Attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common externalizing disorders. Despite previous research demonstrating that both are longitudinally associated with ...adverse outcomes, there have been no systematic reviews examining all of the available evidence linking ADHD and CD with a range of health and psychosocial outcomes.
Electronic databases (EMBASE, Medline, and PsycINFO) were searched for studies published from 1980 up to March 2015. Published cohort and case-control studies were included if they reported a longitudinal association between ADHD or CD and adverse outcomes with a minimum follow-up of 2 years. Outcomes with sufficient data were pooled in a random effects meta-analysis to give overall odds ratios (ORs) with corresponding 95% CIs.
Of the 278 studies assessed, 114 met inclusion criteria and 98 were used in subsequent meta-analyses. ADHD was associated with adverse outcomes including academic achievement (e.g. failure to complete high school; odds ratio OR = 3.7, 95% CIs 2.0-7.0), other mental and substance use disorders (e.g. depression; OR = 2.3, 1.5-3.7), criminality (e.g. arrest; OR = 2.4, 1.5-3.8), and employment (e.g., unemployment; OR = 2.0, 1.0-3.9). CD was associated with outcomes relating to academic achievement (e.g. failure to complete high school; OR = 2.7, 1.5-4.7), other mental and substance use disorders (e.g., illicit drug use; OR = 2.1, 1.7-2.6), and criminality (e.g. violence; OR = 3.5, 2.3-5.3).
This study demonstrated that ADHD and CD are associated with disability beyond immediate health loss. Although the analyses could not determine the mechanisms behind these longitudinal associations, they demonstrate the importance of addressing ADHD and CD early in life so as to potentially avert a wide range of future adverse outcomes.
The growing commercial interest in indoor location-based services (ILBS) has spurred recent development of many indoor positioning techniques. Due to the absence of Global Positioning System (GPS) ...signal, many other signals have been proposed for indoor usage. Among them, Wi-Fi (802.11) emerges as a promising one due to the pervasive deployment of wireless LANs (WLANs). In particular, Wi-Fi fingerprinting has been attracting much attention recently because it does not require line-of-sight measurement of access points (APs) and achieves high applicability in complex indoor environment. This survey overviews recent advances on two major areas of Wi-Fi fingerprint localization: advanced localization techniques and efficient system deployment. Regarding advanced techniques to localize users, we present how to make use of temporal or spatial signal patterns, user collaboration, and motion sensors. Regarding efficient system deployment, we discuss recent advances on reducing offline labor-intensive survey, adapting to fingerprint changes, calibrating heterogeneous devices for signal collection, and achieving energy efficiency for smartphones. We study and compare the approaches through our deployment experiences, and discuss some future directions.
Highlights • Mental health problems and other illicit drug use are associated with Butane Hash Oil (BHO) use. • BHO users were more likely to obtain their cannabis through prescription. • BHO is ...reported to have stronger negative effects than herbal cannabis.
Treatment of human immunodeficiency virus (HIV) infection involves a combination of several antiviral agents belonging to different pharmacological classes. This combination is referred to as highly ...active antiretroviral therapy (HAART). This treatment has proved to be very effective in suppressing HIV replication, but antiretroviral drugs have complex pharmacokinetic properties involving extensive drug metabolism and transport by membrane-associated drug carriers. Combination drug therapy often introduces complex drug–drug interactions that can result in toxic or sub-therapeutic drug concentrations, compromising treatment. This review focuses on the role of ATP-binding cassette (ABC) membrane-associated efflux transporters and solute carrier (SLC) uptake transporters in antiretroviral drug disposition, and identifies clinically important antiretroviral drug–drug interactions associated with changes in drug transport.
•There is a global shift towards cannabis legalization and underestimation of harms.•A systematic review meta-analysed the risk of cannabis use disorders (CUD) from use.•People who use cannabis have ...a 1 in 5 risk of developing a CUD.•Risks increase if cannabis is initiated early and used frequently.•The public needs to be informed about the risks of developing CUD from cannabis use.
We aim to quantify the prevalence and risk of having a cannabis use disorder (CUD), cannabis abuse (CA) or cannabis dependence (CD) among people in the general population who have used cannabis.
