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101. Loneliness and its association with social media use during the COVID-19 outbreak

Author: Hilde Thygesen, Mary C. Ruffolo, Mariyana Schoultz, Tore Bonsaksen, Amy Østertun Geirdal, Daicia Price, and Janni Leung
Subjects: Cultural Studies, Coronavirus disease 2019 (COVID-19), L900, Social distancing, P900, 050105 experimental psychology, medicine, 0501 psychology and cognitive sciences, Social media, Sociology, Association (psychology), Pandemics, Communication, Social distance, 05 social sciences, Communication. Mass media, 050301 education, Outbreak, Loneliness, Creative commons, P87-96, Computer Science Applications, C800, Coronavirus, Cross-national studies, medicine.symptom, Attribution, 0503 education, Social psychology
Abstract: Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution Social distancing rules during the COVID-19 pandemic changed social interaction for many and increased the risk of loneliness in the general population. Social media use has been ambiguously related to loneliness, and associations may differ by age. The study aimed to examine loneliness and its association with social media use within different age groups during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, the United Kingdom, the United States, and Australia during April/May 2020, and 3,810 participants aged 18 years or above were recruited. Multiple regression analyses were conducted to examine associations between social media use and social and emotional loneliness within separate age groups. Emotional loneliness was higher among young adults and among those who used social media several times daily. Adjusting by sociodemographic variables, using more types of social media was associated with lower social loneliness among the oldest participants, and with higher emotional loneliness among the youngest participants. Among middle-aged participants, using social media more frequently was associated with lower social loneliness. We found that the associations between social media use and loneliness varied by age. Older people’s engagement on social media may be a resource to reduce loneliness during the COVID-19 pandemic. We observed higher levels of loneliness among high-frequent social media users of younger age.
Published: 2021

102. Treatment trajectories for alcohol use disorder: Where is the gap?

Author: Leanne Hides, Tesfa Mekonen, Gary C. K. Chan, Janni Leung, and Jason P. Connor
Subjects: medicine.medical_specialty, business.industry, Medicine (miscellaneous), Alcohol use disorder, Toxicology, medicine.disease, Article, Psychiatry and Mental health, Alcoholism, mental disorders, medicine, Humans, Psychiatry, business
Abstract: BACKGROUND: Although effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care for persons with AUD. METHODS: Using 2015–2019 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) adult prevalence of AUD; 2) proportion of adults with AUD who utilized health care in the past 12 months; 3) proportion with AUD screened about their alcohol use; 4) proportion with AUD who received a brief intervention about their alcohol misuse; 5) proportion with AUD who received information about treatment for alcohol misuse; and 6) proportion with AUD who received treatment. Analyses were stratified by AUD severity. RESULTS: Of the 214,505 persons included in the sample, weighted prevalence of AUD was 7.8% (95% CI 7.6–8.0%). Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but only a minority received subsequent steps of care: 81.4% (95% CI 80.7%−82.1%) of persons with AUD utilized health care in the past 12 months and 69.9% (95% CI 68.9–70.8%) reported being screened about alcohol use, but 11.6% (95% CI 11.0–12.2%) reported receiving a brief intervention, 5.1% (95% CI 4.6–5.6%) were referred to treatment, and 5.8% (95% CI 5.4–6.3%) received treatment. Similar patterns were observed when cascades of care were stratified by AUD severity. CONCLUSIONS: Persons with AUD utilize health care and are screened about alcohol use with high prevalence, but few receive treatment. Health care settings- particularly primary care settings- represent a prime opportunity to implement AUD treatment to improve outcomes in this high-risk population.
Published: 2021

103. Mental Health, Information and Being Connected: Qualitative Experiences of Social Media Use during the COVID-19 Pandemic from a Trans-National Sample

Author: Daicia Price, Tore Bonsaksen, Mary C. Ruffolo, Amy Østertun Geirdal, Hilde Thygesen, Mariyana Schoultz, and Janni Leung
Subjects: Coping (psychology), cross-sectional, Leadership and Management, media_common.quotation_subject, L300, P900, social media, Population, Health Informatics, B300, Anger, B700, Article, 03 medical and health sciences, 0302 clinical medicine, Health Information Management, Trans-national studies, medicine, loneliness, Social media, Social medias, 030212 general & internal medicine, education, Pandemics, P100, media_common, education.field_of_study, Loneliness, Health Policy, Social distance, pandemic, COVID-19, Mental health, behavioral_sciences_other, trans-national, B900, Medicine, Cross-sectional surveys, Thematic analysis, medicine.symptom, Psychology, Social psychology, 030217 neurology & neurosurgery, mental health
Abstract: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.
Published: 2021

104. Did the under-reporting of meth/amphetamine use increase in a general population survey in Australia as negative media coverage increased?

Author: Benjamin Johnson, Wayne Hall, Gary Chan, Janni Leung, Daniel Stjepanović, Tianze Sun, Brienna Rutherford, and Carmen Lim
Subjects: Male, Psychiatry and Mental health, Amphetamine, Cross-Sectional Studies, Amphetamine-Related Disorders, Australia, Medicine (miscellaneous), Humans, Female, Middle Aged, Aged, Methamphetamine
Abstract: To test (1) if there was a change in self-reported lifetime prevalence of meth/amphetamine use by birth cohort and (2) if the extent of under-reporting of meth/amphetamine use was associated with the proportion of the population who nominated meth/amphetamine as a drug problem.Observational study using seven waves of repeated cross-sectional nationally representative household surveys between 2001 and 2019.Australia.Participants were from three birth cohorts: 1951-60 (age 68-77 at the 2019 survey; n = 29 458; 55% female), 1961-1970 (age 58-67; n = 29 859; 57% female) and 1971-1980 (age 48-57; n = 28 758; 59% female). Data were weighted to align the sample to the Australian population.Past year meth/amphetamine use; under-reporting of lifetime meth/amphetamine use in each birth cohort, year and survey stratum (operationalised as the difference between self-reported lifetime prevalence in 2001 and that of each subsequent year); proportion of the population who nominated meth/amphetamine as a drug problem in each birth cohort, year and survey stratum. Under-reporting was regressed on the proportion of people holding negative attitude towards meth/amphetamine. Survey year and birth cohort were adjusted for.Between 2001 and 2019, the lifetime prevalence of meth/amphetamine decreased from 6.1% (95% CI = 5.3-6.9) to 1.7% (95% CI = 1.2-2.2) in the 1951-1960 birth cohort (p 0.001), from 13.0% (95% CI = 12.0-14.1) to 4.4% (95% CI = 3.7-5.2) in the 1961-1970 birth cohort (p 0.001) and from 21.4% (95% CI = 19.9-22.9) to 11.2% (95% CI = 10.0-12.4) in the 1971-1980 birth cohort (p 0.001). The proportion who nominated meth/amphetamine as a 'drug problem' increased significantly in all three cohorts (all p 0.001) and the degree of under-reporting of meth/amphetamine use was significantly associated with proportion of people who nominated meth/amphetamine as the 'drug problem' (b = 0.09, SE = 0.01, p 0.001).In Australia, the actual prevalence of lifetime meth/amphetamine use may be two- to fourfold higher than that estimated in the most recent national household surveys (2019). The level of under-reporting is strongly associated with increasing negative attitudes towards methylamphetamine and d-amphetamine use over the same period.
Published: 2021

105. Estimating the global treatment rates for depression: A systematic review and meta-analysis

Author: Jason P. Connor, Tesfa Mekonen, Janni Leung, Leanne Hides, and Gary C. K. Chan
Subjects: Adult, business.industry, Depression, Adult population, CINAHL, PsycINFO, Confidence interval, Help-seeking, Psychiatry and Mental health, Clinical Psychology, Meta-analysis, Health care, Income, Prevalence, Medicine, Humans, business, Depression (differential diagnoses), Demography
Abstract: Background Depression is considered a global crisis due to its high prevalence and associated disabilities. The burden posed by depression could be reduced by increasing access to timely treatment. Limited information is available on treatment rates of depression, particularly in low- and middle-income countries. This study aimed to estimate the treatment rates for depression in the general adult population by World Bank income classification. Methods We searched PubMed, EMBASE, PsycINFO, and CINAHL, supplemented with hand-search of reference lists to identify community-based studies. The overall treatment rate for depression was estimated from studies that reported any treatment (behavioral or pharmacological treatments) in healthcare or informal non-healthcare settings. Data were pooled using a random-effects meta-analysis model. Subgroup analyses by income classification were completed. Meta-regression was conducted by study characteristics. The protocol was pre-registered at PROSPERO (CRD42020161683). Results We included 65 studies comprising 1.1 million participants from 79 countries and territories. The global 12-month/lifetime pooled treatment rate was 34.8% (95% confidence interval: 29.9, 39.9%). The treatment rates were 48.3% (43.0, 53.6%) in high-income countries, 21.4% (15.1, 27.7%) in middle-income countries, and 16.8% (11.3, 23.0%) in low-income countries. Among the treated samples, 12-month minimally adequate treatment was estimated to be 40%. Limitation We reported a substantial level of between-study heterogeneity, which was partially explained by study characteristics in the meta-regression. Conclusion Globally, approximately one-third of people with depression receive treatment. Three in five treated people with depression did not receive minimally adequate treatment. Depression treatment rates are considerably lower in low-and middle-income countries.
Published: 2021

106. Has increased youth e-cigarette use in the USA, between 2014 and 2020, changed conventional smoking behaviors, future intentions to smoke and perceived smoking harms?

Author: Jason P. Connor, Wayne Hall, Gary C. K. Chan, Carmen C.W. Lim, Coral Gartner, Daniel Stjepanović, Tianze Sun, and Janni Leung
Subjects: Adolescent, Medicine (miscellaneous), Cigarette use, Intention, Smoking prevalence, Electronic Nicotine Delivery Systems, Toxicology, law.invention, Smoking behavior, Cigarette smoking, law, Smoke, Surveys and Questionnaires, Tobacco, Medicine, Humans, Multinomial logistic regression, business.industry, Vaping, Smoking, United States, Psychiatry and Mental health, Clinical Psychology, Cross-Sectional Studies, Monitoring the Future, business, Electronic cigarette, Demography
Abstract: Introduction An increase in electronic cigarette (EC) use among US youth has raised concerns that their use may increase conventional cigarette smoking. Methods Repeated cross-sectional data from two large nationally representative samples of US youth were drawn from the National Youth Tobacco Survey (NYTS) and Monitoring the Future (MTF). Students from grade 6–12 of the NYTS (N = 98,454–132,003) and students from grade 12 of the MTF (N = 17,870–30,981) were included in the analyses. Trends in smoking behavior, intention to smoke in the future and perceived smoking harms among youth who do and do not use ECs were estimated from 2014 to 2020 using weighted multinomial logistic regression and predicted marginal probabilities. Results The prevalence for regular smoking decreased among youth who regularly use ECs. For example, among regular EC users, smoking prevalence decreased from 27.8% to 6.7% (−21%; 99.67% CI:[−32.3%, −9.9%]) in the NYTS between 2014 and 2020 and from 31.8% to 10.6% (−21.2%, 99.67% CI:[−35.0%, −7.3%]) in the MTF between 2014 and 2018. Intent to smoke in the future and perceiving smoking as harmless decreased or remained unchanged during the same period. For example, among regular EC users, there was no significant change in intention to smoke next year in the NYTS between 2014 and 2018; intention to smoke in the next 5 years decreased significantly from 30.7% to 11.2% (−19.5%, 99.67% CI:[−37.7%, −1.3%]) in the MTF. Conclusions In two national samples of US youth, smoking prevalence declined by a sizeable relative percentage. Intent to smoke in the future and harm perceptions of smoking declined or remained unchanged while EC use increased. Results provide little evidence that EC use has increased conventional cigarette smoking among youth.
Published: 2021

107. The New Frontier of Esports and Gaming: A Scoping Meta-Review of Health Impacts and Research Agenda

Author: Janni Leung and Sarah Kelly
Subjects: Video gaming, lcsh:Sports, Mini Review, Applied psychology, ComputingMilieux_PERSONALCOMPUTING, Context (language use), Cognition, health, Health outcomes, Meta review, Popularity, 03 medical and health sciences, Frontier, lcsh:GV557-1198.995, 0302 clinical medicine, eSports, Sports and Active Living, video gaming, well-being, Well-being, 030212 general & internal medicine, Psychology, meta-review, human activities, 030217 neurology & neurosurgery
Abstract: Given the rapid evolution of the gaming industry and the rising popularity of a hyper-connected, competitive esports version of online gaming, a meta-review of the impact of online competitive gaming upon health is timely. A scoping meta-review was conducted on 10 reviews that reported on any health consequences (physical, lifestyle, cognitive, mental, or social) of esports, online competitive gaming, or video gaming participation, as a player or spectator. While past reviews have examined health effects of video gaming, few have focused upon the newly evolved gaming context, incorporating both playing and streamed viewing, recognition as a professional sport, and potential career and exponential participation. Most past reviews have focused upon physical health impacts of video gaming among adolescents and young adults, but none have examined impacts of different forms of gaming participation in the new gaming era, and their potential differential health impacts. A scoping meta-review was undertaken on the physical, social, and psychological health outcomes of competitive online gaming and associated screen use, revealing a need for further review and research into lifestyle health outcomes including diet and sedentary behavior among young esports and competitive video gaming participants.
Published: 2021

108. Loneliness and Its Associated Factors Nine Months After the COVID-19 Outbreak: A Cross-National Study

Author: Hilde Thygesen, Mary C. Ruffolo, Mariyana Schoultz, Amy Østertun Geirdal, Daicia Price, Janni Leung, and Tore Bonsaksen
Subjects: Gerontology, L900, Cross-sectional study, Health, Toxicology and Mutagenesis, coronavirus, lcsh:Medicine, Factor IX, 0302 clinical medicine, Health care, 030212 general & internal medicine, media_common, Norway, Social distance, social distancing, Loneliness, concerns, Scale (social sciences), Concerns, medicine.symptom, Risk assessment, Psychology, cross-national study, Social distancing, social media, media_common.quotation_subject, Affect (psychology), Article, 03 medical and health sciences, Perception, medicine, Humans, Social media, Social medias, Pandemics, SARS-CoV-2, business.industry, pandemic, allergology, lcsh:R, Public Health, Environmental and Occupational Health, Australia, COVID-19, C800, Coronavirus, Cross-national studies, Cross-Sectional Studies, business, 030217 neurology & neurosurgery
Abstract: This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY). COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local “social distancing” policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.
Published: 2021

109. Cannabis and Childhood Development

Author: Danielle Dawson, Editor, Janni Leung, Editor, Danielle Dawson, Editor, and Janni Leung, Editor
Subjects: Cannabis--Health aspects, Fetus--Effect of drugs on, Child development
Abstract: This book highlights empirical evidence on the impact of cannabis on childhood development, from infancy up to young adulthood. With the global movement of more relaxed policies and attitudes towards cannabis use, it is important to understand the risks associated with cannabis on youth development. Bridging the gap between knowledge communications and research literature, this volume translates scientific evidence to highlight the consequences of cannabis exposure on young people's lives. Based on academic research literature, it summarizes and critically analyses a large body of scientific evidence to evaluate developmental outcomes from birth to young adulthood on physical, social, and mental health. It will appeal to students and academics, as well as policy makers, psychologists, medical professionals, and epidemiologists in the broader academic community with an interest in the topic.
Published: 2023

110. Prevalence and self-reported reasons of cannabis use for medical purposes in USA and Canada

Author: Janni Leung, Gary Chan, Daniel Stjepanović, Jack Yiu Chak Chung, Wayne Hall, and David Hammond
Subjects: Pharmacology, Cannabinoid Receptor Agonists, Analgesics, Canada, Young Adult, Hallucinogens, Prevalence, Humans, Medical Marijuana, Self Report, Cannabis
Abstract: Rationale There has been increasing attention on cannabis use for medical purposes, but there is currently a lack of data on its epidemiology. Objectives To examine the epidemiology of self-reported cannabis use for medical purposes by (1) estimating its prevalence, (2) comparing gender and age differences, and (3) investigating what reasons they were used to manage. Methods Participants included 27,169 respondents (aged 16–65) who completed Wave 1 of The International Cannabis Policy Study (ICPS) conducted across Canada and the USA in 2018 via online surveys. Cannabis policy conditions were “US legal–recreational” (legal for both recreational and medical uses), “US legal–medical only”, “US illegal”, and “Canada–medical only”. Results The overall prevalence of self-reported ever cannabis use for medical purposes was 27%, with similar rates by sex and the highest prevalence in young adults. Prevalence was higher in US legal–recreational states (34%) than US illegal states (23%), US legal–medical only states (25%), and Canada (25%). The most common physical health reasons include use to manage pain (53%), sleep (46%), headaches/migraines (35%), appetite (22%), and nausea/vomiting (21%). For mental health reasons, the most common were for anxiety (52%), depression (40%), and PTSD/trauma (17%). There were 11% who reported using cannabis for managing other drug or alcohol use and 4% for psychosis. Conclusions A substantial proportion of the North American population self-reported cannabis use for medical purposes for a variety of medical reasons, including those living in jurisdictions without legal markets. Further research is needed to understand the safety and efficacy of these forms of medical cannabis use.
Published: 2021

111. Age-related trends in cannabis use in Australia. Findings from a series of large nationally representative surveys

Author: Vivian Chiu, Wayne Hall, Tianze Sun, Janni Leung, Gary C. K. Chan, and Jason P. Connor
Subjects: Series (stratigraphy), business.industry, media_common.quotation_subject, Australia, Medicine (miscellaneous), Abstinence, Cannabis use, Toxicology, Psychiatry and Mental health, Clinical Psychology, Household survey, Logistic Models, Age groups, Age related, Surveys and Questionnaires, Prevalence, Medicine, Humans, business, Older people, media_common, Demography, Multinomial logistic regression, Aged, Cannabis
Abstract: We examine age-related trends in past-year cannabis use in a series of nationally representative surveys in Australia.We analysed data from the largest nationally representative survey in Australia collected between 2001 and 2019 (National Drug Strategy Household Survey [NDSHS]; N = 157,151). Prevalence of past-year daily/occasional (non-daily)/non-use of cannabis use were estimated using weighted multinomial logistic regression and predicted marginal probabilities. Difference-in-difference analysis was used to examine if trends of cannabis use across age groups were different.The youngest age group (14-17 s) witnessed the largest increase in past-year abstinence rate from 79% to 92% from 2001 to 2019 (p .003); the increase in abstinent rate among the 18-24 and 25-39 were relatively moderate (from 68 to 76% and from 81% to 84% respectively; p .003). The abstinent rate among the 40-54 s and 55-74 s decreased significantly from 93% to 90% and from 99% to 95% respectively (p .003). There were similar diverging trends in occasional and daily cannabis use, with decreases in both patterns of use observed among the younger age group (14-17 s and 18-25 s) but increases among the older age group (40-54 s and 55-74 s).There is a diverging trend in cannabis use among younger and older age groups in Australia between 2001 and 2019. Cannabis use substantially decreased among the youngest age group (14-17 s) but modestly increased among older people (55-74 s).
Published: 2021

