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Devilly GJ, Wilkinson P, Allen C, Piatkowski T. Unmasking Distorted Reflections: Exploring Body Image, Alcohol, and Drug Use in Nighttime Entertainment Districts. Subst Use Misuse 2024; 59:1280-1292. [PMID: 38640402 DOI: 10.1080/10826084.2024.2320377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Background: Violence within nighttime entertainment districts (NEDs) has been blamed on problematic masculinity and has predominantly been attributed to excessive alcohol intake and steroid use in men. In this report we conducted two studies to: (1) ascertain whether researchers could act as third-party raters of body weight and muscle mass in NED patrons; and (2) to examine the relationship between body self-image, inebriation, alcohol preloading behaviors and drug use in the NEDs. Methods: Study 1 employed an observational approach to establish inter-rater reliability for ratings of muscle mass and weight. In Study 2 data (n = 2,745) were collected through breathalyzing and questionnaires to examine individuals' self-image and drinking and drug-taking behaviors. Results: Participants' self-ratings of muscle and weight significantly differed from researchers' ratings, with males perceiving themselves as less muscular and females perceiving themselves as heavier. Perceived weight and muscle size did not relate to alcohol levels, but an interaction was found for female steroid users who perceived themselves as less muscular. Conclusions: Findings indicated a distortion in participants' perceived body image, with a desire for muscularity among both males and females. These results underscore the complex interplay between self-perception, societal ideals, and drug use in young NED patrons.
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Affiliation(s)
- Grant J Devilly
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
| | - Petra Wilkinson
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Corey Allen
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- Queensland Police Service, Inner West Patrol Group, Brisbane, Queensland, Australia
| | - Timothy Piatkowski
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
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Piatkowski T, Benn S, Ayurzana L, King M, McMillan S, Hattingh L. Exploring the role of community pharmacies as a harm reduction environment for anabolic-androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists. Harm Reduct J 2024; 21:59. [PMID: 38481218 PMCID: PMC10935940 DOI: 10.1186/s12954-024-00972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers. OBJECTIVE This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist's regarding AAS harm reduction. METHODS Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis. RESULTS While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively. CONCLUSIONS Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.
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Affiliation(s)
- Timothy Piatkowski
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia.
- Griffith Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.
| | - Sarah Benn
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Lkhagvadulam Ayurzana
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Michelle King
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Sara McMillan
- Griffith Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Laetitia Hattingh
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
- Pharmacy Department, Gold Coast Health, Southport, QLD, 4215, Australia
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Nourse G, Fraser S, Moore D. Masculine enhancement as health or pathology: gender and optimisation discourses in health promotion materials on performance and image-enhancing drugs (PIEDs). HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2024:1-17. [PMID: 38286142 DOI: 10.1080/14461242.2023.2297046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/03/2023] [Indexed: 01/31/2024]
Abstract
The consumption of performance and image-enhancing drugs (PIEDs) is commonly pathologised in public health discourse as stemming from an unhealthy relationship to masculinity, and is often framed as intrinsically 'risky' and fundamentally at odds with 'good health'. This article examines Australian health promotion materials on PIEDs to analyse their role in shaping notions of good health, normal gender and appropriate self-improvement. To do so, it draws on the work of Butler, Law and Latour to consider how these materials co-constitute men and their health, often in problematic ways. First, we examine the ways in which PIEDs are constituted via a politics of the 'natural', then consider how the health promotion materials on PIEDs participate in the regulation of appropriate, healthy masculinity, and conclude by examining how adolescent masculinity is co-constituted with PIEDs. We observe a key tension between health promotion's avowed interest in improvement and optimisation and its treatment of PIED consumers as aberrant, vulnerable and insecure subjects whose drive to enhance and optimise is characterised by pathology and addiction. We conclude by arguing that health promotion materials on PIEDs fail to acknowledge the exceedingly normative character of enhancement practices in contemporary society.
