasion for male; ≥4 for women). Employment status included occupational disability, short (<6 months) and long-term (≥6 months) unemployment. Random- and fixed-effects multinomial regression models were fitted in order to account for residual confounding. Reciprocal causality was assessed through generalized structural equation modelling with fixed-effects. RESULTS Long unemployment spells increase the risk for both binge drinking (β = 0.23; 95% CI 0.04-0.42) and abstinence (β = 0.27; 95% CI 0.11-0.44), and the effects hold after accounting for reciprocal causality and time-constant confounding. Contrarily, the effect of binge drinking on unemployment is weak (β = 0.14; 95% CI -0.03 to 0.31). Abstinence is strongly associated with occupational disability (β = 0.40; 95% CI 0.24-0.57). CONCLUSIONS We find evidence supporting the causation hypothesis (unemployment altering drinking patterns), whereas evidence for the selection hypothesis is weak and mostly confounded by unobserved variables, such as poor health prior to baseline.
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Affiliation(s)
- Lluís Mangot-Sala
- Netherlands Interdisciplinary Demographic Institute (NIDI)—Royal Netherlands Academy of Sciences (KNAW), The Hague, The Netherlands
- Department of Epidemiology, Faculty of Medical Sciences, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, Faculty of Medical Sciences, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute (NIDI)—Royal Netherlands Academy of Sciences (KNAW), The Hague, The Netherlands
- Department of Epidemiology, Faculty of Medical Sciences, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
- Department of Sociology, Vrije University of Amsterdam (VU), Amsterdam, The Netherlands
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Tang F, Jiang Z, Jin M, Sheng H, Feng L, Chen J, Li Y, Huang J, Xu L, Lou J. Association of occupations with decreased semen quality in eastern China: a cross-sectional study of 12 301 semen donors. BMJ Open 2022; 12:e061354. [PMID: 36028265 PMCID: PMC9422844 DOI: 10.1136/bmjopen-2022-061354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aims to examine the association between occupational factors and semen quality in semen donors in eastern China. METHODS We recruited 12 301 semen donors from 2006 to 2020 as the studying population. A self-designed questionnaire was applied for collecting lifestyle and work style information. Semen samples were analysed according to WHO guidelines. A crude and adjusted linear regression model was used to analyse the association between occupational factors and semen quality. RESULTS College students accounted for 36.2% of all semen donors. The majority (81.3%) of semen donors were between 18 year and 30 years. Soldiers or the police had the highest semen volume (the median value=3.8 mL), however, they had the lowest sperm concentration (53.6×106/ml) and sperm motility (45.5%). Workers in finance or insurance had an elevated risk of low semen volume, sperm concentration and total sperm count (OR=1.43, 1.57 and 1.98, respectively). Unemployed men had a high risk of low sperm concentration and low total sperm count (OR=1.84 and 1.58, respectively). Working in the information technology industry had a deleterious effect on the progressive motility of sperm (OR=1.27, 95% CI 1.03 to 1.57). CONCLUSION Our study indicated that sedentary work style and intensive sports in certain professions might be associated with decreased semen quality. We reported evidence of becoming unemployed on the damage to semen quality. Hence, we advocate a healthy work style to improve semen quality in eastern China.
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Affiliation(s)
- Feng Tang
- Human Sperm Bank, Zhejiang Mater Child and Reproductive Health Center, Hangzhou, Zhejiang, China
| | - Zhaoqiang Jiang
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Mingying Jin
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Huiqiang Sheng
- Human Sperm Bank, Zhejiang Mater Child and Reproductive Health Center, Hangzhou, Zhejiang, China
| | - Lingfang Feng
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Junfei Chen
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yongxin Li
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jing Huang
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Ling Xu
- Human Sperm Bank, Zhejiang Mater Child and Reproductive Health Center, Hangzhou, Zhejiang, China
| | - Jianlin Lou
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
- School of Medicine, and The First Affiliated Hospital, Huzhou University, Huzhou, Zhejiang, China
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10
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Christiansen SG, Moan IS. Employment trajectories among those treated for alcohol use disorder: A register-based cohort study. Addiction 2022; 117:913-924. [PMID: 34697851 DOI: 10.1111/add.15726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/30/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Employment during and following treatment for alcohol use disorder (AUD) is important for the individual's health and well-being and for reducing the societal costs associated with benefit payments. Nonetheless, this is an under-researched topic. This study aimed to identify trajectories of labour force participation among people enrolled in AUD treatment and describe the characteristics of those following contrasting pathways. DESIGN Using trajectory analysis, we modelled employment trajectory groups among AUD patients during the year of treatment entry and the 4 subsequent years, applying Norwegian longitudinal register data. SETTING Norway. PARTICIPANTS Patients who entered treatment with AUD as the primary diagnosis during 2009 and 2010 (9000 patients, age 20-61 years). MEASUREMENTS The outcome variable 'labour force attachment' was measured as being in full-time employment, partly employed, on temporary welfare benefits or on permanent disability pension. Predictors were age, gender, education and comorbid mental health and drug use disorders. FINDINGS We distinguished six employment trajectories among AUD patients: 15.8% were on permanent disability pension throughout, 8.7% exited the labour force on permanent disability pension during the observation period, 32.1% had a medium attachment throughout follow-up, and 9.2% had a decreasing attachment; 23.3% had a high labour force attachment throughout, and 10.9% experienced increasing attachment. High attachment throughout was negatively associated with being female (P < 0.001), having lower educational attainment (P < 0.001), and having comorbid mental health (P < 0.001) and drug use disorders (P < 0.001). CONCLUSIONS Norwegian patients treated for alcohol use disorder in 2009 and 2010 followed six employment trajectories during the 5 years following treatment entry and had lower labour force participation than the general population. Nearly a quarter had a high labour force attachment throughout treatment, which was positively associated with being male, having higher educational attainment and having fewer comorbid mental health and drug use disorders.
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Affiliation(s)
| | - Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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11
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Employment status, gender and hazardous alcohol use: National Health Survey, 2013. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01280-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Hamieh N, Descatha A, Zins M, Goldberg M, Czernichow S, Hoertel N, Plessz M, Roquelaure Y, Limosin F, Lemogne C, Matta J, Airagnes G. Physical exertion at work and addictive behaviors: tobacco, cannabis, alcohol, sugar and fat consumption: longitudinal analyses in the CONSTANCES cohort. Sci Rep 2022; 12:661. [PMID: 35027592 PMCID: PMC8758679 DOI: 10.1038/s41598-021-04475-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
We examined the prospective association of physical exertion at work with subsequent tobacco, cannabis, alcohol use, and sugar and fat consumption. Volunteers of the French population-based CONSTANCES cohort currently employed were included from 2012 to 2017 for tobacco and cannabis outcomes (n = 100,612), and from 2012 to 2016 for alcohol and sugar and fat outcomes (n = 75,414). High level of physical exertion at work was defined as a score ≥ 12 at the Rating Perceived Exertion Borg scale. Substance use was self-reported and diet rich in sugar and fat was obtained from principal component analysis and analyzed as quartiles. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to baseline physical exertion at work, while adjusting for sociodemographic factors, depressive symptoms and baseline level of consumption. High physical exertion was associated with tobacco use with dose-dependent relationships. It was also associated with increased odds of cannabis use at least once per month compared to no use in the past and with increased odds of diet rich in sugar and fat. Hence, the role of physical exertion at work on tobacco and cannabis use and diet rich in sugar and fat should be tackled for information and prevention strategies.
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Affiliation(s)
- Nadine Hamieh
- INSERM, Population-Based Epidemiological Cohorts Unit, UMS 011, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France.
