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Background: Scotland currently has amongst the highest rates of drug-related deaths in Europe, leading to increased advocacy for safer drug consumption facilities (SDCFs) to be piloted in the country. In response to concerns about drug-related harms in Edinburgh, elected officials have considered introducing SDCFs in the city. This paper presents key findings from a feasibility study commissioned by City of Edinburgh Council to support these deliberations. Methods: Using a multi-method needs assessment approach, we carried out a spatial and temporal analysis of drug-related data in Edinburgh including health, mortality, consumption, crime and service provision indicators; and 48 interviews including 22 people with lived/living experience (PWLE) of drug use in the city, five family members affected by drug-related harms, and 21 professional stakeholders likely to be involved in commissioning or delivering SDCFs. Data were collected using a convergent parallel design. We carried out a descriptive analysis of quantitative date and a thematic analysis of qualitative data. Quantitative data provides an overview of the local context in terms of recorded harms, service provision and consumption patterns as reported in prior surveys. Qualitative PWLE and families data captures the lived experiences of people who use drugs, and affected loved ones, within that local context, including perceived consumption trends, views on the practicality of SDCF provision, and hopes and anxieties regarding potential service provision. Professional stakeholders data provides insights into how people responsible for strategic planning and service delivery view the potential role of SDCF provision within the context described in the quantitative data. Results: In Edinburgh, drug-related harms and consumption patterns are dispersed across multiple locations, with some areas of higher concentration. Reported levels of opioid use, illicit benzodiazepine use and cocaine injecting are high. Qualitative interviews revealed strong support for the provision of SDCFs, and a preference for services that include peer delivery. However, PWLE also expressed concerns regarding safety and security, and professional stakeholders remained uncertain as to the prioritisation of facilities and possible opportunity costs in the face of restricted budgets. Conclusion: There is a strong case for the provision of SDCFs in Edinburgh. However, service design needs to reflect spatial distributions of consumption and harm, patterns of consumption by drug type, and expressed preferences for both informality and security among potential service users. Models of SDCF provision used elsewhere in Scotland would therefore need to be adapted to reflect such considerations. These findings may apply more broadly to potential SDCF provision in the UK and internationally, given changing patterns of use and harm. [ABSTRACT FROM AUTHOR]

Background: The phenomenon of growth in drug consumption within the framework of national volume-based procurement (VBP) policy raises speculations about demand release and policy inducing. This study aims to explore the reasons and mechanisms of drug consumption increases following VBP policy from two perspectives. Methods: We collected data from the China Drug Supply Information Platform, National Bureau of Statistics and the Joint Procurement Office. Twenty cardiovascular international non-proprietary names (INNs) in the first three VBP batches and 28 observation regions were included, constructing 418 valid INN-region combinations as the unit for analysis. The average monthly consumption volume of VBP cardiovascular drug was assigned as the explained variable. The generalized difference-in-difference method was conducted using the price reduction level and the size of policy assessment task as the policy intensity indicator. Moderating effect model was employed to examine the role of resident's income level. Results: Increased cardiovascular drug consumption was observed in 285 (68.18%) INN-region combinations after policy implementation. Under VBP policy, the price reduction level was significantly correlated with drug consumption in total (β = 0.144, p < 0.001), as well as in tertiary hospitals, secondary hospitals and primary healthcare centers (PHCs) (all p-values < 0.05). Resident's income level negatively moderated the impact of price reduction level on drug consumption in total (β = −0.089, p < 0.001) and in secondary hospitals (β = 0.154, p < 0.001) and PHCs (β = −0.2.9, p < 0.001), rather than in tertiary hospitals (β = −0.079, p > 0.05). The size of policy assessment task was positively associated with drug consumption in total (β = 0.052, p < 0.001), as well as in tertiary hospitals, secondary hospitals and PHCs (all p-values < 0.05). Conclusions: Two mechanisms codrive drug consumption increases under VBP policy: first is the improvement of cardiovascular medication access and consumption toward lower-income groups following price reduction, pointing to the fulfillment of unmet needs, and second is policy pressure from supporting assessment measures on hospital drug use, indicating potential overprescribing. [ABSTRACT FROM AUTHOR]

Aim: Electronic prescribing has allowed for the collection of prescription data in real time in Greece for the first time. Hence, the aim of the current study was to present the characteristics of prescriptions for the Greek population during the period from 2015 to 2021. Methods: This retrospective study was based on data extracted from the nationwide Greek electronic prescription database between January 2015 and December 2021. Descriptive statistics methods were used for the needs of the study. As the basic figures examined depend on the size of the population, in order for the results to be comparable, we estimated the corresponding measures per inhabitant, using population data from the Greek Statistical Authority. Appropriate indicators for the comparison of consumption and expenditure over time were estimated. A study of the trend was also carried out using time series and linear regression models. In order to facilitate the design and implementation of specialized policies, it is useful to identify the drug categories with the highest consumption and expenditure, as well as the geographical areas that present similar characteristics. For the first, ABC analysis was used, which helps to identify the most popular categories of drugs, while for the second, cluster analysis was carried out. Agglomerative clustering was used to divide the regions into similar groups. This hierarchical clustering algorithm classifies the population into several clusters, with areas in the same cluster being more similar, and areas in different clusters being dissimilar. The Ward linkage method with Euclidean distance was used. Results: The analysis of prescription drug consumption and expenditure from 2015 to 2021 revealed significant fluctuations and trends across various drug categories, age groups, and geographical areas. Notably, the quantity of prescriptions increased by 20% since 2015, while expenditure surged by over 30%, with significant spikes following the end of the MoU in 2019 and the onset of the pandemic in 2020. In terms of expenditure, antineoplastic and immunomodulation agents (category L) held the largest share, driven by the introduction of new, costly drugs. The expenditure per inhabitant revealed gender and age disparities, with older populations, particularly women, incurring higher costs. Geographically, drug expenditure, and consumption varied significantly, with distinct regional clusters identified. These clusters, while showing some overlap in consumption and expenditure patterns, also highlighted unique regional characteristics. Conclusions: The insights into prescription drug consumption and expenditure trends offer a valuable basis for developing targeted interventions aimed at optimizing healthcare resource allocation. Moreover, the findings underscore the importance of addressing regional and demographic disparities in pharmaceutical use, thereby contributing to more equitable and cost-effective healthcare strategies. More specifically, the age distribution of prescriptions shows the increase in younger ages, which, as a result, anticipates the overall increase in prescriptions. The knowledge of the most convex categories of medicine, as well as the percentages of the use of generic drugs, shows where interventions should be made, with financial incentives and information through new information channels. The geographic disparities recorded should lead to policies that help the residents of hard-to-reach areas to access prescriptions. In addition, the present study provides a strategic framework for policymakers and healthcare managers to guide future studies and inform decision-making processes. [ABSTRACT FROM AUTHOR]

With the fall of communism and the emergence of new social phenomena, drug trafficking and consumption began to become visible in Romania as well. The continuous increase in the standard of living in Romania, especially after the accession to the European Union, associated with the ignorance of some aspects regarding the consequences in terms of health and individual well-being, have caused a number of young and less young people to become frequent or occasional drug users. The statistics of the National Anti-Drug Agency are relevant in this. In addition to the classic legal aspects and health, respectively social and individual well-being, there are also aspects related to human rights violations. Drug trafficking and consumption are flagrant violations of human rights due to the consequences they cause on an individual, family and community level.