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Affiliation(s)
- Gemma Nourse
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - David Moore
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
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Piatkowski T, Robertson J, Lamon S, Dunn M. Gendered perspectives on women's anabolic-androgenic steroid (AAS) usage practices. Harm Reduct J 2023; 20:56. [PMID: 37098574 PMCID: PMC10127974 DOI: 10.1186/s12954-023-00786-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 04/19/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The masculinizing effects from anabolic-androgenic steroid (AAS) appear to be different between men and women, leading to calls for more gender-specific information regarding women and AAS use. This study sought to gather perspectives from both men and women on the unique challenges surrounding women's use of AAS, irrespective of their personal use. Secondly, the study interrogated how women's AAS practices differ from those of men specifically. METHODS The data presented in this paper come from a subsample of participants who participated in a larger study investigating women and performance and image enhancing drug (PIED) use in Australia. Participants were included in the current analysis if they were: (i) males or females who competed with or coached female strength athletes using AAS and (ii) female and male strength athletes who used AAS. The final sample comprised 21 participants of which there was a proportion of males (n = 7) and females (n = 7) using AAS. RESULTS Women's choices in AAS selection were predominantly around oral compounds (e.g. Oxandrolone) as well as other PIEDs (e.g. Clenbuterol). Some women report the use of injectable AAS represents a change in the profile of the typical female user as it reportedly comes alongside drastic physical and psychological changes. CONCLUSIONS The unique challenges facing women who use AAS are largely isolation and stigma, with little evidence-based practice or education being available to them online or through peer-groups. Future work may consider piloting harm reduction strategies that may be co-designed with this group.
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Affiliation(s)
- Tim Piatkowski
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Jonathan Robertson
- Deakin Business School, Deakin University, Melbourne, VIC, Australia
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Severine Lamon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Matthew Dunn
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia.
- School of Health and Social Development/Institute for Health Transformation, Deakin University, Geelong Waterfront Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia.
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Ganson KT, Hallward L, Cunningham ML, Murray SB, Nagata JM. Anabolic-Androgenic Steroid Use: Patterns of Use among a National Sample of Canadian Adolescents and Young Adults. PERFORMANCE ENHANCEMENT & HEALTH 2023; 11:100241. [PMID: 37841070 PMCID: PMC10571510 DOI: 10.1016/j.peh.2022.100241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Androgenic-anabolic steroid (AAS) use is relatively common among international recreational and community samples and is associated with several deleterious side effects and health consequences that have not been studied recently among a large Canadian sample. Therefore, the purpose of this study was to assess and describe characteristics of AAS users compared to non-AAS users among a national sample of Canadian adolescents and young adults. Methods Data from 2,774 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Participants were recruited via social media advertisements and completed the survey online. Survey items measured sociodemographics, AAS use, AAS side effects, motives for AAS use, AAS administration, body satisfaction, other illicit substance use, mental health, and violence involvement. Results Among the overall sample, 1.6% of participants reported lifetime AAS use, with the majority of users being White, heterosexual males. Most users strived to gain weight, with main motives for AAS use including increased muscularity and strength, and improved appearance. Most AAS users were satisfied with their body compared to non-users. Approximately one in five users had AAS dependence and experienced multiple adverse side effects. Few differences between users and non-users in self-reported mental health were found. Conclusion Findings indicate that AAS use among a community sample of Canadian adolescents and young adults is an important health issue, particularly given the relatively high occurrence of AAS dependence and adverse side effects reported by users. Findings support the need for education and intervention efforts from healthcare professionals. Further investigations among Canadian AAS users may provide more insight regarding the unique supports these individuals require.