112. What is the untreated remission or natural recovery rate of people with depression? A systematic review and meta-analysis

Author: Gary C. K. Chan, Leanne Hides, Janni Leung, Sarah Ford, and Tesfa Mekonen
Subjects: Pediatrics, medicine.medical_specialty, Moderate depression, business.industry, Meta-analysis, medicine, Natural recovery, Spontaneous remission, PsycINFO, business, Methodological quality, Depression (differential diagnoses), Disease burden
Abstract: Background: Depression is the leading cause of disease burden globally and most of the people with this illness left untreated. Remission without treatment may occur in some cases of depression. The aim of this study was to estimate the spontaneous remission (natural recovery) of people from this untreated depression. Methods: Systematic review, conducted in accordance with PRISMA guidelines and registered on PROSPERO, CRD42020198773. We have used two-steps approach searching EMBASE, PsycINFO, and PubMed supplemented with additional relevant sources to identify studies reporting natural recovery from untreated depression. First, we systematically searched for existing reviews and then we conducted a search for original studies. Study selection and screening were carried out by three independent reviewers. Methodological quality assessment of the included studies was conducted. The data were synthesized using narrative summary and random-effects meta-analysis. Results: From 2,574 identified unique records, 16 studies were included in the systematic review and meta-analysis fulfilling the eligibility criteria. Most of the included studies were randomized waitlist control trials. The overall pooled remission from untreated depression (natural recovery) was 22.6% within widely varied follow-up duration ranged from one month to six years. The remission was 11.4% within three months of follow-up period and 49.2% within six months or more duration. Conclusions: Remission within a short untreated period is not common where 1 in 10 people may be remitted within 3 months duration of untreated depression. Interpretation of the result should be considered with caution as the data from waitlist controls may represent mild or moderate depression.
Published: 2021
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113. Concerns over the spread of misinformation and fake news on social media – challenges amid the coronavirus pandemic

Author: Vivian Chiu, Amy Østertun Geirdal, Tore Bonsaksen, Hilde Thygesen, Janni Leung, Daicia Price, Mary C. Ruffolo, and Mariyana Schoultz
Subjects: L900, business.industry, G400, P900, Internet privacy, medicine.disease_cause, Mental health, B900, Political science, Pandemic, medicine, Social media, Fake news, Misinformation, business, Coronavirus
Abstract: IntroductionThe unfolding pandemic of COVID-19, also known as coronavirus, has caused challenges across the globe. Shelter-in-place, lock-down, and social distancing policies increased the use of social media for societies to stay connected. This study investigated psychological issues societies experienced from using social media among community during this critical period.MethodsCross-sectional online surveys were used to collect qualitative data from 1991 respondents living in the UK, USA and Australia during April-May 2020 when shelter-in-place or stay-at-home policies were in place.ResultsConcerns over misinformation, conspiracy theories, and fake news were repetitively raised as a critical challenge associated with reports of negative psychological consequences during the COVID-19 pandemic. Overall, 1 in 3 respondent expressed concerns over misinformation as the key challenge, with higher prevalence among respondents from the USA (41) than UK (35) and Australia (32), χ2(2)=8.5, p=0.015. While some thought social media had facilitated social connections, others said that differing opinions from friends and families have put stress on relationships and created negative psychology. Conflicting information (including information from government bodies, news outlets, information articles and individual opinions) have caused additional stress and anxiety.ConclusionsThe spread of misinformation, fake news, and conspiracy theories have caused psychosocial challenges and disconnections in the community. Special attention is needed to address psychological issues caused by the spread of misinformation on social media during the crisis.
Published: 2021

114. Parent-Child Connectedness and its Association with alcohol, tobacco, and cannabis use among Argentinian Adolescents

Author: Tesfa Mekonen, Janni Leung, and Kaiwen Thompson
Subjects: biology, Social connectedness, Polysubstance dependence, Psychological intervention, Cannabis, Cannabis use, biology.organism_classification, Association (psychology), Psychology, Latent class model, Demography, Multinomial logistic regression
Abstract: Background: In research predominantly from Western countries, studies have been identifying links of parental and peer influences towards adolescent substance use. Evidence from countries that may differ in parental-child relationships across different cultures is limited, e.g. in Argentina, where the prevalence of adolescent substance use is high. Therefore, the objective of this study was to assess the association between parent-child connectedness and substance use among Argentinian adolescents using the Global School-based student Health Survey (GSHS). Methods: We analyzed the 2012 Global School-based student Health Survey of 28,368 Argentinian adolescents aged 11 – 17 years. The GSHS is a self-administered survey asking students about the use of substances (alcohol, cigarette smoking, and cannabis), demographic variables, and social and psychological factors. Latent class analyses were conducted to identify patterns of polysubstance use. Associations between parent-child connectedness and polysubstance latent classes were assessed using multinomial logistic regression after adjusting for other factors. Results: Latent class analysis identified three classes. The first class (67% of the sample) comprised of mainly nonsubstance users and mild alcohol users. The second class (13%) included mainly moderate alcohol/tobacco/cannabis users. The third class (20%) was made up of mainly moderate alcohol/tobacco users and non-cannabis users. Lower parental connectedness was associated with a higher likelihood of polysubstance use (classified as either class 2 or 3) (aOR = 2.49; 95% CI: 2.24, 2.76). Conclusion: Parental connectedness is an important factor when concerning Argentinian adolescent alcohol, tobacco, and cannabis use and should be the focus of interventions to prevent substance-related burden among adolescents.
Published: 2021
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115. Psychological distress and the experience of self-restrained lifestyle through COVID-19 in Japan – public insights from #Coronavirus-depression on Twitter

Author: Hisateru Tachimori, Carmen C.W. Lim, Vivian Chiu, Yan Huo, and Janni Leung
Subjects: medicine.medical_specialty, Crying, media_common.quotation_subject, Mental health, Distress, Feeling, medicine, Anxiety, Social media, Social isolation, medicine.symptom, Psychology, Psychiatry, Depression (differential diagnoses), media_common
Abstract: In Japan, lockdowns were imposed in April 2020 to combat the spread of COVID-19. Many Japanese citizens have taken their mental health concerns to Twitter, a social media platform with 45 million monthly Japanese users. This study investigates the themes of tweets related to mental health during the COVID-19 lockdown period. We analysed the themes of tweets (n = 1734) collected in May 2020 using the #corona-depression [#コロナうつ] trending hashtag in Japan. Tweets were classified into four main themes: i) feeling depressed, as expected (41%), ii) anxiety/fears (17%), iii) lifestyle issues (46%), and iv) positivity (15%). In theme I, over 2/3 were about the loss of sleep/not getting out of bed. Others tweeted about crying (5%) loss of interest in activities or energy (18%), and suicidality (10%), all of which corresponded with symptoms in the Diagnostic and Statistical Manual of Mental Disorders. Among the tweets about frustration in lifestyle consequences, many (64%) expressed distress due to social isolation and the restrained lifestyle. Essential workers were fearful of being exposed to infection (13%), while others expressed distress from the loss of employment (11%). Housewives expressed the increased burden (e.g., home-schooling) with comments of being burn-out (11%). Despite the situation, some users used the platform to provide/gain support by sharing advice for staying positive (15%). Pandemics and lockdowns have significant mental health impacts on the community. Continue monitoring is needed to determine whether these effects are temporary or long-term.
Published: 2021
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116. Trends and Associates of Non-Medical Prescription Opioid Use in Australia

Author: Vivian Chiu, Kaitlyn Harper, and Janni Leung
Subjects: medicine.medical_specialty, business.industry, Opioid use, Family medicine, Medicine, Medical prescription, business
Published: 2021
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117. High times for cannabis-related videos on YouTube during the COVID-19 lockdown: implications on the risk of cannabis use disorders

Author: Carmen C.W. Lim, Tianze Sun, Janni Leung, and Gary C. K. Chan
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), biology, medicine, Cannabis, Cannabis use, Psychiatry, Psychology, biology.organism_classification
Published: 2021
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118. Panic buying behavior analysis of COVID-19 related toilet paper hoarding content on Twitter

Author: Vivian Chiu, Calvert Tisdale, Jack Yiu Chak Chung, Janni Leung, Carmen C.W. Lim, and Gary C. K. Chan
Subjects: Coronavirus disease 2019 (COVID-19), Hoarding, Toilet paper, Panic buying, Content (Freudian dream analysis), Psychology, Social psychology
Published: 2021
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119. Long-Term Conditions in Older People are Linked with Loneliness, but a Sense of Coherence Buffers the Adverse Effects on Quality of Life: A Cross-Sectional Study

Author: Neil J Angus, Janni Leung, Iain Atherton, Hugo Cornelis van Woerden, and Vasiliki Kiparoglou
Subjects: education.field_of_study, loneliness, social loneliness, disability, rurality, quality of life, Cross-sectional study, Journal of Multidisciplinary Healthcare, Population, Loneliness, General Medicine, Interaction, Quality of life (healthcare), Rurality, disability, quality of life, loneliness, medicine, social loneliness, Analysis of variance, medicine.symptom, Psychology, education, Adverse effect, General Nursing, Original Research, rurality, Demography
Abstract: Hugo C van Woerden,1,2 Neil Angus,2 Vasiliki Kiparoglou,3 Iain Atherton,4 Janni Leung5 1University of the Highlands and Islands, Centre for Health Science, Inverness, IV2 3JH, UK; 2Ulster University, Coleraine, County Londonderry, BT52 1SA, Northern Ireland, UK; 3National Institute of Health Research Oxford Biomedical Research Centre, Unipart House Business Centre, Oxford, OX4 2PG, UK; 4Edinburgh Napier University, Edinburgh, EH11 4BN, UK; 5University of Queensland, St Lucia, QLD, 4067, AustraliaCorrespondence: Hugo C van Woerden Email Hugo.VanWoerden@uhi.ac.ukBackground: The impact of disability, long-term conditions, rurality, living alone, and being a carer on health has some evidence base, but the extent to which a strong sense of coherence (SoC), a factor hypothesised to promote wellbeing, may moderate these associations is unknown. A model of physical, environmental and social factors on quality of life was tested, with particular emphasis on whether a strong SoC buffered (mitigated) these determinants of quality of life.Material and Methods: A cross-sectional postal survey was undertaken of a random sample of 1471 respondents aged over 65 years, across a population of rural individuals. Physical, environmental, and psychological variables were assessed against quality of life using ANOVA and a generalised linear model including the interaction effects of SoC.Results: ANOVA demonstrated that age, gender, long-term conditions or disability (LTC-D), living alone, > 20 hours unpaid care for others per week, SoC, and loneliness, were associated with lower quality of life (p< 0.01). There were strong correlations (p> 0.01), between age and LTC-D, living alone, and poor SoC. Living alone was correlated with emotional and social loneliness; but those with higher SoC were less likely to experience loneliness. In an adjusted generalised linear model, significant associations with a lower quality of life were observed from: LTC-D, emotional loneliness and social loneliness (B= â 0.44, â 0.30, and â 0.39, respectively, all p< 0.001). The only interaction with SoC that was statistically significant (at p< 0.05) was LTC-D. A stronger sense of coherence buffered the negative effects of long-term condition/disability on quality of life.Discussion: The physical, environmental and social factors examined, identified LTC-D and loneliness to be the strongest factors associated with poor quality of life.Conclusion: SoC somewhat buffered the adverse effect of LTC-D on quality of life, but did not do so for loneliness.Keywords: loneliness, social loneliness, disability, rurality, quality of life
Published: 2021

120. Video-based communication and its association with loneliness, mental health and quality of life among older people during the COVID-19 outbreak

Author: Mary C. Ruffolo, Mariyana Schoultz, Tore Bonsaksen, Hilde Thygesen, Janni Leung, Amy Østertun Geirdal, and Daicia Price
Subjects: Gerontology, cross-national study, Coronavirus disease 2019 (COVID-19), Social distancing, Cross-sectional study, Health, Toxicology and Mutagenesis, coronavirus, Article, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), medicine, Humans, 030212 general & internal medicine, Association (psychology), physical distancing, Pandemics, Aged, Pandemic, Norway, SARS-CoV-2, Communication, Loneliness, allergology, Social distance, pandemic, Australia, Public Health, Environmental and Occupational Health, social distancing, COVID-19, Outbreak, Mental health, psychological outcomes, B900, Coronavirus, Physical distancing, Cross-Sectional Studies, Mental Health, Cross-national studies, Psychological outcomes, Quality of Life, Medicine, medicine.symptom, Older people, Psychology, 030217 neurology & neurosurgery
Abstract: The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60–69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between the use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60–69 years (60.1%), compared to participants aged 70 or above (51.8%, p &lt, 0.05). Adjusting for all variables, the use of video-based communication was associated with less loneliness (β = −0.12, p &lt, 0.01) and higher quality of life (β = 0.14, p &lt, 0.01) among participants aged 60–69 years, while no associations were observed for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between the use of video-based communication tools and psychological outcomes amongst older people.
Published: 2021

121. Mental health, quality of life, wellbeing, loneliness and use of social media in a time of social distancing during the COVID-19 outbreak. A cross-country comparative study

Author: Mary C. Ruffolo, Mariyana Schoultz, Tore Bonsaksen, Janni Leung, Hilde Thygesen, Amy Østertun Geirdal, and Daicia Price
Subjects: Male, Cross-sectional study, P900, coronavirus, Developmental psychology, 0302 clinical medicine, 030212 general & internal medicine, comparative study, Aged, 80 and over, Norway, Wellbeing, Social distance, Loneliness, General Medicine, Middle Aged, Psychiatry and Mental health, Mental Health, Female, Mental health, medicine.symptom, Psychology, Adult, Adolescent, Social distancing, social media, Physical Distancing, Context (language use), 03 medical and health sciences, Young Adult, Quality of life (healthcare), medicine, Humans, Social media, Life qualities, Aged, SARS-CoV-2, Australia, COVID-19, United Kingdom, United States, 030227 psychiatry, C800, Comparative studies, B900, Cross-Sectional Studies, quality of life, Quality of Life, Social Media
Abstract: Background\ud The COVID-19 outbreak raised questions about how people experience their mental health, quality of life (QoL), wellbeing and loneliness in the context of social distancing, and the use of social media during this time\ud \ud Aims\ud To examine the experience of mental health, QoL, wellbeing and loneliness and use of social media among people living in Norway, USA, UK and Australia.\ud \ud Methods\ud A cross-country comparative survey of people living in Norway, USA, UK and Australia. Relevant statistical analyses were used to examine differences between the countries and to explore associations between demographic, mental health and psychosocial variables and use of social media.\ud \ud Results\ud There were 3810 respondents from four countries, of which 50 − 74% showed a high level of emotional distress. The Norwegian population reported significantly better mental health, QoL and wellbeing and lower levels of loneliness compared to the other countries. High-frequent use of social media after the COVID-19 outbreak was associated with poorer mental- and psychosocial health.\ud \ud Conclusions\ud The results suggest that the COVID-19 outbreak took a toll on people’s experience of mental health, QoL, wellbeing and experienced loneliness, and high-frequent use of social media was associated with these factors.
Published: 2021

122. Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019

Author: Mohsen Naghavi, Saman Esmaeilnejad, Irena Ilic, Chhabi Lal Ranabhat, Hubert Amu, Jalil Jaafari, Walter Mendoza, Yanzhong Wang, Atta Abbas Naqvi, Mahesh P A, Afshin Maleki, Songhomitra Panda-Jonas, Akila Prashant, Jessica Y Islam, Ali H. Mokdad, Rahmatollah Moradzadeh, Roman Shrestha, Muhammad Naveed, Andre M. N. Renzaho, Santi Martini, Reza Rawassizadeh, Chisom Joyqueenet Akunna, Tudorel Andrei, Jason A. Anderson, Martin McKee, Iffat Elbarazi, Golnaz Heidari, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Davood Anvari, Randah R. Hamadeh, G. K. Mini, Emerito Jose A. Faraon, Farhad Islami, Yasir Waheed, Fahad Alanezi, Maciej Banach, Sheikh Mohammed Shariful Islam, Ismaeel Yunusa, Suresh Mehata, Tarun Gupta, Mavra A Riaz, Derrick A Bennett, Nithin Kumar, Ali Soroush, Kurt Straif, Muhammad Aziz Rahman, Hasan Yusefzadeh, Avirup Guha, Catalina Liliana Andrei, Muhammed Shahriar Zaman, Arief Hargono, Sandhya Neupane Kandel, Adam E. Berman, Giulia Carreras, Ali Bijani, Christoph Nowak, Rafael Alves Guimarães, Aziz Sheikh, Kamal Hezam, Carlo Eduardo Medina-Solís, Simon I. Hay, Deborah Carvalho Malta, Rahman Shiri, Ashok Pandey, Ramesh Holla, Gyu Ri Kim, Aidin Abedi, Sharath Burugina Nagaraja, Andem Effiong, Samad Azari, Bhaskar Thakur, Mohsen Mazidi, Vahid Yazdi-Feyzabadi, Prashant Mathur, Bay Vo, Robert Ancuceanu, Eun-Kee Park, Mehdi Fazlzadeh, Thomas Hsiao, Richard G Pestell, Sindhura Lakshmi Koulmane Laxminarayana, Doo Woong Lee, Bayew Kelkay, Erkin M. Mirrakhimov, Hualiang Lin, Mohsen Bayati, Florian Fischer, Wei Liu, Stefan Stortecky, Javad Nazari, Fatemeh Pashazadeh Kan, Virginia Núñez-Samudio, Nitish Naik, Sreenivas Narasimha Swamy, Rajat Gupta, Rakhi Dandona, Hermann Brenner, Chandrashekhar T Sreeramareddy, Mohammad Ali Mansournia, Yuichiro Yano, Pankaj Bhardwaj, Samath D Dharmaratne, Constantine I. Vardavas, Gabriela Fernanda Gil, Azeem Majeed, Akram Pourshams, Nachimuthu Senthil Kumar, Florentino Luciano Caetano dos Santos, Juan Sanabria, Iván Landires, Parkes J Kendrick, Dinh-Toi Chu, Asma Tahir Awan, Khem Narayan Pokhrel, Siddharudha Shivalli, Omid Shafaat, Shankar Prasad Nagaraju, Manu Raj Mathur, Rachel L Updike, Mohammad Ebrahimi Kalan, Ryan David Kennedy, Alessandra Lugo, Olalekan A. Uthman, Tarek Tawfik Amin, Jiregna Darega Gela, Zhi-Jiang Zhang, Yeshambel T. Nigatu, Bedanta Roy, Arielle Wilder Eagan, Jalal Arabloo, Milena Ilic, Mehdi Hosseinzadeh, Jost B. Jonas, Dian Kusuma, Shahrzad Bazargan-Hejazi, Yo Han Lee, Mohammed Shannawaz, Mohammad Ali Moni, Valery L. Feigin, Himal Kandel, Lalit Dandona, Milena Santric-Milicevic, Jasvinder A. Singh, Till Bärnighausen, Neeraj Bhala, Sara Sheikhbahaei, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayana Manjunatha, Giuseppe Gorini, Saif Ullah, Sheikh M. Alif, Giang Thu Vu, Ai Koyanagi, Mahaveer Golechha, Ingan Ukur Tarigan, Sumaira Mubarik, Naohiro Yonemoto, Ahmad Ghashghaee, Yves Miel H Zuniga, Bach Xuan Tran, Sorin Hostiuc, Catherine P. Benziger, Ritesh G. Menezes, Leonardo Roever, Xiaochen Dai, Meghnath Dhimal, Medhat Farwati, Chenwen Zhong, Seyed Sina Naghibi Irvani, G Anil Kumar, Jaya Prasad Tripathy, Amirhossein Sahebkar, Simiao Chen, Zubair Kabir, Meseret Derbew Molla, Tilahun Ali, Animut Tagele Tamiru, Negussie Boti Sidemo, Monika Sawhney, Bright Opoku Ahinkorah, Ruxandra Irina Negoi, Segun Emmanuel Ibitoye, Vin Gupta, Mona Pathak, Lorenzo Monasta, Andrew T Olagunju, Nermin Ghith, Nuwan Darshana Wickramasinghe, Kazumasa Yamagishi, Virendra Singh, Takahiro Tabuchi, Gholamreza Roshandel, Andre R. Brunoni, Hayley D. Tymeson, Madhur Verma, Eyayou Girma Tadesse, Adrian Pana, Isabela M. Benseñor, Abdullah Al Mamun, Jianrong Zhang, Hai Quang Pham, Mihaela Hostiuc, Sung-In Jang, Vinay Nangia, Luca Ronfani, Rizwan Suliankatchi Abdulkader, Dhirendra N Sinha, Josip Car, Sohail Ahmad, Rekha Thapar, Salman Rawaf, Joanna L Whisnant, Sanjay Basu, Abdallah M. Samy, Michal Grivna, Zahid A Butt, Abera Getachew Obsa, Mahdi Nalini, Ted R. Miller, Sanjeev Misra, Utsav Parekh, Budi Aji, Saeed Amini, João Pedro Silva, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Demosthenes B. Panagiotakos, Baye Dagnew, Yousef Khader, Atif Amin Baig, Habib Benzian, Keivan Ahmadi, Marco Vacante, Brijesh Sathian, Akshaya Srikanth Bhagavathula, Savita Lasrado, Maryam Khayamzadeh, Darshan B B, Mohammad Rifat Haider, Yonas Akalu, Irmina Maria Michalek, Simone Vidale, Getie Lake Aynalem, Rosa A. S. Couto, Yigizie Yeshaw, Syed Mohamed Aljunid, Pradhum Ram, Shrikant Pawar, Kevin Welding, Suzanne Barker-Collo, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Hiba Jawdat Barqawi, Marcos Roberto Tovani-Palone, K M Shivakumar, Gebiyaw Wudie Tsegaye, Fares Alahdab, Vafa Rahimi-Movaghar, Om P Kurmi, Nataliya Foigt, André Karch, Marina Pinheiro, Basema Saddik, Paschalis Steiropoulos, Chuanhua Yu, Graeme J. Hankey, Panniyammakal Jeemon, Abdul-Aziz Seidu, Ramaiah Itumalla, Befikadu Legesse Wubishet, Vera Marisa Costa, Shanshan Li, Ambrish Singh, Yuming Guo, Reza Malekzadeh, Nikha Bhardwaj, Mikhail Sergeevich Zastrozhin, Maryam Zamanian, Onyema greg Chido-Amajuoyi, Ibtihal Fadhil, Sabina O Nduaguba, Turki Alanzi, Eun-Cheol Park, Nicholas Arian, Salah Eddin Karimi, Parnaz Daneshpajouhnejad, Minale Tareke, Paramjit Gill, Chukwudi A Nnaji, Haroon Ahmed, Irina Filip, Juwel Rana, Aziz Rezapour, Huong Lan Thi Nguyen, Ashish Badiye, Kewal Krishan, Nima Hafezi-Nejad, Masood Ali Shaikh, Tanuj Kanchan, Shilpashree Madhava Kunjathur, Reza Ghanei Gheshlagh, Thomas R. Hird, Yousef Mohammad, Soraya Siabani, Falk Schwendicke, Ziyad Al-Aly, Desta Debalkie Atnafu, Krittika Bhattacharyya, Mika Kivimäki, Ayodipupo Sikiru Oguntade, Zabihollah Yousefi, Neeti Kapoor, Syed Mahboob Shah, Kavumpurathu Raman Thankappan, Mika Shigematsu, Ben Lacey, Ireneous N. Soyiri, Amir Radfar, Lemma Getacher, Sameer Vali Gopalani, David Laith Rawaf, Amir Masoud Rahmani, Birhan Gebresillassie Gebregiorgis, Morenike Oluwatoyin Folayan, Salime Goharinezhad, Ambuj Roy, Ruth W Kimokoti, Nuworza Kugbey, Getinet Ayano, Mohammad Hifz Ur Rahman, Benny Antony, Katrin Burkart, Christopher J L Murray, Khalid F. AlHabib, Mariam Molokhia, Mansour Ghafourifard, Abebaw Alemayehu Desta, Tariku Tesfaye Bekuma, Shailesh Advani, Kiomars Sharafi, Kurnia Dwi Artanti, E S Abhilash, Ejaz Ahmad Khan, Sana Salehi, Dan J. Stein, Pankaj Chaturvedi, Mahmoud A. Alomari, Kawkab Shishani, Dejana Braithwaite, Jung-Chen Chang, Rajeev Gupta, Giovanni Damiani, Maha El Tantawi, Maria Sofia Sofia Cattaruzza, Amir Abdoli, Narayanaswamy Venketasubramanian, Rakibul M Islam, Ibrahim Abdelmageed Ginawi, Victor Aboyans, Ganesh Kumar Saya, Silvano Gallus, João Mauricio Castaldelli-Maia, Vardhmaan Jain, Masoud Foroutan, Janni Leung, Mohammad Abdollahi, Mohammed Zewdu Yimmer, Vahid Alipour, Wondwossen Niguse Asmare, Ravi Prakash Jha, Gerhard Sulo, Brigid Unim, Sheng-Chia Chung, Sadaf G. Sepanlou, Hamed Mirzaei, Anna Aleksandrovna Skryabina, In-Hwan Oh, Rannveig Sigurvinsdottir, Oladimeji Adebayo, Farshad Farzadfar, Anasthasia Zastrozhina, Shafiu Mohammed, Johan Sundström, Ali Kabir, Paolo Lauriola, Tilahun Belete Mossie, Sadia Bibi, Bartosz Miazgowski, Erin C Mullany, Keyvan Pakshir, Srikanta Banerjee, Mowafa Househ, Mohamed M. Gad, Leila R Kalankesh, Mikk Jürisson, Ismail Tareque, Albertino Damasceno, Musliu Adetola Tolani, Andrea Werdecker, Shane D. Morrison, Inga Dora Sigfusdottir, Marcel Ausloos, Monika Arora, Marissa B Reitsma, Filippos Filippidis, Biniyam Sahiledengle Geberemariyam, Bruno Piassi Sao Jose, Leeberk Raja Inbaraj, Antonio Biondi, Mohsen Abbasi-Kangevari, Junjie Huang, Mohammad Mahdi Zamani, Jean Jacques Noubiap, Emmanuela Gakidou, Valentin Yurievich Skryabin, Mayowa O. Owolabi, Shubha Jayaram, Hiroyasu Iso, Charles Ugochukwu Ibeneme, Molly R Nixon, Rachel Feldman, Liliana G Ciobanu, Kristina Edvardsson, Claudiu Herteliu, Andreea Mirica, Kindie Mitiku Kebede, Department of Public Health, Collaborators, GBD 2019 Chewing Tobacco, and Lacey, B
Subjects: Male, Health Status, Smoking Prevention, DETERMINANTS, Global Health, 01 natural sciences, Global Burden of Disease, SMOKELESS TOBACCO, 0302 clinical medicine, Risk Factors, Global health, Prevalence, 030212 general & internal medicine, 610 Medicine & health, RISK, High prevalence, WOMEN, Public Health, Global Health, Social Medicine and Epidemiology, Articles, Middle Aged, 3142 Public health care science, environmental and occupational health, Chewing tobacco, Smokeless tobacco, Population Surveillance, A990 Medicine and Dentistry not elsewhere classified, Female, Quality-Adjusted Life Years, Burden of disease, Adult, medicine.medical_specialty, Tobacco, Smokeless, Adolescent, WHO Framework Convention on Tobacco Control, VALIDATION, 03 medical and health sciences, Young Adult, Age Distribution, SDG 3 - Good Health and Well-being, Environmental health, medicine, Humans, 0101 mathematics, Sex Distribution, Chewing tobacco, Prevalence, Global Burden, Smokeless tobacco, business.industry, Public health, Smoking Tobacco, 010102 general mathematics, Public Health, Environmental and Occupational Health, Global Burden, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, STATES, Socioeconomic Factors, Smoking Cessation, business
Abstract: Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. For complete list of authors see http://dx.doi.org/10.1016/S2468-2667(21)00065-7
Published: 2021
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123. Anxiety and Panic Buying Behaviour during COVID-19 Pandemic—A Qualitative Analysis of Toilet Paper Hoarding Contents on Twitter

Author: Vivian Chiu, Jack Yiu Chak Chung, Carmen C.W. Lim, Gary C. K. Chan, Calvert Tisdale, and Janni Leung
Subjects: Health, Toxicology and Mutagenesis, media_common.quotation_subject, social media, lcsh:Medicine, Panic buying, Hoarding, Anger, Anxiety, Article, Infodemiology, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Social media, 030212 general & internal medicine, snowball effect, Pandemics, Consumer behaviour, media_common, Sarcasm, pandemic, lcsh:R, Public Health, Environmental and Occupational Health, Panic, COVID-19, Consumer Behavior, psychological phenomena, Bathroom Equipment, medicine.symptom, Psychology, panic buying, Social psychology, 030217 neurology & neurosurgery
Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic had increased population-level anxiety and had elicited panic buying behaviour across the world. The over-hoarding of toilet paper has received a lot of negative public attention. In this work, we used Twitter data to qualitatively analyse tweets related to panic buying of toilet paper during the crisis. Methods: A total of 255,171 tweets were collected. Of these 4,081 met our inclusion criteria and 100 tweets were randomly selected to develop a coding scheme in the initial phase. Random samples of tweets in folds of 100 were then qualitatively analysed in the focused coding phase until saturation was met at 500 tweets analysed. Results: Five key themes emerged: (1) humour or sarcasm, (2) marketing or profiteering, (3) opinion and emotions, (4) personal experience, and (5) support or information. About half of the tweets carried negative sentiments, expressing anger or frustration towards the deficiency of toilet paper and the frantic situation of toilet paper hoarding, which were among the most influential tweets. Discussion: Panic buying of toilet paper was seen during the 2020 pandemic period with a mass amount of related content spread across social media. The spontaneous contagion of fear and panic through social media could fuel psychological reactions in midst of crises. The high level of negative social media posts regarding the toilet paper crisis acts as an emotional trigger of public anxiety and panic. Conclusions: Social media data can provide rapid infodemiology of public mental health. In a pandemic or crisis situation, real-time data could be monitored and content-analysed for authorities to promptly address public concerns.
Published: 2021

124. Perceived trust in public authorities nine months after the COVID-19 outbreak: A cross-national study

Author: Hilde Thygesen, Janni Leung, Tore Bonsaksen, Vivian Chiu, Amy Østertun Geirdal, Mary C. Ruffolo, Mariyana Schoultz, and Daicia Price
Subjects: cross-national study, Coronavirus disease 2019 (COVID-19), social media, L300, coronavirus, accounting, Social Sciences, Logistic regression, Trust, public authorities, B800, Public authorities, A900, Pandemic, Social media, Social medias, Socioeconomics, Pandemics, pandemic, General Social Sciences, Outbreak, trust, Coronavirus, B900, Geography, Cross-national studies, Residence, Psychology, Cross national, Demography
Abstract: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited This study aimed to examine the perceived trust in information provided by public authorities and financial measures put in place to address the impact of COVID-19. Using a cross-national approach among four Western countries—the United States of America, Norway, Australia, and the United Kingdom—provides an analysis of responses related to trust and how they were associated with age group, gender, education level, employment status, size of place of residence, infection status, and social media use. When controlling for all included variables in logistic regression analyses, the likelihood of having trust in the public authorities’ information was higher for women, those with higher levels of education, and those living in urban areas. Being infected with the coronavirus, and spending more time daily on social media, were both associated with lower likelihood of reporting trust in information. Although policies implemented to respond to economic concerns varied cross-nationally, higher age, identifying as female, being employed, living in a city, no COVID-19 infection experience and lower levels of social media usage were associated with a higher likelihood of trusting in the financial measures put in place to counteract the economic effects of COVID-19
Published: 2021

125. Employment Uncertainty and Mental Health during the COVID-19 Pandemic Initial Social Distancing Implementation: A Cross-national study

Author: Mary C. Ruffolo, Tore Bonsaksen, Mariyana Schoultz, Hilde Thygesen, Daicia Price, Amy Østertun Geirdal, and Janni Leung
Subjects: Gerontology, Employment, medicine.medical_specialty, L900, Sociology and Political Science, Social distancing, Article, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), 030225 pediatrics, medicine, 030212 general & internal medicine, Social work, Social distance, Public health, COVID-19, Loneliness, Mental health, C800, Economic uncertainty, B900, Coronavirus, Distress, medicine.symptom, Psychology, Psychosocial, Economic uncertainties
Abstract: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Background Social distancing during the COVID-19 pandemic has resulted in changes in the work environment and employment uncertainty. This paper reports on a cross-national comparison of four countries (Norway, UK, USA and Australia) and examines the differences in mental health between those individuals employed and those not employed during the social distancing implementation. Methods Participants (N = 3,810) were recruited through social media in April/May 2020 and were invited to complete a self-administered electronic survey over a 3-week period. Differences between those employed and those not employed with regard to their sociodemographic characteristics and mental health were investigated with chi-square tests, independent t tests, and one-way analysis of variances (ANOVAs). Results Compared with their counterparts, participants who were employed reported lower levels of mental health distress (p
Published: 2021

126. Public health impacts to date of the legalisation of medical and recreational cannabis use in the USA

Author: Louisa Degenhardt, Vivian Chiu, Daniel Stjepanović, Wayne Hall, and Janni Leung
Subjects: 0301 basic medicine, Adult, medicine.medical_specialty, Adolescent, Poison control, Medical Marijuana, Suicide prevention, Occupational safety and health, 03 medical and health sciences, Cellular and Molecular Neuroscience, 0302 clinical medicine, Environmental health, Recreational Drug Use, Injury prevention, Medicine, Humans, Recreation, Cannabis, Pharmacology, biology, business.industry, Public health, Human factors and ergonomics, biology.organism_classification, Legislation, Drug, United States, 030104 developmental biology, Public Opinion, Drug and Narcotic Control, Public Health, business, 030217 neurology & neurosurgery
Abstract: The legality of cannabis use has been changing in a number of jurisdictions around the world. In the U.S., it has been legalised for medicinal and/or recreational uses in 34 jurisdictions and counting. This study leverages the decades-long experience of legalisation in the U.S. to provide an overview of the associated changes in public attitudes, cannabis markets and adverse health effects. We found a broad-based warming of public attitudes toward legalisation, potentially influenced by the increasingly positive portrayal of cannabis in media and declines in cannabis risk perceptions. Potency of cannabis products increased significantly while prices fell sharply. Although adults were less responsive to price changes than adolescents, adults who use cannabis regularly were sensitive to prices, with an estimated 10% price reduction leading to about 2.5% increase in the rate of use. Overall, past-year cannabis use has increased in adults since 2002, and adults over 26 years old who resided in states with medicinal cannabis laws were more likely to have used cannabis in the past 30 days, to have used daily, and to have higher rates of cannabis use disorders than adults who resided in states without legalised medicinal cannabis. Traffic fatalities involving cannabis temporarily increased in some states post-legalisation, and there were more presentations to medical services related to chronic regular cannabis use. There is suggestive evidence that adverse health consequences have increased among people who use cannabis regularly since legalisation. More robust research is needed to determine whether these effects of legalisation are temporary or long-term.
Published: 2020

127. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Soufiane Boufous, Yousef Veisani, Mehran Asadi-Aliabadi, Sharath Burugina Nagaraja, Maziar Moradi-Lakeh, Getachew Mullu Kassa, Edward J Mills, Dimas Ria Angga Pribadi, William James Dangel, Mohamad-Hani Temsah, Catherine O. Johnson, Gregory A. Roth, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Alberto Ortiz, Samad Azari, Assefa Ayalew Ayalew Ayalew Gebreslassie, Salime Goharinezhad, Stephanie R. M. Zimsen, Peng Zheng, Michael Assmus, Elisabetta Pupillo, Bach Xuan Tran, Lal B. Rawal, Narayanaswamy Venketasubramanian, Noushin Mohammadifard, Stephen S Lim, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Suzanne Lyn Barker-Collo, Leah E. Cahill, Tauseef Ahmad, Platon D. Lopukhov, Kazumasa Yamagishi, Abdullah Al Mamun, Iqbal R. F. Elyazar, Giovanni Damiani, Mohammad Hossein Bakhshaei, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Alyssa Pennini, Dietrich Plass, Atkilt Esaiyas Etisso, Gebre Teklemariam Demoz, Alexandrea Watson, Arvin Haj-Mirzaian, Paul S Briant, Frank B. Osei, Blair R. Bumgarner, Maciej Banach, Ravensara S. Travillian, Kai-Lan Chang, Shirin Djalalinia, Hasan Yusefzadeh, Silvano Gallus, Seyyed Meysam Mousavi, Bernhard T. Baune, Aaron van Donkelaar, Azeem Majeed, Hans Kromhout, Robert Ancuceanu, Blessing J. Akombi, Pushpendra Singh, Nayu Ikeda, William M. Gardner, Zahid A Butt, Mohammad Abdollahi, Temesgen Yihunie Akalu, Rahman Shiri, Benn Sartorius, Ai-Min Wu, Bing Fang Hwang, Flavia M. Cicuttini, Hiroyasu Iso, Luis Camera, Amin Soheili, Félix Carvalho, Yun Jin Kim, Caleb Mackay Salpeter Irvine, Mehdi Mirzaei-Alavijeh, Iman Halvaei, Saqib Ali, Giulio Castelpietra, Catalina Liliana Andrei, Ali Kazemi Karyani, Parkes J Kendrick, Hamidreza Haririan, Lucas Guimarães Abreu, Mukhammad David Naimzada, Jeff T. 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Postma, Chhabi Lal Ranabhat, Jalil Jaafari, Walter Mendoza, Mahesh P A, Pallab K. Maulik, Ali H. Mokdad, Andre M. N. Renzaho, Milena Santric-Milicevic, Parvaiz A Koul, Foad Abd-Allah, Mihaela Hostiuc, Richard G. Cowden, Ronny Westerman, Meghdad Pirsaheb, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Tampere University, Tays Research Services, Health Sciences, Murray, C. J. L., Aravkin, A. Y., Zheng, P., Abbafati, C., Abbas, K. M., Abbasi-Kangevari, M., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abegaz, K. H., Abolhassani, H., Aboyans, V., Abreu, L. G., Abrigo, M. R. M., Abualhasan, A., Abu-Raddad, L. J., Abushouk, A. I., Adabi, M., Adekanmbi, V., Adeoye, A. M., Adetokunboh, O. O., Adham, D., Advani, S. M., Agarwal, G., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Ahmadi, K., Ahmadi, M., Ahmadieh, H., Ahmed, M. B., Akalu, T. Y., Akinyemi, R. O., Akinyemiju, T., Akombi, B., Akunna, C. J., Alahdab, F., Al-Aly, Z., Alam, K., Alam, S., Alam, T., Alanezi, F. M., Alanzi, T. M., Alemu, B. W., Alhabib, K. F., Ali, M., Ali, S., Alicandro, G., Alinia, C., Alipour, V., Alizade, H., Aljunid, S. M., Alla, F., Allebeck, P., Almasi-Hashiani, A., Al-Mekhlafi, H. M., Alonso, J., Altirkawi, K. A., Amini-Rarani, M., Amiri, F., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Anderson, J. A., Andrei, C. L., Andrei, T., Angus, C., Anjomshoa, M., Ansari, F., Ansari-Moghaddam, A., Antonazzo, I. C., Antonio, C. A. T., Antony, C. M., Antriyandarti, E., Anvari, D., Anwer, R., Appiah, S. C. Y., Arabloo, J., Arab-Zozani, M., Ariani, F., Armoon, B., Arnlov, J., Arzani, A., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Ashbaugh, C., Assmus, M., Atafar, Z., Atnafu, D. D., Atout, M. M. W., Ausloos, F., Ausloos, M., Ayala Quintanilla, B. P., Ayano, G., Ayanore, M. A., Azari, S., Azarian, G., Azene, Z. N., Badawi, A., Badiye, A. D., Bahrami, M. A., Bakhshaei, M. H., Bakhtiari, A., Bakkannavar, S. M., Baldasseroni, A., Ball, K., Ballew, S. H., Balzi, D., Banach, M., Banerjee, S. K., Bante, A. B., Baraki, A. G., Barker-Collo, S. L., Barnighausen, T. W., Barrero, L. H., Barthelemy, C. M., Barua, L., Basu, S., Baune, B. T., Bayati, M., Becker, J. S., Bedi, N., Beghi, E., Bejot, Y., Bell, M. L., Bennitt, F. B., Bensenor, I. M., Berhe, K., Berman, A. E., Bhagavathula, A. S., Bhageerathy, R., Bhala, N., Bhandari, D., Bhattacharyya, K., Bhutta, Z. A., Bijani, A., Bikbov, B., Bin Sayeed, M. S., Biondi, A., Birihane, B. M., Bisignano, C., Biswas, R. K., Bitew, H., Bohlouli, S., Bohluli, M., Boon-Dooley, A. S., Borges, G., Borzi, A. M., Borzouei, S., Bosetti, C., Boufous, S., Braithwaite, D., Breitborde, N. J. K., Breitner, S., Brenner, H., Briant, P. S., Briko, A. N., Briko, N. I., Britton, G. B., Bryazka, D., Bumgarner, B. R., Burkart, K., Burnett, R. T., Burugina Nagaraja, S., Butt, Z. A., Caetano dos Santos, F. L., Cahill, L. E., Camera, L. L. A., Campos-Nonato, I. R., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Castro, F., Causey, K., Cederroth, C. R., Cercy, K. M., Cerin, E., Chandan, J. S., Chang, K. -L., Charlson, F. J., Chattu, V. K., Chaturvedi, S., Cherbuin, N., Chimed-Ochir, O., Cho, D. Y., Choi, J. -Y. J., Christensen, H., Chu, D. -T., Chung, M. T., Chung, S. -C., Cicuttini, F. M., Ciobanu, L. G., Cirillo, M., Classen, T. K. D., Cohen, A. J., Compton, K., Cooper, O. R., Costa, V. M., Cousin, E., Cowden, R. G., Cross, D. H., Cruz, J. A., Dahlawi, S. M. A., Damasceno, A. A. M., Damiani, G., Dandona, L., Dandona, R., Dangel, W. J., Danielsson, A. -K., Dargan, P. I., Darwesh, A. M., Daryani, A., Das, J. K., Das Gupta, R., das Neves, J., Davila-Cervantes, C. A., Davitoiu, D. V., De Leo, D., Degenhardt, L., Delang, M., Dellavalle, R. P., Demeke, F. M., Demoz, G. T., Demsie, D. G., Denova-Gutierrez, E., Dervenis, N., Dhungana, G. P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Dibaji Forooshani, Z. S., Djalalinia, S., Do, H. T., Dokova, K., Dorostkar, F., Doshmangir, L., Driscoll, T. R., Duncan, B. B., Duraes, A. R., Eagan, A. W., Edvardsson, D., El Nahas, N., El Sayed, I., El Tantawi, M., Elbarazi, I., Elgendy, I. Y., El-Jaafary, S. I., Elyazar, I. R., Emmons-Bell, S., Erskine, H. E., Eskandarieh, S., Esmaeilnejad, S., Esteghamati, A., Estep, K., Etemadi, A., Etisso, A. E., Fanzo, J., Farahmand, M., Fareed, M., Faridnia, R., Farioli, A., Faro, A., Faruque, M., Farzadfar, F., Fattahi, N., Fazlzadeh, M., Feigin, V. L., Feldman, R., Fereshtehnejad, S. -M., Fernandes, E., Ferrara, G., Ferrari, A. J., Ferreira, M. L., Filip, I., Fischer, F., Fisher, J. L., Flor, L. S., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Force, L. M., Foroutan, M., Franklin, R. C., Freitas, M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gakidou, E., Gallus, S., Garcia-Basteiro, A. L., Gardner, W. M., Geberemariyam, B. S., Gebreslassie, A. A. A. A., Geremew, A., Gershberg Hayoon, A., Gething, P. W., Ghadimi, M., Ghadiri, K., Ghaffarifar, F., Ghafourifard, M., Ghamari, F., Ghashghaee, A., Ghiasvand, H., Ghith, N., Gholamian, A., Ghosh, R., Gill, P. S., Ginindza, T. G. G., Giussani, G., Gnedovskaya, E. V., Goharinezhad, S., Gopalani, S. V., Gorini, G., Goudarzi, H., Goulart, A. C., Greaves, F., Grivna, M., Grosso, G., Gubari, M. I. M., Gugnani, H. C., Guimaraes, R. A., Guled, R. A., Guo, G., Guo, Y., Gupta, R., Gupta, T., Haddock, B., Hafezi-Nejad, N., Hafiz, A., Haj-Mirzaian, A., Hall, B. J., Halvaei, I., Hamadeh, R. R., Hamidi, S., Hammer, M. S., Hankey, G. J., Haririan, H., Haro, J. M., Hasaballah, A. I., Hasan, M. M., Hasanpoor, E., Hashi, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, S. I., Hayat, K., Heidari, G., Heidari-Soureshjani, R., Henrikson, H. J., Herbert, M. E., Herteliu, C., Heydarpour, F., Hird, T. R., Hoek, H. W., Holla, R., Hoogar, P., Hosgood, H. D., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsairi, M., Hsieh, V. C. -R., Hu, G., Hu, K., Huda, T. M., Humayun, A., Huynh, C. K., Hwang, B. -F., Iannucci, V. C., Ibitoye, S. E., Ikeda, N., Ikuta, K. S., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Inbaraj, L. R., Ippolito, H., Iqbal, U., Irvani, S. S. N., Irvine, C. M. S., Islam, M. M., Islam, S. M. S., Iso, H., Ivers, R. Q., Iwu, C. C. D., Iwu, C. J., Iyamu, I. O., Jaafari, J., Jacobsen, K. H., Jafari, H., Jafarinia, M., Jahani, M. A., Jakovljevic, M., Jalilian, F., James, S. L., Janjani, H., Javaheri, T., Javidnia, J., Jeemon, P., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Johansson, L., John, O., John-Akinola, Y. O., Johnson, C. O., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kabir, A., Kabir, Z., Kalani, H., Kalani, R., Kalankesh, L. R., Kalhor, R., Kanchan, T., Kapoor, N., Karami Matin, B., Karch, A., Karim, M. A., Kassa, G. M., Katikireddi, S. V., Kayode, G. A., Kazemi Karyani, A., Keiyoro, P. N., Keller, C., Kemmer, L., Kendrick, P. J., Khalid, N., Khammarnia, M., Khan, E. A., Khan, M., Khatab, K., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khazaei, S., Kieling, C., Kim, Y. J., Kimokoti, R. W., Kisa, A., Kisa, S., Kivimaki, M., Knibbs, L. D., Knudsen, A. K. S., Kocarnik, J. M., Kochhar, S., Kopec, J. A., Korshunov, V. A., Koul, P. A., Koyanagi, A., Kraemer, M. U. G., Krishan, K., Krohn, K. J., Kromhout, H., Kuate Defo, B., Kumar, G. A., Kumar, V., Kurmi, O. P., Kusuma, D., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Lallukka, T., Lami, F. H., Landires, I., Lang, J. J., Langan, S. M., Larsson, A. O., Lasrado, S., Lauriola, P., Lazarus, J. V., Lee, P. H., Lee, S. W. H., Legrand, K. E., Leigh, J., Leonardi, M., Lescinsky, H., Leung, J., Levi, M., Li, S., Lim, L. -L., Linn, S., Liu, S., Liu, Y., Lo, J., Lopez, A. D., Lopez, J. C. F., Lopukhov, P. D., Lorkowski, S., Lotufo, P. A., Lu, A., Lugo, A., Maddison, E. R., Mahasha, P. W., Mahdavi, M. M., Mahmoudi, M., Majeed, A., Maleki, A., Maleki, S., Malekzadeh, R., Malta, D. C., Mamun, A. A., Manda, A. L., Manguerra, H., Mansour-Ghanaei, F., Mansouri, B., Mansournia, M. A., Mantilla Herrera, A. M., Maravilla, J. C., Marks, A., Martin, R. V., Martini, S., Martins-Melo, F. R., Masaka, A., Masoumi, S. Z., Mathur, M. R., Matsushita, K., Maulik, P. K., Mcalinden, C., Mcgrath, J. J., Mckee, M., Mehndiratta, M. M., Mehri, F., Mehta, K. M., Memish, Z. A., Mendoza, W., Menezes, R. G., Mengesha, E. W., Mereke, A., Mereta, S. T., Meretoja, A., Meretoja, T. J., Mestrovic, T., Miazgowski, B., Miazgowski, T., Michalek, I. M., Miller, T. R., Mills, E. J., Mini, G. K., Miri, M., Mirica, A., Mirrakhimov, E. M., Mirzaei, H., Mirzaei, M., Mirzaei, R., Mirzaei-Alavijeh, M., Misganaw, A. T., Mithra, P., Moazen, B., Mohammad, D. K., Mohammad, Y., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammadifard, N., Mohammadpourhodki, R., Mohammed, A. S., Mohammed, H., Mohammed, J. A., Mohammed, S., Mokdad, A. H., Molokhia, M., Monasta, L., Mooney, M. D., Moradi, G., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morawska, L., Morgado-da-Costa, J., Morrison, S. D., Mosapour, A., Mosser, J. F., Mouodi, S., Mousavi, S. M., Mousavi Khaneghah, A., Mueller, U. O., Mukhopadhyay, S., Mullany, E. C., Musa, K. I., Muthupandian, S., Nabhan, A. F., Naderi, M., Nagarajan, A. J., Nagel, G., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Najafi, F., Nangia, V., Nansseu, J. R., Naserbakht, M., Nayak, V. C., Negoi, I., Ngunjiri, J. W., Nguyen, C. T., Nguyen, H. L. T., Nguyen, M., Nigatu, Y. T., Nikbakhsh, R., Nixon, M. R., Nnaji, C. A., Nomura, S., Norrving, B., Noubiap, J. 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A., Rajabpour-Sanati, A., Rajati, F., Rakovac, I., Ram, P., Ramezanzadeh, K., Ranabhat, C. L., Rao, P. C., Rao, S. J., Rashedi, V., Rathi, P., Rawaf, D. L., Rawaf, S., Rawal, L., Rawassizadeh, R., Rawat, R., Razo, C., Redford, S. B., Reiner, R. C., Reitsma, M. B., Remuzzi, G., Renjith, V., Renzaho, A. M. N., Resnikoff, S., Rezaei, N., Rezapour, A., Rhinehart, P. -A., Riahi, S. M., Ribeiro, D. C., Ribeiro, D., Rickard, J., Rivera, J. A., Roberts, N. L. S., Rodriguez-Ramirez, S., Roever, L., Ronfani, L., Room, R., Roshandel, G., Roth, G. A., Rothenbacher, D., Rubagotti, E., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, E., Sadeghi, M., Saeedi, R., Saeedi Moghaddam, S., Safari, Y., Safi, S., Safiri, S., Sagar, R., Sahebkar, A., Sajadi, S. M., Salam, N., Salamati, P., Salem, H., Salem, M. R. R., Salimzadeh, H., Salman, O. M., Salomon, J. A., Samad, Z., Samadi Kafil, H., Sambala, E. Z., Samy, A. M., Sanabria, J., Sanchez-Pimienta, T. G., Santomauro, D. F., Santos, I. 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N., Spotin, A., Sreeramareddy, C. T., Srinivasan, V., Stanaway, J. D., Stein, C., Stein, D. J., Steiner, C., Stockfelt, L., Stokes, M. A., Straif, K., Stubbs, J. L., Sufiyan, M. B., Suleria, H. A. R., Suliankatchi Abdulkader, R., Sulo, G., Sultan, I., Szumowski, Tabares-Seisdedos, R., Tabb, K. M., Tabuchi, T., Taherkhani, A., Tajdini, M., Takahashi, K., Takala, J. S., Tamiru, A. T., Taveira, N., Tehrani-Banihashemi, A., Temsah, M. -H., Tesema, G. A., Tessema, Z. T., Thurston, G. D., Titova, M. V., Tohidinik, H. R., Tonelli, M., Topor-Madry, R., Topouzis, F., Torre, A. E., Touvier, M., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Tsatsakis, A., Tudor Car, L., Tyrovolas, S., Uddin, R., Umeokonkwo, C. D., Unnikrishnan, B., Upadhyay, E., Vacante, M., Valdez, P. R., van Donkelaar, A., Vasankari, T. J., Vasseghian, Y., Veisani, Y., Venketasubramanian, N., Violante, F. S., Vlassov, V., Vollset, S. E., Vos, T., Vukovic, R., Waheed, Y., Wallin, M. 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S., Lacey, B, Sartorius, B, Abbafati, C, Abbas, K, Abbasi-Kangevari, M, Abd-Allah, F, Abdelalim, A, Abdollahi, M, Abdollahpour, I, Abegaz, K, Abolhassani, H, Aboyans, V, Abreu, L, Abrigo, M, Abualhasan, A, Abu-Raddad, L, Abushouk, A, Adabi, M, Adekanmbi, V, Adeoye, A, Adetokunboh, O, Adham, D, Advani, S, Afshin, A, Agarwal, G, Aghamir, S, Agrawal, A, Ahmad, T, Ahmadi, K, Ahmadi, M, Ahmadieh, H, Ahmed, M, Akalu, T, Akinyemi, R, Akinyemiju, T, Akombi, B, Akunna, C, Alahdab, F, Al-Aly, Z, Alam, K, Alam, S, Alam, T, Alanezi, F, Alanzi, T, Alemu, B, Alhabib, K, Ali, M, Ali, S, Alicandro, G, Alinia, C, Alipour, V, Alizade, H, Aljunid, S, Alla, F, Allebeck, P, Almasi-Hashiani, A, Al-Mekhlafi, H, Alonso, J, Altirkawi, K, Amini-Rarani, M, Amiri, F, Amugsi, D, Ancuceanu, R, Anderlini, D, Anderson, J, Andrei, C, Andrei, T, Angus, C, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Antonazzo, I, Antonio, C, Antony, C, Antriyandarti, E, Anvari, D, Anwer, R, Appiah, S, Arabloo, J, Arab-Zozani, M, Aravkin, A, Ariani, F, Armoon, B, Arnlov, J, Arzani, A, Asadi-Aliabadi, M, Asadi-Pooya, A, Ashbaugh, C, Assmus, M, Atafar, Z, Atnafu, D, Atout, M, Ausloos, F, Ausloos, M, Ayala Quintanilla, B, Ayano, G, Ayanore, M, Azari, S, Azarian, G, Azene, Z, Badawi, A, Badiye, A, Bahrami, M, Bakhshaei, M, Bakhtiari, A, Bakkannavar, S, Baldasseroni, A, Ball, K, Ballew, S, Balzi, D, Banach, M, Banerjee, S, Bante, A, Baraki, A, Barker-Collo, S, Barnighausen, T, Barrero, L, Barthelemy, C, Barua, L, Basu, S, Baune, B, Bayati, M, Becker, J, Bedi, N, Beghi, E, Bejot, Y, Bell, M, Bennitt, F, Bensenor, I, Berhe, K, Berman, A, Bhagavathula, A, Bhageerathy, R, Bhala, N, Bhandari, D, Bhattacharyya, K, Bhutta, Z, Bijani, A, Bikbov, B, Bin Sayeed, M, Biondi, A, Birihane, B, Bisignano, C, Biswas, R, Bitew, H, Bohlouli, S, Bohluli, M, Boon-Dooley, A, Borges, G, Borzi, A, Borzouei, S, Bosetti, C, Boufous, S, Braithwaite, D, Brauer, M, Breitborde, N, Breitner, S, Brenner, H, Briant, P, Briko, A, Briko, N, Britton, G, Bryazka, D, Bumgarner, B, Burkart, K, Burnett, R, Burugina Nagaraja, S, Butt, Z, Caetano Dos Santos, F, Cahill, L, Camera, L, Campos-Nonato, I, Cardenas, R, Carreras, G, Carrero, J, Carvalho, F, Castaldelli-Maia, J, Castaneda-Orjuela, C, Castelpietra, G, Castro, F, Causey, K, Cederroth, C, Cercy, K, Cerin, E, Chandan, J, Chang, K, Charlson, F, Chattu, V, Chaturvedi, S, Cherbuin, N, Chimed-Ochir, O, Cho, D, Choi, J, Christensen, H, Chu, D, Chung, M, Chung, S, Cicuttini, F, Ciobanu, L, Cirillo, M, Classen, T, Cohen, A, Compton, K, Cooper, O, Costa, V, Cousin, E, Cowden, R, Cross, D, Cruz, J, Dahlawi, S, Damasceno, A, Damiani, G, Dandona, L, Dandona, R, Dangel, W, Danielsson, A, Dargan, P, Darwesh, A, Daryani, A, Das, J, Das Gupta, R, das Neves, J, Davila-Cervantes, C, Davitoiu, D, De Leo, D, Degenhardt, L, Delang, M, Dellavalle, R, Demeke, F, Demoz, G, Demsie, D, Denova-Gutierrez, E, Dervenis, N, Dhungana, G, Dianatinasab, M, Dias da Silva, D, Diaz, D, Dibaji Forooshani, Z, Djalalinia, S, Do, H, Dokova, K, Dorostkar, F, Doshmangir, L, Driscoll, T, Duncan, B, Duraes, A, Eagan, A, Edvardsson, D, El Nahas, N, El Sayed, I, El Tantawi, M, Elbarazi, I, Elgendy, I, El-Jaafary, S, Elyazar, I, Emmons-Bell, S, Erskine, H, Eskandarieh, S, Esmaeilnejad, S, Esteghamati, A, Estep, K, Etemadi, A, Etisso, A, Fanzo, J, Farahmand, M, Fareed, M, Faridnia, R, Farioli, A, Faro, A, Faruque, M, Farzadfar, F, Fattahi, N, Fazlzadeh, M, Feigin, V, Feldman, R, Fereshtehnejad, S, Fernandes, E, Ferrara, G, Ferrari, A, Ferreira, M, Filip, I, Fischer, F, Fisher, J, Flor, L, Foigt, N, Folayan, M, Fomenkov, A, Force, L, Foroutan, M, Franklin, R, Freitas, M, Fu, W, Fukumoto, T, Furtado, J, Gad, M, Gakidou, E, Gallus, S, Garcia-Basteiro, A, Gardner, W, Geberemariyam, B, Ayalew Gebreslassie, A, Geremew, A, Gershberg Hayoon, A, Gething, P, Ghadimi, M, Ghadiri, K, Ghaffarifar, F, Ghafourifard, M, Ghamari, F, Ghashghaee, A, Ghiasvand, H, Ghith, N, Gholamian, A, Ghosh, R, Gill, P, Ginindza, T, Giussani, G, Gnedovskaya, E, Goharinezhad, S, Gopalani, S, Gorini, G, Goudarzi, H, Goulart, A, Greaves, F, Grivna, M, Grosso, G, Gubari, M, Gugnani, H, Guimaraes, R, Guled, R, Guo, G, Guo, Y, Gupta, R, Gupta, T, Haddock, B, Hafezi-Nejad, N, Hafiz, A, Haj-Mirzaian, A, Hall, B, Halvaei, I, Hamadeh, R, Hamidi, S, Hammer, M, Hankey, G, Haririan, H, Haro, J, Hasaballah, A, Hasan, M, Hasanpoor, E, Hashi, A, Hassanipour, S, Hassankhani, H, Havmoeller, R, Hay, S, Hayat, K, Heidari, G, Heidari-Soureshjani, R, Henrikson, H, Herbert, M, Herteliu, C, Heydarpour, F, Hird, T, Hoek, H, Holla, R, Hoogar, P, Hosgood, H, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsairi, M, Hsieh, V, Hu, G, Hu, K, Huda, T, Humayun, A, Huynh, C, Hwang, B, Iannucci, V, Ibitoye, S, Ikeda, N, Ikuta, K, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Ippolito, H, Iqbal, U, Irvani, S, Irvine, C, Islam, M, Islam, S, Iso, H, Ivers, R, Iwu, C, Iyamu, I, Jaafari, J, Jacobsen, K, Jafari, H, Jafarinia, M, Jahani, M, Jakovljevic, M, Jalilian, F, James, S, Janjani, H, Javaheri, T, Javidnia, J, Jeemon, P, Jenabi, E, Jha, R, Jha, V, Ji, J, Johansson, L, John, O, John-Akinola, Y, Johnson, C, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kabir, A, Kabir, Z, Kalani, H, Kalani, R, Kalankesh, L, Kalhor, R, Kanchan, T, Kapoor, N, Matin, B, Karch, A, Karim, M, Kassa, G, Katikireddi, S, Kayode, G, Kazemi Karyani, A, Keiyoro, P, Keller, C, Kemmer, L, Kendrick, P, Khalid, N, Khammarnia, M, Khan, E, Khan, M, Khatab, K, Khater, M, Khatib, M, Khayamzadeh, M, Khazaei, S, Kieling, C, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kivimaki, M, Knibbs, L, Knudsen, A, Kocarnik, J, Kochhar, S, Kopec, J, Korshunov, V, Koul, P, Koyanagi, A, Kraemer, M, Krishan, K, Krohn, K, Kromhout, H, Kuate Defo, B, Kumar, G, Kumar, V, Kurmi, O, Kusuma, D, La Vecchia, C, Lal, D, Lalloo, R, Lallukka, T, Lami, F, Landires, I, Lang, J, Langan, S, Larsson, A, Lasrado, S, Lauriola, P, Lazarus, J, Lee, P, Lee, S, Legrand, K, Leigh, J, Leonardi, M, Lescinsky, H, Leung, J, Levi, M, Li, S, Lim, L, Linn, S, Liu, S, Liu, Y, Lo, J, Lopez, A, Lopez, J, Lopukhov, P, Lorkowski, S, Lotufo, P, Lu, A, Lugo, A, Maddison, E, Mahasha, P, Mahdavi, M, Mahmoudi, M, Majeed, A, Maleki, A, Maleki, S, Malekzadeh, R, Malta, D, Mamun, A, Manda, A, Manguerra, H, Mansour-Ghanaei, F, Mansouri, B, Mansournia, M, Mantilla Herrera, A, Maravilla, J, Marks, A, Martin, R, Martini, S, Martins-Melo, F, Masaka, A, Masoumi, S, Mathur, M, Matsushita, K, Maulik, P, Mcalinden, C, Mcgrath, J, Mckee, M, Mehndiratta, M, Mehri, F, Mehta, K, Memish, Z, Mendoza, W, Menezes, R, Mengesha, E, Mereke, A, Mereta, S, Meretoja, A, Meretoja, T, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, I, Miller, T, Mills, E, Mini, G, Miri, M, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Mirzaei, R, Mirzaei-Alavijeh, M, Misganaw, A, Mithra, P, Moazen, B, Mohammad, D, Mohammad, Y, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammadpourhodki, R, Mohammed, A, Mohammed, H, Mohammed, J, Mohammed, S, Mokdad, A, Molokhia, M, Monasta, L, Mooney, M, Moradi, G, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morawska, L, Morgado-Da-Costa, J, Morrison, S, Mosapour, A, Mosser, J, Mouodi, S, Mousavi, S, Khaneghah, A, Mueller, U, Mukhopadhyay, S, Mullany, E, Musa, K, Muthupandian, S, Nabhan, A, Naderi, M, Nagarajan, A, Nagel, G, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Najafi, F, Nangia, V, Nansseu, J, Naserbakht, M, Nayak, V, Negoi, I, Ngunjiri, J, Nguyen, C, Nguyen, H, Nguyen, M, Nigatu, Y, Nikbakhsh, R, Nixon, M, Nnaji, C, Nomura, S, Norrving, B, Noubiap, J, Nowak, C, Nunez-Samudio, V, Oancea, B, Odell, C, Ogbo, F, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, B, Olusanya, J, Omer, M, Ong, K, Onwujekwe, O, Orpana, H, Ortiz, A, Osarenotor, O, Osei, F, Ostroff, S, Otoiu, A, Otstavnov, N, Otstavnov, S, Overland, S, Owolabi, M, Mahesh, P, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Parry, C, Pasovic, M, Pasupula, D, Patel, S, Pathak, M, Patten, S, Patton, G, Toroudi, H, Peden, A, Pennini, A, Pepito, V, Peprah, E, Pereira, D, Pesudovs, K, Pham, H, Phillips, M, Piccinelli, C, Pilz, T, Piradov, M, Pirsaheb, M, Plass, D, Polinder, S, Polkinghorne, K, Pond, C, Postma, M, Pourjafar, H, Pourmalek, F, Poznanska, A, Prada, S, Prakash, V, Pribadi, D, Pupillo, E, Syed, Z, Rabiee, M, Rabiee, N, Radfar, A, Rafiee, A, Raggi, A, Rahman, M, Rajabpour-Sanati, A, Rajati, F, Rakovac, I, Ram, P, Ramezanzadeh, K, Ranabhat, C, Rao, P, Rao, S, Rashedi, V, Rathi, P, Rawaf, D, Rawaf, S, Rawal, L, Rawassizadeh, R, Rawat, R, Razo, C, Redford, S, Reiner, R, Reitsma, M, Remuzzi, G, Renjith, V, Renzaho, A, Resnikoff, S, Rezaei, N, Rezapour, A, Rhinehart, P, Riahi, S, Ribeiro, D, Rickard, J, Rivera, J, Roberts, N, Rodriguez-Ramirez, S, Roever, L, Ronfani, L, Room, R, Roshandel, G, Roth, G, Rothenbacher, D, Rubagotti, E, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, E, Sadeghi, M, Saeedi, R, Saeedi Moghaddam, S, Safari, Y, Safi, S, Safiri, S, Sagar, R, Sahebkar, A, Sajadi, S, Salam, N, Salamati, P, Salem, H, Salem, M, Salimzadeh, H, Salman, O, Salomon, J, Samad, Z, Samadi Kafil, H, Sambala, E, Samy, A, Sanabria, J, Sanchez-Pimienta, T, Santomauro, D, Santos, I, Santos, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suarez, R, Sarrafzadegan, N, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Saxena, S, Schaeffer, L, Schiavolin, S, Schlaich, M, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Senbeta, A, Senthilkumaran, S, Sepanlou, S, Serdar, B, Serre, M, Shadid, J, Shafaat, O, Shahabi, S, Shaheen, A, Shaikh, M, Shalash, A, Shams-Beyranvand, M, Shamsizadeh, M, Sharafi, K, Sheikh, A, Sheikhtaheri, A, Shibuya, K, Shield, K, Shigematsu, M, Shin, J, Shin, M, Shiri, R, Shirkoohi, R, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, J, Simpson, K, Singh, J, Singh, P, Skiadaresi, E, Skou, S, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soshnikov, S, Soyiri, I, Spencer, C, Spotin, A, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stein, C, Stein, D, Steiner, C, Stockfelt, L, Stokes, M, Straif, K, Stubbs, J, Sufiyan, M, Suleria, H, Suliankatchi Abdulkader, R, Sulo, G, Sultan, I, Tabares-Seisdedos, R, Tabb, K, Tabuchi, T, Taherkhani, A, Tajdini, M, Takahashi, K, Takala, J, Tamiru, A, Taveira, N, Tehrani-Banihashemi, A, Temsah, M, Tesema, G, Tessema, Z, Thurston, G, Titova, M, Tohidinik, H, Tonelli, M, Topor-Madry, R, Topouzis, F, Torre, A, Touvier, M, Tovani-Palone, M, Tran, B, Travillian, R, Tsatsakis, A, Tudor Car, L, Tyrovolas, S, Uddin, R, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Vacante, M, Valdez, P, van Donkelaar, A, Vasankari, T, Vasseghian, Y, Veisani, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vos, T, Vukovic, R, Waheed, Y, Wallin, M, Wang, Y, Watson, A, Wei, J, Wei, M, Weintraub, R, Weiss, J, Werdecker, A, West, J, Westerman, R, Whisnant, J, Whiteford, H, Wiens, K, Wolfe, C, Wozniak, S, Wu, A, Wu, J, Wulf Hanson, S, Xu, G, Xu, R, Yadgir, S, Yahyazadeh Jabbari, S, Yamagishi, K, Yaminfirooz, M, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeheyis, T, Yilgwan, C, Yilma, M, Yip, P, Yonemoto, N, Younis, M, Younker, T, Yousefi, B, Yousefi, Z, Yousefinezhadi, T, Yousuf, A, Yu, C, Yusefzadeh, H, Moghadam, T, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zhang, Y, Zhang, Z, Zhao, J, Zhao, X, Zhao, Y, Zheng, P, Zhou, M, Ziapour, A, Zimsen, S, Lim, S, Murray, C, GBD 2019 Risk Factors Collaborator, Violante FS, Biosciences, Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Sub Foundations&PhilosophyofNaturSc begr, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Public Health, Bin Sayeed, M. S. B., Caetano Dos Santos, F. L., Camera, L. A., Elyazar, I. R. F., Ayalew Gebreslassie, A. A. A., Ginindza, T. G., Matin, B. K., Morgado-Da-Costa, J., Khaneghah, A. M., Mahesh, P. A., Toroudi, H. P., Syed, Z. Q., Salem, M. R., Skou, S. T., Tovani-Palone, M. R., Tudor Car, L. T., and Moghadam, T. Z.
Subjects: Male, Nutritional Sciences, Specific risk, Contaminación del Aire Interior, 030204 cardiovascular system & hematology, Socioeconomic Factor, systematic analysis, Global Health, Body Mass Index, Global Burden of Disease, Health Risk Behavior, Health Risk Behaviors, Disease studies, 0302 clinical medicine, Risk Factors, METABOLIC RISKS, 030212 general & internal medicine, 11 Medical and Health Sciences, Factores de Riesgo, 2. Zero hunger, education.field_of_study, Public health, Injuries, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, GBD, risck factors, attributable burden of disease, 3142 Public health care science, environmental and occupational health, 3. Good health, Relative risk, Environmental health, Health, Hypertension, Global Burden of Diseases, Injuries, Risk Factors, A990 Medicine and Dentistry not elsewhere classified, Female, Leading risk factors, Global Health Metrics, Cohort study, Human, medicine.medical_specialty, Substance-Related Disorders, Population, UNITED-STATES, Risk Assessment, DIET, ITC-HYBRID, 03 medical and health sciences, Life Expectancy, MORTALITY, DISABILITY, POLLUTION, CLUSTERS, SDG 3 - Good Health and Well-being, General & Internal Medicine, medicine, Humans, Global Burden of Disease Study, Risk factor, education, Global burden, business.industry, Risk Factor, Malnutrition, Klinisk medicin, Global Burden of Diseases, Environmental Exposure, medicine.disease, Enfermedades, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, Socioeconomic Factors, Risk factors, Disease study, Hyperglycemia, ITC-ISI-JOURNAL-ARTICLE, NA, Clinical Medicine, business, RA
Abstract: Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10.8 million (95% uncertainty interval [UI] 9.51-12.1) deaths (19.2% [16.9-21.3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8.71 million (8.12-9.31) deaths (15.4% [14.6-16.2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11.6% [10.3-13.1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. Interpretation Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.
Published: 2020
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128. A systematic review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation

Author: Gary C. K. Chan, Aathavan Shanmuga Anandan, Coral Gartner, Wayne Hall, Tianze Sun, Janni Leung, Carmen C.W. Lim, Daniel Stjepanović, and Jason P. Connor
Subjects: medicine.medical_specialty, medicine.medical_treatment, Network Meta-Analysis, 030508 substance abuse, Medicine (miscellaneous), PsycINFO, Electronic Nicotine Delivery Systems, Toxicology, Placebo, law.invention, Nicotine, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Humans, 030212 general & internal medicine, Nicotinic Agonists, Nicotine replacement, Randomized Controlled Trials as Topic, business.industry, Psychiatry and Mental health, Clinical Psychology, Relative risk, Meta-analysis, Smoking cessation, Smoking Cessation, 0305 other medical science, business, medicine.drug
Abstract: Aim E-cigarettes, or nicotine vaping products, are potential smoking cessation aids that provide both nicotine and behavioural substitution for combustible cigarette smoking. This review aims to compare the effectiveness of nicotine e-cigarettes for smoking cessation with licensed nicotine replacement therapies (NRT) and nicotine-free based control conditions by using network meta-analysis (NMA). Methods We searched PubMed, Web of Science and PsycINFO for randomised controlled trials (RCTs) that allocated individuals to use nicotine e-cigarettes, compared to those that used licensed NRT (e.g., nicotine patches, nicotine gums, etc), or a nicotine-free control condition such as receiving placebo (nicotine-free) e-cigarettes or usual care. We only included studies of healthy individuals who smoked. Furthermore, we identified the latest Cochrane review on NRT and searched NRT trials that were published in similar periods as the e-cigarette trials we identified. NMA was conducted to compare the effect of e-cigarettes on cessation relative to NRT and control condition. Cochrane risk-of-bias tool for randomized trials Version 2 was used to access study bias. Results For the e-cigarette trials, our initial search identified 4,717 studies and we included 7 trials for NMA after removal of duplicates, record screening and assessment of eligibility (Total N = 5,674). For NRT trials, our initial search identified 1,014 studies and we included 9 trials that satisfied our inclusion criteria (Total N = 6,080). Results from NMA indicated that participants assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those in the control condition (pooled Risk Ratio (RR) = 2.08, 97.5% CI = [1.39, 3.15]) and those who were assigned to use NRT (pooled RR = 1.49, 97.5% CI = [1.04, 2.14]. There was a moderate heterogeneity between studies (I2 = 42%). Most of the e-cigarette trials has moderate or high risk of bias. Conclusion Smokers assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those assigned to use licensed NRT, and both were more effective than usual care or placebo conditions. More high quality studies are required to ascertain the effect of e-cigarette on smoking cessation due to risk of bias in the included studies.
Published: 2020