Objective: Social support plays a crucial role in modifying health-related behaviors aimed at controlling chronic diseases, such as type 2 diabetes. This research investigates the social support status of patients with type 2 diabetes in Kerman, Iran. Materials and Methods: This cross-sectional study utilized a descriptive-analytical approach and investigated 184 patients referred to the diabetes clinic. The participants were selected through systematic sampling, and data were collected using a questionnaire. Descriptive statistics, including frequency, mean, and standard deviation, were calculated. Multivariate linear regression was employed to analyze the data, which were entered into the Statistical Package for the Social Sciences version 16 statistical software. Results: The findings indicate that social support was most prominent in the area of nutrition, whereas it was least prominent in the area of exercise. Gender was found to have a statistically significant relationship with both nutritional status and drug consumption dimensions, as women demonstrated lower average scores in these areas compared to men. Moreover, gender and education were observed to impact the dimension of general care. However, none of the demographic characteristics analyzed showed a statistically significant relationship with exercise and physical activity. Conclusion: It is crucial to give ample attention to supporting and empowering patients’ families and social groups. Furthermore, adding psychological dimensions to social support could be beneficial. These findings underscore the importance of tailored interventions that target specific areas of support, such as exercise and general care, and take into account the differences between men and women.

Background: The assessment of antidepressant and anxiolytic consumption and expenditures represents a reliable barometer of the burden of such mental health disorders and the effectiveness of relative healthcare services. Objectives: The current analysis aims to evaluate trajectories of consumption and expenditures of antidepressant and anxiolytic drugs to define patterns of usage and spending across 14 European countries between 2012 and 2021. Methods: A retrospective longitudinal study was performed based on pooled time series secondary data analysis over 2012/2021. Defined Daily Doses (DDD) per 1000 inhabitants and health expenditure per capita were analysed. Linear and quadratic trends were computed to determine relationships between the variables of interest. Results: Only 2 patterns of consumption/expenditure of antidepressants can be identified: consumption and expenditure both grow; consumption grows, and spending decreases. Consumption and expenditures registered 2 main patterns, decreasing in most European countries and increasing only in 2 cases. Conclusion: Prevailing patterns of consumption and spending show an increase in antidepressants and a decrease in anxiolytics. The variation in consumption of such drugs during this timeframe is attributable to several reasons, such as the epidemiological characteristics of mental disease, for instance, the prevalence and incidence of disorders, the accessibility of drugs and alternative treatments, like psychotherapy, different clinical practices and national guidelines. However, such analyses deserve attention for targeted policies and strategies for promoting mental health. [ABSTRACT FROM AUTHOR]

Objective: Social support plays a crucial role in modifying health-related behaviors aimed at controlling chronic diseases, such as type 2 diabetes. This research investigates the social support status of patients with type 2 diabetes in Kerman, Iran. Materials and Methods: This cross-sectional study utilized a descriptive-analytical approach and investigated 184 patients referred to the diabetes clinic. The participants were selected through systematic sampling, and data were collected using a questionnaire. Descriptive statistics, including frequency, mean, and standard deviation, were calculated. Multivariate linear regression was employed to analyze the data, which were entered into the Statistical Package for the Social Sciences version 16 statistical software. Results: The findings indicate that social support was most prominent in the area of nutrition, whereas it was least prominent in the area of exercise. Gender was found to have a statistically significant relationship with both nutritional status and drug consumption dimensions, as women demonstrated lower average scores in these areas compared to men. Moreover, gender and education were observed to impact the dimension of general care. However, none of the demographic characteristics analyzed showed a statistically significant relationship with exercise and physical activity. Conclusion: It is crucial to give ample attention to supporting and empowering patients' families and social groups. Furthermore, adding psychological dimensions to social support could be beneficial. These findings underscore the importance of tailored interventions that target specific areas of support, such as exercise and general care, and take into account the differences between men and women. [ABSTRACT FROM AUTHOR]

Illicit drug use is common among attendees of electronic dance music (EDM) festivals, but is often significantly underreported by participants. The current study aimed to compare the prevalence and over- and under-reporting of illicit drug use among attendees at EDM festivals in two European countries with distinct drug laws and cultures. Self-reported data regarding recent drug use were collected through interviews. Participants' blood alcohol concentrations were measured using a breathalyzer. Recent illicit drug use was assessed through sampling microparticles in the breath and consequent off-site analysis through liquid chromatography and tandem mass spectroscopy. Illicit drug use was higher in Belgium than in Sweden as indicated by self-reports (56.8 vs. 4.3%) and drug testing (37.2 vs. 12.5%). Underreporting was higher in Sweden than in Belgium; in Sweden, only 2.6% reported taking an illicit drug other than cannabis, whereas 11.6% tested positive, while the corresponding figures in Belgium were 36.5% and 36.9%. In both countries, results from self-reporting and drug testing for specific drugs matched poorly at the individual level, indicating unwitting consumption of substances. This study indicates that the drug use prevalence and the likelihood of disclosure may differ between countries or cultures, which should be considered when choosing methods to investigate drug use prevalence. [ABSTRACT FROM AUTHOR]

Hydration status plays a key role in healthy ageing, and it is potentially affected by several factors, including drug consumption. However, research on this issue to date is scarce, especially in highly vulnerable groups, such as the elderly. We aimed to study the relationship linking hydration status, analysed by means of a validated questionnaire, 24 h urine analysis, body composition assessment, and drug consumption in a sample of old adults. A total of 144 elders were included in the study. Cardiovascular drug consumption was significantly associated with a lower water intake in men (β = −0.282, p = 0.029). Moreover, urinary analysis revealed that total drug intake as well as the consumption of diuretics and cardiovascular drugs were associated with poorer hydration status, whereas genito-urinary drugs were associated with an opposite effect, and these results were confirmed in terms of body composition. Hence, total drug consumption (β = −0.205), diuretic (β = −0.408), cardiovascular (β = −0.297), and genito-urinary drugs (β = 0.298) were significantly associated (p < 0.05) with total body water. The obtained results confirmed the impact of chronic treatment with certain drugs on hydration status. Nutritional interventions may be of great interest in certain population groups in order to prevent complications due to altered hydration status. [ABSTRACT FROM AUTHOR]

Music is a form of art that can directly and indirectly convey thoughts and feelings. Sadness and anger are powerful emotions when expressed via music. Music has been used to heal mental and physical health situations for a long time. Sometimes, the visual industry is the mirror of society but sometimes it creates the society also. Music has both positive and negative effects. It has impact on education, psychological health, culture and education among others. In this study, the researcher, had tried to understand the impact of Punjabi songs on university students. The study collected data from different university students in the district of Bathinda. The universe of the study was the college-going students in the Bathinda district of Punjab. Three universities were selected for this study and from those three universities, students were selected randomly to explore the impact of Punjabi songs on youth. Data was collected from 120 students. The study showed that students think the songs are for entertainment and important for relaxing the mind. The study also recorded the responses of students on the effect of Punjabi songs on education, culture, psychology, human behaviour and drug consumption attitudes. [ABSTRACT FROM AUTHOR]

