It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Saturday, March 20, 2021
Text me about cervical cancer
Digital communication is a way to bridge the racial disparity gap in cervical cancer information and follow up
IMAGE: FORD LEARNED THAT WOMEN WANT TO RECEIVE TEXT MESSAGES ABOUT THEIR HEALTH CARE, BUT PRESENTLY CAN'T BECAUSE OF FEDERAL MEDICAL PRIVACY AND TELECOMMUNICATION LAWS. view more
CREDIT: PHOTO BY NATIONAL CANCER INSTITUTE ON UNSPLASH
An estimated 14,480 new cases of invasive cervical cancer will be diagnosed in the United States this year, according to the American Cancer Society. Cases that could be prevented or cured with better education from screening to treatment based on improved provider-patient communication, says a Michigan State University researcher.
The issue is particularly acute for Black women, said Sabrina Ford, an associate professor in the Department of Obstetrics, Gynecology and Reproductive Biology within MSU's College of Human Medicine. Ford's research was published online Feb. 1 in the journal Gynecologic Oncology.
"More Black women were being screened for cervical cancer (compared to white women) but they were still dying from cervical cancer at twice the rate," she said. "It didn't make sense."
When Black women were told they had an abnormal cervical cancer finding on their Pap test screening, they often failed to follow up with their medical provider. The reason for this is complicated and two-pronged. One prong is about education and information. Providing clear clinical information in an easily accessible form is key to patient engagement.
"Culture does come into play because Black women do get their information from family, friends and personal experience," she said. "Sometimes there is medical mistrust, shame or fear and so, some women delay or don't follow up."
The other prong is about communication, specifically how medical providers are communicating with their patients. A doctor trying not to unnecessarily alarm a patient might not be telling their patients enough information, for instance that the Pap test screens for cancer. Handing a patient a one-page flyer about cervical cancer may easily get lost, never read or understood depending on a patient's health literacy.
Ford learned that there needs to be improvements on both prongs in order to bridge the disparity gap. Women want to receive text messages about their health care, Ford said, but presently can't because of federal medical privacy and telecommunication laws. With regulatory changes, patients could consent to receive provider text messages, when they fill out initial office paperwork.
Also, Black women reported using their online patient portal, which also provides an opportunity to educate and advise patients so they can make informed decisions.
Another gap is communicating consistent messages. Medical providers should provide uniform information to patients on all fronts: in the office, on the patient portal, flyers and pamphlets or text messages.
"We can't blame the patient. We can't blame the doctor either when the communication isn't clear," she said. "I want to move the needle forward on cervical cancer and HPV. They are highly preventable, curable and could be eradicated."
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Public health expert Shattuck studies impact of social distancing on spread of infection
(March 17, 2021) -- Eric Shattuck, assistant professor of research in the UTSA Institute for Health Disparities Research (IHDR) at The University of Texas at San Antonio, is studying the phenomenon of social distancing in response to infectious disease and its effects on pathogen transmission and the health of individuals and communities.
Many animals, including humans, exhibit behavioral changes during the early stages of an infection, including reduced social contacts, called sickness behavior. His findings suggest innate social distancing might help prevent the infection from spreading within social groups.
"The similarities between public health directives and what we see operating on a biological level in nature is remarkable, Shattuck said.
"For instance, we've been advised to keep 6 feet apart from others to prevent COVID transmission in case they're asymptomatic carriers of the virus. We know that some ants have a similar strategy, where individual ants increase their physical distance to others after they recognize that there is a possible infection in the colony" Shattuck added. "This shows us that some of the most basic interventions, like social distancing, can be highly effective at preventing outbreaks, whether of COVID-19, flu, or other pathogens."
This research has been at the center of a study titled "Infectious Diseases and Social Distancing in Nature," the manuscript for which has been published in the journal Science. Shattuck collaborated with researchers from universities and research centers across the country and in the United Kingdom.
While the other authors have research interests in vampire bats, rodents, insects and more, Shattuck is the only author who studies humans.
"Because humans are highly social creatures with complex and varied cultures -- and because culture can affect both our biology and the way that we interpret physical and emotional sensations -- I use an anthropological framework that focuses on human biological and cultural variation," Shattuck said about his research on sickness behavior.