| | - Alexis Descatha
- Poison Control Center, Academic Hospital CHU Angers, F-49000, Angers, France
- Univ Angers, Centre Hospitalier Universitaire CHU Angers, Université de Rennes, INSERM, École des hautes études en santé publique, Institut de recherche en santé, environnement et travail Irset UMR_S 1085, F-49000, Angers, France
| | - Marie Zins
- INSERM, Population-Based Epidemiological Cohorts Unit, UMS 011, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France
- Université de Paris, Faculty of Health, School of Medicine, Paris, France
| | - Marcel Goldberg
- INSERM, Population-Based Epidemiological Cohorts Unit, UMS 011, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France
- Université de Paris, Faculty of Health, School of Medicine, Paris, France
| | - Sébastien Czernichow
- Université de Paris, AP-HP, Hôpital européen Georges-Pompidou, Service de Nutrition, Paris, France
| | - Nicolas Hoertel
- Université de Paris, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Issy-les-Moulineaux, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Marie Plessz
- INRAE, Centre Maurice Halbwachs (ENS, EHESS, CNRS) UMR 8097, Paris, France
| | - Yves Roquelaure
- Poison Control Center, Academic Hospital CHU Angers, F-49000, Angers, France
- University of Angers, Centre Hospitalier Universitaire d'Angers, Université de Rennes, Centre de consultations de pathologie professionnelle et santé au travail, F-49000, Angers, France
| | - Frédéric Limosin
- Université de Paris, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Issy-les-Moulineaux, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Joane Matta
- INSERM, Population-Based Epidemiological Cohorts Unit, UMS 011, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France
| | - Guillaume Airagnes
- INSERM, Population-Based Epidemiological Cohorts Unit, UMS 011, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France
- Université de Paris, Faculty of Health, School of Medicine, Paris, France
- Université de Paris, AP-HP.Centre-Université de Paris, DMU Psychiatrie et Addictologie, Paris, France
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13
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Mangot-Sala L, Smidt N, Liefbroer AC. The association between unemployment trajectories and alcohol consumption patterns. Evidence from a large prospective cohort in The Netherlands. ADVANCES IN LIFE COURSE RESEARCH 2021; 50:100434. [PMID: 36661293 DOI: 10.1016/j.alcr.2021.100434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 06/17/2023]
Abstract
Unemployment is expected to influence alcohol consumption, but studies show mixed results, partly because most studies concentrate on current employment status. However, unemployment could be particularly consequential if it is part of a trajectory of employment precariousness. Moreover, the association between unemployment and alcohol consumption may not be homogeneous across the population, but differ by subgroups (e.g. socioeconomic status). This study longitudinally analyses the association between different employment trajectories and alcohol consumption, and examines if the association is moderated by socioeconomic status (SES), partner status, age and gender. Four waves of data of the Lifelines Cohort study are used. Sample consists of individuals from 18-50 years old, active in the labor market (n = 104,766) from the northern provinces of the Netherlands. Employment trajectories are defined by employment status in each wave, duration of unemployment, and number of exposures to unemployment. Drinking patterns are divided into "abstainers", "moderate drinking" (<1.5 drinks/day), "heavy drinking" (≥1.5 drinks/day) and "binge drinking" (≥5 drinks/occasion; 4 for women). The associations are estimated with multinomial logistic regression models. Results show that recent, long-term unemployment (≥ 6 months) is associated with higher rates of heavy drinking (RRR = 1.26 [95 % CI 1.03-1.54]), whereas short-term unemployment does not show any association with the outcome. Being continuously unemployed throughout the observation period shows a strong association with binge drinking (RRR = 1.43 [95 % CI 1.06-1.93]), as well as reporting 2 or more long unemployment spells (RRR = 1.49 [95 % CI 1.21-1.83]). The group of abstainers (77.95 % women) have significantly lower SES, and poorer health than their peers. For some individuals, recent unemployment increases the likelihood for abstinence (RRR = 1.23 [95 % CI 1.00-1.51]). Evidence suggests that length of unemployment is key in order to grasp its effects in terms of changing drinking patterns.
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Affiliation(s)
- Lluís Mangot-Sala
- Netherlands Interdisciplinary Demographic Institute (NIDI) - Royal Netherlands Academy of Sciences (KNAW), the Netherlands; University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands.
| | - Nynke Smidt
- University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute (NIDI) - Royal Netherlands Academy of Sciences (KNAW), the Netherlands; University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands; Department of Sociology, Vrije University of Amsterdam (VU), the Netherlands
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14
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Dokkedal-Silva V, Fernandes GL, Morelhão PK, Pires GN, Rowlett JK, Galduróz JCF, Berro LF, Tufik S, Andersen ML. Sleep, psychiatric and socioeconomic factors associated with substance use in a large population sample: A cross-sectional study. Pharmacol Biochem Behav 2021; 210:173274. [PMID: 34547353 DOI: 10.1016/j.pbb.2021.173274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022]
Abstract
Multiple elements modulate drug use, including sleep, which is increasingly being considered as an important contributor to substance use and abuse. The present study aimed to evaluate the association between sleep, psychiatric and socioeconomic/demographic factors and substance use in a large-scale representative sample from the city of São Paulo, Brazil. Data from the 2007 São Paulo Epidemiological Sleep Study (EPISONO) database were used. In the EPISONO study, volunteers underwent a polysomnographic exam and completed a series of questionnaires to assess objective and subjective sleep quality and associated comorbidities. Drug use was assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Linear (univariate and multivariate) and logistic regressions were performed to identify factors associated with the use of the 4 most commonly used substances in the sample (tobacco, alcohol, cannabis and cocaine/crack). Structural equation models were used to establish theoretical networks to explain the relationship between sleep, psychiatric and socioeconomic factors and use of these substances. The logistic regression results showed that psychiatric symptoms, lower income, and poorer subjective sleep were the main factors associated with tobacco consumption; gender and occupational status with alcohol intake; age and occupation with cannabis use; and education with cocaine/crack use. The structural equation models partially supported these findings and identified significant effects of psychiatric symptoms on tobacco consumption, both directly and mediated by sleep. Our results reinforce previous findings concerning factors associated with generally misused substances and suggest that sleep should be considered as an important element in future substance use disorder studies.
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Affiliation(s)
- Vinícius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Guilherme L Fernandes
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Priscila K Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Gabriel N Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - James K Rowlett
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N State St, Jackson, 39216 Jackson, United States
| | - José Carlos F Galduróz
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Laís F Berro
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N State St, Jackson, 39216 Jackson, United States.
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
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15
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Income generation and the patterning of substance use: A gender-based analysis. Drug Alcohol Depend 2021; 226:108862. [PMID: 34198138 PMCID: PMC8356895 DOI: 10.1016/j.drugalcdep.2021.108862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous research has demonstrated how income-generating activities among marginalized people who use drugs (PWUD)-including employment, income assistance, street-based activities, sex work, and illegal activities-can provide both benefit (e.g., additional income) and harm (e.g., violence, criminalization). However, little is known about gender differences in factors such as drug use patterns that are associated with income-generating activities among PWUD. METHODS Using data from prospective cohorts of HIV-positive and HIV-negative PWUD in Vancouver, Canada, we conducted exploratory gender-stratified analyses of associations between substance use patterns and income-generating activities, using generalized linear mixed-models. RESULTS Participants reported income sources as employment (23.4 %), income assistance (88.1 %), street-based activities (24.9 %), sex work (15.2 %), drug dealing (31.5 %), or other illegal activities (13.9 %). GLMM results showed gendered patterns of engagement in specific income-generating activities and some diverging patterns of substance use. For instance, men receiving income assistance were less likely to use opioids (Adjusted odds ratio(AOR) = 0.64; 95 % confidence interval(CI) = 0.50-0.82) and women engaged in sex work were more likely to use crack-cocaine (AOR = 2.74, 95 % CI = 2.22-3.37). However, results reflected primarily converging patterns of substance use between women and men across income-generating activities, particularly for drug dealing and other illegal activities. CONCLUSIONS Our results suggest that substance use patterns may be more closely associated with income generation context than gender. Given potential harms associated with some income generation activities, results highlight the need for further investigation of the social and structural context of income generation, its intersections with gender and substance use, and the expansion of low-threshold work opportunities.
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16
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Yang F, Jiang Y, Pu X. Impact of Work Value Perception on Workers' Physical and Mental Health: Evidence from China. Healthcare (Basel) 2021; 9:healthcare9081059. [PMID: 34442196 PMCID: PMC8393698 DOI: 10.3390/healthcare9081059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022] Open
Abstract
Research on the effect of work value perception on workers’ health, especially in emerging economies, is scarce. This study, therefore, explored how work value perception affects the physical and mental health of workers in China. We also examined the mediating role of life satisfaction in the relationship between work value perception and health. Taking a random sample of 16,890 individuals in China, we used ordered probit regression and instrumental variable ordered probit regression to test the links between work value perception and workers’ health based on existence, relatedness, and growth (ERG) theory. The results showed that work value perception significantly affected both the physical and mental health of workers; the results remained robust after solving the endogeneity problem. The subsample regression results showed that work value perception significantly affected the physical and mental health of female, male, married, unmarried, religious, and nonreligious workers. Furthermore, life satisfaction mediated the effect of work value perception on workers’ health. These results shed light on the relationship between work value perception and health and thus have implications for improving workers’ physical and mental health. This study can provide a reference for both governmental and corporate policymakers in emerging economies.