Background: When addressing antisocial behaviour among adolescents, programs based on the paradigm of positive psychology through enhancing self-efficacy have demonstrated their effectiveness in furthering the positive development of young people with a history of antisocial behaviour. Nevertheless, there has been little research into the effectiveness of these type of programs in mitigating substance abuse among juvenile offenders. The aim of this paper is to analyse the effectiveness of a contingency management program in reducing the prevalence of relapses into drug consumption among adolescents who have committed serious crimes. Methods: The study consisted of a sample of 91 male adolescents, between 15 and 19 years, in juvenile detention, who were divided into two treatment groups. For both groups, biological testing was used to detect drug consumption upon their re-turn from leave permits from the Centre. Results: The quasi-experimental group had significantly lower rates of relapse than the quasi-control group. Furthermore, being part of the quasi-experimental group was a significant predictor of reduced rates of relapses. Conclusion: The results suggest that the incorporation of treatment strategies which reinforce feelings of self-efficacy and adequate orientation towards the future, as a complement to disciplinary sanctions, are effective in reducing relapses in drug use among adolescent offenders. [ABSTRACT FROM AUTHOR]

Abstract Background Respiratory Syncytial Virus (RSV) infections may lead to severe consequences in infants born preterm with breathing problems (such as bronchopulmonary dysplasia (BPD) and respiratory distress syndrome (RDS)) or congenital heart diseases (CHD). Since studies investigating the influence of different gestational age (WGA) and concomitant specific comorbidities on the burden of RSV infections are scarce, the present study aimed to better characterize these high-risk populations in the Italian context. Methods This retrospective, longitudinal and record-linkage cohort study involved infants born between 2017 and 2019 in Lazio Region (Italy) and is based on data extracted from administrative databases. Each infant was exclusively included in one of the following cohorts: (1) BPD-RDS (WGA ≤35 with or without CHD) or (2) CHD (without BPD and/or RDS) or (3) Preterm (WGA ≤35 without BPD (and/or RDS) or CHD). Each cohort was followed for 12 months from birth. Information related to sociodemographic at birth, and RSV and Undetermined Respiratory Agents (URA) hospitalizations and drug consumption at follow-up were retrieved and described. Results A total of 8,196 infants were selected and classified as 1,084 BPD-RDS, 3,286 CHD and 3,826 Preterm. More than 30% of the BPD-RDS cohort was composed by early preterm infants (WGA ≤ 29) in contrast to the Preterm cohort predominantly constitute by moderate preterm infants (98.2%), while CHD infants were primarily born at term (83.9%). At follow-up, despite the cohorts showed similar proportions of RSV hospitalizations, in BPD-RDS cohort hospitalizations were more frequently severe compared to those occurred in the Preterm cohort (p

Background: Respiratory Syncytial Virus (RSV) infections may lead to severe consequences in infants born preterm with breathing problems (such as bronchopulmonary dysplasia (BPD) and respiratory distress syndrome (RDS)) or congenital heart diseases (CHD). Since studies investigating the influence of different gestational age (WGA) and concomitant specific comorbidities on the burden of RSV infections are scarce, the present study aimed to better characterize these high-risk populations in the Italian context. Methods: This retrospective, longitudinal and record-linkage cohort study involved infants born between 2017 and 2019 in Lazio Region (Italy) and is based on data extracted from administrative databases. Each infant was exclusively included in one of the following cohorts: (1) BPD-RDS (WGA ≤35 with or without CHD) or (2) CHD (without BPD and/or RDS) or (3) Preterm (WGA ≤35 without BPD (and/or RDS) or CHD). Each cohort was followed for 12 months from birth. Information related to sociodemographic at birth, and RSV and Undetermined Respiratory Agents (URA) hospitalizations and drug consumption at follow-up were retrieved and described. Results: A total of 8,196 infants were selected and classified as 1,084 BPD-RDS, 3,286 CHD and 3,826 Preterm. More than 30% of the BPD-RDS cohort was composed by early preterm infants (WGA ≤ 29) in contrast to the Preterm cohort predominantly constitute by moderate preterm infants (98.2%), while CHD infants were primarily born at term (83.9%). At follow-up, despite the cohorts showed similar proportions of RSV hospitalizations, in BPD-RDS cohort hospitalizations were more frequently severe compared to those occurred in the Preterm cohort (p<0.01), in the BPD-RDS cohort was also found the highest proportion of URA hospitalizations (p<0.0001). In addition, BPD-RDS infants, compared to those of the remaining cohorts, received more frequently prophylaxis with palivizumab (p<0.0001) and were more frequently treated with adrenergics inhalants, and glucocorticoids for systemic use. Conclusions: The assessment of the study clinical outcomes highlighted that, the demographic and clinical characteristics at birth of the study cohorts influence their level of vulnerability to RSV and URA infections. As such, continuous monitoring of these populations is necessary in order to ensure a timely organization of health care system able to respond to their needs in the future. [ABSTRACT FROM AUTHOR]

This study uses 26 in‐depth interviews conducted with people who use drugs (PWUD) who had sought care for chronic non‐cancer pain in public health facilities in Nigeria, to explore how drug consumption stigma constitutes patient legitimacy based on neoliberal ideals. It found drug consumption stigma to be salient and pervasive in PWUD health‐care encounters, operating through interpersonal interactions and institutionalised policies and practices to shape access to care. Crucially, stigma emerged through disciplinary opioid prescribing and dispensing practices that defined, categorised and marginalised PWUD based on how their drug consumption disrupted normative values of rationality and responsibility. Accounts additionally revealed disengagement from biomedical care and reliance on alternative pain management approaches (e.g. herbal remedies and illegal drugs), which show how structural positions shape the exercise of choice and agency in socially marginalised populations. In conclusion, the study considers the need to improve the health‐care experiences of PWUD as a strategy for enhancing health‐care engagement and improving health outcomes. It called for interventions to address the structural factors and interactional dynamics that influence stigma in health‐care settings as well as for a review of current guidelines and practices to improve access to opioids for chronic non‐cancer pain management. [ABSTRACT FROM AUTHOR]

Wastewater-based epidemiology (WBE) has been already proposed by several authors for estimating the consumption of drugs, mainly the illicit ones. However, not much information is available about the actual reliability of this tool given the absence of comparison with the actual consumption. This work aims to evaluate the reliability of the WBE as a tool for estimating the consumption of pharmaceuticals in urban area. Measured consumption back-calculated with a WBE approach was compared with prescription of pharmaceutical products as "control." Moreover, seasonal influence on (i) pharmaceutical consumption, (ii) load of pharmaceutical products in the sewer system, and (iii) reliability of WBE was evaluated. Ciprofloxacin, sulfamethoxazole, metoprolol, carbamazepine, and citalopram were estimated by WBE with a difference respect to the "control" value lower than 0.2 order of magnitude while only trimethoprim and sotalol exceeded the 0.5 order of magnitude of difference but below the 1 order of magnitude. Sedatives were the best represented by WBE (on average 0.15 order of magnitude of difference compared to prescription data). However, further studies are suggested to fully estimate the influence of the type of APs on the reliability of the WBE. Seasonal patterns were found for the load of ciprofloxacin in the sewer and for the consumption of sulfamethoxazole and trimethoprim by population but seasonal changes did not have a significant impact (p > 0.05) on the reliability of WBE. Despite some gaps remained to optimize the reliability of the tool, WBE can be considered a valid method to estimate the consumption of prescribed drugs from the analysis of the sewer system. [ABSTRACT FROM AUTHOR]