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Affiliation(s)
- Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Laura Hallward
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Kinesiology, Western University, London, Ontario, Canada
| | | | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Ceci F, Di Carlo F, Burkauskas J, Salone A, De Luca I, Cicconcelli D, Giorgetti V, La Fratta I, Todaro A, Simonato P, Martinotti G, di Giannantonio M, Corazza O. Physical Activity and Exercise Addiction During the Covid-19 Pandemic in Italy. Int J Ment Health Addict 2022; 21:1-21. [PMID: 35469185 PMCID: PMC9020546 DOI: 10.1007/s11469-022-00815-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/24/2022] Open
Abstract
Severe restrictive measures were implemented globally to limit the spread of the Covid-19 pandemic leading to significant lifestyle changes and impacting on both the physical and the mental health of citizens. Caught by the fear of getting sick, some individuals have adopted behaviors which favored the development of exercise addiction (EA). Our aim was to evaluate physical activity habits and the risk of EA in the general Italian population during phase 1 of the lockdown. The role of appearance anxiety (AA), self-compassion, and use of performance and image enhancing drugs (PIEDs) as predictors of EA development were investigated. A comparison between physically active subjects with the inactive ones was also included. Between April and May 2020, an online survey was conducted across Italy. Nine hundred thirty-six answers were collected. The rate of EA in the physically active sample (782 subjects) was 4.1%. The physically active group showed higher SCS scores and a greater use of PIEDs. Of the physically active participants, 84.2% reported variations in their fitness routine. Perceived benefit of exercising resulted significantly higher in those with EA. Subjects with EA reported stronger motivation in engaging in physical activity as for "physical wellness," "psychological well-being," and "sexual attractiveness and confidence in relationship." A higher level of AA, a lower level of self-compassion, and a higher perceived benefit of exercising during lockdown were all significant predictors for the presence of EA. Our findings suggest that the fear of getting sick from Covid-19, combined with radical changes in the lifestyles induced by the lockdown and individual personological characteristics, can favor the development of EA and related phenomena in the general population.
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Affiliation(s)
- Franca Ceci
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Anatolia Salone
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Ilaria De Luca
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Dorotea Cicconcelli
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Valentina Giorgetti
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Irene La Fratta
- Department of Medical and Oral Sciences and Biotechnologies, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Pierluigi Simonato
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Ornella Corazza
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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Campbell A, Carins J, Rundle-Thiele S, Deshpande S, Baker B. Motivators of Indiscriminate and Unsafe Supplement Use among Young Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199974. [PMID: 34639275 PMCID: PMC8507933 DOI: 10.3390/ijerph18199974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is growing concern about the self-administration of supplements, which can often be indiscriminate, counterproductive to health, and serve as a gateway to more harmful drugs and substances. Research suggests that high uptake of performance- and image-enhancing drugs (PIEDs) is correlated with body image to accentuate masculinity. This study provides insights into limiting unhealthy supplement usage. This research identifies reasons for casual unhealthy supplement use among young adult Australians through the Theory of Planned Behavior (TPB) lens, providing practitioners with insights into developing interventions to deter their use. METHOD Semi-structured in-depth interviews were conducted with ten participants aged between 18 and 40, using a convenience sample. Leximancer analysis was used to assess word co-occurrence and map to TPB constructs. RESULTS Leximancer identified positive attitudes, social norms, and perceived behavioral control towards supplement usage. Key themes that influenced supplement use were weight loss, body image, nutrition, training, education, challenges, need, and time. Furthermore, using TPB constructs, affective and instrumental attitudes and prevailing norms were observed when investigating what would cause an individual to use supplements in an unhealthy manner. CONCLUSION Through understanding the motivations of indiscriminate supplement use across the Australian population, the study has uncovered several social factors that may reduce or limit the practice of unsafe supplement usage.