He added that this study can start important conversations across scientific fields about integrating these normal biological responses into our thinking about disease transmission and public health. "People should listen to their bodies if they think they might be sick but we also need to work to ensure that rest, recuperation and isolation aren't stigmatized or otherwise prevented. Shattuck said"
In his role with IHDR, Shattuck explores various research projects to further the mission of the Institute: to reduce and eliminate health disparities in South Texas through integration of biomedical and socio-behavioral science approaches.
Another project he's working on investigating the beneficial effects of hospital arts programs on mood, pain and nausea in adult cancer patients. Along with members of the UTSA music faculty, Drs. Tracy Cowden and John Nix, Shattuck is working with a San Antonio non-profit, Hearts Need Art, to collect data.
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COVID-19 denial depends on apopulation's trust in social institutions
Meanwhile, in Western Europe, people trust their governments more than in other EU countries
NATIONAL RESEARCH UNIVERSITY HIGHER SCHOOL OF ECONOMICS
An international team of scholars studied how the COVID-19 pandemic has impacted Europeans' stress levels and their trust in their national governments and the healthcare systems. They found that respondents were most stressed by the state of the national economy, and only after that, by the risk of catching COVID-19 and possibly being hospitalized. The results of the study were published in Royal Society Open Science.
The authors of the study represent over 50 universities. Among them is Dmitrii Dubrov, Junior Research Fellow at the HSE Center for Sociocultural Research, who developed and organized the global survey, COVIDiSTRESS. The researchers studied the psychological consequences of the current pandemic-related crisis, as reflected in stress levels. Over 150,000 respondents from over 50 countries participated in the study. The results (below) include answers from 75,570 respondents in 27 countries of the European Union (EU), who were surveyed from March 30 to April 20, 2020.
The general level of respondents' stress was measured on a 10-grade scale developed by psychologists Cohen, Kamarck, and Mermelstein (1983). This scale illustrates people's stress levels over the course of a recent week. The study participants were asked, for example, whether they experienced a lack of control over events, felt pressure due to growing difficulties, or disappointment due to unexpected change. Scores over 2.4 points were considered moderate, while those over 3.7 were considered high.
'Stress is a natural human reaction to negative change. We wanted to find out how humans would behave under stress, during the pandemic, whether they would follow recommendations by the WHO and authorities on how to protect oneself and others from COVID-19,' explains Dmitrii Dubrov, Junior Research Fellow at the HSE Centre for Sociocultural Research.
In many EU countries, levels of stress were moderate or even low. Poland and Portugal demonstrated the highest levels of stress in Europe, while the lowest rates were registered in Denmark and the Netherlands. Women worried more about the pandemic's consequences than men. The respondents were 74.18% female and 24.63% male.
The study participants also talked about the reasons of stress. The results showed that Europeans are most of all concerned about the state of the national economy, with the risk of catching COVID-19 and being hospitalized coming in second place. A total of 24 factors were indicated, including concerns about family and friends, work, or feeling isolated.
The respondents were also asked about their trust in the six key institutions, such as the healthcare system, the WHO, the police, social services, and national governments. Europeans demonstrate the highest levels of trust in their national healthcare systems and the WHO. Trust in national governments was lower than in other institutions. Finland and Denmark demonstrated the highest levels of trust in their governments. On the contrary, people in Bulgaria and Poland were much less inclined to trust their respective national governments.
The participants also evaluated the adequacy of anti-COVID measures implemented by their governments. Citizens of Slovenia and Slovakia believed the national measures to be excessive, while people in Hungary and France thought they were insufficient. Populations in countries were people trust their governments' efforts better, also better comply with social distancing guidelines.
'We have learned that COVID-19 denial depends on people's trust in social institutions, a belief that the government won't leave them on their own with their problems. Institutional trust in impacted by many factors, such as the level of corruption in the country. The results of our study can be used to prepare recommendations on how governments should communicate with people in situations of uncertainty. As we discovered here, the problem is global, which means that systematic work with citizen's demands is needed,' Dmitrii Dubrov said.
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Parental burnout hits individualist Western countries hardest
IMAGE: WESTERN COUNTRIES ARE THE MOST AFFECTED BY THE PHENOMENON OF PARENTAL BURNOUT view more
CREDIT: ISABELLE ROSKAM
IN BRIEF:
It's a first: approximately 100 scientists in 42 countries joined forces to learn about the incidence of parental burnout.