129. Cross-national study of worrying, loneliness, and mental health during the COVID-19 pandemic: a comparison between individuals with and without infection in the family

Author: Hilde Thygesen, Tore Bonsaksen, Amy Østertun Geirdal, Janni Leung, Daicia Price, Mary C. Ruffolo, and Mariyana Schoultz
Subjects: cross-national study, L700, Social distancing, L900, Leadership and Management, media_common.quotation_subject, Population, coronavirus, Health Informatics, Article, Immediate family, 03 medical and health sciences, 0302 clinical medicine, Health Information Management, Pandemic, worry, medicine, loneliness, 030212 general & internal medicine, education, Pandemics, media_common, education.field_of_study, Loneliness, Health Policy, Social distance, pandemic, social distancing, COVID-19, Mental health, 030227 psychiatry, C800, Coronavirus, B900, Cross-national studies, Medicine, medicine.symptom, Worry, Psychology, mental health, Demography
Abstract: Objective: The objective of this study was to examine differences in worry, loneliness, and mental health between those individuals infected by COVID-19 or having someone their family infected, and the rest of the population. Methods: A cross-sectional online survey was conducted in Norway, UK, USA, and Australia during April/May 2020. Participants (n = 3810) were recruited via social media postings by the researchers and the involved universities. Differences between those with and without infection in the family were investigated with chi-square tests and independent t-tests. Multiple regression analyses were used to assess associations between sociodemographic variables and psychological outcomes (worry, loneliness, and mental health) in both groups. Results: Compared to their counterparts, participants with infection in the family reported higher levels of worries about themselves (p &lt, 0.05) and their family members (p &lt, 0.001) and had poorer mental health (p &lt, 0.05). However, the effect sizes related to the differences were small. The largest effect (d = 0.24) concerned worries about their immediate family. Poorer psychological outcomes were observed in those who were younger, female, unemployed, living alone and had lower levels of education, yet with small effect sizes. Conclusions: In view of the small differences between those with and without infection, we generally conclude that the mental health effects of the COVID-19 situation are not limited to those who have been infected or have had an infection within the family but extend to the wider population.
Published: 2020
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130. Gateway or common liability? A systematic review and meta-analysis of studies of adolescent e-cigarette use and future smoking initiation

Author: Coral Gartner, Wayne Hall, Jason P. Connor, Aathavan Shanmuga Anandan, Janni Leung, Tianze Sun, Gary C. K. Chan, Carmen C.W. Lim, and Daniel Stjepanović
Subjects: Adolescent, 030508 substance abuse, Medicine (miscellaneous), Sample attrition, Cigarette use, Electronic Nicotine Delivery Systems, Cigarette Smoking, 03 medical and health sciences, 0302 clinical medicine, Cigarette smoking, medicine, Tobacco Smoking, Humans, Attrition, 030212 general & internal medicine, business.industry, Vaping, Confounding, Smoking, Publication bias, medicine.disease, Psychiatry and Mental health, Smoking initiation, Meta-analysis, 0305 other medical science, business, Demography
Abstract: 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.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.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.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.
Published: 2020

131. A Web-Based Program for Cannabis Use and Psychotic Experiences in Young People (Keep It Real): Protocol for a Randomized Controlled Trial

Author: Jan Copeland, Amanda L. Baker, Melissa M. Norberg, Stoyan Stoyanov, David J. Kavanagh, Janni Leung, Zoe Walter, Leanne Hides, and Catherine Quinn
Subjects: cannabis, medicine.medical_specialty, mindfulness, digital intervention, Computer applications to medicine. Medical informatics, Psychological intervention, Motivational interviewing, R858-859.7, substance use, CBT, motivational interviewing, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, well-being, eHealth, Protocol, Medicine, psychosis, psychotic experiences, Cannabis Dependence, Psychiatry, education, biology, business.industry, General Medicine, psychotic, biology.organism_classification, 030227 psychiatry, Distress, adolescent, Anxiety, Cannabis, medicine.symptom, business, marijuana, 030217 neurology & neurosurgery, web-based program
Abstract: Background Young Australians (16-25 years) have the highest rates of past-month cannabis use in the world. Cannabis use increases the risk of alcohol and other drug disorders and depressive disorders, and has a robust dose-response association with psychotic experiences (PEs) and disorders. PEs are subthreshold positive psychotic symptoms, including delusions and hallucinations, which increase the risk of substance use, depressive or anxiety disorders, and psychotic disorders. Access to effective web-based early interventions targeting both cannabis use and PEs could reduce such risk in young people. Objective The objective of this study is to determine the efficacy and cost-effectiveness of the Keep it Real web-based program compared to an information-only control website among young cannabis users (16-25 years) with PEs. Methods Participants are recruited online, and consenting individuals meeting inclusion criteria (aged 16-25 years, who have used cannabis in the past month and experienced PEs in the past 3 months) are automatically randomized to either the Keep it Real web-based program (n=249) or an information-only control website (n=249). Both websites are self-guided (fully automated). The baseline and follow-up assessments at 3, 6, 9, and 12 months are self-completed online. Primary outcome measures are weekly cannabis use, PEs, and the relative cost-effectiveness for quality-adjusted life years. Secondary outcomes include other substance use and related problems, PE-related distress, cannabis intoxication experiences, severity of cannabis dependence, depression/anxiety symptoms, suicidality, and mental well-being and functioning. Results Recruitment commenced in February 2019, and the results are expected to be submitted for publication in mid-2021. Conclusions This study protocol describes a large randomized controlled trial of a new web-based program for young cannabis users experiencing PEs. If effective, the accessibility and scalability of Keep it Real could help reduce growing public health concerns about the significant social, economic, and health impacts of cannabis use. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618001107213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374800 International Registered Report Identifier (IRRID) DERR1-10.2196/15803
Published: 2020

132. Brief Psychological Interventions for Reducing Prescription Opioid Use, Related Harm, and Pain Intensity in Patients With Chronic Pain: A Systematic Review and Assessment of Patient Interest

Author: Rachel A. Elphinston, Simone Scotti Requena, Paul Gray, Jason P. Connor, Michele Sterling, and Janni Leung
Subjects: Male, medicine.medical_specialty, Adolescent, Psychological intervention, Psychosocial Intervention, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Medicine, Humans, In patient, Medical prescription, business.industry, Chronic pain, medicine.disease, Opioid-Related Disorders, Patient preference, Analgesics, Opioid, Anesthesiology and Pain Medicine, Harm, Prescriptions, Prescription opioid, Physical therapy, Female, Neurology (clinical), Substance use, Chronic Pain, business, 030217 neurology & neurosurgery
Abstract: Brief psychological interventions (BPIs) have demonstrated effectiveness in reducing substance use and related harm. No systematic review has examined their potential to reduce or prevent prescription opioid use or related harm, and/or pain intensity in opioid-using patients with chronic non-cancer pain (CNCP). Recognizing the importance of patient preferences in evidence-based practice, we also sought to assess patient interest in BPIs. A systematic review of studies published between 1980-2020 was conducted using five databases. Eligible treatment studies included patients ≥18 years old, with CNCP, and who were using prescription opioids. An adjunctive study independent of our review was also undertaken in 188 prescription opioid-using patients (77% female; Mage=49▒y) diagnosed with CNCP. Patients completed pain-related questionnaires online and indicated if they would consider BPI treatment options. The review identified six studies. Given the heterogeneity across studies, a meta-analysis was not conducted. A narrative review found all of the six studies demonstrated some evidence for BPI effectiveness for reducing opioid use or related harms; these were assessed as having mostly low methodological quality. Mixed support for the effect on pain intensity was found in one study. Despite the inconclusive findings and heterogenous studies identified in the review, 92% of patients in our survey reported interest in receiving a BPI. In combination, these findings highlight the inconsistency between patient demand and the availability of evidence for BPIs targeting opioid use, related harm and/or pain intensity. Future work should examine the effectiveness of BPIs in higher quality studies.
Published: 2020

133. Predicting vaping uptake, vaping frequency and ongoing vaping among daily smokers using longitudinal data from the International Tobacco Control (ITC) Four Country Surveys

Author: Wayne Hall, Janni Leung, Kylie Morphett, Hua-Hie Yong, Coral Gartner, Ron Borland, and Gary C. K. Chan
Subjects: Adult, Cross-Cultural Comparison, Male, Canada, Longitudinal data, medicine.medical_treatment, 030508 substance abuse, Medicine (miscellaneous), Intention, Article, Intention to quit, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Longitudinal Studies, 030212 general & internal medicine, Depressive symptoms, Aged, Motivation, business.industry, Vaping, Smoking, Tobacco control, Australia, Odds ratio, Middle Aged, medicine.disease, Health Surveys, United Kingdom, United States, Confidence interval, 3. Good health, Substance abuse, Psychiatry and Mental health, Smoking cessation, Female, Smoking Cessation, 0305 other medical science, business, Demography
Abstract: Aim To assess (1) how far smoking patterns, depression and smoking-related beliefs and intentions predict vaping uptake, current vaping and vaping frequency among daily smokers; and (2) how far the aforementioned predictors and baseline vaping frequency predict current vaping among those who reported ever vaped. Design Analysis of data from six waves of a longitudinal survey over 8 years. Longitudinal associations between predictors and outcomes were examined using multi-level models. Setting United Kingdom, United States, Canada and Australia. Participants A total of 6296 daily smokers (53% females) who contributed data to at least two consecutive survey waves. Measurements The outcome variables were vaping uptake, vaping frequency and current vaping at follow-up. The key predictor variables, measured in previous waves, were time to first cigarette, cigarettes smoked per day, depressive symptoms, intention to quit smoking, quitting self-efficacy and worry about adverse health effects of smoking. Findings Number of cigarettes smoked daily was associated with (1) subsequent vaping uptake [odds ratio (OR) = 1.69, 95% confidence interval (CI) = 1.19, 2.39 for 30+ cigarette per day; reference category: 0-10 cigarettes] and (2) a higher frequency of current vaping (OR = 1.97, 95% CI = 1.36, 2.85 for 30+ cigarettes). Intention to quit was associated with a higher frequency of current vaping (OR = 1.48, 95% CI = 1.21, 1.82). Among those who reported ever vaped, higher baseline vaping frequency (OR = 11.98, 95% CI = 6.00, 23.93 for daily vaping at baseline; reference category: vaped less than monthly) predicted current vaping. Conclusion Among daily smokers, amount smoked and intention to quit smoking appear to predict subsequent vaping uptake. Vaping frequency at baseline appears to predict current vaping at follow-up.
Published: 2019
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134. Non-medical use of pharmaceutical opioids with and without other illicit substances in Australia: Prevalence and correlates

Author: Wayne Hall, Gary Chung Kai Chan, and Janni Leung
Subjects: Drug, medicine.medical_specialty, Health (social science), business.industry, media_common.quotation_subject, Illicit substance use, Medicine (miscellaneous), Daily smoking, Household survey, Pharmaceutical opioid, Epidemiology, Medicine, Substance use, Codeine products, business, Psychiatry, media_common
Abstract: To estimate the prevalence of non-medical use of pharmaceutical opioids and examine the socio-demographic, psychological, health and behavioural correlates and type of opioids used. Data from the Australian National Drug Strategy Household Survey 2016 was used. The sample consisted of. 23 448 participants aged over 14 years (54% female). The key measure was opioid use status in the past year. Based on participants' responses to questions about their substance use in the past 12 months, they were grouped into four opioid use status: (i) No illicit substance use (ISU) and no non-medical use of pharmaceutical opioids (NMUPO); (ii) ISU but no NMUPO; (iii) NMUPO but no ISU; and (iv) NMUPO and ISU. The prevalence non-medical pharmaceutical opioid use was 3.56%. Two-thirds of them engaged in NMUPO but no ISU; one-third engaged in NMUPO and ISU. Younger people were more likely to use pharmaceutical opioids in addition to other illicit drugs, while older people were more likely to only use pharmaceutical opioids. Alcohol risk and daily smoking were associated with using pharmaceutical opioids and other illicit drugs, but not with pharmaceutical opioids only. Those who reported only using pharmaceutical opioids were more likely to use over-the-counter codeine products. Over 700 000 Australian used pharmaceutical opioids for non-medical purpose. Among users, two-thirds used only opioids and one-third used opioids in addition to other illicit drugs. Profile of these two types of users were substantially different. Future prevention efforts targeting different type of opioids users may need to be optimised based on their profiles.
Published: 2019
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135. Personal Correlates of Support for Medical and Recreational Cannabis Legalization in Australia

Author: Vivian Chiu, Gary Chan, Wayne Hall, Leanne Hides, Carmen Lim, and Janni Leung
Subjects: Drug, medicine.medical_specialty, lcsh:RC435-571, media_common.quotation_subject, 030508 substance abuse, Logistic regression, 03 medical and health sciences, Household survey, 0302 clinical medicine, lcsh:Psychiatry, medicine, Confidentiality, 030212 general & internal medicine, Psychiatry, Recreation, media_common, Legalization, Original Research, attitudes, biology, business.industry, opinion, Chronic pain, determinants, biology.organism_classification, medicine.disease, Psychiatry and Mental health, cannabis (marijuana), Cannabis, 0305 other medical science, business, marijuana
Abstract: Introduction and Aims: Increasingly more Australians are in favor of legalizing medical and recreational cannabis use. This paper explored the personal characteristics of those who supported each of these policies in Australia.Design: Cross-sectional national survey.Methods: This study included 21,729 participants aged 18 years and above who responded to the 2016 National Drug Strategy Household Survey. Participants were provided the assurance of confidentiality for their participations. Logistic regression models were used to examine the relationships between personal characteristics and support for the legalization of medical and recreational cannabis.Results: Overall, 77 and 40% of participants supported the legalization of medical and recreational cannabis respectively. People of older age were more likely to support medical cannabis legalization while those who supported legalization of recreational cannabis use were more likely to be younger. Medical cannabis supporters were more likely to report chronic pain (OR = 1.44, 95% CI: 1.04, 2.00) while recreational cannabis supporters were more likely to suffer high level of psychological distress (OR = 1.28, 95% CI: 1.14, 1.43). Experience with cannabis use was strongly associated with supportive attitudes, with recent cannabis users almost 14 times (OR = 14.13, 95% CI: 5.37, 37.20) and 34 times (OR = 33.74, 95% CI: 24.22, 47.01) more likely to support the legalization of medical and recreational cannabis use, respectively.Discussion and Conclusions: The majority of Australians approve the legalization of cannabis for medicinal purposes but most remain cautious about legalizing recreational cannabis use. The sociodemographic and clinical profile of supporters of medical and recreational legalization suggests a potential interaction of self-interests and beliefs about the harms of cannabis use.
Published: 2020

136. Effect of income inequality, community infrastructure and individual stressors on adult depression

Author: Renuka Mahadevan, Janni Leung, and Vanessa Sha Fan
Subjects: Adult, Rural Population, medicine.medical_specialty, Aging, China, Health (social science), Resource (biology), 03 medical and health sciences, 0302 clinical medicine, Depression (economics), Economic inequality, Environmental health, medicine, Humans, 030212 general & internal medicine, Aged, 030503 health policy & services, Public health, Policy mix, Multilevel model, Stressor, Public Health, Environmental and Occupational Health, Investment (macroeconomics), Socioeconomic Factors, Income, Female, 0305 other medical science, Psychology
Abstract: This paper considers the impact of variables at three different levels—city, community and individual—on the depression of adults aged 45 years and above in China. Evidence shows that community factors, such as infrastructure and elderly centres, are critical to reduce depression but the effect of city-level factors such as lowering income inequality and improving public health investment is different for the segments of poor and non-poor as well as the rural and urban residents. This highlights the need to consider targeted policy mix options to avoid resource misallocation. Lastly, Chinese females’ depression has worsened over time with ageing, particularly those who drink alcohol or are less educated are prone to depression prompting the need for specialist women health centres.
Published: 2020

137. How many more young Australians say that they would use cannabis if it were legal?

Author: Jack Yiu Chak Chung, Gary C. K. Chan, Vivian Chiu, Janni Leung, and Wayne Hall
Subjects: Adult, medicine.medical_specialty, Health (social science), Adolescent, Population, 030508 substance abuse, Medicine (miscellaneous), Intention to use, Intention, Medical Marijuana, 03 medical and health sciences, Household survey, Young Adult, 0302 clinical medicine, Surveys and Questionnaires, Epidemiology, medicine, Prevalence, Humans, 030212 general & internal medicine, Young adult, education, Cannabis, education.field_of_study, biology, Australia, Cannabis use, biology.organism_classification, Survey data collection, 0305 other medical science, Psychology, Demography
Abstract: Introduction and Aims. The potential for increased cannabis use by young people after legalisation remains a key concern of opponents of legalisation. This study used survey data to estimate how many young Australians may be prepared to use cannabis if it became legally available. Design and Methods. The study included 3052 youths (adolescents aged 12–17 and young adults aged 18–25 years) in Australia who participated in the 2016 National Drug Strategy Household Survey. Incident cases were estimated by multiplying the prevalence and estimated population sizes from the Australian Bureau of Statistics. Results. It was estimated that 17% of adolescents would try (13%) or use (4%), and 32% of young adults would try (15%) or use (17%) cannabis if it were legal. Among those who reported an intention to try it, 85% of adolescents and 59% of young adults had never used cannabis. These translate to 199 000 and 238 000 potential initiators, respectively. Among those with an intention to use cannabis, 21% of adolescents and 3% of young adults had never used cannabis. These translate to 14 000 adolescents and 12 000 young adults who intended to use cannabis if it were legal. Discussion and Conclusions. A substantial minority of young Australians say that they would use cannabis for the first time if it were legalised. A proportion of young people who have used cannabis also expressed an interest in increasing their use. Both would warrant special attention if cannabis were legalised.
Published: 2020