BackgroundWhen addressing antisocial behaviour among adolescents, programs based on the paradigm of positive psychology through enhancing self-efficacy have demonstrated their effectiveness in furthering the positive development of young people with a history of antisocial behaviour. Nevertheless, there has been little research into the effectiveness of these type of programs in mitigating substance abuse among juvenile offenders. The aim of this paper is to analyse the effectiveness of a contingency management program in reducing the prevalence of relapses into drug consumption among adolescents who have committed serious crimes.MethodsThe study consisted of a sample of 91 male adolescents, between 15 and 19 years, in juvenile detention, who were divided into two treatment groups. For both groups, biological testing was used to detect drug consumption upon their re-turn from leave permits from the Centre.ResultsThe quasi-experimental group had significantly lower rates of relapse than the quasi-control group. Furthermore, being part of the quasi-experimental group was a significant predictor of reduced rates of relapses.ConclusionThe results suggest that the incorporation of treatment strategies which reinforce feelings of self-efficacy and adequate orientation towards the future, as a complement to disciplinary sanctions, are effective in reducing relapses in drug use among adolescent offenders.

Background: Osteoporosis, as the most common bone-related disease, causes massive irrecoverable consequences for the health level and life quality of people, especially at advanced ages. The present research aimed to evaluate the prevalence and risk factors of osteoporosis and the correlation between drug consumption and osteoporosis. The present study is a cross-sectional study and is the first stage in the longitudinal Fasa branch of the PERSIAN cohort study. Materials and Methods: The subjects of the present cross-sectional-descriptive study consisted of all cohort populations of Fasa University of Medical Sciences (n=10123) who were chosen through census sampling. The data were collected through a demographic data form and medication checklist, and SPSS-22 was used to analyze the data. Results: Among a total population of 10133, 994 had osteoporosis, of which 880 were women and 114 were men, which was statistically significant (P

Obesity is a chronic, complex, relapsing disease impacting healthcare systems and the economy worldwide. We aim to analyze the utilization trends of antiobesity drugs, and their reimbursement status on drug lists of health insurance funds (HIF) in selected European countries. The DDD/1000 inhabitants/day methodology is used for utilization trend analysis, where data from official national utilization reports were used. For the reimbursement status analysis of 5 antiobesity drugs (orlistat, semaglutide, liraglutide, naltrexone/bupropion, setmelanotide), the websites of national health insurance funds (HIF) of 22 European countries were screened. Trend analysis revealed fluctuation for almost all antiobesity drugs (the highest decrease seen for orlistat in Serbia, and the highest increase for liraglutide in Croatia). Novel antiobesity drugs show an increasing utilization trend in almost all the countries. In two out of three European countries, 437 antiobesity drugs are not covered by the HIF. Slovenia and Denmark reimburse most of the antiobesity drugs. The Netherlands is the only country where the cost of setmelanotide is paid by the HIF. Our results emphasize the importance of prioritizing the introduction and implementation of new strategies and reimbursement scheme models in global and national antiobesity policies.

Drug abuse are on the rise, with many users enter the addiction phase, often resulting in overdose and death. Drugs are chemical compounds that are capable of affecting biological functions, and they can induce feelings of happiness and reduce pain. To address this growing problem, a proactive measure is needed. Therefore, this study aims to classify drug users and non-users, so that health workers and therapists can educate about the dangers of drugs to non-users and rehabilitate drug users. This study uses drug consumption data taken from the UCI Irvine Machine Learning Repository. The data consist of 1885 rows with 32 attributes and 2 classes, where there are 18 types of legal and illegal drugs. This research utilizes machine learning methods, specifically Artificial Neural Networks (ANN), Decision Tree (DT), K-Nearest Neighbor (KNN), Support Vector Machine (SVM) and Random Forest (RF), in addition to evaluation methods such as Confusion Matrix and Area Under Curve (AUC). The results showed that RF outperformed the other methods, with accuracy, precision, and recall of 93%, and an f1 score of 89%, while the AUC value was still suboptimal at 0.66. DT had the worst results, with 82% precision, 87% precision, 82% recall, 84% f1 score, and an AUC value of 0.56. With these results, this research can be continued into an application that can classify drug users and nonusers.

Illicit drug use is common among attendees of electronic dance music (EDM) festivals, but is often significantly underreported by participants. The current study aimed to compare the prevalence and over- and under-reporting of illicit drug use among attendees at EDM festivals in two European countries with distinct drug laws and cultures. Self-reported data regarding recent drug use were collected through interviews. Participants’ blood alcohol concentrations were measured using a breathalyzer. Recent illicit drug use was assessed through sampling microparticles in the breath and consequent off-site analysis through liquid chromatography and tandem mass spectroscopy. Illicit drug use was higher in Belgium than in Sweden as indicated by self-reports (56.8 vs. 4.3%) and drug testing (37.2 vs. 12.5%). Underreporting was higher in Sweden than in Belgium; in Sweden, only 2.6% reported taking an illicit drug other than cannabis, whereas 11.6% tested positive, while the corresponding figures in Belgium were 36.5% and 36.9%. In both countries, results from self-reporting and drug testing for specific drugs matched poorly at the individual level, indicating unwitting consumption of substances. This study indicates that the drug use prevalence and the likelihood of disclosure may differ between countries or cultures, which should be considered when choosing methods to investigate drug use prevalence.

The objective of this study is to analyze the relationship between the public policies implemented and their impacts on addiction rehabilitation centers in the city of Mazatlán. The research was carried out using a qualitative methodological approach, using the focus group technique aimed at those in charge of said centers established in the city. Among the findings, the inefficiency of public policies stands out due to the lack of specific protocols for the treatment of addictions to new drugs of greater impact, such as crystal or methamphetamine, for which there are no specific treatment protocols. Finally, this work will contribute to generating new knowledge that will improve the regulations of rehabilitation centers, including specific procedures to combat emerging drugs that come onto the market, which will help prevent social problems. [ABSTRACT FROM AUTHOR]

Introduction/Aim. Analgesics are drugs used in the pain pharmacotherapy and are one of the most prescribed drugs in all countries. Modern pain pharmacotherapy involves the use of analgesic steps. The objective of this paper was to analyze the consumption of drugs used in the pain pharmacotherapy in the Republic of Serbia (RS), in the period from 2015 to 2018, and to compare the obtained results with the consumption of the mentioned drugs in the Kingdom of Norway (KN) and the Republic of Finland (RF) in the same time period interval. Material and methods. Data on drug consumption were taken from the website of the Agency for Medicines and Medical Devices of Serbia, the official website of the Norwegian Institute of Public Health and from the official website of the Finnish Medicines Agency. The consumption of medicines is monitored using the defined daily dose (DDD) methodology. Results. Paracetamol consumption was 13 to even 20 times lower in the RS compared to the KN and 10 to 15 times lower compared to the RF. The average consumption of diclofenac during the four observed years was about 30 DDD/1,000 inhabitants/day in the RS, about 7 in the KN and about 4 DDD/1,000 inhabitants/day in the RF. Conclusion. In the pain pharmacotherapy in the RS, the consumption of non-steroidal anti-inflammatory drugs is dominated by diclofenac, while in the KN and the RF ibuprofen and paracetamol from nonopioids. [ABSTRACT FROM AUTHOR]