They found that Western countries are the most affected by parental burnout.
The cause? The often individualistic culture of Western countries. This international study, published in Affective Science, shows how culture, rather than socio-economic factors, plays a predominant role in parental burnout.
The individualism is more pronounced during health crises.
Does the incidence of parental burnout depend on a country's culture? This question was at the heart of the first international study on the subject for which hundreds of scientists in 42 countries mobilised. In other words, the global scientific community is worried about family stress-induced parental burnout. A high level of stress in the family can lead to parental exhaustion. Such suffering has serious consequences for both parents and children.
'We worked in close collaboration with scientists from all the cultures involved,' UCLouvain researchers and study initiators and coordinators Isabelle Roskam and Moïra Mikolajczak explained in a statement. 'They were the only ones capable of collecting data in their countries, guaranteeing their validity and interpreting them correctly. Such exceptional collaboration deserves to be highlighted.'
The study's findings are categorical: rich, individualistic Western countries, which on average have few children, are the most affected by the phenomenon. Culture, rather than socio-economic and demographic differences between countries, plays a predominant role in parental burnout. 'Prevalence varies greatly from one culture and country to another,' Prof. Roskam explains. 'We could have hypothesised that it would be the same everywhere but that the reasons for exhaustion would be different.' This is not the case.
CAPTION
Western countries are the most affected by the phenomenon of parental burnout
CREDIT
UCLouvain
Published in Affective Science, the study shows that the values of individualism in Western countries can subject parents to higher levels of stress. The results force us to question ourselves in a context where the mantra of "every one for oneself" is spreading all over the world.
'Our individualistic countries cultivate a cult of performance and perfectionism,' says Prof. Roskam, a parental burnout specialist. 'Parenthood in these countries is a very solitary activity, unlike in African countries, for example, where the entire village is involved in raising children.' These poorer countries, which often have many children, are more collectivist. This dimension seems to protect against parental burnout. In addition, Western individualism is exacerbated by the current health crisis: families find themselves isolated and cut off from their social relations.
What measures can be taken to prevent stress in parenting? 'The first would be to revive in our cultures the dimension of sharing and mutual aid among parents within a community,' Prof. Roskam says. 'And abandon the cult of the perfect parent and gain some perspective on all the parenting advice out there in order to choose what works for you.'
Thanks to the study consortium's collective dynamics, their work opens up many avenues for future intercultural investigations. Until now, all studies on parental burnout focused on personal factors. However, parents affected by this syndrome exercise their parenting in a particular cultural context. It is important to take this into account when treating symptoms.
A new study in Behavioral Ecology, published by Oxford University Press, finds that women are less likely to procreate in urban areas that have a higher percentage of females than males in the population.
Although the majority modern cities have more women than men and thus suffer from lower fertility rates, the effects of female-biased sex ratios - having more women than men in a population - is less studied than male-biased ratios. Researchers here analyzed how female-biased sex ratios are linked to marriages, reproductive histories, dispersal, and the effects of urbanization on society.
The research team from University of Turku, University of Helsinki and Pennsylvania State University used a massive internal migration event that occurred in Finland during WWII, when 10% of Finnish territory was ceded to the Soviet Union and over 400,000 citizens were evacuated. The Finnish government implemented a settlement act to provide land for farmers to replace the territory they lost. Each village in the ceded territory was assigned to a specific location in western Finland to keep communities together, though evacuees were not required to move to their assigned location. Researchers consulted a database of the evacuees, which was compiled of interviews of evacuees between 1968 and 1970. The database entries list the name, sex, date of birth, birthplace, occupation, year of marriage, reproductive records, and the years and names of all places the evacuee lived from birth until the time of the interview.
Researchers followed the annual reproductive and dispersal decisions of 8,296 evacuee women from 1945 to 1955 who were between the ages of 19 and 42 during this time, were unmarried when the war ended in 1945, and whose reproductive status and annual place of residence were known. Researchers measured the sex ratios in the locations these women lived throughout this period and estimated women's probability to start a family or disperse.
