810 resultados para National Comorbidity Survey


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This paper examines the critical issue of public confidence in sentencing, and presents findings from Phase I of an Australia-wide sentencing and public confidence project. Phase I comprised a nationally representative telephone survey of 6005 participants. The majority of respondents expressed high levels of punitiveness and were dissatisfied with sentences imposed by the courts. Despite this, many were strongly supportive of the use of alternatives to imprisonment for a range of offences. These nuanced views raise questions regarding the efficacy of gauging public opinion using opinion poll style questions; indeed the expected outcome from this first phase of the four phase sentencing and public confidence project. The following phases of this project, reported on elsewhere, examined the effects of various interventions on the robustness and nature of these views initially expressed in a standard ‘top of the head’ opinion poll.

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Objective: Food insecurity may be associated with a number of adverse health and social outcomes however our knowledge of its public health significance in Australia has been limited by use of a single-item measure in the Australian National Health Surveys (NHS) and, more recently, the exclusion of food security items from these surveys. The current study compares prevalence estimates of food insecurity in disadvantaged urban areas of Brisbane using the one-item NHS measure with three adaptations of the United States Department of Agriculture Food Security Survey Module (USDA-FSSM). Design: Data were collected by postal survey (n= 505, 53% response). Food security status was ascertained by the measure used in the NHS, and the 6-, 10- and 18-item versions of the USDA-FSSM. Demographic characteristics of the sample, prevalence estimates of food insecurity and different levels of food insecurity estimated by each tool were determined. Setting: Disadvantaged suburbs of Brisbane city, Australia, 2009. Subjects: Individuals aged ≥ 18 years. Results: Food insecurity was prevalent in socioeconomically-disadvantaged urban areas, estimated as 19.5% using the single-item NHS measure. This was significantly less than the 24.6% (P <0.01), 22.0% (P = 0.01) and 21.3% (P = 0.03) identified using the 18-item, 10-item and 6-item versions of the USDA-FSSM, respectively. The proportion of the sample reporting more severe levels of food insecurity were 10.7%, 10% and 8.6% for the 18-, 10- and 6-item USDA measures respectively, however this degree of food insecurity could not be ascertained using the NHS measure. Conclusions: The measure of food insecurity employed in the NHS may underestimate its prevalence and public health significance. Future monitoring and surveillance efforts should seek to employ a more accurate measure.

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Background As relatively little is known about adult wheeze and asthma in developing countries, this study aimed to determine the predictors of wheeze, asthma diagnosis, and current treatment in a national survey of South African adults. Methods A stratified national probability sample of households was drawn and all adults (>14 years) in the selected households were interviewed. Outcomes of interest were recent wheeze, asthma diagnosis, and current use of asthma medication. Predictors of interest were sex, age, household asset index, education, racial group, urban residence, medical insurance, domestic exposure to smoky fuels, occupational exposure, smoking, body mass index, and past tuberculosis. Results A total of 5671 men and 8155 women were studied. Although recent wheeze was reported by 14.4% of men and 17.6% of women and asthma diagnosis by 3.7% of men and 3.8% of women, women were less likely than men to be on current treatment (OR 0.6; 95% confidence interval (CI) 0.5 to 0.8). A history of tuberculosis was an independent predictor of both recent wheeze (OR 3.4; 95% CI 2.5 to 4.7) and asthma diagnosis (OR 2.2; 95% CI 1.5 to 3.2), as was occupational exposure (wheeze: OR 1.8; 95% CI 1.5 to 2.0; asthma diagnosis: OR 1.9; 95% CI 1.4 to 2.4). Smoking was associated with wheeze but not asthma diagnosis. Obesity showed an association with wheeze only in younger women. Both wheeze and asthma diagnosis were more prevalent in those with less education but had no association with the asset index. Independently, having medical insurance was associated with a higher prevalence of diagnosis. Conclusions Some of the findings may be to due to reporting bias and heterogeneity of the categories wheeze and asthma diagnosis, which may overlap with post tuberculous airways obstruction and chronic obstructive pulmonary disease due to smoking and occupational exposures. The results underline the importance of controlling tuberculosis and occupational exposures as well as smoking in reducing chronic respiratory morbidity. Validation of the asthma questionnaire in this setting and research into the pathophysiology of post tuberculous airways obstruction are also needed.