138. An age-period-cohort analysis of trends in psychedelic and ecstasy use in the Australian population

Author: Gary Chan, Tianze Sun, Carmen Lim, Wing See Yuen, Daniel Stjepanović, Brienna Rutherford, Wayne Hall, Ben Johnson, and Janni Leung
Subjects: Adult, Aged, 80 and over, Male, Adolescent, N-Methyl-3,4-methylenedioxyamphetamine, Australia, Medicine (miscellaneous), Middle Aged, Toxicology, Cohort Studies, Young Adult, Psychiatry and Mental health, Clinical Psychology, Cross-Sectional Studies, Hallucinogens, Humans, Birth Cohort, Female, Aged
Abstract: To test the age, cohort, and period effect on past-year use trends in psychedelic drugs and ecstasy.Data were from a repeated cross-sectional nationally representative household survey in Australia conducted every three years between 2001 and 2019. An age-period-cohort model was used to test the effect of age, birth cohort, and period on past year psychedelic and ecstasy use. Participants were between 18 and 80 years old at the time of the survey. The total sample size was 149,296 (Mean age = 45.8; 56% female). Past-year use of psychedelics and ecstasy were the key outcome variables. There were six birth cohorts that were derived in each survey: 1936-50, 1951-60, 1961-70, 1971-80, 1981-90, and 1991-2001. There were seven periods that coincided with survey years: 2001, 2004, 2007, 2010, 2013, 2016 and 2019. Age was treated as continuous.Past-year use of both psychedelics and ecstasy decreased with age, b = -0.87, 95% CI [-1.14, -0.61] and b = -0.84, 95% CI [-1.08, -0.60]. For ecstasy, while there was significant variation across periods (p .001), there was no obvious trend. There was a significant birth cohort effect (p .001), with prevalence increasing from the 1936-50 cohort, peaking in the 1971-80 cohort and then decreasing in the 1991-2001 cohort. For psychedelics, there was significant variation across periods (p .001) with an upward trend. There was a significant birth cohort effect (p .001), with prevalence increasing from the 1936-50 cohort to similarly high prevalence for the three most recent cohorts (1971-80, 1981-90, 1991-2001).There were strong cohort and period effects in trends in the use of psychedelic and ecstasy.
Published: 2022
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139. State-Level Prevalence and Associates of Opioid Dependence in the USA

Author: Janni Leung, Gary C. K. Chan, Samuel X. Tan, Caitlin McClure-Thomas, Louisa Degenhardt, and Wayne Hall
Subjects: Adult, Analgesics, Opioid, Heroin, opioid-related disorders, heroin dependence, analgesics, opioid, public health, socio-economic, socio-demographic, Heroin Dependence, Health, Toxicology and Mutagenesis, Prevalence, Public Health, Environmental and Occupational Health, Humans, Middle Aged, Opioid-Related Disorders, United States
Abstract: Traditionally, opioid-related disease burden was primarily due to heroin use. However, increases in extra-medical (or non-medicinal use of prescription opioids; NMPOs) use has precipitated the current overdose epidemic in North America. We aim to examine the state-level prevalence of heroin and NMPO dependence and their associations with opioid-related mortality and state-level socio-demographic profiles. Data were pooled from the 2005–2014 National Survey on Drug Use and Health (NSDUH). We examine opioid-related mortality from CDC WONDER (Cause of Death database) by the past year prevalence of DSM-IV heroin and NMPO dependence, by age and sex, and their associations with state-level socio-demographic characteristics from census data. State-level rates of heroin dependence were associated with opioid-related death rates in young and mid-aged adults, while rates of NMPO dependence were associated with opioid-related death rates across all ages. The prevalence of heroin dependence was positively associated with state-level GDP/capita and urbanity. State-level NMPO dependence prevalence was associated with higher unemployment, lower GDP/capita, and a lower high-school completion rate. The prevalence of heroin and NMPO dependence are associated with a broad range of geographical and socio-demographic groups. Taking a wider view of populations affected by the opioid epidemic, inclusive interventions for all are needed to reduce opioid-related disease burden.
Published: 2022
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140. Has the Legalisation of Medical and Recreational Cannabis Use in the USA Affected the Prevalence of Cannabis Use and Cannabis Use Disorders?

Author: Daniel Stjepanović, Wayne Hall, Janni Leung, and Chui Ying Vivian Chiu
Subjects: medicine.medical_specialty, education.field_of_study, Treatment seeking, biology, business.industry, Population, Cannabis use, biology.organism_classification, 03 medical and health sciences, Psychiatry and Mental health, Clinical Psychology, 0302 clinical medicine, Medical cannabis, Epidemiology, medicine, 030212 general & internal medicine, Cannabis, Psychiatry, business, education, Recreation, 030217 neurology & neurosurgery
Abstract: Since California legalised medical use of cannabis in 1996, 29 other US states have done so. Eight US states have legalised the retail sale of cannabis to adults over the age of 21 years since 2012. Critics of these policy changes have suggested that they will increase the prevalence of cannabis use and cannabis use disorders. This paper (1) briefly describes the types of regulatory regimes for medical and recreational cannabis use in the USA, (2) describes possible effects of these policies on cannabis use and (3) assesses the impacts to date of the legalisation of medical and recreational cannabis use on the prevalence of cannabis use and cannabis use disorders in the US population. We (1) describe the regulatory regimes for medical and recreational cannabis use in the USA, (2) make predictions about their possible effects on the price and availability of cannabis, (3) conduct a review to summarise studies of the effects of legalising medical cannabis use in the USA on rates of cannabis use and cannabis use disorders and (4) assess early indications of the effects of legalising recreational cannabis use on cannabis use and cannabis use disorders. Liberal forms of medical cannabis regulation have probably reduced prices and increased the availability of cannabis. Analyses of survey data suggest that these changes have increased the prevalence and frequency of cannabis use among adults over the age of 21 years, but they have not to date increased rates of cannabis use among adolescents. Two series of epidemiological studies over a decade following the introduction of medical cannabis laws have produced inconsistent results on the effects of policy changes on the prevalence of cannabis use disorders in adults. One study found that the prevalence had increased; the other did not find an increase. An analysis of data on treatment seeking for cannabis use disorders showed an increase in states with medical cannabis laws in the number of adults seeking treatment who were not under legal coercion. There are major limitations with these studies, many of which have mistakenly assumed that all states with medical cannabis laws have similarly liberal policies. It may be a decade or more before we can fully assess the effects of liberalisation of cannabis policies on cannabis use and cannabis use disorders in the USA. It is critical that the effects of these policy changes are evaluated to ensure that cannabis is regulated in ways that minimise the harmful effects of its regular use, especially among young people.
Published: 2018
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141. Prevalence of Adolescent Cannabis Vaping

Author: Carmen C.W. Lim, Daniel Stjepanović, Jason P. Connor, Wayne Hall, Janni Leung, Vivian Chiu, Tianze Sun, Gary C. K. Chan, Coral E. Gartner, and Jack Yiu Chak Chung
Subjects: Canada, Marijuana Abuse, medicine.medical_specialty, Visual Analog Scale, Population, MEDLINE, PsycINFO, Environmental health, Epidemiology, Prevalence, Humans, Medicine, education, Original Investigation, education.field_of_study, biology, business.industry, Vaping, Clinical study design, biology.organism_classification, United States, Meta-analysis, Pediatrics, Perinatology and Child Health, Monitoring the Future, Cannabis, business
Abstract: Importance 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. Objective To summarize the findings of epidemiological studies that reported the global prevalence of cannabis vaping in adolescents by survey year and school grades. Data sources 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. Study selection Publications that reported the prevalence of cannabis vaping in adolescents in the general population were included. Data extraction and synthesis 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. Main outcomes and measures Prevalence of cannabis vaping. Results 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. Conclusions and relevance 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. Trial registration PROSPERO Identifier: CRD42020219644.
Published: 2022
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142. The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015

Author: Liliana G Ciobanu, Bernhard T. Baune, Azmeraw T. Amare, Alize J. Ferrari, Holly E. Erskine, Damian Santomauro, Janni Leung, Fiona J Charlson, Andrew T Olagunju, Harvey Whiteford, Ciobanu, Liliana G, Ferrari, Alize J, Erskine, Holly E, Santomauro, Damian F, Charlson, Fiona J, Leung, Janni, Amare, Azmeraw T, Olagunju, Andrew T, Whiteford, Harvey A, and Baune, Bernhard T
Subjects: Adult, Male, Burden of disease, medicine.medical_specialty, Adolescent, Substance-Related Disorders, prevalence, Global Burden of Disease, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, Environmental health, Epidemiology, Prevalence, medicine, Humans, 030212 general & internal medicine, Disease burden, Aged, Aged, 80 and over, global burden of disease, Mortality, Premature, Mental Disorders, Australia, General Medicine, Middle Aged, Health Surveys, mental disorders, Time of death, Psychiatry and Mental health, Systematic review, Years of potential life lost, substance use disorders, Life expectancy, epidemiology, Substance use, 030217 neurology & neurosurgery
Abstract: Objectives: Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. Methods: For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Results: Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Conclusion: Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.
Published: 2018
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143. Socio-economic differentials in cannabis use trends in Australia

Author: Gary C. K. Chan, Megan Weier, Janni Leung, Wayne Hall, and Catherine Quinn
Subjects: Low income, biology, business.industry, 030508 substance abuse, Medicine (miscellaneous), Cannabis use, biology.organism_classification, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Middle level, Personal income, Medicine, 030212 general & internal medicine, Cannabis, 0305 other medical science, business, Lower income, Socioeconomic status, Demography
Abstract: Aim To test if the degree of change in cannabis use between 2001 and 2013 differed according to socio-economic status. Design Repeated cross-sectional household surveys that were nationally representative. Setting Australia. Participants Adult samples from the 2001 and 2013 National Drug Strategy Household Surveys (n = 23 642 in 2001 and n = 21 353 in 2013), the largest nationally representative survey on drug use in Australia. Measurements Frequency of cannabis use coded as daily use, weekly use, less than weekly use and non-current use; socio-economic status (SES) as measured by personal income and educational level. Finding There were significant differences in changes to levels of cannabis use between SES groups. Among participants who completed high school, the probability of daily use decreased from 0.014 to 0.009 (P
Published: 2017
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144. Short-Term Effects of State Legalization on Adolescent Cannabis Use May Not Predict Any Longer-Term Effects

Author: Wayne Hall and Janni Leung
Subjects: medicine.medical_specialty, Public Health, Environmental and Occupational Health, medicine, Cannabis use, Psychology, Psychiatry, Term (time), Legalization
Published: 2020
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145. Socio-demographic and ecological factors associated with anti-HCV prevalence in people who inject drugs: A systematic review

Author: Adam Trickey, Jason Grebely, Sarah Larney, Matthew Hickman, Jack Stone, Samantha Colledge, Peter Vickerman, Amy Peacock, Louisa Degenhardt, and Janni Leung
Subjects: Adult, medicine.medical_specialty, Socio demographics, people who inject drugs, Population health, Hepacivirus, Toxicology, World Health Organization, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Prevalence, Humans, Pharmacology (medical), 030212 general & internal medicine, Human Development Index, Substance Abuse, Intravenous, Pharmacology, Ecology, Transmission (medicine), Anti hiv, business.industry, Hepatitis C virus, Public health, HIV, Hepatitis C Antibodies, global, Hepatitis C, Confidence interval, HCV Antibody, Psychiatry and Mental health, Socioeconomic Factors, ecological factors, Female, business, 030217 neurology & neurosurgery
Abstract: Background The World Health Organization (WHO) aim to eliminate hepatitis C virus (HCV) as a public health threat by 2030. People who inject drugs (PWID) are a key risk group for HCV transmission globally. We explored socio-demographic and ecological variables associated with HCV antibody (anti-HCV) prevalence among samples of PWID. Methods We systematically searched for and screened journal articles and online reports published between January 2011 and June 2017. Serologically confirmed anti-HCV prevalence among PWID and other study-level socio-demographic variables were extracted. Country-level ecological indicators were sourced from online databases. We used generalized linear models to investigate associations between anti-HCV prevalence estimates and other study-level and country-level variables. Results There were 223 studies from 84 countries contributing 569 estimates of anti-HCV prevalence among PWID. Among study-level indicators, higher levels of anti-HCV prevalence were associated with higher HIV prevalence (B = 0.20; 95% Confidence Interval [95%CI] = 0.12, 0.29, p
Published: 2020
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146. Injecting risk behaviours amongst people who inject drugs: A global multi-stage systematic review and meta-analysis

Author: Jason Grebely, Peter Vickerman, Lucy Thi Tran, Amy Peacock, Louisa Degenhardt, Sonja Memedovic, Matthew Hickman, Sarah Larney, Jack Stone, Adam Trickey, Janni Leung, and Samantha Colledge
Subjects: Virus transmission, Psychological intervention, 030508 substance abuse, Medicine (miscellaneous), HIV Infections, 03 medical and health sciences, 0302 clinical medicine, Risk-Taking, Harm Reduction, Syringe sharing, Environmental health, Medicine, Humans, Needle Sharing, 030212 general & internal medicine, Substance Abuse, Intravenous, Syringe, Harm reduction, Risk behaviour, business.industry, Health Policy, Multi stage, Pharmaceutical Preparations, Meta-analysis, Female, 0305 other medical science, business
Abstract: BackgroundInjecting risk behaviour, such as receptive sharing of injecting equipment and/or re-using one's equipment, is associated with bloodborne virus transmission and infections in people who inject drugs (PWID). We aimed to estimate prevalence and correlates of injecting risk behaviours amongst PWID.MethodsWe conducted a systematic review and meta-analyses to estimate country, regional, and global prevalences of injecting risk behaviours (including sharing or re-using needle/syringe and sharing other injecting equipment). Using meta-regression analyses, we determined associations between study- and country-level characteristics and receptive needle/syringe sharing.ResultsFrom 61,077 identified papers and reports and 61 studies from expert consutation, evidence on injecting risk behaviours was available for 464 studies from 88 countries. Globally, it is estimated that 17.9% (95%CI: 16.2–19.6%) of PWID engaged in receptive needle/syringe sharing at last injection, 23.9% (95%CI: 21.2–26.5%) in the past month, and 32.8% (95%CI: 28.6–37.0%) in the past 6–12 months. Receptive sharing of other injecting equipment was common. Higher prevalence of receptive needle/syringe sharing in the previous month was associated with samples of PWID with a lower proportion of females, shorter average injecting duration, a higher proportion with ≥daily injecting, and older studies. Countries with lower development index, higher gender inequality and lower NSP coverage had higher proportions reporting receptive needle/syringe sharing.ConclusionsHigh levels of injecting risk behaviours were observed amongst PWID globally, although estimates were only available for half of the countries with evidence of injecting drug use. There is a need for better capturing of injecting risk behaviours in these countries to inform implementation of harm reduction services and evaluate potential impacts of interventions to reduce risk.
Published: 2020
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147. A long term condition / disability, loneliness, and social isolation are associated with lower quality of life, but a sense of coherence buffers the adverse effects: a cross sectional study in older people

Author: Neil J Angus, Janni Leung, Vasiliki Kiparoglou, Iain Atherton, and Hugo Cornelis van Woerden
Subjects: Gerontology, Quality of life (healthcare), Cross-sectional study, medicine, Loneliness, Social isolation, medicine.symptom, Older people, Adverse effect, Psychology, Sense of coherence, Term (time)
Abstract: Background The impact of disability, long term conditions, rurality, living alone, and being a carer on health has some evidence base. The extent to which a strong sense of coherence, a factor hypothesised to promote wellbeing, may moderate these associations is unknown. A model of physical, environmental and social factors on quality of life was tested, with particular emphasis on whether a strong sense of coherence (SoC) buffered these determinants of quality of life.Methods A cross sectional postal survey was undertaken of a random sample of 3,000 individuals over 65 years, across a rural population. Physical, environmental, and psychological variables were assessed against quality of life using ANOVA and a generalised linear model including the interaction effects of SoC.Results Of 1,547 responses, 1,471 were analysable and provided permission for research use. ANOVA demonstrated that age, gender, long-term condition / disability (LTC-D), living alone, >20 hours unpaid care for others per week, SoC, and loneliness, were associated with lower quality of life (p0.01), between age and LTC-D, living alone, and poor SoC. Living alone was correlated with emotional and social loneliness; but those with higher SoC were less likely to experience loneliness. In an adjusted generalised linear model, significant associations with a lower quality of life were observed from: LTC-D, emotional loneliness and social loneliness (B= -0.44, -0.30, and -0.39, respectively, all p
Published: 2020
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148. Contributors