The study found that the likelihood of reproducing was strongly influenced by local sex ratio but that this relationship differed between rural and urban environments. While female biased population sex ratio lowered women's probability to reproduce for the first time in urban environments this was not the case in rural areas. However, women did not move into areas with more men, instead they were more likely to relocate to urban areas, despite the sex ratio being strongly female-biased in these locations. The researchers concluded that women probably moved to urban areas for work and education opportunities, but then experienced a competitive market for finding a spouse and thus were less likely to have children than women who lived outside of urban areas. Overall, women were 15% less likely to reproduce in urban areas compared to rural areas. In towns, every percentage of increase of men in the population increased women's probability to have first child by 2.7% whereas in rural areas increase was only 0.4%.
Researchers also noted that while the population they studied is historical, the findings can be applicable to present day urban environments. Women outnumber men in many cities across the developing and developed world, and they may be finding themselves in the same predicament experienced by Finnish women many decades ago.
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What is the probability of ships becoming beset in ice in Arctic waters?
IMAGE: THE POLAR SHIP CATEGORY OF A SHIP HAS A CRUCIAL IMPACT ON THE PROBABILITY OF BESETTING. SHIPS OF A LOWER CATEGORY ARE MOST AT RISK, AND MANY OF THEM BECOME... view more
CREDIT: PHOTO: ARCTIA LTD
Statisticians have calculated the probability of ships of different Polar Ship Categories becoming beset in ice along the Northern Sea Route. Their data will help assess the risks of maritime traffic in the Arctic.
The results of the new study, published recently in the Cold Regions Science and Technology journal, will support safer maritime transport planning and the prevention of oil spills. The results will also benefit authorities that regulate maritime traffic by providing a foundation for statutes and legislation. A comprehensive approach to computing helps shipping companies plan transport routes.
Tankers more common on the Northern Sea Route
The Northern Sea Route is attracting more tankers and cargo ships travelling from Russia and Asia to Europe, and traffic is expected to increase along the route in tandem with global warming (Figure 1).
In the winter, the sea is frozen over, making it inaccessible to ships of a lower Polar Ship Category without the assistance of an icebreaker. Ships can also become beset in ice in the spring and summer, leading to transport delays. At its worst, ice may force a vessel off its course so that it runs aground, with disastrous consequences.
"This is the first time a comprehensive risk assessment of a besetting event was performed using open data only," says Assistant Professor of Statistics Jarno Vanhatalo, head of the Environmental and Ecological Statistics group and director of the Master's Programme in Life Science Informatics at the University of Helsinki.
The researchers used satellite data on ice conditions in Arctic marine areas as well as open data sources on shipping.
"One of the biggest tasks required the merger of open datasets so that analyses could be conducted. This task was performed by Aalto University. The statistical analyses were carried out at the University of Helsinki, using a traditional generalised linear model, to which a Bayesian approach was applied," Vanhatalo explains.
Ice conditions on northern maritime routes
"If we know the ice conditions prevailing in a specific area, which can usually be ascertained from satellite images, we can make a prediction for, say, today and for each point along the Northern Sea Route," states Vanhatalo. The prediction indicates the probability of a ship of a particular type becoming beset in ice in a particular area (Figure 2).
The Polar Ship Category of a ship has a crucial impact on the probability of besetting. Ships of a lower category are most at risk, and many of them become beset in ice each year.
The researchers also analysed the effect of ice concentration on the probability of besetting. Ice concentration indicates the share of the sea covered by ice. In the winter, ice concentration is 100%, whereas in the spring and summer it varies from 0% to 100%, which means that the marine area is a mosaic of ice floes and open water.
The probability of a ship becoming beset in ice increases the longer the distance it travels in ice-covered waters and also increases significantly with higher ice concentrations. There are also considerable differences between ships of different Polar Ship Categories. For the best vessels, i.e., Category A ships, the probability of besetting on a journey of 3,000 nautical miles (NM) in 90%-100% ice concentration is just 0.04. Correspondingly, the probability for Category B ships is 7.5 times higher, or 0.3, whereas the probability for Category C ships is 22.5 times higher, or 0.9.
The newly published study is part of an international long-term research project funded by the Lloyd's Register Foundation and aimed at improving maritime safety. Launched in 2003, the project will conclude at the end of 2021. Participants in the CEARCTIC and CEPOLAR projects, headed by Aalto University, include not only the University of Helsinki, but also the Norwegian University of Science and Technology (NTNU), the Memorial University of Newfoundland in Canada, and the Hamburg University of Technology in Germany.