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Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

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OBJECTIVES: To examine patterns of onset and abuse/dependence episodes of prescription opioid (PO) and heroin use disorders in a national sample of adults, and to explore differences by gender and substance abuse treatment status. METHODS: Analyses of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093). RESULTS: Of all respondents, 5% (n = 1815) reported a history of nonmedical PO use (NMPOU) and 0.3% (n = 150) a history of heroin use. Abuse was more prevalent than dependence among NMPOUs (PO abuse, 29%; dependence, 7%) and heroin users (heroin abuse, 63%; dependence, 28%). Heroin users reported a short mean interval from first use to onset of abuse (1.5 years) or dependence (2.0 years), and a lengthy mean duration for the longest episode of abuse (66 months) or dependence (59 months); the corresponding mean estimates for PO abuse and dependence among NMPOUs were 2.6 and 2.9 years, respectively, and 31 and 49 months, respectively. The mean number of years from first use to remission from the most recent episode was 6.9 years for PO abuse and 8.1 years for dependence; the mean number of years from first heroin use to remission from the most recent episode was 8.5 years for heroin abuse and 9.7 years for dependence. Most individuals with PO or heroin use disorders were remitted from the most recent episode. Treated individuals, whether their problem was heroin or POs, tended to have a longer mean duration of an episode than untreated individuals. CONCLUSION: Periodic remissions from opioid or heroin abuse or dependence episodes occur commonly but take a long time. Timely and effective use of treatment services are needed to mitigate the many adverse consequences from opioid/heroin abuse and dependence.

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Background: Minority ethnic groups in the UK are reported to have a poor experience of mental health services, but comparative information is scarce. Aims: To examine ethnic differences in patients’ experience of community mental health services. Method: Trusts providing mental health services in England conducted surveys in 2004 and 2005 of users of community mental health services. Multiple regression was used to examine ethnic differences in responses. Results: About 27 000 patients responded to each of the surveys, of whom 10% were of minority ethnic origin. In the 2004 survey, age, living alone, the 2004 survey, age, living alone, detention and hospital admissions were stronger predictors of patient experience than ethnicity. Self-reported mental health status had the strongest explanatory effect. In the 2005 survey, the main negative differences relative to the White British were for Asians. Conclusions: Ethnicity had a smaller effect on patient experience than other variables. Relative to the White British, the Black group did not report negative experiences whereas the Asian group were most likely to respond negatively. However, there is a need for improvements in services for minority ethnic groups, including access to talking therapies and better recording of ethnicity.

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A National Frog Survey of Ireland is planned for spring 2011. We conducted a pilot survey of 25 water bodies in ten 0.25 km2 survey squares in Co. Mayo during spring 2010. Drainage ditches were the most commonly available site for breeding and, generally, two 100 m stretches of ditch were surveyed in each square. The restricted period for peak spawning activity renders any methodology utilizing only one site visit inherently risky. Consequently, each site was visited three times from late March to early April. Occurrence of spawn declined significantly from 72 % to 44 % between the first and third visit whilst the overall occurrence of spawn at all sites was 76 %. As the breeding season advanced, spawn either hatched or was predated and, therefore, disappeared. In those water bodies where spawning was late, however, greater densities of spawn were deposited than in those sites where breeding was early. Consequently, spawn density and estimated frog density did not differ significantly between site visits. Future surveys should nevertheless include multiple site visits to avoid biased estimation of species occurrence and distribution. Ecological succession was identified as the main threat present at 44 % of sites.

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The aim was to explore the predictive ability of sources of stress and a range of dispositional and coping behaviours on student satisfaction and motivation. Most research exploring sources of stress and coping in students construes stress as psychological distress, with little attempt to consider positive experiences of stress. A questionnaire was administered to 120 first-year UK psychology students. Questions were asked which measured sources of stress when rated as likely to contribute to distress (a hassle) and likely to help one achieve (an uplift). The sources of stress were amended from the UK National Student Survey (NSS, 2011). Support, control, self-efficacy, personality and coping style were also measured, along with their potential affect on
course satisfaction, motivation and feeling part of a learning community. The sources of stress likely to lead to distress were more often significant than sources of stress likely to lead to positive, eustress states. Ironically,
factors one would consider would help students, such as the university support facilities, only did so when rated as a hassle, not as an uplift. Published university league tables draw heavily on student course satisfaction but this negatively correlated with intellectual motivation and feeling part of a learning
community. This suggests course satisfaction alone reveals an incomplete picture of the student experience. Course educators need to consider how course experiences contribute not just to potential distress but to
potential eustress. Teaching quality, effective support and work-life balance are key to student satisfaction and motivation. How educators interact with their students and the opportunities they create in and outside the class to promote peer support are likely to enhance satisfaction and motivation.

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The aim was to explore the relationship between sources of stress and a range of coping behaviours on student
satisfaction and motivation. Most research exploring sources of stress construes stress as distress, with little
attempt to consider positive, good stress or ‘eustress’ experiences. A cohort of first-year psychology students (N=88)
were surveyed on a range of stressors. These were amended from the UK National Student Survey (NSS, 2011).
Published university league tables draw heavily on student course satisfaction but study results suggest there was
also merit in measuring students’ intellectual motivation and the extent to which they felt part of a learning
community. Using multiple regression analyses, it was found that even the attributes that normally help one to adjust to change, such as self-efficacy, do little to help the new student adjust to university life, such was the acuteness of perceived stress in the first year. Social opportunities within the university were important to help new students integrate into university life and to help them network and build support. Educators need to consider how course experiences contribute, not just to potential distress but to potential eustress.