We conducted a systematic review of epidemiological cross-sectional and longitudinal studies on the prevalence and risks of CUDs among cannabis users. We identified studies published between 2009 and 2019 through PubMed, the Global Burden Disease (GBD) Database, and supplementary searches up to 2020. The outcomes of interest were CUDs based on DSM or ICD criteria. Estimates were synthesized using random-effects meta-analyses, followed by meta-regression of study characteristics on effect sizes.
From 1383 records identified, 21 studies were included. Meta-analyses showed that among people who used cannabis, 22% (18–26%) have CUD, 13% (8–18%) have CA, and 13% (10–15%) have CD. Estimates from cohort studies, showed that the risk of developing CD increased to 33% (22–44%) among young people who engaged in regular (weekly or daily) use of cannabis. There was a lack of data from cohort studies to estimate the risk of CUD or CA among regular cannabis users.
Cannabis users need to be informed about the risks of developing CUDs and the higher risks among those who initiate early and use frequently during adolescence. Future studies are needed to examine how changes in cannabis policies may affect the risks of CUDs in the population.
Aims
To estimate the treatment rate for alcohol use disorders (AUDs) in the general adult population. Treatment rates were also considered in relation to economic differences.
Methods
Systematic ...review and meta‐analysis. We searched PubMed, EMBASE, PsycINFO and CINAHL databases to identify studies that reported treatment rates for alcohol use disorders in the general population. Independent reviewers screened the articles based on predefined inclusion criteria. Data were extracted using a standardized data extraction form. We conducted quality assessments of the included studies. The overall treatment rates were estimated from studies that reported any treatment for AUDs from healthcare or informal non‐healthcare settings (any treatment). We estimated the separate treatment rates for each diagnostic category as reported in the primary studies: AUD as a single disorder, alcohol abuse and alcohol dependence. Data were pooled using a random‐effect model.
Results
Thirty‐two articles were included to estimate the treatment rates (percentage treated among the total number of people with AUDs). The pooled estimate of people with AUDs who received any treatment were 14.3% (95% CI: 9.3–20.3%) for alcohol abuse, 16.5% (95% CI: 12–21.5%) for alcohol dependence and 17.3% (95% CI: 12.8–22.3%) for AUD. A subgroup analysis by World Bank economic classification of countries found that the treatment rate for AUD was 9.3% (95% CI: 4.0–15.7%) in low and lower‐middle‐income countries.
Conclusion
Globally, approximately one in six people with AUDs receives treatment. Treatment rates for AUDs are generally low, with even lower rates in low and lower‐middle‐income countries.
Vaping products were initially designed to deliver nicotine as a tobacco cigarette substitute (eg, electronic cigarettes) but are now frequently used to deliver psychoactive substances, such as ...cannabis and its derivatives. Large, nationally representative surveys, such as Monitoring the Future, found that approximately 1 in 3 grade-12 students vaped cannabis in 2018 alone.
To summarize the findings of epidemiological studies that reported the global prevalence of cannabis vaping in adolescents by survey year and school grades.
PubMed, PsycINFO, Scopus, and Web of Science were searched systematically on August 19, 2020, for studies published globally between January 1, 2003, and August 19, 2020.
Publications that reported the prevalence of cannabis vaping in adolescents in the general population were included.
Study characteristics and prevalence estimates were extracted from each article. Random-effects meta-analysis based on the DerSimonian and Laird method and meta-regression were performed on lifetime, 12-month, and 30-day prevalence estimates. Meta-regression was also conducted using survey year and school grades as moderators.
Prevalence of cannabis vaping.
Seventeen studies met the eligibility criteria (n = 198 845 adolescents). Although no restrictions were imposed on study location, all 17 studies were from the US and Canada. Across all school grades, the pooled prevalence increased for lifetime use (6.1% in 2013-2016 to 13.6% in 2019-2020), use in the past 12 months (7.2% in 2017-2018 to 13.2% in 2019-2020), and use in the past 30 days (1.6% in 2013-2016 to 8.4% in 2019-2020). Heterogeneity across studies was large. The limited evidence from studies using similar survey and study designs suggested that adolescents' preference for cannabis products other than dried herbs, which usually contain higher Δ9-tetrahydrocannabinol levels, may have shifted over time.
The findings of this study suggest that the prevalence of cannabis vaping has increased among adolescents in the US and Canada and that more effective preventive and response measures are required.
PROSPERO Identifier: CRD42020219644.