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Affiliation(s)
- Alexander Campbell
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
- Correspondence: ; Tel.: +61-7-37358449
| | - Julia Carins
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
| | - Sharyn Rundle-Thiele
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
| | - Sameer Deshpande
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
| | - Bradley Baker
- Defence Science & Technology Group, Land Division, Scottsdale, TAS 7260, Australia;
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Cadri A, Nagumsi BAA, Twi-Yeboah A, Yeboah LD, Adomah-Afari A, Ane-Loglo MG, Aboagye RG. Facilitators and Barriers to Health Seeking among People Who Use Drugs in the Sunyani Municipality of Ghana: An Exploratory Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2868953. [PMID: 34471636 PMCID: PMC8405291 DOI: 10.1155/2021/2868953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/12/2021] [Indexed: 11/23/2022]
Abstract
Drug use is one of the global public health issues, and its accompanying disorders have consequences on people's mental, physical, and environmental health. Nevertheless, the majority of people who use drugs have never been treated for drug dependence and other health conditions whilst others discontinue their treatment for drug use disorder. Using the health belief model, the study aimed at exploring facilitators and barriers to health-seeking among people who use drugs in the Sunyani Municipality of Ghana. A descriptive study design was used, employing a qualitative approach. In-depth interviews were conducted with a total of 22 participants, including two key informants (male and female). The first group of participants was recruited from the ghetto (an area in the municipality where people who use drugs are usually located). The other group of participants was recruited using hospital-based records. The interview data were transcribed, coded, and analysed for the generation of themes with the aid of Nvivo version 12 pro. The results showed that people who use drugs face health challenges such as drug dependence, malaria, lungs and breathing complications, cardiovascular complications, and skin complications. People who use drugs experienced poor perceived quality of life and low health status. Health-seeking behaviours of interviewees were influenced by the perceived benefit, perceived severity, cues to action, among others. Multiple sources of healthcare were used by the people who use drugs. Whereas ease of communication, perceived severity, benefit, among others were facilitators to their health-seeking behaviours, cost, dwindling social support, lack of knowledge of the condition, and fear of arrest by law enforcement agencies also served as barriers to seeking healthcare at the orthodox health facilities. This paper suggests a holistic approach to help improve the health and health-seeking behaviours of people who use drugs. The researchers wish to indicate that an earlier version of this manuscript has been presented at the University of Ghana as a thesis.
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Affiliation(s)
- Abdul Cadri
- Department of Social and Behavioural Science, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Bonyo Abdul Aziz Nagumsi
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Alberta Twi-Yeboah
- Department of Social and Behavioural Science, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Linda Darko Yeboah
- Department of Social and Behavioural Science, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Augustine Adomah-Afari
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Maria Goretti Ane-Loglo
- School of Law, University of Ghana, Legon, Ghana
- West Africa Drug Policy Network, East Legon, Accra, Ghana
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McMillan SS, Chan H, Hattingh LH. Australian Community Pharmacy Harm-Minimisation Services: Scope for Service Expansion to Improve Healthcare Access. PHARMACY 2021; 9:pharmacy9020095. [PMID: 33926030 PMCID: PMC8167599 DOI: 10.3390/pharmacy9020095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 11/16/2022] Open
Abstract
Community pharmacies are well positioned to participate in harm-minimisation services to reduce harms caused by both licit and illicit substances. Considering developments in pharmacist practices and the introduction of new professional pharmacy services, we identified a need to explore the contemporary role of community pharmacy in harm minimisation. Semi-structured interviews were undertaken to explore the opinions of stakeholders, pharmacy staff, and clients about the role of community pharmacy in harm minimisation, including provision of current services, experiences, and expectations. Participants (n = 28) included 5 stakeholders, 9 consumers, and 14 staff members from seven community pharmacies. Three over-arching themes were identified across the three participants groups: (i) scope and provision, (ii) complexity, and (iii) importance of person-centred advice and support in relation to community pharmacy harm minimisation services. Community pharmacies are valuable healthcare destinations for delivery of harm minimisation services, with scope for service expansion. Further education, support, and remuneration are needed, as well as linkage to other sector providers, in order to ensure that pharmacists and pharmacy staff are well equipped to provide a range of harm minimisation services.
