A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students.

BACKGROUND: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. METHODS/DESIGN: An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. DISCUSSION: This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. FINAL TRIAL REGISTRATION NUMBER: DRKS00004375 on the ‘German Clinical Trials Register’

Carriage of an ACME II variant may have contributed to methicillin-resistant staphylococcus aureus sequence type 239-like strain replacement in Liverpool hospital, Sydney, Australia

Approximately 39% of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 239 (ST239)-like bloodstream isolates from Liverpool Hospital (obtained between 1997 and 2008) carry an arginine catabolic mobile element (ACME). Whole-genome sequencing revealed that an ACME II variant is located between orfX and SCCmec III, and based on pulsed-field gel electrophoresis patterns and temporal relationships of all ST239-like isolates (n = 360), ACME carriage may have contributed to subpulsotype strain replacement

Student estimations of peer alcohol consumption: links between the Social Norms Approach and the Health Promoting University concept.

The Social Norms Approach, with its focus on positive behaviour and its consensus orientation, is a health promotion intervention of relevance to the context of a Health Promoting University. In particular, the approach could assist with addressing excessive alcohol consumption

Personal and Perceived Peer Use of and Attitudes Toward Alcohol Among University and College Students in Seven EU Countries: Project SNIPE.

The objective of this study was to explore perceptions of peer substance use and related attitudes among European students. Challenging perceptions about peer substance use has become the basis of a form of prevention and intervention known as the social norms approach, which can be delivered using personalized online feedback. This article reports baseline alcohol use and attitudes data for university students across Europe collected as part of the Social Norms Intervention for the prevention of Polydrug usE project (Project SNIPE)

Illicit substance use among university students from seven European countries: A comparison of personal and perceived peer use and attitudes towards illicit substance use

Objective: To compare European students' personal use and approval of illicit substance use with their perceptions of peer behaviours and attitudes, and investigate whether perceptions of peer norms are associated with personal use of illicit substances and attitudes. Method: This study used baseline data fromthe Social Norms Intervention for the prevention of Polydrug usE (SNIPE) project involving 4482 students from seven European countries in 2012. Students completed an online surveywhich included questions on personal and perceived peer illicit substance use and personal and perceived peer attitude towards illicit substances. Results: 8.3% of students reported having used illicit substances at least once in their life. 49.7% of students perceived that the majority of their peers have used illicit substances more frequently than themselves. The perception was significantly associated with higher odds for personal illicit substance use (OR: 1.97, 95% CI: 1.53–2.54). The perception that the majority of peers approve illicit substance use was significantly associated with higher odds for personal approval of illicit substance use (OR: 3.47, 95% CI: 2.73–4.41). Conclusion: Students commonly perceived that their peers used illicit subtances more often than themselves. We found an association between the perceived peer norms/attitudes and reported individual behaviour/ attitudes

Symmetry Breaking and Finite Size Effects in Quantum Many-Body Systems

We consider a quantum many-body system on a lattice with a continuous symmetry which exhibits a spontaneous symmetry breaking in its infinite volume ground states, but in which the order operator does not commute with the Hamiltonian. A typical example is the Heisenberg antiferromagnet with a Neel order. In the corresponding finite system, the symmetry breaking is usually "obscured" by "quantum fluctuation" and one gets a symmetric ground state with a long range order. In such a situation, we prove that there exist ever increasing numbers of low-lying eigenstates whose excitation energies are bounded by a constant times 1/N, where N denotes the number of sites. By forming linear combinations of these low-lying states and the (finite-volume) ground state, and by taking infinite volume limits, we construct infinite volume ground states with explicit symmetry breaking. Our general theorems do not only shed light on the nature ofsymmetry breaking in quantum many-body systems, but provide indispensable information for numerical approaches to these systems. We also discuss applications of our general results to a variety of examples. The present paper is intended to be accessible to the readers without background in mathematical approaches to quantum many-body systems.Comment: LaTeX, 58 pages, no figures. Notes about Bose-Einstein condenstaion are added after the publicatio

Normative perceptions of cannabis use amongst European University students: associations between perceived peer use and peer attitudes with personal use and attitudes.

Objective: Perceptions of peer behavior and attitudes exert considerable social pressure on young adults to use substances. This study investigated whether European students perceive their peers’ cannabis use and approval of cannabis use to be higher than their own personal behaviors and attitudes, and whether estimations of peer use and attitudes are associated with personal use and attitudes. Method: University students (n = 4131) from Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey and the United Kingdom completed an online survey as part of the Social Norms Intervention for Polysubstance usE in students (SNIPE) project, a feasibility study of a web-based normative feedback intervention for substance use. The survey assessed students’ (1) personal substance use and attitudes, and (2) perceptions of their peers’ cannabis use (descriptive norms) and attitudes (injunctive norms). Results: Although most respondents (92%) did not personally use cannabis in the past two months, the majority of students thought that the majority of their peers were using cannabis and that their peers had more permissive attitudes towards cannabis than themselves. Controlling for students’ age, sex, study year and religious beliefs, perceived peer descriptive norms were associated with personal cannabis use (OR: 1.42; 95% CI: 1.22, 1.64) and perceived injunctive norms were associated with personal attitudes towards cannabis use (OR: 1.46; 95% CI: 1.09, 1.94). Conclusions: European students appear to possess similar discrepancies between personal and perceived peer norms for cannabis use and attitudes as found in North American students. Interventions which address such discrepancies may be effective in reducing cannabis use. Keywords: cannabis, social norms, student health, social influenc

Early detection of cervical cancer in western Kenya: determinants of healthcare providers performing a gynaecological examination for abnormal vaginal discharge or bleeding

Background: In western Kenya, women often present with late-stage cervical cancer despite prior contact with the health care system. The aim of this study was to predict primary health care providers’ behaviour in examining women who present with abnormal discharge or bleeding. Methods: This was a cross-sectional survey using the theory of planned behaviour (TPB). A sample of primary health care practitioners in western Kenya completed a 59-item questionnaire. Structural equation modelling was used to identify the determinants of providers’ intention to perform a gynaecological examination. Bivariate analysis was conducted to investigate the relationship between the external variables and intention. Results: Direct measures of subjective norms (DMSN), direct measures of perceived behavioural control (DMPBC), and indirect measures of attitude predicted the intention to examine patients. Negative attitudes toward examining women had a suppressor effect on the prediction of health workers’ intentions. However, the predictors of intention with the highest coefficients were the external variables being a nurse (β = 0.32) as opposed to a clinical officer and workload of attending less than 50 patients per day (β = 0.56). In bivariate analysis with intention to perform a gynaecological examination, there was no evidence that working experience, being female, having a lower workload, or being a private practitioner were associated with a higher intention to conduct vaginal examinations. Clinical officers and nurses were equally likely to examine women. Conclusions: The TPB is a suitable theoretical basis to predict the intention to perform a gynaecological examination. Overall, the model predicted 47% of the variation in health care providers’ intention to examine women who present with recurrent vaginal bleeding or discharge. Direct subjective norms (health provider’s conformity with what their colleagues do or expect them to do), PBC (providers need to feel competent and confident in performing examinations in women), and negative attitudes toward conducting vaginal examination accounted for the most variance. External variables in this study also contributed to the overall variance. As the model in this study could not explain 53% of the variance, investigating other external variables that influence the intention to examine women should be undertaken