Introduction: Studies on alcohol consumption in university students generally include a single instrument to classify them. This limits the detection of other substances, conditioning the brief interventions and other preventive measures. This study aims to review the patterns of alcohol by integrating the information provided simultaneously by several screening instruments. Method: The results of test AUDIT and Weekly Consumption Diary for the screening of alcohol problems and the DAST-10 test for drugs in 1309 university students were analyzed. The latent class analysis identifies subgroups with- in heterogeneous populations from multivariate data. Results: The method identified three latent classes or patterns: low alcohol consumption (75.2%); weekend consumption (18%); and high alcohol consumption with probable dependence (6.7%). The main finding is that drug use and binge drinking episodes appear in all categories of drinkers, including those traditionally considered low-risk or non problematic. Conclusions: the patterns found with the latent class analysis show the need to review preventive practices in reducing alcohol consumption, even with low consumption. [ABSTRACT FROM AUTHOR]

The objective of this article is to give an account of the labor reintegration process in subjects in condition of drug addiction during their rehabilitation. Using a qualitative methodology, in-depth interviews were conducted with ten people in addiction in rehabilitation. Those who were interviewed have more than 15 years of sobriety and are part of a self-help group that implements the 12-step program of Alcoholics Anonymous in Guadalajara, Jalisco, Mexico. Among the results, it stands out that labor reintegration is a process that involves several phases, one of them is the period of service where the subject is prepared in the practice of punctuality, responsibility, commitment, and respect, as well as in emotional management for the performance of paid work. The decision of when, where and what activity to carry out falls, in principle, on the sponsor and the employer, since it depends on the subject's progress in their rehabilitation, the management of their emotions and the establishment of non-conflictive interpersonal relationships. To assign work activities, support networks made up of members of the self-help group are used, since the subjects must be monitored to avoid emotional and consumption relapses. [ABSTRACT FROM AUTHOR]

Considerable resources have been spent on estimating the size of populations of people who use drugs (PWUD) and people who inject drugs (PWID) in Africa. Precise estimates are elusive, not least because of stigma and criminalization faced by these populations. Bio-behavioral surveys focused on injection drug use can be useful but are expensive and have not always been designed and implemented with meaningful participation of PWID themselves. A pan-African effort of the African Union (AU) to collect drug-use data from drug treatment facilities is undermined by the dearth of facilities addressing the drug problems posing the greatest morbidity and mortality risks. Efforts that have involved PWID meaningfully and respectfully in designing and implementing data collection have shown some success in informing health service programming for PWID as well as sustained regular monitoring of drug use. But meaningful participation in data collection may be contingent on both concerted anti-stigma measures and some form of decriminalization of minor drug offenses to reduce the fear of arrest and incarceration experienced by people who use drugs, a change as yet little realized in Africa. [ABSTRACT FROM AUTHOR]

The Romanian justice system has several components, one of which is the probation system. The current study presents a preliminary data analysis on persons who committed drug law offences, registered by the Bucharest Probation Service. Both protective and risk factors were considered. The results show that the drug offenders in Bucharest have recurrent offensive behavior, and the protective factors, if they exist, cannot stop the individuals committing an offence. The age at which these persons were convicted of drug law offences is between 25 and 44 years, and a proportion of them were identified mainly when committing other drug offences, as members of an organized criminal group or when driving without license or under the influence of alcohol. Last, but not least, the drug offences are associated with the offence of establishing an organized criminal group. [ABSTRACT FROM AUTHOR]

The rapid spread of the SARS-CoV-2 virus during the early phase of the pandemic led to an unprecedented global health crisis. Various factors have influenced self-medication practices among the general population and unsubstantiated prescribing practices among healthcare professionals. This study aimed to describe trends in the purchase and sale of medicines during the COVID-19 pandemic period (2020–2022) in Ecuador, by comparing them with pre-pandemic periods. In this study, a cross-sectional design was employed to conduct a comprehensive analysis of 28 pharmacological groups, categorized according to the Anatomical Therapeutic Chemical Classification (ATC). Utilizing an integrated drug consumption database, the study examined physician prescribing data, medicine usage, and spending levels in Ecuador during the COVID-19 pandemic. The analysis involved computing absolute differences in monthly resolution, calculating excessive expenditure in comparison to previous yearly averages, and using Defined Daily Dose (DDD) methodology for internationally comparable results. Furthermore, a correlation analysis was performed to investigate potential associations between prescribed and consumed medicines and the number of new cases and deaths. In Ecuador, the average yearly expenditure among these groups prior to the pandemic (2017–2019) amounted to $150,646,206 USD, whereas during 2020 and 2021, the same groups represented a total expenditure of $228,327,210, reflecting a significant increase. The excess expenditure during this period reached 51.4%, equivalent to $77,681,004 USD. Notably, 13% of this expenditure consisted of Over the Counter (OTC) Medicines. The study also identified a remarkable surge in sales of ivermectin, which increased by 2,057%, and hydroxychloroquine, which increased by 171%, as measured by DDD. This study highlights the substantial consumption of medicines by the population in Ecuador during the pandemic. It is concerning that many medications were sold without proven therapeutic indications, indicating that misinformation and desperation may have led to improper prescribing by physicians and patients resorting to ineffective drugs. Moreover, since the sale of these therapeutic drugs requires a prescription, poor regulation, and a lack of control within pharmacies likely contributed to such practices. [ABSTRACT FROM AUTHOR]

Copyright of Industrial Water Treatment is the property of CNOOC Tianjin Chemical Research & Design Institute and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Social media serves as a platform for sharing information and connecting with others on various subjects, including healthcare and drugs. Analyzing drug sentiment from various social media like Twitter, reddit, quora etc are crucial for monitoring drug safety, identifying adverse reactions, and providing an early warning system for potential safety concerns, benefiting healthcare organizations and governments. This paper aims to study the opinions of people from all over the world by analyzing their messages, posts on social media. For this study 39,069 drug related message corpus were fetched making a comparison between the high income countries, and middle income and low income countries on the basis of drug consumption from 2021 to 2023. The dataset used for the study consisted of 41.63% text-corpus from high income countries out of which on an average from 2021 to 2023, 40.2% was found to have a positive sentiment. Whereas 34.65% of text-corpus are from middle-income countries out of which on an average 26.4% of was of a positive sentiment and 23.70% text-corpus are from low income countries with 23.6% having a positive sentiment. Furthermore, the primary factor for having such differences from people's sentiment on drug consumption from high to low income countries includes Cultural and Social Norms, Legalization, availability etc therefore, In high-income countries, drug use is more socially accepted than in other regions. This proposed study gives an insight into people's opinion on various drugs from different countries and regions. The results of this study attempted to understand how the public is responding to different types of information and to identify potential misinformation which can be used to formulate policies for existing and future drug prevention campaigns in order to improve public health and promote public education. [ABSTRACT FROM AUTHOR]

BackgroundNew data sources and analysis methods are urgently needed to improve opioid surveillance and prevent potential overdose. Social media data is one potential data source that might be used and integrated to address this issue. Objective: This study explored opioid-related topics discussed across geographical regions of varying population sizes to determine whether social media data might inform opioid surveillance. Methods: Between March 17th to July 17th, 2020, we collected tweets (N = 19,721) mentioning opioid-related keywords across seven cities within the United States. Results: Results found that opioid-related keywords were distributed as follows: New York (29%), Los Angeles (23%), Chicago (18%), Atlanta (18%), San Francisco (8%), Iowa (3%), and Orange County, CA (1%). We also found regional differences in the types of opioids and topics mentioned. Conclusions: Findings suggest the feasibility of using opioid-related social media data to inform surveillance efforts, as well as potential regional and time-varying differences in topics discussed.