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Affiliation(s)
- Sara S. McMillan
- Gold Coast Campus, School of Pharmacy and Pharmacology, Griffith University, Southport 4215, Australia;
| | - Hidy Chan
- The Pharmacy Guild of Australia, Queensland Branch, Brisbane 4000, Australia;
| | - Laetitia H. Hattingh
- Gold Coast Campus, School of Pharmacy and Pharmacology, Griffith University, Southport 4215, Australia;
- Gold Coast Hospital and Health Service, Southport 4215, Australia
- Correspondence:
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10
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The pharmaceuticalisation of 'healthy' ageing: Testosterone enhancement for longevity. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 95:103159. [PMID: 33583680 DOI: 10.1016/j.drugpo.2021.103159] [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: 04/28/2020] [Revised: 12/08/2020] [Accepted: 02/02/2021] [Indexed: 12/15/2022]
Abstract
The United Nations estimates that the world's population will reach 8.5 billion by 2030, and the populations of most countries are expected to grow older. This is case for many developed countries, including Australia, the United Kingdom, Canada, the United States of America, and member states of the European Union. Older cohorts will comprise a larger proportion of overall populations, driven in part by our increases in life expectancy. An ageing population poses challenges for governments; notably, older people tend to have multiple, chronic health conditions which can place a burden of health budgets. At the same time, we are witnessing a shift in how we respond to the health needs of our populations, with global drug policy acknowledging that some substances are contributing to increased morbidity and mortality (e.g. opioids) while others may have beneficial therapeutic effects (e.g. psylocibin, cannabis). There is general agreement that as men age their levels of testosterone decrease, and there is some evidence to suggest that there have been population-level declines in testosterone which are not associated with age. Anecdotally, testosterone is accessed by men seeking to self-medicate in the belief that they are experiencing low testosterone levels. There has also been a rise in anti-ageing clinics in the United States, providing access to testosterone replacement therapy (TRT). The non-medical use of testosterone can result in a number of adverse health events, including complications from the use of black market or underground products. Placing testosterone under a new prescribing regime may address some of these concerns, but is society ready for this change, and if so, what would this regime look like? This paper will explore the issue of how society responds to enhancement for longevity, or how we increasingly use pharmaceuticals to address and prevent illness, with a specific focus on testosterone and testosterone deficiency.
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Piatkowski TM, White KM, Hides LM, Obst PL. Australia's Adonis: Understanding what motivates young men's lifestyle choices for enhancing their appearance. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12451] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Timothy M. Piatkowski
- School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
- Centre for Youth Substance Abuse Research, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Katherine M. White
- School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Leanne M. Hides
- Centre for Youth Substance Abuse Research, Queensland University of Technology, Brisbane, Queensland, Australia,
- Centre for Youth Substance Abuse Research, School of Psychology and Counselling, University of Queensland, Brisbane, Queensland, Australia,
| | - Patricia L. Obst
- School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
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12
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Hope VD, McVeigh J, Begley E, Glass R, Edmundson C, Heinsbroek E, Kean J, Campbell J, Whitfield M, Morgan G, Acreman D, Smith J. Factors associated with hepatitis C and HIV testing uptake among men who inject image and performance enhancing drugs. Drug Alcohol Rev 2020; 40:586-596. [PMID: 33164293 DOI: 10.1111/dar.13198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND AIMS Historically, people who inject image and performance enhancing drugs (IPED) were not perceived as being at high risk of HIV or hepatitis C virus (HCV) infection. However, recent studies indicate HCV and HIV prevalences are elevated, with many HCV infections undiagnosed. DESIGN AND METHODS Men who inject IPEDs recruited from community settings and specialist services, including needle-syringe programs, across UK during 2016 self-completed a questionnaire. Multivariate analyses examined factors associated with HCV/HIV testing. RESULTS The participants' (n=562; 24% service recruited) median age was 31 years, 4% identified as gay or bisexual, 18% had ever been imprisoned and 6% had ever injected a psychoactive drug. Those community recruited more often reported sharing drugs vials (16% vs. 8%, P=0.021) and, among those with 2+ sexual partners, poor condom use (50% vs. 36%, P=0.063), than those service recruited. Overall, one-third had ever been tested for HCV (31%) and/or HIV (34%). Testing uptake was associated with other risk factors for HCV/HIV, being recruited through services and having received metabolic tests. Participants' motivations for using IPEDs were associated with recruitment setting and HIV/HCV testing uptake. DISCUSSION AND CONCLUSIONS The majority were untested for HCV/HIV. HCV/HIV testing and risks were associated with recruitment through services. Previous needle and syringe program-based studies have potentially overestimated testing uptake and underestimated risk. Targeted interventions are needed, particularly for those not accessing services. The association between HCV/HIV testing uptake and receipt of metabolic tests suggests that developing a combined offer of these tests as part of health monitoring could improve uptake.
