RESUMO
OBJECTIVES: To determine the prevalence of alcohol use patterns, sociodemographic factors and risk of alcohol dependence among vehicle drivers in Jamaica. DESIGN: A secondary data analysis. SETTING: This study was conducted using the Jamaica National Drug Prevalence Survey 2016 dataset. PARTICIPANTS: This included 1060 vehicle drivers derived from the population sample of 4623. The participants from each household were randomly selected as the respondent for the survey. PRIMARY AND SECONDARY OUTCOME MEASURES: Alcohol use and dependence were measured using the Alcohol Use Disorders Identification Test questionnaire. Driving under the influence of alcohol (DUIA) was assessed by questions regarding its use in the past 12 months. The analysis involved the use of Pearson's χ2 test and logistic regression. RESULTS: 75% of Jamaicans reported lifetime alcohol use. Approximately 65% of drivers indicated that they currently drink alcohol. 18% of drivers who currently drink alcohol admitted to DUIA. Reportedly, 54.5% of these drivers were alcohol binge drinkers, with 41.5% also driving under the influence of cannabis. The bivariate analysis demonstrated that DUIA was higher among Christian participants and those who worked in non-machine operator jobs (p=0.002 and p=0.008, respectively). Vehicle drivers altogether and drivers who drive under the influence of alcohol had significant associations with hazardous drinking (p=0.011 and p<0.001, respectively). Logistic regressions highlighted drivers 34 years and under (p=0.012), male drivers (p=0.002) and the head of the household (p=0.050) were 1.82, 3.30 and 1.86 times more likely, respectively, to report driving under the influence of alcohol in the past year. CONCLUSIONS: The prevalence of alcohol use among Jamaica's population and vehicle drivers is high. That one in five drivers, who currently consume alcohol, also admits to driving under the influence suggests the urgent need for mitigation strategies and legislative action as part of a preventative effort to reduce drunk driving.
Assuntos
Alcoolismo , Dirigir sob a Influência , Masculino , Humanos , Jamaica/epidemiologia , Etanol , Consumo de Bebidas Alcoólicas/epidemiologiaRESUMO
A high percentage of persons with Schizophrenia also uses Cannabis and this may potentially alter the therapeutic benefits of the antipsychotic medications prescribed. The aim of this study was to assess the impact of Cannabis usage on antipsychotic therapy of sleep disturbances in schizophrenia subjects. Male subjects, ≥18 years, admitted to the University Hospital of the West Indies psychiatric ward between October 2015 and October 2016, and diagnosed with schizophrenia were recruited for the study. Following written informed consent to the study, subjects were prescribed either risperidone monotherapy or haloperidol monotherapy orally for 14 days and classified as Cannabis users (CU) or non-users (non-CU), with presence/absence of Cannabis metabolite in urine samples. After 1 week of admission, subjects wore the Actiwatch-2 device, to record sleep data for 7 consecutive nights. Inferential statistical analysis involved non-parametric tests, expressed as median and inter-quartile ranges (IQR), with p<0.05 considered statistically significant. Fifty subjects were assessed, with a median (IQR) age of 28 (14) years. Majority (30; 60%) were CU, displaying longer sleep latency (SL) than non-CU when receiving haloperidol; but equivalent SL when receiving risperidone. In comparison to non-CU, the CU also displayed longer time in bed, but shorter durations asleep, awoke more frequently during the nights and for longer durations, whether receiving haloperidol or risperidone. This resulted in lower sleep efficiency for the CU (<85%) compared to the non-CU (≥85%). Over the study period, sleep efficiency was significantly improved for non-CU receiving either risperidone (p = 0.032) or haloperidol (p = 0.010); but was only significantly improved with risperidone for the CU (p = 0.045). It is apparent that the presence of Cannabis may be impacting the therapeutic benefits of antipsychotic drugs on sleep. In schizophrenia subjects with concomitant Cannabis use, risperidone is more beneficial than haloperidol in improving sleep efficiency.
RESUMO
This study explored how locus of control (LOC), depression and quality of life (QOL) interplay in patients with sickle cell disease. One hundred and forty-three sickle cell clinic patients with consecutive clinic consultations completed the Multidimensional Health Locus of Control and Short Factor 36 (SF-36) scales as well as the Beck Depression Inventory. Participants in this study had higher scores on the "chance", "other people" and "internal" domains of LOC than persons with a number of other chronic illnesses in a previous study. Hierarchical regression analyses showed that high scores on the "internal" domain of LOC were associated with better QOL and fewer symptoms of depression. Depressive symptoms were greater in persons with high scores on the "other people" LOC domain and in younger persons. These findings would suggest that it is possible that interventions which enhance internal LOC and discourage "other people" orientations might improve QOL and ameliorate depression among persons with sickle cell disease.