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Affiliation(s)
- Fan Yang
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu 610065, China;
| | - Yao Jiang
- Department of Sociology, Zhou Enlai School of Government, Nankai University, Tianjin 300350, China;
| | - Xiaohong Pu
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu 610065, China;
- Correspondence: ; Tel.: +86-180-0807-8523
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Kuhn U, Herrlein J. Suchtspezifische Schulungsbedarfe von Jobcenterfachkräften in der Beratung und Vermittlung von Menschen mit einer Suchterkrankung. SUCHTTHERAPIE 2021. [DOI: 10.1055/a-1473-4814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Zusammenfassung
Ziel der Studie Der suchtspezifische Qualifikationsstand von Jobcenterfachkräften hat einen Einfluss auf die berufliche Integration von Arbeitslosengeld II-Beziehenden mit Suchtproblemen. In der vorliegenden Studie wurde der suchtspezifische Weiterbildungsbedarf von Jobcenterfachkräften in 4 Grundsicherungsstellen in Nordrhein-Westfalen (NRW) ermittelt, um auf der Grundlage dieser Bedarfsanalyse ein passgenaues Weiterbildungskonzept zum Thema Sucht für Beschäftigte in den Jobcentern zu entwickeln.
Methode Um die Weiterbildungsbedarfe sowie geeignete Rahmenbedingungen zu identifizieren, wurde eine standardisierte Onlinebefragung in 4 Jobcentern in Nordrhein-Westfalen (im Rechtskreis des Sozialgesetzbuchs II (SGB II)) durchgeführt. Diese orientierte sich inhaltlich an der bundesweiten Erhebung zu den Rahmenbedingungen für suchtkranke Leistungsbeziehende und enthielt neben Items zu Schulungs- und Beratungsbedarfen auch Fragen zu bisher besuchten suchtspezifischen Weiterbildungen sowie geeigneten Rahmenbedingungen für eine bedarfsorientierte Umsetzung einer Schulung zum Thema Sucht.
Ergebnisse Insgesamt nahmen an der Befragung 511 Jobcenterfachkräfte teil. Es konnte eine Netto-Rücklaufquote von 64,1% erzielt werden. 76% der Befragten geben einen suchtbezogenen Schulungsbedarf an, wobei insgesamt 29,4% der Stichprobe hierzu bereits geschult worden sind. Die größten Bedarfe werden bereichsübergreifend im Erkennen von Suchtproblemen (55,1%) und im Ansprechen auf Suchtverdacht (52,1%) gesehen. Je nach Fachkräftegruppe zeigen sich unterschiedliche Schwerpunktsetzungen in den Bedarfen: Integrationsfachkräfte geben neben den genannten Aspekten einen hohen Bedarf in der Bedeutung der Sucht für die Arbeitsfähigkeit (54,3%) und im Überblick über suchtspezifische Behandlungsangebote (51,4%) an, Leistungssachbearbeiterinnen und -bearbeiter in Deeskalationsstrategien (49,8%). Eine Präsenzschulung wird von 85,8% gegenüber Online- oder Blended-Learning-Angeboten bevorzugt. Diese soll eher von einer externen Bildungsleitung (90,1%) als von internen Mitarbeitenden (9,9%) durchgeführt werden.
Schlussfolgerung Der Bedarf an suchtspezifischen Schulungen ist trotz verschiedener Bemühungen und Initiativen der letzten Jahre weiterhin hoch. Die wichtigsten Schulungsbedarfe beziehen sich eher auf konkrete Integrationsangebote und praktische Unterstützungsmöglichkeiten der Betroffenen als auf Informationen zu Sucht oder Methoden und Vorgehensweisen im Beratungsprozess. Auch Leistungssachbearbeiterinnen und -bearbeiter sollten in Schulungen einbezogen werden. In diesem Bereich sind jedoch stärker Beratungsstrategien relevant.
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Affiliation(s)
- Ulrike Kuhn
- Sozialdienst Katholischer Männer Köln (SKM Köln)
| | - Jannah Herrlein
- Abt. Paderborn, Institut für Teilhabeforschung, Katholische Hochschule Nordrhein-Westfalen
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18
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Yang F, Jiang Y, Paudel KP. Impact of Work Value Awareness on Self-Rated Physical Health of Rural-to-Urban Migrant Workers in China. Healthcare (Basel) 2021; 9:healthcare9050505. [PMID: 33925693 PMCID: PMC8146592 DOI: 10.3390/healthcare9050505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/07/2021] [Accepted: 04/21/2021] [Indexed: 12/31/2022] Open
Abstract
We used data based on the China Labor-Force Dynamics Survey 2016 to examine the relationship between the work value awareness and the physical health of rural-to-urban migrant workers. The work value awareness was characterized by five dimensions: awareness of the emotional value, social value, respect value, ability value and interest value. Physical health was measured by a self-rated health assessment. The results from an IV-ordered probit model show that the awareness of work value has a statistically significant impact on the self-rated physical health of rural-to-urban migrant workers. The results also show that the impacts of work value awareness on rural-to-urban migrant workers’ physical health are heterogeneous to genders and ages. Mental health plays a mediating role between the awareness of work value and the physical health of rural-to-urban migrant workers. It is beneficial for rural-to-urban migrant workers to improve awareness of the value of work to enhance their physical health. The findings of this paper have policy implications for improving the health and welfare of Chinese rural-to-urban migrant workers as well as temporary migrants to cities in many developing countries.
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Affiliation(s)
- Fan Yang
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu 610065, China;
| | - Yao Jiang
- Department of Sociology, Zhou Enlai School of Government, Nankai University, Tianjin 300350, China;
| | - Krishna P. Paudel
- Department of Agricultural Economics and Agribusiness, Louisiana State University (LSU) and LSU AgCenter, Baton Rouge, LA 70803, USA
- Correspondence: ; Tel.: +1-225-578-7363
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19
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Guillouard M, Authier N, Pereira B, Soubrier M, Mathieu S. Cannabis use assessment and its impact on pain in rheumatologic diseases: a systematic review and meta-analysis. Rheumatology (Oxford) 2021; 60:549-556. [PMID: 33159797 DOI: 10.1093/rheumatology/keaa534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Despite classic analgesic or effective treatments in rheumatic diseases, such as synthetic DMARDs in RA, patients remain in pain and often turn to non-prescribed pharmacological alternatives, such as cannabis self-therapeutic use. However, this medical use of cannabis has not been thoroughly studied. METHODS We performed a systematic literature review up to June 2020. The incidence of cannabis consumption was calculated by metaproportion. Differences between cannabis users and non-users were expressed as standardized mean differences using the inverse-variance method. We also assessed the effects of cannabis on pain. RESULTS A total of 2900 patients reported cannabis consumption in a sample of 10 873 patients [incidence 40.4% (95% confidence interval (CI): 0.28, 0.54)], and 15.3% (95% CI: 0.07, 0.27) specified that they were currently taking cannabis. Cannabis use was higher in the four fibromyalgia studies [68.2% (95% CI: 0.41, 0.90), n = 611] compared with seven articles concerning RA or lupus [26.0% (95% CI: 0.14, 0.41), n = 8168]. Cannabis consumption was associated with a decrease in pain intensity [VAS pain at baseline 8.2 (2.9) vs 5.6 (3.5) mm over time; pooled effect size -1.75 (95% CI: -2.75, -0.76)]. Cannabis users were younger [58.4 (11.4) vs 63.6 (12.1) years; P <0.001], more often smokers [OR 2.91 (95% CI: 1.84, 4.60)] or unemployed [OR 2.40 (95% CI: 1.31, 4.40)], and had higher pain intensity [5.0 (2.4) vs 4.1(2.6) mm; P <0.001] than non-users. CONCLUSION Nearly 20% of patients suffering from rheumatologic diseases actively consume cannabis, with an improvement in pain. The issue of cannabis use in the management of these patients should be addressed during medical consultation, essentially with cannabis-based standardized pharmaceutical products.
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Affiliation(s)
- M Guillouard
- Rheumatology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - N Authier
- Université Clermont Auvergne, UMR INSERM 1107, CHU, Clermont-Ferrand, France.,Institut ANALGESIA, Faculté de Médecine, Clermont-Ferrand, France.,Observatoire Français des Médicaments Antalgiques (OFMA), French Monitoring Centre for Analgesic Drugs, CHU, Clermont-Ferrand, France
| | - B Pereira
- Biostatistics Unit (Clinical Research Direction), University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - M Soubrier
- Rheumatology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - S Mathieu
- Rheumatology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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20
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Cannabis use and psychosocial functioning: evidence from prospective longitudinal studies. Curr Opin Psychol 2021; 38:19-24. [DOI: 10.1016/j.copsyc.2020.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/31/2023]
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21
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Williams MW, Ulrich N, Woods SP. Semantic Clustering During Verbal List Learning Is Associated With Employment Status in a Community Sample. Percept Mot Skills 2021; 128:1235-1251. [PMID: 33641505 DOI: 10.1177/0031512521996875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The ability to learn and remember verbal information is highly relevant to many work roles and environments, but we know little about the underlying cognitive mechanisms of those associations. This study examined the hypothesis that unemployment is associated with decreased spontaneous use of higher-order encoding strategies deployed during list learning and recall. Participants were 120 employed and 59 unemployed community-dwelling adults who completed the California Verbal Learning Test-Second Edition (CVLT-II) as part of a broader neuropsychological assessment. Standardized measures of semantic, serial, and subjective clustering were generated from the CVLT-II. After adjusting for data-driven covariates, a significant interaction emerged between employment status and clustering strategy, whereby participants in the employed group exhibited significantly higher scores on semantic clustering, but not serial or subjective clustering, than the unemployed group. The semantic clustering slope score was higher among the employed group and was positively associated with executive functions and declarative memory. These findings suggest that higher-order semantic organizational strategies during supraspan list learning may be relevant to maintaining gainful employment (e.g., mentally organizing work-related instructions and task lists). Future studies might examine semantic clustering in relation to employment changes and work performance, as well as the potential benefit of metacognitive interventions for learning and employment success.