Author: Abdul Rahman Ahmad Badayai, Nadzirah Ahmad Basri, Katrina Champion, Yoke Yong Chen, Genevieve F. Dash, Louisa Degenhardt, Paul H. Delfabbro, Cecilia A. Essau, Sarah W. Feldstein Ewing, Jessica Furtado, Wayne Hall, Sarah Head, Cecilie Juul Hinze, Delyse Hutchinson, Daniel L. King, Janni Leung, Mia Beck Lichtenstein, Dennis Long, Paul McArdle, Nicola C. Newton, Michèle Preyde, Jennifer A. Silvers, Steve Sussman, Samantha Teague, Kristine Rømer Thomsen, Chuong Hock Ting, Jennifer Y. Tsai, and Suzaily Wahab
Published: 2020
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149. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. Prakash, Shuhei Nomura, Inga Dora Sigfusdottir, Anders Larsson, Sharareh Eskandarieh, Abdollah Mohammadian-Hafshejani, Somayeh Bohlouli, Joana Morgado-da-Costa, Siamak Sabour, Theo Vos, Han Yong Wunrow, Khaled Khatab, Alireza Zangeneh, Ann Kristin Knudsen, Marissa B Reitsma, Hannah J. Henrikson, Randah R. Hamadeh, Tuomo J. Meretoja, Ireneous N. Soyiri, Giuseppe Grosso, Ziyad Al-Aly, Taraneh Yousefinezhadi, Joseph L Ward, Roba Khundkar, Ricardo Santiago Gomez, Reza Malekzadeh, John J. McGrath, Sandra B. Munro, Shahin Soltani, Amy E. Peden, Rufus Akinyemi, Marcel Ausloos, Naohiro Yonemoto, Bogdan Wojtyniak, Ahmad Ghashghaee, Guilherme Borges, Sadia Bibi, Farhad Islami, Hamed Mirzaei, Mohammad Ali Sahraian, M. Ashworth Dirac, Hosna Janjani, Kairat Davletov, Hermann Brenner, Yuichiro Yano, Elissa M. Abrams, Ana Vukovic, Bartosz Miazgowski, Jobert Richie Nansseu, Jennifer O Lam, Mona Pathak, Leeberk Raja Inbaraj, Thirunavukkarasu Sathish, Asadollah Gholamian, Carlos A Castañeda-Orjuela, Babak Eshrati, Edgar Denova-Gutiérrez, Atte Meretoja, Lorenzo Monasta, Ronan A. Lyons, Neda Kianipour, Desalegn Getnet Demsie, Yasir Waheed, Desta Debalkie Atnafu, Davide Sattin, Kevin S Ikuta, Ghobad Moradi, Srinivas Goli, Krittika Bhattacharyya, Mika Kivimäki, Christopher Troeger, Jordi Alonso, Alireza Ahmadi, Navid Manafi, Caroline Stein, Songhomitra Panda-Jonas, Jason Nguyen, Moses K. Muriithi, Aziz Rezapour, Ismael R. Campos-Nonato, Adrian Pana, H. Dean Hosgood, Noore Alam, James L. Fisher, Mariam Molokhia, Susan F. Rumisha, Ernoiz Antriyandarti, Ayman Grada, Emma Nichols, Babak Asghari, André Luiz Sena Guimarães, Ferrán Catalá-López, Aletta E. Schutte, Fiona B. Bennitt, Maciej Banach, Antonio Biondi, Donal Bisanzio, Josip Car, Ronny Westerman, Shafiu Mohammed, Biniyam Sahiledengle Geberemariyam, Kenji Shibuya, Meghdad Pirsaheb, Milena Santric-Milicevic, Karen M. Tabb, Paula Moraga, Soheil Hassanipour, Hasan Yusefzadeh, Avina Vongpradith, Dara K. Mohammad, Ralph Maddison, Babak Moazen, Getachew Mullu Kassa, Rahman Shiri, Fernando Neves Hugo, Hmwe H Kyu, Zachary V Dingels, Florian Fischer, Valentin Yurievich Skryabin, Rafael Tabarés-Seisdedos, Massimo Cirillo, Nikita Otstavnov, Robert C. Reiner, Van C. Lansingh, Rodrigo Sarmiento-Suarez, Ashkan Afshin, Benjamin A Stark, Mohsen Abbasi-Kangevari, Natalie C. Galles, Behnam Heidari, Eun-Kee Park, Mohammad Ali Jahani, Suzanne Polinder, Mahalaqua Nazli Khatib, Farhad Jadidi-Niaragh, Amir Radfar, Mowafa Househ, Derrick A Bennett, Gaorui Guo, Hesam Ghiasvand, Taweewat Wiangkham, Tamás Joó, Cristiana Abbafati, Kathryn Mei Ming Lau, Anita K. Nandi, Miklós Szócska, Manasi Kumar, Eduardo A. Undurraga, Oladimeji M. Adebayo, Simon Yadgir, Victor Aboyans, Justin J. Lang, Catherine O. Johnson, Soewarta Kosen, Carla Sofia e.Sá Farinha, Marcos Roberto Tovani-Palone, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Heather Orpana, Samuel B. Albertson, Mahdi Afshari, Nicholas J K Breitborde, Nelson J. Alvis-Zakzuk, Adrian Oţoiu, Iván Landires, Robert G. Weintraub, Kidanemaryam Berhe, André Faro, Sophia Emmons-Bell, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Yordanos Gizachew Yeshitila, Mehdi Hosseinzadeh, Arash Etemadi, Oleguer Plana-Ripoll, Theodore Patrick Younker, Joemer C. Maravilla, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayanaswamy Venketasubramanian, Seyed Mohammad Kazem Aghamir, Linda Morales, Amanda Deen, Noushin Mohammadifard, Obinna Onwujekwe, Ai Koyanagi, Michele Nguyen, Chieh Han, Kiana Ramezanzadeh, Mika Shigematsu, Mohammed Shannawaz, Khurshid Alam, Javad Nazari, Bryan L. Sykes, Rajat Das Gupta, Stephen S Lim, Lingkan Barua, Zubair Kabir, Michael Brauer, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Kaja Abbas, Gholamreza Bazmandegan, Mark A. Stokes, Rajaa Al-Raddadi, Kanyin L. Ong, Kate Causey, Ahmed Omar Bali, Matilde Leonardi, Jeffrey V. Lazarus, Wondimeneh Shibabaw Shiferaw, André Karch, Blair R. Bumgarner, Nelson Alvis-Guzman, Jennifer H MacLachlan, Saeed Amini, Parvaiz A Koul, Blessing J. Akombi, Ro Ting Lin, Dabere Nigatu, Alaa Badawi, Flavia M. Cicuttini, Deanna Anderlini, Claudio Alberto Dávila-Cervantes, Rupert R A Bourne, Tanuj Kanchan, Catherine P. Benziger, Tahiya Alam, M. Mofizul Islam, Muktar Omer Omer, Leila Zaki, Mehdi Mirzaei-Alavijeh, Inbal Salz, Katharine J Looker, Shiwei Liu, Fatemeh Amiri, Christopher R. Cederroth, Mitra Abbasifard, Hamidreza Pazoki Toroudi, Gbenga A. Kayode, Antonio Luiz Pinho Ribeiro, Krishna Kumar Aryal, Mu'awiyyah Babale Sufiyan, Mohamed M. Gad, Assefa Desalew, Lidia Morawska, Davood Anvari, Mohammad Reza Salahshoor, Hadi Pourjafar, Abdu A. Adamu, Maryam Adabi, Zulfiqar A. Bhutta, Jessica A. Cruz, Foad Abd-Allah, Amir Hasanzadeh, Jordan Weiss, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Joanna L Whisnant, Kelly Compton, Priya Parmar, Sanjay Basu, Leila R Kalankesh, Nickolas Reinig, Ana Maria Mantilla Herrera, Fatemeh Rajati, Damian Santomauro, Mojisola Oluwasanu, Sheikh Mohammed Shariful Islam, David M. Pereira, Joht Singh Chandan, Deepak Kumar Pasupula, Aristidis Tsatsakis, Hoa Thi Do, Whitney L. Teagle, Hans W. Hoek, James Leigh, Morteza Arab-Zozani, Yasser Vasseghian, Stephanie R M Zimsen, Charlie Ashbaugh, Fariba Dorostkar, Abdelrahman Ibrahim Abushouk, Mikk Jürisson, Golnaz Heidari, Kala M. Mehta, Saeed Shahabi, Sarah Wulf Hanson, Nizal Sarrafzadegan, Dharmesh Kumar Lal, Hai Quang Pham, Aleksandr Y. Aravkin, Joshua A. Salomon, David C. Schwebel, Milena Ilic, Kareha M Agesa, Jost B. Jonas, Dian Kusuma, Benjamin B. Massenburg, Santosh Varughese, Yousef Mohammad, Beatriz Paulina Ayala Quintanilla, Mihaela Hostiuc, Richard G. Cowden, Morteza Shamsizadeh, Thomas Pilgrim, Alessandra C. Goulart, Leila Doshmangir, Gabriele Nagel, Saravanan Muthupandian, Zahra Sadat Dibaji Forooshani, Maryam Mirzaei, Zabihollah Yousefi, Shadrach Wilson, Iman El Sayed, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Eirini Skiadaresi, Reza Shirkoohi, Tim Driscoll, Morteza Jafarinia, Maha El Tantawi, Telma Zahirian Moghadam, Katarzyna Kissimova-Skarbek, Abdilahi Yousuf Yousuf, Dickson A. Amugsi, Awoke Misganaw, Maseer Khan, Norito Kawakami, Jingkai Wei, Jai K Das, Vishnu Renjith, Tessa M. Pilz, Sameer Vali Gopalani, Roghiyeh Faridnia, Islam Y. Elgendy, Prateek Rastogi, Lauren B. Wilner, Josep Maria Haro, Zahiruddin Quazi Syed, Ben Lacey, Ketema Bizuwork Gebremedhin, Sam Rolfe, Iffat Elbarazi, Yannick Béjot, Raimundas Lunevicius, Sezer Kisa, Harish Chander Gugnani, Basema Saddik, Manu Raj Mathur, Mansour Ghafourifard, Riaz Uddin, Anna Poznańska, Faris Lami, Niguse Meles Alema, Michael T. Chung, Arya Aminorroaya, Arash Sarveazad, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, João M. Furtado, Hamid Ahmadieh, Sara Conti, Yunquan Zhang, Manthan D Janodia, Aislyn U. Orji, S. Mohammad Sajadi, Jalal Arabloo, Gabrielle B. Britton, Colm McAlinden, Francisco Rogerlândio Martins-Melo, Simona Cătălina Ştefan, Ester Cerin, Nuno Taveira, Lars Jacob Stovner, Amir Taherkhani, Masoud Foroutan, Tomasz Miazgowski, Amir Manafi, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Man Mohan Mehndiratta, Graeme J. Hankey, Mojgan Gitimoghaddam, Chantal Huynh, G Anil Kumar, Martin Amogre Ayanore, Abbas Sheikhtaheri, Turki Alanzi, Simon Øverland, David Laith Rawaf, Brian J. Hall, Edward J Mills, Ali Kabir, Ravi Prakash Jha, Akbar Barzegar, Simin Mouodi, Alize J. Ferrari, Chirag P. Doshi, Saleh Salehi Zahabi, Mohsen Naghavi, Mohammad Hassan Emamian, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Maarten J. Postma, David Edvardsson, Chhabi Lal Ranabhat, Catherine M. Antony, Hannah Han, Ken Lee Chin, Getinet Ayano, Kewal Krishan, Maryam Zamanian, Farshad Farzadfar, Ali A. Asadi-Pooya, Daniel Diaz, Oliver J. Brady, Mohsen Bayati, Christopher M Odell, Jalil Jaafari, Walter Mendoza, Susanna Dunachie, Raffaele Palladino, Raaj Kishore Biswas, Alessandra Lugo, Reshmi Bhageerathy, Paulo A. Lotufo, Maia Kereselidze, Salman Rawaf, Olayinka Stephen Ilesanmi, Mousa Yaminfirooz, Neeraj Bedi, Mahesh P A, Harvey Whiteford, Gina Agarwal, Pallab K. Maulik, Ranjitha S Shetty, Adhanom Gebreegziabher Baraki, Prasanna Mithra, Binyam Minuye Birihane, Mohammad Ali Mansournia, Tomislav Mestrovic, Razique Anwer, Marcello Tonelli, Hanne Christensen, Juan Jesus Carrero, Ali H. Mokdad, Alberto Ortiz, Samad Azari, Ted R. Miller, Rebecca Ivers, Stephen R. Robinson, Saeid Safiri, Masood Ali Shaikh, Rajesh Sagar, Kelly Cercy, Mehran Asadi-Aliabadi, João Vasco Santos, Maziar Moradi-Lakeh, Sarah Lewington, Dimas Ria Angga Pribadi, Savita Lasrado, Abdul Moiz Hafiz, Amir Almasi-Hashiani, Burcu Kucuk Bicer, Praveen Hoogar, Fatemeh Heydarpour, Hala Rashad Elhabashy, Peng Zheng, Senthilkumar Balakrishnan, Paul H. Lee, Cameron J. Kneib, Srinivasa Rao Bolla, Harrison Chase Gottlich, Andrew M. Briggs, Alibek Mereke, Om P Kurmi, Kavumpurathu Raman Thankappan, Nikolay Ivanovich Briko, Shahram Saeidi, Anbissa Muleta Senbeta, Assefa Ayalew Ayalew Ayalew Gebreslassie, Aminu K. Bello, Tomi Akinyemiju, Ambrish Singh, Anamika Pandey, Matthew Cunningham, Endalkachew Worku Mengesha, Christine Linehan, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Stanislav S. Otstavnov, Andre M. N. Renzaho, Dinesh Bhandari, Masoud Moghadaszadeh, Atkilt Esaiyas Etisso, Valery L. Feigin, Christopher J L Murray, James D. Harvey, Daniel Cury Ribeiro, Girikumar Kumaresh, Javad Yoosefi Lebni, Elisabetta Pupillo, Shaimaa I. El-Jaafary, Marlena S Bannick, Caitlyn Steiner, Agus Sudaryanto, Eduardo Bernabé, Fereshteh Mehri, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Shaun Roberts, Rajeev Gupta, Jamal A. Yearwood, Nima Rezaei, Muhammad Shahdaat Bin Sayeed, David M. Pigott, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Pankaj Bhardwaj, Suzanne Lyn Barker-Collo, Fiona J Charlson, Norberto Perico, Jonathan M. Kocarnik, Sergio I. Prada, Mohammad Sadegh Rezai, Mustafa Z. Younis, Neeraj Bhala, Mahmoud Yousefifard, Hue Thi Mai, Marwa Rashad Salem, Reza Pourmirza Kalhori, Carl Abelardo T. Antonio, Stefan Lorkowski, Farzad Jalilian, Nicholas J Kassebaum, Haley Lescinsky, Gholamreza Roshandel, Reza Heidari-Soureshjani, Kirsten E. Wiens, Ionut Negoi, Bhaskaran Unnikrishnan, Daniel J. Weiss, Sare Safi, Hamid Reza Tohidinik, Fablina Sharara, François Alla, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Jack T Fox, Amirhossein Sahebkar, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Firooz Esmaeilzadeh, Brittney S. Sheena, Kyle E. Simpson, Muluken Bekele Sorrie, Vivekanand Jha, Morteza Abdullatif Khafaie, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, George C. Patton, Rashid Abdi Guled, Tim C.D. Lucas, Alberto Raggi, Peter W. Gething, Mohaimenul Islam, Abdallah M. Samy, Cuong Tat Nguyen, Kaleab Alemayehu Zewdie, Ahamarshan Jayaraman Nagarajan, Roman Topor-Madry, C. E. G. Brayne, Phoebe Anne Rhinehart, Isabela M. Benseñor, Michal Grivna, Taren M. Gorman, Natalie C. Momen, Afsaneh Arzani, Tufa Kolola, Maryam Khayamzadeh, Alexandra S. Boon-Dooley, Ihoghosa Osamuyi Iyamu, Nima Hafezi-Nejad, Hassan Abolhassani, Perminder S. Sachdev, Vivek Kumar, Anton Sokhan, Mahmood Moosazadeh, Davoud Adham, Ahad Bakhtiari, Nataliya A. Foigt, Venkatesh Maled, Henok Biresaw Netsere, Seyedeh Zahra Masoumi, Ashley Marks, Rizwan Kalani, Soraya Siabani, Jiayu Wang, Samath Dhamminda Dharmaratne, Lucas Guimarães Abreu, Vivian Chia-Rong Hsieh, Kris J. Krohn, Falk Schwendicke, Alex R. Chang, Muhammad Ali, Christine Lin, Rose G Bender, Arielle Wilder Eagan, Tissa Wijeratne, Chris D Castle, Saif Ullah, Nikolaos Dervenis, Joan B. Soriano, Syed Amir Gilani, Jianing Ma, Giuseppe Remuzzi, Dana Bryazka, Christian Razo, Manuela L. Ferreira, Ankur Joshi, Alireza Rafiei, Vinay Nangia, Victor Adekanmbi, Frances E. Dean, Chuanhua Yu, Elizabeth A. Cromwell, Pascual R. Valdez, Jennifer Rickard, Daniel Youngwhan Cho, Ashish Pathak, Angel Paternina-Caicedo, Mehdi Ahmadi, Zichen Liu, Achala Upendra Jayatilleke, Diego De Leo, Sarah Charlotte Johnson, Getenet Dessie, Zhi Jiang Zhang, Christopher S. Crowe, Farhad Ghamari, Behshad Naghshtabrizi, Francesco Saverio Violante, Muhammad Aziz Rahman, Ramesh Holla, Kate E. LeGrand, Christian Kieling, Vahid Yazdi-Feyzabadi, Shivanthi Balalla, Molly H Biehl, Mostafa Dianatinasab, Mina Anjomshoa, Abdel Douiri, Laith J. Abu-Raddad, Rade Vukovic, Amiran Gamkrelidze, Michael R. Phillips, Yafeng Wang, Sachin R Atre, Miriam Levi, Zelalem Nigussie Azene, Kevan R. Polkinghorne, Deepak Paudel, Hung Chun Liu, Zainab Samad, Robert P. Dellavalle, Florentino Luciano Caetano dos Santos, Juan Sanabria, Mohammad Fareed, Enrico Rubagotti, Samantha Leigh Larson, Anurag Agrawal, Shai Linn, Saad M.A. Dahlawi, Janni Leung, Shokofeh Maleki, Michael R.M. Abrigo, Michael Kravchenko, Mohd Anisul Karim, Alyssa N. Sbarra, Jacob L. 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L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL
Subjects: Male, Life expectancy, Disability-Adjusted Life Year, Diseases, Disease, communicable disease, systematic analysis, Global Burden of Disease, 0302 clinical medicine, 80 and over, Medicine, 10. No inequality, Child, 11 Medical and Health Sciences, injuries, Aged, 80 and over, education.field_of_study, Sjúkdómar, DEMENTIA, FALLS, General Medicine, Forvarnir, 3. Good health, Child, Preschool, Human, GBD, Population health, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Global Burden of Disease Study, education, Aged, Spatial Analysis, Global burden, Disability, Prevention, DISABILITY, Infant, Spatial Analysi, Mortality rate, Global Burden of Disease, Diseases, Injuries, Systematic analysis, PREVENTION, Years of potential life lost, Risk factors, Disease study, ITC-ISI-JOURNAL-ARTICLE, RISK-FACTORS, Clinical Medicine, RA, Demography, Fötlun, Dánartíðni, Áhættuþættir, 030204 cardiovascular system & hematology, Risk Factors, Cause of Death, Global health, 030212 general & internal medicine, 1. No poverty, Disability-Adjusted Life Years, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, 3142 Public health care science, environmental and occupational health, Adolescent, Adult, Age Distribution, Female, Infant, Newborn, Young Adult, Lýðheilsa, CLINICAL-TRIALS, Population, Settore MED/01 - Statistica Medica, diseases, ITC-HYBRID, Heilbrigðisvísindi, General & Internal Medicine, Mortality, Preschool, Disease burden, business.industry, Risk Factor, Klinisk medicin, Newborn, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Áverkar, Systematic analysis, NA, business
Abstract: Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"
Published: 2020
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150. Adolescent cannabis use disorders

Author: Wayne Hall, Janni Leung, and Louisa Degenhardt
Subjects: Drug, medicine.medical_specialty, biology, business.industry, media_common.quotation_subject, Cannabis use, biology.organism_classification, medicine, Anxiety, Cannabis, Substance use, medicine.symptom, Psychiatry, business, Cannabis Dependence, Imprisonment, Depression (differential diagnoses), media_common
Abstract: Cannabis is the illicit drug that is most often used by adolescents and the one that young people are most likely to develop dependence on. Cannabis dependence is more common in males, especially those who display disruptive and antisocial behavior and, to a lesser extent, in those with anxiety and depression. Problem cannabis use is strongly associated with alcohol and other forms of drug dependence, early school leaving, antisocial behavior and imprisonment. We describe patterns of cannabis use, present evidence on the development of cannabis use disorders, associated outcomes and risk factors, and discuss the special challenges in treatment. Broader preventive initiatives involving parents, schools, and communities are required to address the multiple risk factors and high rates of comorbid substance use and mental disorders associated with problem cannabis use in adolescents.
Published: 2020
Full Text: View/download PDF

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