Although the research project is coming to a close, before the end of this year it will publish more statistical analyses of uncertainties associated with the modelling.
"Due to the limited measurement data available from Arctic marine areas, there are major uncertainties concerning shipping, living organisms and the behaviour of oil. Another major uncertainty relates to the natural stochasticity of highly unstable environmental conditions," Vanhatalo adds.
Another article currently being written explores the relative significances of factors affecting the overall risk as well as how risk analyses should be carried out and how the conclusions drawn differ depending on what is examined. Does the examination focus solely on the accident risk of vessels or also on the risk they pose to marine biotic communities? The results depend on whether both are examined separately or at the same time.
Other upcoming publications include summarising reports on the project as a whole and recommendations based on the research conducted
CAPTION
Figure 1. Development of shipping on the Northern Sea Route, 2013-2017, as indicated in the research data, distributed by Polar Ship Category (A = highest, C = lowest) as well as by distance travelled in open water and in ice.
CREDIT
Jari vanhatalo et al.
CAPTION
Figure 2. Probability of Category A ships becoming beset in ice on five shipping routes in the Kara Sea during different seasons. The figures indicate the probability of besetting when travelling a distance of five kilometres.
CREDIT
Credit: Vanhatalo et al. 2021
Reference:
Probability of a ship becoming beset in ice along the Northern Sea Route - A Bayesian analysis of real-life data. Jarno Vanhatalo, Juri Huuhtanen, Martin Bergström, Inari Helle, Jussi Mäkinen, Pentti Kujala https://doi.org/10.1016/j.coldregions.2021.103238
Cold regions science and technology, Volume 184, April 2021, 103238
IMAGE: CHRISTER HENRIK PURSIAINEN, PROFESSOR AT DEPARTMENT OF TECHNOLOGY AND SAFETY AT UIT THE ARCTIC UNIVERSITY OF NORWAY. view more
CREDIT: UIT
- It is as if China is two completely different countries, if we look at how they appear in two such different cases as Africa and the Arctic, says Christer Henrik Pursiainen. He is a professor at the Department of Technology and Security at UiT The Arctic University of Norway.
According to Pursiainen, it is not just the temperature difference that separates Africa from the Arctic. It also provides a good opportunity to take a closer look at how China adapts to two completely different situations and how they use widely differing methods to gain influence.
Together with professors Rasmus Gjedssø Bertelsen from UiT and Chris Alden from the London School of Economics, he has published the article "The Arctic and Africa in China's Foreign Policy: How Different Are They and What Does This Tell Us?" in the journal Arctic Review on Law and Politics.
Economic growth provides calm
China will soon be the world's largest economy and many of the country's 1.4 billion inhabitants are experiencing a real increase when it comes to standard of living. The country's elite want to keep the Communist Party in power and to ensure inner peace and stability, they must ensure continuous economic growth.
- This is much of the reason why China is increasing its global presence. To ensure the legitimacy of the Communist Party, economic growth must be maintained. China's worst nightmare is that what happened in the Soviet Union will also happen there, says Pursiainen.
To ensure economic growth, China is completely dependent on international trade. They are the world's largest importer of raw materials and energy and are the world's largest trading nation. The vast majority of this trade goes by sea, and therefore it is absolutely crucial to secure and strengthen the transport of goods and services.
China therefore, in 2013, started what has gradually become known as the Belt and Road Initiative. As a modern silk road, trade, and the road to becoming the world's largest superpower, will be increased through a massive investment in the development of trade routes and infrastructure across large parts of the world.
- China knows very well that they will slowly but surely become the leading superpower for the next 100 years. It can only be delayed by the United States, but I think the chance of this is small. The United States has had its century, says Pursiainen.
He points out that China is not in a hurry, and that they may have a different perception of time than politicians in most Western countries.
- Chinese leaders are elected for life. And the Chinese look 50-100 years ahead in time and thousands of years back. They know they have been a great power - and will be again, he says.
A learning state
China gradually began its presence in Africa as early as the mid-1950s. At first modestly, but today China is Africa's largest trading partner, measured at $ 204 billion in 2018. Weak governance and little international control has given China great flexibility in how to position itself in Africa.