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Affiliation(s)
- Michael W Williams
- Department of Psychology, University of Houston, Houston, Texas, United States
| | - Nathalie Ulrich
- Department of Psychology, University of Houston, Houston, Texas, United States
| | - Steven Paul Woods
- Department of Psychology, University of Houston, Houston, Texas, United States
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22
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Xu W, Gilmer DO, Starkweather A, Kim K. Associations among marijuana use, health-related quality of life, exercise, depression and sleep in cancer survivors. J Adv Nurs 2021; 77:2386-2397. [PMID: 33599000 DOI: 10.1111/jan.14780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/04/2021] [Accepted: 01/27/2021] [Indexed: 11/29/2022]
Abstract
AIMS To assess associations among cannabis use, health-related quality of life, exercise, depression and sleep among a nationally representative sample of US adults living with cancer. DESIGN A cross-sectional correlational study. METHODS We used survey data from the 2016-2018 Behavioral Risk Factor Surveillance System. Analyses were considered for sample weights and the complex designs. Logistic regression was performed to assess associations among cannabis use (0, 1-19, vs. 20-30 [frequent] days), health-related quality of life (0-13 vs. ≥14 mentally or physically unhealthy days in the past 30 days; 0-13 vs. ≥14 functionally limited days), exercise, depression, and sleep after accounting for covariates. Reason for cannabis use (medical vs. non-medical) was also assessed. RESULTS Frequent users had significantly more physically unhealthy days (adjusted odds ratio [OR]: 1.79, 95% CI: 1.28-2.51, p < .01) and reported ≥ 14 mentally unhealthy days (adjusted OR: 2.43, 95% CI: 1.78-3.32, p < .001) and depression (adjusted OR: 2.65, 95% CI: 1.97-3.57, p < .001) compared with non-users. A positive relationship between frequency of cannabis use and depression existed only among non-medical cannabis users. CONCLUSION Cancer survivors using cannabis frequently (20 days+ in the past month) had poorer mental health-related quality of life. The reason for cannabis use as well as frequency of use may be important considerations in predicting depression. IMPACT This is the first study that evaluates the associations among cannabis use, the purpose of cannabis use, HRQoL, exercise, depression and sleep in a nationally representative sample of US adults living with cancer. Frequent cannabis users are likely vulnerable to poorer mental health-related quality of life and depression, and non-medical cannabis use in frequent users was associated with depression. Given expanding medical cannabis legalization, these findings warrant further attention so that this information can be used by people living with cancer in decision-making for symptom self-management.
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Affiliation(s)
- Wanli Xu
- School of Nursing, University of Connecticut, Storrs, CT, USA.,Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | - Declan O Gilmer
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Angela Starkweather
- School of Nursing, University of Connecticut, Storrs, CT, USA.,Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | - Kyounghae Kim
- College of Nursing, Korea University, Seoul, South Korea.,Institute of Nursing Research, Korea University, Seoul, South Korea.,Transdisciplinary Major in Learning Health Systems, Korea University, Seoul, South Korea
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Peláez-Fernández MA, Rey L, Extremera N. Pathways from emotional intelligence to well-being and health outcomes among unemployed: Mediation by health-promoting behaviours. J Health Psychol 2020; 27:879-889. [PMID: 33233967 DOI: 10.1177/1359105320974431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study investigated whether health-promoting behaviours mediate the relationship between emotional intelligence (EI) and well-being and health outcomes in the unemployed population. Spanish unemployed (N = 530) completed questionnaires of EI, health-promoting lifestyles, subjective well-being and perceived health. Path-analytic results showed that EI predicted well-being and self-reported health. Health-promoting behaviours: spiritual growth, stress management and physical activity, partially mediated the link between EI and well-being and health outcomes. Findings are discussed in terms of the role that promoting health behaviours might play regarding to well-being and health outcomes after job-loss, and in developing of EI and health-promotion programmes for unemployed populations.
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Bezyak J, Moser E, Iwanaga K, Wu JR, Chen X, Chan F. Disability inclusion strategies: An exploratory study. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-201095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jill Bezyak
- University of Northern Colorado, Greeley, CO, USA
| | - Erin Moser
- University of Northern Colorado, Greeley, CO, USA
| | | | - Jia-Rung Wu
- Northeastern Illinois University, Chicago, IL, USA
| | - Xiangli Chen
- University of Wisconsin-Madison, Madison, WI, USA
| | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, USA
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25
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López-Pelayo H, Aubin HJ, Drummond C, Dom G, Pascual F, Rehm J, Saitz R, Scafato E, Gual A. "The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic. BMC Med 2020; 18:241. [PMID: 32731868 PMCID: PMC7392642 DOI: 10.1186/s12916-020-01693-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks. MAIN BODY Renewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three "best buys" of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information. CONCLUSION The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.
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Affiliation(s)
- Hugo López-Pelayo
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Rosselló 149, 08036, Barcelona, Spain. .,Socidrogalcohol (Spanish Society of Drug and Alcohol Specialists), Barcelona, Spain.
| | - Henri-Jean Aubin
- Département de psychiatrie et d'addictologie, Université Paris-Saclay, Route de l'Orme aux Merisiers - RD 128 91190 Saint-Aubin, Paris, France.,Centre de Recherche en Epidémiologie et Santé des Populations (CESP), INSERM 1018, Paris, France.,Groupe Hospitalo-Universitaire AP-HP, Paris, France
| | - Colin Drummond
- Addiction Psychiatry, Addictions Department, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience King's College, 16 De Crespigny Park, Camberwell, London, SE5 8AF, UK.,European Federation of Addiction Societies (EUFAS), 16 De Crespigny Park, Camberwell, London, SE5 8AF, UK
| | - Geert Dom
- Antwerp University (UA, CAPRI), Antwerp, Belgium.,Belgian Professional Psychiatry Association, Antwerp, Belgium.,European Federation of Addiction Societies (EUFAS), Antwerp, Belgium.,European Psychiatric Association (EPA), Prinsstraat 13, 2000, Antwerp, Belgium
| | - Francisco Pascual
- SOCIDROGALCOHOL, Barcelona, Spain.,CAARFE, Valencia, Spain.,Departamento de Biología Aplicada, Alicante, Spain.,UCA, Alcoy, Alicante, Spain
| | - Jürgen Rehm
- Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto (UofT), 155 College St., Toronto, Canada.,Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie and Psychotherapie, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Richard Saitz
- Department of Community Health Sciences (CHS), Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA.,Medicine, Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, 02118, USA.,Grayken Center on Addiction, Boston Medical Center, Boston, MA, 02118, USA
| | - Emanuele Scafato
- WHO Collaborating Centre on Research and Health-Osservatorio Nazionale Alcol, Promotion on Alcohol and Alcohol-related Health, Problems (ITA-79), Istituto Superiore di Sanità, Rome, Italy.,Società Italiana di Alcologia - SIA, EUFAS Istituto Superiore di Sanità, Rome, Italy
| | - Antoni Gual
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clínic Barcelona, Rosselló 149, 08036, Barcelona, Spain.,International Network on Brief Interventions for Alcohol and Other Drugs (INEBRIA), Barcelona, Spain
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26
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Plessz M, Ezdi S, Airagnes G, Parizot I, Ribet C, Goldberg M, Zins M, Meneton P. Association between unemployment and the co-occurrence and clustering of common risky health behaviors: Findings from the Constances cohort. PLoS One 2020; 15:e0232262. [PMID: 32374756 PMCID: PMC7202648 DOI: 10.1371/journal.pone.0232262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 04/10/2020] [Indexed: 11/29/2022] Open
Abstract
Background Unemployment is associated with a high prevalence of risky health behaviors. Mortality increases with the number of co-occurring risky behaviors but whether these behaviors co-occur with a greater than expected frequency (clustering) among unemployed people is not known. Methods Differences according to unemployment status in co-occurrence and clustering of smoking, alcohol abuse, low leisure-time physical activity and unhealthy diet (marked by low fruit and vegetable intake) were assessed in 65,630 salaried workers, aged 18 to 65, who were participants in Constances, a French population-based cohort. Among them, 4573 (7.0%) were unemployed without (n = 3160, 4.8%) or with (n = 1413, 2.1%) past experience of unemployment. Results Compared to the employed, unemployed participants without or with past experience of unemployment were similarly overexposed to each risky behavior (sex and age adjusted odds-ratios ranging from 1.38 to 2.19) except for low physical activity, resulting in higher rates of co-occurrence of two, three and four behaviors (relative risk ratios, RRR 1.20 to 3.74). Association between behavior co-occurrence and unemployment did not vary across gender, partnership status or income category. Risky behavior clustering, i.e., higher than expected co-occurrence rates based on the prevalence of each behavior, was similar across unemployment status. The same observations can be made in employed participants with past experience of unemployment, although overexposure to risky behaviors (ORs 1.15 to 1.38) and increased rates of co-occurrence (ORs 1.19 to 1.58) were not as pronounced as in the unemployed. Conclusions Co-occurrence of risky behaviors in currently and/or formerly unemployed workers is not worsened by behavior clustering. Engagement in each of these behaviors should be considered an engagement in distinct social practices, with consequences for preventive policies.