Se realizó un estudio longitudinal con 95 adolescentes que habían cumplido una medida judicial de internamiento dentro del Sistema de Justicia Juvenil Español. Todos los participantes mostraban una trayectoria delictiva y un consumo de drogas elevado. La tasa de reincidencia tras un año fue del 32.60%. El modelo de regresión clasificó correctamente el 92.6% de los casos, χ2(23) = 82,53, p < .001, pronosticando de manera adecuada el 84.4% de los reincidentes y al 96.8% de los no reincidentes. Se encontraron 12 variables predictoras: duración y régimen de medida, internamientos previos, número de delitos, nacionalidad, estudios previos, consumo de cannabis tras internamiento y problemas tras el internamiento en consumo de drogas, escolares, de empleo/recursos, psíquicos y legales. Las variables dinámicas ganan mayor peso predictivo cuando se evalúan tras la intervención. De igual modo, ciertas variables dinámicas operan como mediadoras de las estáticas en la predicción de la reincidencia delictiva.

This study delves into recent legislation in Jordan regarding the decriminalization of narcotics and traces the evolution of related legislation in the country. It explores the definition and underlying philosophy of decriminalization while examining arguments from both proponents and opponents of drug decriminalization from a jurisprudential perspective. Additionally, the research sheds light on practices that have emerged in response to the decriminalization of narcotics in other jurisdictions. The study thoroughly examines the advantages and disadvantages of decriminalizing narcotics, analyzing its potential impact on drug consumption. Finally, the researcher proposes the implementation of a gradual and partial systematic plan within Jordanian legislation to address the growing trend of drug decriminalization. The paper also provides insights into the stances of the United States and other countries on this issue and how their legislations have addressed it. [ABSTRACT FROM AUTHOR]

Background and Aims: Vitamin D plays several roles in keeping the body’s cells healthy and functioning the way they should. Most people do not get enough Vitamin D, so supplements are common. However, it is also possible for this vitamin to build up and reach toxic levels in the body. This study investigated the prescription of Vitamin D and Analogues in primary care and outpatient consumption in Türkiye between the years 2015- 2018. Also, the number of protocols created with Hypervitaminosis D was evaluated. Methods: In this study, drug consumption data were evaluated by Prescription Information System (PIS) and ATC/DDD (Anatomical, Therapeutic and Chem- Defined Daily Dose) Methodology. Descriptive statistics were used for evaluation of the data, and numerical values were presented via tables and graphics. Statistical analysis of the data was performed using the SPSS 23 (Statistical Package for the Social Sciences) package program. The Chi-square test was used to evaluate the relationship between the variables, and the P value below 0.05 was accepted as a statistical significance. Results: Between 2015 and 2018, a total of 11.874.898 prescriptions containing drugs with the A11CC (Vitamin D and Analogues) ATC code were created by family physicians. The total number and the percentage of prescriptions containing Vitamin D and Analogues increased over these years. There was a statistically significant difference between the number of prescriptions. While the percentage of prescriptions containing Vitamin D and Analogues was 0.89 in 2015, it was 3.38 in 2018. It was determined that the percentage of prescriptions increased over these years. The consumption of the drugs with the A11CC ATC code in outpatients increased over these years according to the ATC/DDD methodology. Conclusion: The study showed that the prescription of preparations containing Vitamin D by family physicians increased significantly over the years and there was an increase in Vitamin D consumption in outpatients. In addition, it was shown that the number of protocols established for the diagnosis of Hypervitaminosis D increased over the years in Türkiye. [ABSTRACT FROM AUTHOR]

Marko Antunovic,1,2 Slavica Vucinic,1,2 Jelena Kotur-Stevuljevic,3 Kristijan Krstic,4 Jasmina Jovic-Stosic,1,2 Vesna Kilibarda,1,2 Natasa Perkovic-Vukcevic,1,2 Snezana Djordjevic1,2 1Medical Faculty Military Medical Academy, University of Defense, Belgrade, Serbia; 2National Poison Control Center, Military Medical Academy, Belgrade, Serbia; 3Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia; 4Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, SerbiaCorrespondence: Marko Antunovic, National Poison Control Center, Military Medical Academy, Crnotravska 17, Belgrade, 11040, Serbia, Tel +381 11 3608 264, Fax +381 11 367 21 87 264, Email antunovic.marko87@gmail.comPurpose: The aim of this study was to analyze data on gabapentinoid-related attendances to the National Poison Control Center of Serbia (NPCC), particularly abuse cases; to estimate its changes and to compare it with trends in national consumption rates of these drugs. We also aimed to analyze the main characteristics of the study population and to investigate the major clinical effects in poisoned patients.Patients and Methods: This is a retrospective study of patients admitted to the NPCC for acute poisoning involving gabapentinoids from 1 May 2012 to 1 October 2022.Results: There were 357 (95.5%) pregabalin-related and 17 (4.5%) gabapentin-related poisoning cases in 302 patients. Abuse of pregabalin was detected in 27.8% (84/302), while gabapentin abuse occurred in 0.7% (2/302) of all patients. A steady increase in rates of pregabalin poisoning and abuse cases strongly correlated with the increase in overall consumption of this drug, while there were no significant changes in rates of gabapentin consumption, poisoning and abuse rate during the study period. Most patients who abused pregabalin pregabalin were males (84.5%) and the median age was 26 years (range: 15– 45 years). Almost 60% of patients who abused pregabalin (48/84) belonged to the migrant population. Co-ingestions occurred in 89.4% of pregabalin-related cases (319/357), resulting in more severe poisoning. The most often co-ingested drugs were benzodiazepines and among them clonazepam was detected in the largest number of cases.Conclusion: The poisoning and abuse cases involving pregabalin are on the rise in Serbia, which coincided with an increase in its overall consumption during the study period. Isolated pregabalin ingestions resulted in mild poisoning, although severe symptoms such as coma and bradycardia were recorded. When prescribing pregabalin to patients at risk of abuse caution is needed. Strengthening the measures for dispensing of pregabalin may reduce the risks associated with its abuse.Keywords: gabapentinoids, overdose, misuse, drug consumption, psychoactive substances

Purpose: This study aims to investigate the role of applying additional balneotherapy to fibromyalgia patients while receiving conventional physical therapy. Materials and Methods: 107 female patients diagnosed with fibromyalgia for the first time were studied in two groups. Group 1 included patients receiving Transcutaneous Electrical Nerve Stimulation and physical therapy modalities, including superficial hot and therapeutic ultrasounds. Patients in Group 2 received balneotherapy in addition to the therapeutic modalities given to the first group. All patients went through a 10-session treatment program. The evaluation was based on the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), and Quality of Life Short Form-36 (SF-36) before and after the treatment. The total amount of paracetamol tablets consumed was also recorded. Results: There were significant recovery in post-treatment pain VAS, FIQ, and PSQI scores in both groups, compared to before treatment, but the improvements were more pronounced after the balneotherapy. The drug consumption was also significantly lower, and patients treated with balneotherapy expressed better general health and social function scores of SF-36. Conclusion: A combination of balneotherapy with conventional physical modalities appears to be an effective treatment option for fibromyalgia as it positively contributes to the patient's pain, functional status, quality of life and sleep, and drug consumption.