- China is a learning state and they began their relations with Africa a long time ago. They gradually started investing, and today Africa is a major borrower. China has become a power factor throughout Africa and Chinese companies and migrants have established themselves across the continent in telecommunications, ports, car factories, small farms and shops, says Pursiainen.
He believes that one of the reasons why China has gained so much influence and acceptance in the various African countries is that they are open about the intention not to export communism and that they do not in principle interfere in national politics. This has made it easier for heads of state to let them into their countries.
Over time, large Chinese investments have led to a relationship of dependence.
- It has turned into a relationship where many African countries have become dependent on Chinese support - and more specifically Chinese companies and people, says Pursiainen.
Must secure own investments
To ensure stability in the areas of Africa in which they operate, and to ensure trade flows and investments, China is choosing a proven method.
- They use the same tactics as the United States, with the establishment of military bases, they contribute with peacekeeping forces to the UN and the African Union (AU) and they have a number of "private" security companies, which are subordinate to the Communist Party, says Pursiainen.
In 2015, the Chinese established their first, and so far only, military base in Djibouti on the Horn of Africa. The base has about 10,000 soldiers and is closely linked to a major port project nearby. Although they claim this is primarily a logistics base and for defense against piracy in the area, it gives the Chinese authorities a significant military presence and a full overview of all ship traffic through the Red Sea and the Gulf of Aden.
- They claim they are there to help and ensure stability, but this is a way for China to become a global superpower, says Pursiainen.
In addition, China has several agreements with various African countries when it comes to arms sales, military exercises and other forms of cooperation.
CAPTION
International collaboration led by The Chinese Arctic and Antarctic Administration (CHINARE).
CREDIT
Timo Palo/ CC BY-SA 3.
The Arctic
As China has gained a stronger voice in international politics in recent years, they have also turned their attention and interest to the Arctic and the opportunities that exist there.
The motivation is the same - to ensure economic growth and influence. But the approach China chooses is completely different. While they have been able to gain a foothold due to weak states and a poorly developed system of government in Africa, the situation is quite different in the north. The Arctic is surrounded by developed countries with established laws and regulations and is an area that has far greater international attention.
This means that China must seek influence by other means.
- Chinese foreign policy is very adaptable and flexible. They are very good at this. China has defined itself as a near-Arctic country. Of course they are not, but still they claim that right. And what we observe is that while China follows existing rules in the Arctic, they are actively working to influence and change them to their advantage, says Pursiainen.
China is doing this by engaging broadly in global organizations where they already have an important seat. This applies, for example, to the UN, where they are trying to influence the future use of the Arctic through both the Convention on the Law of the Sea and the International Maritime Organization (IMO).
The same applies to the Arctic Council. After gaining an ad-hoc role as an observer in 2007, China worked purposefully to gain a more permanent role in the Council. Despite the fact that this was first met with skepticism from Canada, Russia and the USA, they eventually gained a permanent place as an observer in 2013. Although this does not give China an active role in the decisions made, they get to legitimately participate in the debate on the future of the Arctic.
Important with laws and regulations
Although China claims that through increased presence in the Arctic, they can achieve win-win situations for everyone involved, those who are researching this are divided. Some push the alarm button, some are moderate, while others predict a more positive effect of China's entry into the Arctic.
While Chinese investment has to some extent been welcomed by the countries around the Arctic, many are concerned about the economic and political influence that may accompany such investments.
- If we are to learn from such a comparison between two continents as different as Africa and the Arctic, then that must be that it is important to secure and maintain strong regional and national institutions, based on laws and regulations. This will counteract any negative aspects of increased Chinese involvement, says Pursiainen.
He points out that it is crucial to ensure that China does not use its economic muscles to enter into agreements with countries in a vulnerable situation. This will create a dependency relationship, as seen in some African countries, where China gains too much power.
- What we are trying to say is that one should be happy that China is investing, also in the Arctic. But, we must be vigilant and not let them establish their own rules, says Pursiainen.
IMAGE: UNIVERSITY OF ILLINOIS RESEARCHERS ALLEN BARTON (LEFT) AND DOUG SMITH FOUND OPIOID USE AMONG ILLINOIS HIGH SCHOOL STUDENTS TIED TO OTHER SUBSTANCE USE AND MENTAL HEALTH CONCERNS. view more
CREDIT: PHOTO: L. BRIAN STAUFFER, UNIVERSITY OF ILLINOIS.