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Affiliation(s)
- Marie Plessz
- Centre Maurice Halbwachs (EHESS, ENS, CNRS, PSL), INRAE, Paris, France.,Centre Maurice Halbwachs (EHESS, ENS, CNRS, PSL), Paris, France
| | - Sehar Ezdi
- Centre Maurice Halbwachs (EHESS, ENS, CNRS, PSL), Paris, France
| | - Guillaume Airagnes
- Department of Psychiatry and Addictology, Hôpitaux Universitaires Paris Ouest, Paris, France.,UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | | | - Céline Ribet
- UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Marcel Goldberg
- UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Marie Zins
- UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Pierre Meneton
- UMR 1142 LIMICS, Inserm, Sorbonne Université, Université Paris 13, Paris, France
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27
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Campeny E, López-Pelayo H, Nutt D, Blithikioti C, Oliveras C, Nuño L, Maldonado R, Florez G, Arias F, Fernández-Artamendi S, Villalbí JR, Sellarès J, Ballbè M, Rehm J, Balcells-Olivero MM, Gual A. The blind men and the elephant: Systematic review of systematic reviews of cannabis use related health harms. Eur Neuropsychopharmacol 2020; 33:1-35. [PMID: 32165103 DOI: 10.1016/j.euroneuro.2020.02.003] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 02/17/2020] [Indexed: 01/24/2023]
Abstract
Cannabis is the third most used psychoactive substance worldwide. The legal status of cannabis is changing in many Western countries, while we have very limited knowledge of the public health impact of cannabis-related harms. There is a need for a summary of the evidence of harms and risks attributed to cannabis use, in order to inform the definition of cannabis risky use. We have conducted a systematic review of systematic reviews, aiming to define cannabis-related harms. We included systematic reviews published until July 2018 from six different databases and following the PRISMA guidelines. To assess study quality we applied the AMSTAR 2 tool. A total of 44 systematic reviews, including 1,053 different studies, were eligible for inclusion. Harm was categorized in three dimensions: mental health, somatic harm and physical injury (including mortality). Evidence shows a clear association between cannabis use and psychosis, affective disorders, anxiety, sleep disorders, cognitive failures, respiratory adverse events, cancer, cardiovascular outcomes, and gastrointestinal disorders. Moreover, cannabis use is a risk factor for motor vehicle collision, suicidal behavior and partner and child violence. Cannabis use is a risk factor for several medical conditions and negative social consequences. There is still little data on the dose-dependency of these effects; evidence that is essential in order to define, from a public health perspective, what can be considered risky use of cannabis. This definition should be based on quantitative and qualitative criteria that informs and permits the evaluation of current approaches to a regulated cannabis market.
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Affiliation(s)
- E Campeny
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain.
| | - H López-Pelayo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain
| | - D Nutt
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, London W12 0NN, UK
| | - C Blithikioti
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain
| | - C Oliveras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain
| | - L Nuño
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain
| | - R Maldonado
- Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain
| | - G Florez
- Hospital Universitario de Ourense, Ourense, Spain
| | - F Arias
- Hospital Doce de Octubre, Madrid, Spain
| | | | - J R Villalbí
- Public Health Agency of Barcelona, Barcelona, Spain
| | - J Sellarès
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain
| | - M Ballbè
- Catalan Institute of Oncology, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
| | - J Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, (CAMH), Canada; Campbell Family Mental Health Research Institute, CAMH, Canada; Addiction Policy, Dalla Lana School of Public Health, University of Toronto (UofT), Canada; Department of Psychiatry, Faculty of Medicine, UofT, Canada; Epidemiological Research Unit, Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - M M Balcells-Olivero
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain
| | - A Gual
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Grup Recerca Addiccions Clinic (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Spain
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Thern E, Ramstedt M, Svensson J. Long-term effects of youth unemployment on alcohol-related morbidity. Addiction 2020; 115:418-425. [PMID: 31618497 DOI: 10.1111/add.14838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/17/2019] [Accepted: 09/24/2019] [Indexed: 11/26/2022]
Abstract
AIM To test if exposure to unemployment in young adulthood is associated with an increased risk of later alcohol-related morbidity. DESIGN A nation-wide register-linked longitudinal population-based study. SETTING Sweden. PARTICIPANTS A total of 16 490 individuals born between 1967 and 1978, who had participated in the Labour Force Survey between the ages of 16-24 years during 1990-95. MEASUREMENT Information on the outcome of alcohol-related morbidity was obtained from the National Hospital Discharge Register. The Swedish index of alcohol-related in-patient care was used to define the outcome. Information on sex, age and country of birth, as well as parents' level of education, socio-economic status and alcohol-related health problems, were also obtained. Average follow-up time was 22 years. Cox regression analysis was used to obtain hazard ratios (HR) with 95% confidence intervals (CI). FINDINGS Compared with full-time students, individuals who experienced short- and long-term unemployment spells at a young age were at an increased risk of later alcohol-related morbidity; < 3 months (HR = 2.04, 95% CI = 1.35-3.09), 3-6 months (HR = 2.20, 95% CI = 1.29-3.75) and > 6 months (HR = 1.99, 95% CI = 1.06-3.71) of unemployment, after adjusting for several important individual and family level covariates. CONCLUSION In Sweden, a nation-wide register-based study with a 22-year follow-up suggests that being unemployed in young adulthood is associated with an increased risk of alcohol-related morbidity later in life.
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Affiliation(s)
- Emelie Thern
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Mats Ramstedt
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Johan Svensson
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Hult M, Lappalainen K, Saaranen TK, Räsänen K, Vanroelen C, Burdorf A. Health-improving interventions for obtaining employment in unemployed job seekers. Cochrane Database Syst Rev 2020; 1:CD013152. [PMID: 31912888 PMCID: PMC6956407 DOI: 10.1002/14651858.cd013152.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Unemployment is associated with decreased health which may be a reason or a consequence of becoming unemployed. Decreased health can inhibit re-employment. OBJECTIVES To assess the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. SEARCH METHODS We searched (3 May 2018, updated 13 August 2019) the Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, PsycINFO, CINAHL, SocINDEX, OSH Update, ClinicalTrials.gov, the WHO trials portal, and also reference lists of included studies and selected reviews. SELECTION CRITERIA We included randomised controlled trials (RCTs) of the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. The primary outcome was re-employment reported as the number or percentage of participants who obtained employment. Our secondary outcomes were health and work ability. DATA COLLECTION AND ANALYSIS Two authors independently screened studies, extracted outcome data, and assessed risk of bias. We pooled study results with random-effect models and reported risk ratios (RRs) with 95% confidence intervals (CIs) and assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS We included 15 randomised controlled trials (16 interventions) with a total of 6397 unemployed participants. Eight studies evaluated therapeutic interventions such as cognitive behavioural therapy, physical exercise, and health-related advice and counselling and, in seven studies, interventions were combined using therapeutic methods and job-search training. Therapeutic interventions Therapeutic interventions compared to no intervention may increase employment at an average of 11 months follow-up but the evidence is very uncertain (RR = 1.41, 95% CI 1.07 to 1.87, n = 1142, 8 studies with 9 interventions, I² = 52%, very low-quality evidence). There is probably no difference in the effects of therapeutic interventions compared to no intervention on mental health (SMD 0.12, 95% CI -0.06 to 0.29, n = 530, 2 studies, low-quality evidence) and on general health (SMD 0.19, 95% CI -0.04 to 0.41, n = 318, 1 study, moderate-quality evidence). Combined interventions Combined interventions probably increase employment slightly compared to no intervention at an average of 10 months follow-up (RR 1.12, 95% CI 1.06 to 1.20, n = 4101, 6 studies, I² = 7%). There were no studies that measured work-ability, adverse events, or cost-effectiveness. AUTHORS' CONCLUSIONS Interventions combining therapeutic methods and job-search training probably have a small beneficial effect in increasing employment. Therapeutic interventions may have an effect on re-employment, but we are very uncertain. Therapeutic interventions may not improve health in unemployed job seekers. Large high-quality RCTs targeting short-term or long-term unemployed people are needed to increase the quality of the evidence. A cost-effectiveness assessment is needed of the small beneficial effects.