Mental health services are advocated to move from specialized care to more integrated and accessible primary care settings. The integration of mental health into primary health services is expanding ...in Ethiopia. However, there is a lack of research on the perspectives of health professionals on mental health services in Ethiopia. This study aimed to explore the perspectives, views, and experiences of health professionals regarding mental health services and the help-seeking behavior of people with mental illness in Northwest Ethiopia.
This qualitative study included sixteen health professionals. The participants were interviewed using a semi-structured interview guide. Interviews were conducted in Amharic and translated into English. We analyzed the data using reflexive thematic analysis.
Five key themes were generated from the interview data: (1) Avoidance of mental healthcare; (2) Low literacy about mental illness; (3) Stigma as a hindrance to accessing mental health services; (4) The role of culture and religion in mental health services; and (5) Lack of government concern about mental health services.
This study identified important factors related to mental health services in Northwest Ethiopia, from the perspectives of health professionals. Our findings highlighted that the government health agenda needs to prioritize mental health services. The role of religious and cultural healing places in the help-seeking pathway should be given due consideration to ensure success in mental health services provision and utilization.
Background and Aims
Studies have consistently found a longitudinal association between e‐cigarette use (vaping) and cigarette smoking. Many have interpreted such association as causal. This ...systematic review and meta‐analysis evaluated the plausibility of a causal interpretation by (1) estimating the effect of adolescent vaping on smoking initiation, adjusted for study quality characteristics, (2) evaluating the sufficiency of adjustment for confounding based on the social development model (SDM) and the social ecological model (SEM) and E‐value analyses and (3) investigating sample attrition and publication bias.
Methods
Systematic review and meta‐analysis of longitudinal studies that examined the association between e‐cigarette use at baseline and smoking at follow‐up. Participants were non‐smokers aged < 18 at baseline.
Results
Meta‐analysis of 11 studies showed a significant longitudinal association between vaping and smoking adjusted odds ratio (aOR) = 2.93, 95% confidence interval (CI) = 2.22, 3.87. Studies with sample sizes < 1000 had a significantly higher odds ratio (OR = 6.68, 95% CI = 3.63, 12.31) than studies with sample sizes > 1000 (OR = 2.49, 95% CI = 1.97, 3.15). Overall, the attrition rate was very high (median = 30%). All but one study reported results from complete sample analysis, despite those dropping out having higher risk profiles. Only two studies comprehensively adjusted for confounding. The median E‐value was 2.90, indicating that the estimates were not robust against unmeasured confounding.
Conclusions
There is a longitudinal association between adolescent vaping and smoking initiation; however, the evidence is limited by publication bias, high sample attrition and inadequate adjustment for potential confounders.
IntroductionThe rising popularity of TikTok among adolescents may influence their awareness and perceptions of e-cigarette use via user-generated content. This study aimed to examine how ...e-cigarette/vaping-related videos are portrayed on TikTok.MethodsThe nine most viewed hashtag based keywords were used to identify popular e-cigarette/vaping-related videos on TikTok (n=1000) from its inception (earliest upload date: January 2019) to November 2020. Five researchers independently coded the number of views, likes, user category and theme.ResultsA final sample of 808 e-cigarette/vaping-related videos that met study criteria were included. Collectively, these videos were viewed over 1.5 billion times, with a median view count of 1 000 000 (range 112 900–78 600 000) and a median ‘likes’ count of 143 000 (range 10 000–1 000 000). A majority of the videos portrayed e-cigarette use positively (63%; collectively viewed over 1.1 billion times). Neutral depictions of e-cigarette use were viewed a total of 290 million times (24%) and negative depictions of e-cigarettes were viewed a total of 193 million times (13%). The video themes included (not mutually exclusively): ‘comedy and joke’ (52%; total of 618 million views), ‘lifestyle and acceptability’ (35%; 459 million), ‘marketing’ (29%; 392 million), ‘vaping tricks’ (20%; 487 million), ‘nicotine and addiction’ (20%; 194 million), ‘creativity’ (16%; 322 million) and ‘warning’ (11%; 131 million).ConclusionOur findings illustrated that positively framed e-cigarette and vaping-related postings available without age restrictions on TikTok—a rising video-sharing platform that is popular among adolescents—have been viewed many times. Effective age restrictions are needed to reduce adolescents’ potential exposure to videos that portray vaping positively.
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