This research aims to analyze the relationship between the characteristics of teenagers and family functions as well as the understanding of narcotics, psychotropics, and addictive substances on the behavior of teenagers consuming drugs in East Java as a response variable with a binary scale. The data source obtained through secondary data from the Performance Survey and Accountability Program 2019 with the observation unit teenagers aged 10-24 years. The sample used is 4,649. The analytical method used is descriptive statistics, the Chi-square method, and Odds Ratio (OR). The percentage of adolescent consuming drugs is 4.1% descriptively. The relationship analysis shows that the variables significantly related to young people's behavior in consuming drugs are gender, place of residence, level of education, age group, religious values, and psychological consequences. From the OR figures concluded that young males are 3.2 times more at risk of consuming drugs than young females. From the aspect of family function, it can be inferred that the percentage of young substance abusers from families who apply religious values is greater than those who do not. The findings of this research show that the risk of young people from families who practice religious functions becoming substance abusers are 1.61 times more compared to families who do not practice it. The understanding of drugs is not always related to teenagers' behavior in consuming drugs, because those who understand the psychological consequences of substance abuse are also 1.64 times more at risk of using drugs compared to teenagers who do not understand.

BackgroundMany countries use the WHO Essential Medicines List (EML) as a guide for health policy choices to promote the efficient use of healthcare resources or adopt the concept of essential medicines (EMs) to develop their own national list of essential medicines. The aim of this study is to analyse the availability and use of medicines included in the 22nd WHO EML in Italy.MethodsUsing the ATC code (5th level), a comparison was made between the medicines included in the WHO EML and those retrieved from the Italian Medicines Agency (AIFA) database. The availability (regulatory and reimbursement status) of EMs, as well as the market share in expenditure (million euros) and consumption [measured in WHO-defined daily doses (DDDs)], compared to all reimbursed medicines in 2021, were analysed.ResultsIn 2021, approximately 85.2% (n = 414) of medicines included in the WHO EML were commonly marketed in Italy. Of these, 396 EMs were fully reimbursed by the Italian National Healthcare Service (INHS), corresponding to 81.5% (396/486) of the WHO EML, while the remaining 18.5% (90/486) were neither authorised (n = 72) nor reimbursed (n = 18). The study found a low coverage for anti-parasitic, insecticides, and repellent products (ATC P) in addition to medicines for the genitourinary system and sex hormones (ATC G). Even though medicines on the WHO EML, including therapeutic alternatives, accounted for ~48.5% of the expenditure for medicines reimbursed by INHS, the list covered 74% of all national drug consumed. Novel high-cost therapies indicated in high-prevalence diseases and rare conditions, mostly antineoplastic and immune-modulating agents (ATC L) not included in the WHO EML, were also guaranteed.ConclusionsIn Italy, high coverage of EMs was found. It was largely reimbursed by the INHS, even when compared to other European countries. Essential medicines represented a high percentage of the overall expenditure and consumption in Italy. The WHO EML could be an important tool to guide the health policy choices of high-income countries, although a more frequent update and easier access to information on rejected medicines are needed.

Introduction: The first COVID-19 wave in Ecuador started in March 2020 and extended until November. Several types of drugs have been proposed as a potential treatment during this period, and some affected people have self-medicated. Method: A retrospective study was conducted with 10,175 individuals who underwent RT-PCR tests for SARS-CoV-2 from July to November 2020. We compared the number of positive and negative cases in Ecuador with symptoms and drug consumption. The Chi-square test of independence compared clinical and demographic data and PCR test results. Odds ratios analyzed drug consumption dynamics. Results: Of 10,175 cases, 570 were positive for COVID-19, while 9,605 were negative. In positive cases, there was no association between the RT-PCR result and sex, age, or comorbidities. When considering demographic data, Cotopaxi and Napo had the highest rates of positive cases (25.7% and 18.8%, respectively). Manabí, Santa Elena, and Guayas regions had fewer than 10% positive cases. The Drug consumption dynamic analysis showed that negative COVID-19 cases presented higher drug consumption than positive cases. In both groups, the most consumed medication was acetaminophen. Acetaminophen and Antihistamines had higher odds of consumption in positive PCR cases than in negative. Symptoms like fever and cough were more related to positive RT-PCR results. Conclusion: The first COVID-19 wave in Ecuador has affected the provinces differently. At a national level, the consumption of drugs has been highly associated with self-medication. [ABSTRACT FROM AUTHOR]

Introduction: The first COVID-19 wave in Ecuador started in March 2020 and extended until November. Several types of drugs have been proposed as a potential treatment during this period, and some affected people have self-medicated.Method: A retrospective study was conducted with 10,175 individuals who underwent RT-PCR tests for SARS-CoV-2 from July to November 2020. We compared the number of positive and negative cases in Ecuador with symptoms and drug consumption. The Chi-square test of independence compared clinical and demographic data and PCR test results. Odds ratios analyzed drug consumption dynamics.Results: Of 10,175 cases, 570 were positive for COVID-19, while 9,605 were negative. In positive cases, there was no association between the RT-PCR result and sex, age, or comorbidities. When considering demographic data, Cotopaxi and Napo had the highest rates of positive cases (25.7% and 18.8%, respectively). Manabí, Santa Elena, and Guayas regions had fewer than 10% positive cases. The Drug consumption dynamic analysis showed that negative COVID-19 cases presented higher drug consumption than positive cases. In both groups, the most consumed medication was acetaminophen. Acetaminophen and Antihistamines had higher odds of consumption in positive PCR cases than in negative. Symptoms like fever and cough were more related to positive RT-PCR results.Conclusion: The first COVID-19 wave in Ecuador has affected the provinces differently. At a national level, the consumption of drugs has been highly associated with self-medication.