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Affiliation(s)
- Marja Hult
- University of Eastern FinlandKuopioFinland
| | | | - Terhi K Saaranen
- University of Eastern FinlandDepartment of Nursing ScienceP.O.Box 1627KuopioFinland70211
| | - Kimmo Räsänen
- University of Eastern FinlandInstitute of Public Health and Clinical Nutrition, Occupational Health UnitPO Box 1627KuopioFinland70211
| | - Christophe Vanroelen
- Vrije Universiteit BrusselInterface Demography, Department of SociologyPleinlaan 2BrusselsBelgium1050
| | - Alex Burdorf
- Erasmus Medical CenterDepartment of Public HealthPO Box 2040RotterdamNetherlands3000 CA
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Blest-Hopley G, Colizzi M, Giampietro V, Bhattacharyya S. Is the Adolescent Brain at Greater Vulnerability to the Effects of Cannabis? A Narrative Review of the Evidence. Front Psychiatry 2020; 11:859. [PMID: 33005157 PMCID: PMC7479242 DOI: 10.3389/fpsyt.2020.00859] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/06/2020] [Indexed: 01/01/2023] Open
Abstract
Cannabis use during the critical neurodevelopmental period of adolescence, may lead to brain structural, functional, and histological alterations that may underpin some of the longer-term behavioral and psychological harms associated with it. The endocannabinoid system performs a key regulatory and homeostatic role, that undergoes developmental changes during adolescence making it potentially more susceptible to the effects of exposure to cannabis during adolescence. Here, we synthesize evidence from human studies of adolescent cannabis users showing alterations in cognitive performance as well as in brain structure and function with relevant preclinical evidence to summarize the current state of knowledge. We also focus on the limited evidence that speaks to the hypothesis that cannabis use during adolescence, may pose a greater risk than use during adulthood, identify gaps in current evidence and suggest directions for new research. Existing literature is consistent with the association of cannabis use during adolescence and neurological changes. Adolescence cannabis users show altered functional connectivity within known functional circuits, that may underlie inefficient recruitment of brain regions, as largely increased functional activation has been observed compared to controls. This disruption in some cases may contribute to the development of adverse mental health conditions; increasing the chances or accelerating the onset, of their development. Preclinical evidence, further supports disruption from cannabis use being specific to the developmental period. Future studies are required to better investigate adolescent cannabis use with more accuracy using better defined groups or longitudinal studies and examine the permanency of these changes following caseation of use. Furthermore, research is required to identify heritable risk factors to cannabis use. There is a need for caution when considering the therapeutic potential of cannabis for adolescence and particularly in public discourse leading to potential trivialization of possible harm from cannabis use in adolescence. Current evidence indicates that adolescence is a sensitive period during which cannabis use may result in adverse neurocognitive effects that appear to show a level of permanency into adulthood.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Marco Colizzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Vincent Giampietro
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Assessing the impacts of daily Cannabis versus alcohol and methamphetamines on young Australians in youth AOD treatment. BMC Psychiatry 2019; 19:416. [PMID: 31870339 PMCID: PMC6929317 DOI: 10.1186/s12888-019-2403-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 12/11/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Cannabis is the most widely used illicit substance by Australian young people, including those engaged with youth alcohol and other drug (AOD) systems. While recreational cannabis use in young people may be a developmental activity for some, for others, this usage becomes regular and be associated with poorer long term outcomes. This study reports on the rates of cannabis use and co-existing psychosocial complexity factors in the Youth Needs Census (2013 and 2016) where workers report on all clients in the youth AOD system, a cohort considered highly vulnerable. METHODS Data was examined for two rounds of data collection for the Youth Needs Census, including 823 youth AOD service engaged young people in 2016 and 1000 AOD service engaged young people in 2013, to identify usage rates, psychosocial outcomes, and changes over time. RESULTS Daily use of cannabis alone significantly exceeded daily usage rates for methamphetamines, alcohol, and cannabis used alongside other substances. Daily cannabis use was significantly associated with mental health problems, employment problems, education problems, family problems, and housing problems. Daily cannabis use was associated with most psychosocial complexity factors to the same extent as daily methamphetamine use and daily alcohol use, with daily cannabis users only showing lower incidence of the drug-related harm measure. Notably, daily cannabis use also increased from 2013 (47.5%) to 2016 (54.2%). CONCLUSIONS It is imperative that the number of individuals using cannabis is considered alongside the severity of harm when assessing the social impact of this substance. Within cannabis users engaged with the youth AOD system, who often have high levels of psychosocial complexity, cannabis is used daily by a large proportion of these youths and may play a role in negatively impacting their lives.
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Thern E, Ramstedt M, Svensson J. The associations between unemployment at a young age and binge drinking and alcohol-related problems. Eur J Public Health 2019; 30:368-373. [DOI: 10.1093/eurpub/ckz218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Youth unemployment remains at a high stable level in many countries making it a public health problem of importance. The aim was to examine the short-term effect of unemployment at a young age (aged 17–29 years) on self-reported binge drinking and alcohol-related problems.
Methods
We used data from a cross-sectional national study that took place in 2013, with a follow-up in 2014. A sample of young adults aged 17–29 years (n = 1188, response rate of 46.3%) that completed both surveys served as the study sample in the current study. The same self-reported questionnaire, consisting of questions regarding their alcohol habits and sociodemographic information, was used on both occasions. Information on the outcomes of binge drinking and alcohol-related harm were obtained from the 2014 survey. From the 2013 survey, information on individual and family level covariates were collected. Odds ratios (ORs) with 95% confidence intervals (CIs) with employed individuals as the reference group were estimated by logistic regression analysis.
Results
At baseline, results indicate that employed individuals reported the greatest prevalence of weekly binge drinking. In the fully adjusted models, unemployment appeared to be associated with an increased risk of alcohol-related problems (OR 1.37, 95% CI 0.77–2.45); however, this was not the case for weekly binge drinking (OR 0. 94, 95% CI 0.45–1.96).
Conclusion
Unemployment at a young age may be a risk factor for later alcohol-related problems. Thus, targeting youth unemployment could be one element in an effective health policy aimed at reducing rates of alcohol use disorders.
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Affiliation(s)
- Emelie Thern
- Department of Analysis and Method, The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
| | - Mats Ramstedt
- Department of Analysis and Method, The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Johan Svensson
- Department of Analysis and Method, The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Manhica H, Lundin A, Danielsson AK. Not in education, employment, or training (NEET) and risk of alcohol use disorder: a nationwide register-linkage study with 485 839 Swedish youths. BMJ Open 2019; 9:e032888. [PMID: 31615804 PMCID: PMC6797427 DOI: 10.1136/bmjopen-2019-032888] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate to what extent being outside education, employment or training after completed secondary education in Sweden might affect the risk of subsequent alcohol use disorders (AUDs), with sociodemographic indicators, such as sex, domicile and origin, taken into account. DESIGN Population register-based cohort study with 485 839 Swedish youths. SETTING Sweden. PARTICIPANTS All youths who were born between 1982 and 1991 and were aged between 19 and 24 years when they completed secondary education in Sweden, between 2005 and 2009. PRIMARY OUTCOME MEASURE Cox regression models were used to estimate the HR of first record of entry into alcohol-related medical care with a diagnosis of an AUD, by level of labour market attachment, from 1 January 2009 to 31 December 2016. RESULTS About 4% of the youth population were outside education, employment or training and 25% were in insecure workforce after they completed secondary education. The risk of AUD was higher among youths in insecure workforce, HR 1.40 (95% CI 1.30 to 1.50), and among those outside education, employment or training, HR 1.30 (95% CI 1.11 to 1.51), compared with youths within the core workforce, also after adjusting for age, domicile, sex and origin. Being in education was associated with lower HR of AUD, HR=0.84 (95% CI 0.78 to 0.90). CONCLUSION Youths who are in insecure workforce and outside education, employment or training are at higher risk of AUD. Targeted policy actions are needed to support a successful school-work transition to secure equal opportunities for young people.