URBANA, Ill. - Opioid use has dramatically increased in the 21st century, especially among young adults. A new study from the University of Illinois provides insights on usage patterns among Illinois high school students to help inform prevention and treatment strategies.
"The societal and personal costs of opioid misuse are massive. There's been a lot of focus on trying to understand how to combat the current epidemic. But we also need to make sure we have good data in order to know how we should apply our efforts," says Allen Barton, assistant professor in the Department of Human Development and Family Studies at U of I and lead author on the study.
The researchers based their study on information from the 2018 Illinois Youth Survey (IYS), which measures risk behaviors among high school students.
Over 230,000 students across Illinois typically participate in the biannual survey, says Doug Smith, professor of social work and director of the Center for Prevention Research and Development at U of I. Smith is co-author on the opioid study and principal investigator for the IYS.
The study focused on 18-to 19-year-olds, the beginning of a developmental stage when opioid use vulnerability is highest, Barton says.
Among the more than 26,000 respondents in this age group, 5.6% (1,468 youth) indicated they had used prescription pain medication in the past year without a prescription or differently than intended; that is, non-medical use of prescription opioids.
"Another 2.6% (682 youth) reported they had used prescription painkillers to get high. This addresses motive of use, which is an important part of understanding the issue," Barton says.
Finally, 0.4% of the sample (105 youth) reported they had used heroin in the past year. Heroin is another form of opioid that is not in the form of prescription medication, Barton notes.
The researchers found clear differences in characteristics of opioid users versus non-users.
"The individuals engaging in opioid use are also engaging in heightened levels of other forms of substance misuse, primarily alcohol and cannabis. They have more mental health concerns and higher suicide intent. And those who are using opioids report much lower grades and much higher levels of being victims of bullying," Barton says.
As opioid use is closely linked with other forms of substance misuse, counselors and medical practitioners should treat it as part of a pattern, Smith states. "This contradicts the typical image of a non-substance-using youth who one day decides to use opioids and then gets progressively addicted. That doesn't typically happen. These kids are already using other substances, often at levels indicative of problematic use. It seems more like a progression of general substance use than specific opioid usage," he notes.
The researchers also analyzed the data to look for profiles among the subset of youth using opioids.
"Our findings indicated three main profiles of individuals reporting opioid use. You have one group, comprising slightly more than half of this subsample, that's using opioids, but not specifically to get high. You have another group of individuals reporting a clear motive of use to get high. And a third, small group that's just using heroin," Barton notes.
While there were many similarities among the three groups, individuals who reported using opioids to get high also reported much more problematic substance abuse overall, as well as higher suicide risk compared to people who are engaged in non-medical use of prescription opioids without such motive, Smith adds.
The researchers say their study shows opioid use is a complex issue which needs tailored approaches to treatment and prevention.
"In order to address opioid use at this developmental stage, which is a transition to adulthood, we need to realize it is indicative of a broader pattern of factors related to other substance use and mental health issues that require attention. A one-step approach to just address the opioid use may not be sufficient," Barton states.
"The good news in this data is that opioid use rates are very low for this demographic across the state. However, for a subset of youth who do use, it appears to be making a difficult situation all the more challenging."
Barton and Smith say the correlation with other forms of substance misuse can help identify opioid use at an early stage.
"For any youth who is getting treatment for another substance, we need to be screening for whether they're using opioids, and we need to have a prevention program within a treatment program," Smith says.
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The IYS is administered every other year to schools across Illinois. Survey reports are available at the Illinois Youth Survey website. Schools can also register online for participation.
The Department of Human Development and Family Studies is in the College of Agricultural, Consumer and Environmental Sciences, University of Illinois.
The paper, "Opioid use at the transition to emerging adulthood: A latent class analysis of non-medical use of prescription opioids and heroin use," is published in Addictive Behaviors. [DOI: 10.1016/j.addbeh.2020.106757]
Authors include Allen Barton, Crystal Reinhart, Corey Campbell, and Doug Smith.
Support for the development of this article was provided by the Illinois Department of Human Services (#43CZZ03292; PI: Smith). The views expressed by the authors are their own, however, and do not reflect official positions of the State of Illinois.