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Affiliation(s)
- Vivian D Hope
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - James McVeigh
- Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Emma Begley
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Rachel Glass
- National Infection Service, Public Health England, London, UK
| | | | | | - Joseph Kean
- NHS Greater Glasgow and Clyde, National Health Service Scotland, Glasgow, UK
| | | | - Mark Whitfield
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Gareth Morgan
- Commissioning Team, Cardiff and Vale University Health Board, Cardiff, UK
| | - Dean Acreman
- Substance Misuse Programme, Public Health Wales, Cardiff, UK
| | - Josie Smith
- Substance Misuse Programme, Public Health Wales, Cardiff, UK
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Hibbert MP, Brett CE, Porcellato LA, Hope VD. Image and performance enhancing drug use among men who have sex with men and women who have sex with women in the UK. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 95:102933. [PMID: 32912823 DOI: 10.1016/j.drugpo.2020.102933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/16/2020] [Accepted: 08/13/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of image and performance enhancing drugs (IPEDs) among men who have sex with men (MSM) and women who have sex with women (WSW) is rarely studied, with most of this research focused on anabolic androgenic steroid use among MSM. To address this gap, the extent of recent IPED use and the associated factors are explored in a community-recruited sample of MSM and WSW METHODS: Data from the UK LGBT Sex and Lifestyles Survey was used, which recruited through social-media advertising and community organisations (April-June 2018). Participants were asked if they had taken any IPEDs (e.g. anabolic steroids, growth hormone, hCG, Melanotan, non-prescribed diet pills) in the past 12 months. Factors associated with recent (in past 12 months) IPED use among MSM and WSW were investigated using stepwise binary logistic regression. RESULTS 1,658 MSM and 1,507 WSW were included in the analysis. Among MSM, 3.4% (n = 57) had recently taken IPEDs, 60% of those taking IPEDs had used psychoactive drugs. In the multivariable analysis, IPED use among MSM was associated with psychoactive drug use, Viagra use, higher body dissatisfaction, and lower sexual satisfaction. Among WSW, 4.1% (n = 62) had recently taken IPEDs, and 50% of those taking IPEDs had used psychoactive drugs. In the multivariable analysis, IPED use among WSW was associated with being aged 45 years and over, recent STI diagnosis, recent sexual contact without consent, and higher body dissatisfaction. CONCLUSION IPED use was reported by around 1-in-25 MSM and WSW, and was associated with a number of health and psychological problems. Research to better understand the drivers and impacts of IPED use among MSM and WSW, and how this compares to use among heterosexual people is needed.
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Affiliation(s)
- Matthew Peter Hibbert
- Public Health Institute, Liverpool John Moores University, Exchange Station, Liverpool, L2 2QP, United Kingdom.
| | - Caroline E Brett
- School of Natural Sciences and Psychology, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Lorna A Porcellato
- Public Health Institute, Liverpool John Moores University, Exchange Station, Liverpool, L2 2QP, United Kingdom
| | - Vivian D Hope
- Public Health Institute, Liverpool John Moores University, Exchange Station, Liverpool, L2 2QP, United Kingdom
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14
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Bates G, Van Hout MC, Teck JTW, McVeigh J. Treatments for people who use anabolic androgenic steroids: a scoping review. Harm Reduct J 2019; 16:75. [PMID: 31888665 PMCID: PMC6937954 DOI: 10.1186/s12954-019-0343-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems. METHODS A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. RESULTS In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided. CONCLUSION This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health- or drug-related journals, will support development of the evidence base.