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Affiliation(s)
- Helio Manhica
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Andreas Lundin
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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Kosiba JD, Maisto SA, Ditre JW. Patient-reported use of medical cannabis for pain, anxiety, and depression symptoms: Systematic review and meta-analysis. Soc Sci Med 2019; 233:181-192. [PMID: 31207470 DOI: 10.1016/j.socscimed.2019.06.005] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 05/17/2019] [Accepted: 06/03/2019] [Indexed: 12/20/2022]
Abstract
RATIONALE Certifications for medical cannabis are generally restricted to a small number of specific medical conditions, yet patients frequently report symptoms of pain, anxiety, and depression as reasons for use. This is a critical concern for researchers, healthcare providers, and policymakers, yet research in this area is currently obstructed by the lack of a focused review or empirical synthesis on patient-reported reasons for medical cannabis use. OBJECTIVES AND METHOD: The first aim of this project was to conduct the first systematic review and meta-analysis of empirical studies of patient-reported symptoms of pain, anxiety, and depression as reasons for medical cannabis use. The second aim was to conduct an empirical assessment of the methodological quality of extant research, test for publication bias, and test sex composition and quality scores of individual studies as possible sources of observed heterogeneity. RESULTS Meta-analytic results indicated that pain (64%), anxiety (50%), and depression/mood (34%) were common reasons for medical cannabis use. No evidence for publication bias was detected, despite heterogeneity in prevalence rates. A comprehensive assessment of study quality identified a number of specific methodological limitations of the existing research, including challenges in patient recruitment, use of restrictive sampling frames, and a lack of randomized recruitment methods and validated assessment measures. CONCLUSION Findings are discussed with regard to possible explanations for current results, clinical considerations, and areas of future research that are needed to move the field forward.
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Affiliation(s)
- Jesse D Kosiba
- Department of Psychology, Syracuse University, United States.
| | | | - Joseph W Ditre
- Department of Psychology, Syracuse University, United States
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Gariépy G, Iyer S. The Mental Health of Young Canadians Who Are Not Working or in School. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:338-344. [PMID: 30595044 PMCID: PMC6591889 DOI: 10.1177/0706743718815899] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Recent studies suggest that youth who have a mental health problem are more likely to be NEET-not in education, employment, or training-but findings remain mixed, and evidence from Canada is limited. We examined this association across a range of mental and substance disorders in a representative sample of Canadian youth. METHOD Data were from the 2012 Canadian Community Health Survey-Mental Health ( n = 5622; ages 15-29). The survey identified past-year mental (depression, bipolar, generalized anxiety) and substance (alcohol, cannabis, other drugs) disorders from a structured interview and included questions on suicidal ideation. We classified as NEET respondents who were not in school or employed in the past week. Logistic regression models tested the associations between mental and substance disorders and NEET status, adjusted for sociodemographic, health, and geographic variables. RESULTS About 10% of youth were NEET. Being NEET was associated with past-year depression (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.06 to 2.63); bipolar (OR = 2.31; 95% CI, 0.98 to 5.45), generalized anxiety (OR = 2.65; 95% CI, 1.37 to 5.12), and drug use (OR = 3.22; 95% CI, 1.33 to 7.76) disorders; and suicidal ideation (OR = 1.75; 95% CI, 0.99 to 3.09) but was not associated with alcohol (OR = 1.03; 95% CI, 0.63 to 1.69) or cannabis (OR = 0.97; 95% CI, 0.47 to 2.00) disorders. CONCLUSIONS Poor mental health was associated with being NEET in Canadian youth. Efforts targeting NEET should include provisions for mental health. Moreover, youth mental health initiatives should consider educational and employment outcomes. Further longitudinal and intervention studies are warranted.
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Affiliation(s)
- Geneviève Gariépy
- 1 Douglas Mental Health University Institute, McGill University, Montreal, Quebec.,2 Department of Psychiatry, McGill University, Montreal, Quebec
| | - Srividya Iyer
- 1 Douglas Mental Health University Institute, McGill University, Montreal, Quebec.,2 Department of Psychiatry, McGill University, Montreal, Quebec
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Feigl AB, Goryakin Y, Devaux M, Lerouge A, Vuik S, Cecchini M. The short-term effect of BMI, alcohol use, and related chronic conditions on labour market outcomes: A time-lag panel analysis utilizing European SHARE dataset. PLoS One 2019; 14:e0211940. [PMID: 30856184 PMCID: PMC6411140 DOI: 10.1371/journal.pone.0211940] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 01/20/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Non-communicable diseases (NCDs) like cancer, cardiovascular disease, and diabetes have spread at a remarkable pace in European countries over the past decades. Overweight/obesity and alcohol use are two leading risk factors contributing to both economic and epidemiological burden associated with NCDs. In OECD countries, the impact of indirect costs of obesity varies between 0.20% and 1.21% of GDP. Indirect costs of alcohol use range from 0.19% (Portugal) to 1.6% (Estonia) of GDP. AIM To assess the longitudinal impact of alcohol use and high body-mass index (BMI) on labour market outcomes in the European region by modeling the direct effect of high BMI and alcohol use, and the effect via associated diseases. METHODS The impact of BMI, alcohol use, and associated diseases on employment likelihood, intent to retire early, days of absenteeism, and hours of work per week, were modelled via lagged Poisson and Zero-inflated Poisson regressions, adjusting for missingness via inverse probability weighting, as appropriate, using European SHARE data. RESULTS Controlling for other chronic conditions, being overweight increases employment likelihood among men, but not among women. Obesity decreased female, but not male, employment chances. All chronic conditions linked with high BMI negatively affected employment likelihood, and increased the intention to retire early significantly. Alcohol use positively affects employment likelihood in women at all drinking levels relative to lifetime abstainers, but only in moderate (not heavy) male drinkers. There is super-additionality of impact of NCDs on absenteeism and hours worked, presenting a key economic argument to tackle NCD prevention and compression of morbidity. IMPLICATIONS NCD prevention is not just important for employment and hours worked, but also for employee morale, especially given increasing retirement age in Europe and globally.
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Affiliation(s)
- Andrea B. Feigl
- Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, MA, United States of America
| | | | - Marion Devaux
- Organization of Economic Cooperation and Development, Paris, France
| | - Aliénor Lerouge
- Organization of Economic Cooperation and Development, Paris, France
| | - Sabine Vuik
- Organization of Economic Cooperation and Development, Paris, France
| | - Michele Cecchini
- Organization of Economic Cooperation and Development, Paris, France
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Prins SJ, McKetta S, Platt J, Muntaner C, Keyes KM, Bates LM. Mental illness, drinking, and the social division and structure of labor in the United States: 2003-2015. Am J Ind Med 2019; 62:131-144. [PMID: 30565724 DOI: 10.1002/ajim.22935] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/22/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND We draw on a relational theoretical perspective to investigate how the social division and structure of labor are associated with serious and moderate mental illness and binge and heavy drinking. METHODS The Panel Study of Income Dynamics and the Occupational Information Network were linked to explore how occupation, the productivity-to-pay gap, unemployment, the gendered division of domestic labor, and factor-analytic and theory-derived dimensions of work are related to mental illness and drinking outcomes. RESULTS Occupations involving manual labor and customer interaction, entertainment, sales, or other service-oriented labor were associated with increased odds of mental illness and drinking outcomes. Looking for work, more hours of housework, and a higher productivity-to-pay gap were associated with increased odds of mental illness. Physical/risky work was associated with binge and heavy drinking and serious mental illness; technical/craft work and automation were associated with binge drinking. Work characterized by higher authority, autonomy, and expertise was associated with lower odds of mental illness and drinking outcomes. CONCLUSIONS Situating work-related risk factors within their material context can help us better understand them as determinants of mental illness and identify appropriate targets for social change.
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Affiliation(s)
- Seth J. Prins
- Department of Epidemiology; Columbia University; New York New York
- Department of Sociomedical Sciences; Columbia University; New York New York
| | - Sarah McKetta
- Department of Epidemiology; Columbia University; New York New York
| | - Jonathan Platt
- Department of Epidemiology; Columbia University; New York New York
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto Ontario
| | - Katherine M. Keyes
- Department of Epidemiology; Columbia University; New York New York
- Center for Research on Society and Health; Universidad Mayor; Santiago Chile
| | - Lisa M. Bates
- Department of Epidemiology; Columbia University; New York New York
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Blest-Hopley G, Giampietro V, Bhattacharyya S. Regular cannabis use is associated with altered activation of central executive and default mode networks even after prolonged abstinence in adolescent users: Results from a complementary meta-analysis. Neurosci Biobehav Rev 2018; 96:45-55. [PMID: 30395923 PMCID: PMC6331661 DOI: 10.1016/j.neubiorev.2018.10.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/23/2018] [Accepted: 10/31/2018] [Indexed: 01/17/2023]
Abstract
Adolescent abstinent cannabis users showed significantly greater activation in the dorsolateral and ventrolateral prefrontal and posterior parietal cortices compared to controls. Adolescent users showed increased activation in regions involved in executive functioning, attentional control and the default mode network compared to non-using controls. No significant group differences in brain activation observed between abstinent and current adolescent cannabis users.