Background: Wastewater analysis has emerged as a promising methodology for realtime monitoring of illicit drug consumption. The main objective of this article is to identify the occurrence and distribution of illicit drugs and their metabolites in the wastewater treatment plants (WWTP) of municipalities with adequate sewage coverage systems, in terms of water and sewage services, in the Hydrographic Regions of the State of Rio de Janeiro (HRRJ). Methods: Diurnal composite samples of influent were collected from 13 wastewater treatment plants between December 27, 2022, and January 10, 2023, to detect the presence of illicit drugs, including Ecstasy, Amphetamine, Methamphetamine, Cocaine, Benzoylecgonine, and Cannabis. The excretion products were quantified using liquid chromatography coupled with mass spectrometry. Results: The highest per capita consumption was observed for Cannabis, with a consumption rate of 432mg/day/1,000 inhabitants. Benzoylecgonine was the second most consumed drug, with a rate of 190mg/day/1,000 inhabitants, followed by Cocaine with a rate of 98mg/day/1,000 inhabitants. Amphetamine had a consumption rate of 104mg/day/1,000 inhabitants, while Methamphetamine had a rate of 42mg/day/1,000 inhabitants. 3,4-Methylene-dioxy-N-methylamphetamine had the lowest consumption rate, with a rate of 23.8mg/day/1,000 inhabitants. Conclusion: The consumption patterns of illicit drugs were analyzed, and it was observed that stimulant drugs such as Cocaine, Ecstasy, and Amphetamines were consumed to a greater extent in municipalities located on the coast or with greater purchasing power. In contrast, Cannabis consumption was found to be more widespread across the surveyed locations, with higher consumption rates observed in regions with high traffic. [ABSTRACT FROM AUTHOR]

ABSTRACT: Objectives: Ecuador is a lower-to-middle-income country not yet adherent to World Health Organization (WHO) antibiotic stewardship strategies, and data regarding basic metrics are still lacking. Methods: We conducted a retrospective study of an antibiotic stewardship programme (ASP) consisting of restrictive measures on carbapenem dispensing pending required pre-authorisation and expert audit. We evaluated antibiotic consumption and its relationship to carbapenem resistance at a 610-bed, tertiary-level hospital in Quito, Ecuador. We used prescription data from 2010–2017 and converted them into defined daily doses (DDD). We then correlated these findings with the nature of service provided and antibiotic resistance data from the microbiology laboratory. We used descriptive statistics and interrupted time series (ITS) analysis. Results: Throughout the study period, we analysed 16 984 355 prescriptions of 8 191 418.57 g of antibiotics (5 760 479.37 DDD). The in-hospital mean antibiotic prescription rate was 148.8 ± 14.8 DDD/100 occupied bed-days and 293.5 ± 65.3 DDD/100 occupied bed-days in the ICU. First-, second- and third-line antibiotic consumption was 38%, 52% and 10%, respectively. Our hospital data showed a high rate of antibiotic prescription in all hospital areas, mainly broad-spectrum antibiotics. Regarding the ASP introduced in 2016, ITS analysis showed a change in the outcome level immediately following the introduction for imipenem [–3.97; 95% confidence interval (CI) –5.31 to –2.61] but not for meropenem (0.66; 95% CI –0.37 to 1.71). Conclusion: Although our institution's ASP was successful in reducing imipenem consumption, a more embracing plan is required for further interventions to avoid unexpected effects.

Antimicrobial resistance (AMR) represents a major issue in healthcare being correlated to global inappropriate use of antibiotics. The aim of this study was to compare the data on hospital antibiotic consumption in 2020–2021 with those related to 2019 in order to evaluate the impact of the COVID-19 pandemic on antibiotic prescriptions and appropriate use at national level and in the different geographical areas. To estimate the consumption of antibiotics, two indicators were calculated: "number of DDD per 1000 inhabitants per day" and "number of DDD per 100 hospitalisation days". Consumption data on antibiotics dispensed in public health facilities were based on the Italian "traceability of medicines" information flow. Data on hospitalisation days were extracted from the Italian "hospital discharge form" flow. Pearson correlation analysis was performed between the number of patients hospitalised for COVID-19 and the consumption of antibiotics in public healthcare facilities. During 2020, about 1.7 DDD/1000 inhabitants per day (12.3% of the overall consumption of reimbursed antibiotics) were dispensed exclusively in Italian hospitals (+0.8% compared to 2019). Considering the number of DDD per 100 hospitalisation days, consumption increased by 19.3% in 2020 compared to 2019. Comparing the first semester of 2020 and 2019, a decrease of DDD/1000 inhabitants per day was observed (−1.6%) at national level, with opposite trends in the different geographical areas; an increase in the use of azithromycin and carbapenems was also observed, with a stable consumption of third-generation cephalosporins. The use of antibiotics in the second semester of 2020 compared to the same period of 2019 showed a clear reduction at national level (−8.5%), appreciable to a similar extent in all geographic areas. In the first semester of 2021 compared to the same period of 2020, there was a huge reduction (−31.4%) in consumption at national level. However, the variations were heterogeneous between different geographical areas. To our knowledge, this study represents the most comprehensive analysis performed on antibiotic consumption data in hospital settings in Italy during the COVID-19 pandemic to date. Despite international and national guideline recommendations, a substantial overall increase in antibiotic prescriptions was observed during the COVID-19 pandemic, with variability in terms of geographical distribution and prescription strategies. These findings may be related to the dichotomy between perceived and real significance of guidelines, expert panels, or consensus. Therefore, new approaches or strategies to antimicrobial stewardship should be proposed. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jurnal Biometrika dan Kependudukan is the property of Universitas Airlangga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pharmaceuticals represent the third-largest expenditure item in health care spending in the OECD countries, and cost growth is around 5% per year in many OECD countries. One possible way to contain the rise in pharmaceutical spending is the use of cost-sharing schemes that makes insured individuals directly bear parts of the cost of a drug. This study estimates the price sensitivity of demand for prescription drugs using data on all prescription drug purchases from a random sample of 400,000 Swedes followed from 2010 to 2013. We use a regression kink design (RKD) by exploiting the kinked Swedish cost-sharing scheme to assess the price elasticity. Further, since the cost-sharing scheme has changed over time, we also use a double-difference RKD to account for potential confounding nonlinearities around the kink. Our results indicate that the standard RKD results are biased and exaggerate the price sensitivity. Our preferred double-difference RKD specifications show no or minor price sensitivity (95% CI price elasticity from − 0.12 to 0.02). The results are similar in several sub-group analyses across age groups, sexes, and income quartiles. [ABSTRACT FROM AUTHOR]

Aim: LANDSCAPE aimed to estimate the annual incidence and prevalence of treated diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) between 2008 and 2018. Methods: This French nationwide observational study used data from the French National Health Insurance Databases covering 99% of the French population. Data about healthcare consumption were used to identify adults treated with anti-VEGFs or dexamethasone implants (for DME) and with pan-retinal photocoagulation (for PDR). All French patients newly treated between 2008 and 2018 were included. Incidence and prevalence of treated DME and PDR were estimated for the age-matched general population and the population with diabetes in France. Sociodemographic characteristics and medical history were described in both populations. Results: We identified 53,584 treated DME patients and 127,273 treated PDR patients between 2008 and 2018, and 11,901 DME and 11,996 PDR new incident patients in 2018. The treated DME incidence in 2018 was 2.5 per 10,000 in the general population and 37.3 per 10,000 in the population with diabetes. Prevalence in 2018 was 9.5 and 143.7 per 10,000 in the respective populations. Treated PDR incidence in 2018 was 2.3 per 10,000 in the general population and 31.2 per 10,000 in the population with diabetes. Prevalence in 2018 was 19.9 and 270.3 per 10,000 in the respective populations. Incidence and prevalence were not age-dependent. Incidence of treated PDR incidence was relatively stable from 2008–2018. Incidence of treated DME incidence rose from 2012–2018, probably due to widening access to newly available treatments, such as anti-VEGFs. Conclusions: We provide exhaustive nationwide data on the incidence and prevalence of treated diabetic ocular complications in France over a 10-year period. [ABSTRACT FROM AUTHOR]