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Affiliation(s)
- Geoff Bates
- Public Health Institute, Liverpool John Moores University, Liverpool, England
| | | | | | - Jim McVeigh
- Department of Sociology, Manchester Metropolitan University, Manchester, England
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15
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Fomiatti R, Lenton E, Latham JR, Fraser S, Moore D, Seear K, Aitken C. Maintaining the healthy body: Blood management and hepatitis C prevention among men who inject performance and image-enhancing drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 75:102592. [PMID: 31855731 DOI: 10.1016/j.drugpo.2019.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 10/21/2019] [Accepted: 10/27/2019] [Indexed: 12/11/2022]
Abstract
Australia's ambitious aim to 'eliminate' hepatitis C as a public health concern by 2030 requires researchers, policy makers and health practitioners to engage with populations rarely identified as a priority. Men who inject performance and image-enhancing drugs (PIEDs) are one such population, yet research suggests they have low rates of knowledge about hepatitis C. Although rates of needle-sharing in this group are thought to be low, other risks of blood-to-blood contact exist due to the use of large-gauge needles, intramuscular injecting, hard-to-reach injection sites, repeated injecting and peer-to-peer injecting. How should health initiatives engage people who might not customarily consider themselves vulnerable to hepatitis C? Drawing on the work of body theorist Margrit Shildrick, this article considers how men who inject PIEDs understand their bodies, with a particular focus on injecting practices, blood awareness and infection control, in order to inform hepatitis C prevention efforts. In our analysis, we draw on qualitative interviews with 60 men who inject PIEDs, which we conducted for an Australian Research Council-funded project focused on better understanding PIED injecting to improve health and minimise hepatitis C transmission. The interviews suggest that men who inject PIEDs closely monitor potential external infection risks, such as dirt and bacteria that might intrude upon the 'purity and security' of the body. However, less attention appears to be paid to what might be transferred out of the body and potentially to others, such as blood. Notions of trust and cleanliness, and normative perceptions of intravenous drug use, also shaped injecting practices and cursory attention to blood management. While environmental transmission poses a smaller transmission risk than needle-sharing, educating PIED consumers about it is nevertheless warranted. Focusing targeted health promotion materials on environmental blood as a potential route of hepatitis C transmission may help engage this population in prevention, and encourage more frequent hepatitis C testing.
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Affiliation(s)
- Renae Fomiatti
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia.
| | - Emily Lenton
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - J R Latham
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, Australia; School of Culture and Communication, University of Melbourne, Parkville, Australia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - David Moore
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Kate Seear
- National Drug Research Institute, Curtin University, Perth, Australia; Faculty of Law, Monash University, Clayton, Australia
| | - Campbell Aitken
- Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Australia
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16
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Steroid Madness- has the dark side of anabolic-androgenic steroids (AAS) been over-stated? ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.peh.2019.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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van de Ven K, Zahnow R, McVeigh J, Winstock A. The modes of administration of anabolic-androgenic steroid (AAS) users: are non-injecting people who use steroids overlooked? DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1608910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Katinka van de Ven
- Drug Policy Modelling Program, Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Renee Zahnow
- School of Social Science, University of Queensland, Brisbane, Australia
| | - Jim McVeigh
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Adam Winstock
- King’s College London, School of Medical Education, London, UK
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18
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Salinas M, Floodgate W, Ralphs R. Polydrug use and polydrug markets amongst image and performance enhancing drug users: Implications for harm reduction interventions and drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 67:43-51. [DOI: 10.1016/j.drugpo.2019.01.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/26/2018] [Accepted: 01/16/2019] [Indexed: 11/30/2022]
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19
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Corazza O, Simonato P, Demetrovics Z, Mooney R, van de Ven K, Roman-Urrestarazu A, Rácmolnár L, De Luca I, Cinosi E, Santacroce R, Marini M, Wellsted D, Sullivan K, Bersani G, Martinotti G. The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study. PLoS One 2019; 14:e0213060. [PMID: 30943200 PMCID: PMC6447162 DOI: 10.1371/journal.pone.0213060] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/15/2019] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements. METHODS A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements. RESULTS Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08). CONCLUSIONS This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals.
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Affiliation(s)
- Ornella Corazza
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Pierluigi Simonato
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Dual-Diagnosis Unit, Clinic Parco dei Tigli, Padova, Italy
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Roisin Mooney
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Katinka van de Ven
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Andres Roman-Urrestarazu
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
- Department of International Health, Maastricht University, Maastricht, Netherlands
| | - Lili Rácmolnár
- Department of Clinical Psychology and Addiction, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ilaria De Luca
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Eduardo Cinosi
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, United Kingdom
| | - Rita Santacroce
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging, and Clinical Science, University of Chieti Pescara, Chieti, Italy
| | - Massimo Marini
- Department of Psychiatry, University of Padua, Padua, Italy
| | - David Wellsted
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Keith Sullivan
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Giuseppe Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Giovanni Martinotti
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Neuroscience, Imaging, and Clinical Science, University of Chieti Pescara, Chieti, Italy
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