Whether the effects of cannabis use on brain function persist or recover following abstinence remains unclear. Therefore, using meta-analytic techniques, we examined whether functional alterations measured using fMRI persist in cannabis users abstinent for over 25 days (or 600 h) as evidence suggests that the effects on cognitive performance no longer persist beyond this period. Systematic literature search identified 20 studies, of which, 12 examined current cannabis users (CCU) (361 CCU versus 394 non-cannabis using controls (NU)) and 3 examined abstinent cannabis users (ACU) in 5 separate comparisons (98 ACU versus 106 NU). Studies in ACU were carried out in adolescents and suggest significantly greater activation in components of the central executive and default mode networks in adolescent ACU compared to NU. While this evidence is to be interpreted with caution because studies were carried out in overlapping samples, they indicate a pressing need for independent confirmation whether certain neurofunctional alterations in adolescent cannabis users may persist even after cannabis and its metabolites are likely to have left their bodies.
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Affiliation(s)
- Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Centre for Neuroimaging Sciences, PO Box 089, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK.
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Health-improving interventions for obtaining employment in unemployed job seekers. Hippokratia 2018. [DOI: 10.1002/14651858.cd013152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Association between good work ability and health behaviours among unemployed: A cross-sectional survey. Appl Nurs Res 2018; 43:86-92. [PMID: 30220370 DOI: 10.1016/j.apnr.2018.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 06/15/2018] [Accepted: 07/25/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND There has been relatively little research on the possible factors promoting good work ability among unemployed people. Consequently, the role of health behaviours in good work ability among the unemployed is unknown. PURPOSE To explore the work ability and health behaviours of unemployed people through sociodemographic factors and examine the association between good work ability and health behaviours. DESIGN A cross-sectional survey. METHODS The study is based on the Finnish nationwide Regional Health and Well-being Study using mailed and online questionnaires in 2014-2015. A total of 1973 unemployed or laid-off people between the ages of 20 and 65 responded to the survey. The associations of work ability with sociodemographic factors - gender, age, marital status, minors (i.e. under-18s) living in the household, education, living environment, and duration of unemployment - and health behaviours with sociodemographic factors were first explored using cross-tabulations. Health behaviours included body mass index, daily smoking, alcohol consumption, vegetable consumption, health promotion groups, physical exercise, and sitting in one's leisure time. Health behaviours were then examined using logistic regression analyses, in association with good work ability; the latter was measured with the Work Ability Score. RESULTS Being aged below 45, being married or cohabiting, having a high level of education, and short-term unemployment were associated with good work ability. A quarter of participants were daily smokers. A proportion of women with risk level alcohol use (79%) was higher than that of men (59.9%). A third of unemployed people participated in high-intensity physical activity. In regression analyses, high-intensity physical activity (OR 2.25, 95% CI 1.06-4.78) was associated with good work ability. CONCLUSIONS Unemployed women and men widely exhibited unhealthy behaviours such as daily smoking and a risk level use of alcohol. Health promotion actions for enhancing a healthy lifestyle and good work ability among unemployed people, particularly in emphasizing the importance of physical activity, are highly recommended.
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Abstract
PURPOSE OF REVIEW The aim of this article is to present a state-of-the-art review of the scientific studies that have evaluated healthcare systems, services and programs for addiction treatment in Latin America. As a secondary aim, this article presents a brief description and analysis of the addiction prevention and treatment resources and programs available in Latin America, based on information from the ATLAS on Substance Use (ATLAS-SU) project led by the WHO. RECENT FINDINGS Substance use disorders (SUDs) are among the main causes associated with global burden of disease. Around the world, many initiatives have been proposed to promote policies to reduce substance use and reduce the impact of SUD, including integrating treatments into healthcare systems, increasing access to treatment programs and impacting outcome measures. In Latin America, multiple efforts have been implemented to improve addiction services and programs, although little is known about the impact they have generated. SUMMARY International studies report the availability of strategies and public inicitatives on prevention and treatment of addiction in Latin America. These studies also report established networks of public and private services that include prevention and detoxification programs, outpatient and residential treatment, and also social reintegration initiatives. However, despite these advances, information on the evaluation of the progress, results and impact of these programs is limited.
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Berg N, Kiviruusu O, Huurre T, Lintonen T, Virtanen P, Hammarström A. Associations between unemployment and heavy episodic drinking from adolescence to midlife in Sweden and Finland. Eur J Public Health 2018; 28:258-263. [PMID: 29240887 DOI: 10.1093/eurpub/ckx207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Unemployment and alcohol use have often been found to correlate and to act as risk factors for each other. However, only few studies have examined these associations at longitudinal settings extending over several life phases. Moreover, previous studies have mostly used total consumption or medical diagnoses as the indicator, whereas subclinical measures of harmful alcohol use, such as heavy episodic drinking (HED), have been used rarely. The aim of this study was to examine the associations between HED and unemployment from adolescence to midlife in two Nordic countries. Methods Participants of separate cohort studies from Sweden and Finland were recruited at age 16 in 1981/1983 and followed up at ages 21/22, 30/32 and 43/42, (n = 1080/2194), respectively. Cross-lagged autoregressive models were used to determine associations between HED and unemployment. Results In the Swedish cohort, HED at ages 16 and 30 in men and HED at age 21 in women were associated with subsequent unemployment. In the Finnish cohort, we found corresponding associations at age 16 in women and at age 22 in men. However, the gender differences were not statistically significant. The associations from unemployment to HED were non-significant in both genders, in both cohorts and at all ages. Conclusions Our results suggest that heavy drinkers are more likely to experience unemployment in subsequent years. The associations from HED to unemployment seem to exist through the life course from adolescence to midlife. More emphasis should be put on reducing alcohol related harms in order to improve labour-market outcomes.
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Affiliation(s)
- Noora Berg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Olli Kiviruusu
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Taina Huurre
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.,Department of Health and Social Welfare, City of Vantaa, Vantaa, Finland
| | - Tomi Lintonen
- Finnish Foundation for Alcohol Studies, Helsinki, Finland.,Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Pekka Virtanen
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Anne Hammarström
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Acevedo A, Miles J, Garnick DW, Panas L, Ritter G, Campbell K, Acevedo-Garcia D. Employment after beginning treatment for substance use disorders: The impact of race/ethnicity and client community of residence. J Subst Abuse Treat 2018; 87:31-41. [PMID: 29471924 DOI: 10.1016/j.jsat.2018.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/07/2017] [Accepted: 01/08/2018] [Indexed: 11/30/2022]
Abstract
Employment is an important substance use treatment outcome, frequently used to assess individual progress during and after treatment. This study examined whether racial/ethnic disparities exist in employment after beginning treatment. It also examined the extent to which characteristics of clients' communities account for such disparities. Analyses are based on data that linked individual treatment information from Washington State's Behavioral Health Administration with employment data from the state's Employment Security Department. Analyses subsequently incorporated community-level data from the U.S. Census Bureau. The sample includes 10,636 adult clients (Whites, 68%; American Indians, 13%, Latinos, 10%; and Blacks, 8%) who had a new outpatient treatment admission to state-funded specialty treatment. Heckman models were used to test whether racial/ethnic disparities existed in the likelihood of post-admission employment, as well as employment duration and wages earned. Results indicated that there were no racial/ethnic disparities in the likelihood of employment in the year following treatment admission. However, compared to White clients, American Indian and Black clients had significantly shorter lengths of employment and Black clients had significantly lower wages. With few exceptions, residential community characteristics were associated with being employed after initiating treatment, but not with maintaining employment or with wages. After accounting for community-level variables, disparities in length of employment and earned wages persisted. These findings highlight the importance of considering the race/ethnicity of a client when examining post-treatment employment alongside community characteristics, and suggest that the effect of race/ethnicity and community characteristics on post-treatment employment may differ based on the stage of the employment process.
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Affiliation(s)
- Andrea Acevedo
- Department of Community Health, Tufts University, United States; Heller School for Social Policy and Management, Institute for Behavioral Health, Brandeis University, United States.
| | - Jennifer Miles
- Heller School for Social Policy and Management, Institute for Behavioral Health, Brandeis University, United States
| | - Deborah W Garnick
- Heller School for Social Policy and Management, Institute for Behavioral Health, Brandeis University, United States
| | - Lee Panas
- Heller School for Social Policy and Management, Institute for Behavioral Health, Brandeis University, United States
| | - Grant Ritter
- Heller School for Social Policy and Management, Institute for Behavioral Health, Brandeis University, United States
| | - Kevin Campbell
- Behavioral Health Administration, Washington State Department of Social and Health Services, United States
| | - Dolores Acevedo-Garcia
- Institute for Child, Youth, and Family Policy, Heller School for Social Policy and Management, Brandeis University, United States
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