Incidence of self-reported brain injury and the relationship with substance abuse: findings from a longitudinal community survey

BACKGROUND: Traumatic or serious brain injury (BI) has persistent and well documented adverse outcomes, yet 'mild' or 'moderate' BI, which often does not result in hospital treatment, accounts for half the total days of disability attributed to BI. There are currently few data available from community samples on the incidence and correlates of these injuries. Therefore, the study aimed to assess the 1) incidence of self-reported mild (not requiring hospital admission) and moderate (admitted to hospital)) brain injury (BI), 2) causes of injury 3) physical health scores and 4) relationship between BI and problematic alcohol or marijuana use. METHODS: An Australian community sequential-cohort study (cohorts aged 20-24, 40-44 and 60-64 years at wave one) used a survey methodology to assess BI and substance use at baseline and four years later. RESULTS: Of the 7485 wave one participants, 89.7% were re-interviewed at wave two. There were 56 mild (230.8/100000 person-years) and 44 moderate BI (180.5/100000 person-years) reported between waves one and two. Males and those in the 20-24 year cohort had increased risk of BI. Sports injury was the most frequent cause of BI (40/100) with traffic accidents being a greater proportion of moderate (27%) than mild (7%) BI. Neither alcohol nor marijuana problems at wave one were predictors of BI. BI was not a predictor of developing substance use problems by wave two. CONCLUSIONS: BI were prevalent in this community sample, though the incidence declined with age. Factors associated with BI in community samples differ from those reported in clinical samples (e.g. typically traumatic brain injury with traffic accidents the predominate cause). Further, detailed evaluation of the health consequences of these injuries is warranted

‘Ecstasy’ and the use of sleep medications in a general community sample: a four-year follow-up

Aims: Animal models show that a single dose of MDMA (‘ecstasy’) can result in long-term disruption of sleep. We evaluated the relationship between ecstasy consumption and the use of sleep medications in humans after controlling for key factors. Design: The Personality and Total Health Through Life project uses a longitudinal cohort with follow-up every four years. This study reports data from waves two and three. Setting: Participants were recruited from the electoral roll in the Australian Capital Territory and Queanbeyan, New South Wales, Australia. Participants: Participants were aged 20-24 years at wave one (1999-2000). Measures: The study collected self-reported data on ecstasy, meth/amphetamine, cannabis, alcohol, tobacco and use of sleeping medications (pharmaceutical or other substances). Depression was categorised with the Brief Patient Health Questionnaire (BPHQ). Other psychosocial measures included lifetime traumas. We used generalised estimating equations to model outcomes. Results: Ecstasy data were available from 2128 people at wave two and 1977 at wave three: sleeping medication use was reported by 227 (10.7%) respondents at wave two and 239 (12.1%) at wave three. Increased odds ratios (OR) for sleeping medication use was found for those with depression (OR=1.88, (95% confidence interval (CI) 1.39, 2.53), women (OR=1.44, 95% CI 1.13, 1.84), and increased by 19% for each lifetime trauma. Ecstasy use was not a significant predictor, but >monthly versus never meth/amphetamine use increased the odds (OR=3.03, 95% CI 1.30, 7.03). Conclusion: The use of ecstasy was not associated with the use of sleeping medications controlling for other risk factors.The PATH study was supported by an NHMRC Program Grant 179805 and NHMRC Project Grant 157125. The sponsors had no role in the design, conduct or reporting of the research. None of the authors have connections (direct or indirect) with the tobacco, alcohol, pharmaceutical or gaming industries or any body substantially funded by one of these organisations

A structure theorem for product sets in extra special groups

Hegyv\'ari and Hennecart showed that if $B$ is a sufficiently large brick of a Heisenberg group, then the product set $B\cdot B$ contains many cosets of the center of the group. We give a new, robust proof of this theorem that extends to all extra special groups as well as to a large family of quasigroups.Comment: This manuscript has been updated to include referee corrections. To appear in Journal of Number Theor

Some Problems in the Mathematical Theory of Elasticity

The problems tackled in this thesis fall into two main sections. Part I deals with and develops a method of solving steady-state thermoelastic problems and Part II gives a method of solving crack problems for elastic bodies of cylindrical form

Hormone Excretion During the Normal Menstrual Cycle

To recapitulate, the at present accepted theory concerning the mechanism controlling the menstrual cycle is, that it is governed by the anterior lobe, which probably produces two hormones: (1) Prolan A, which stimulates follicular maturation in the ovary, and the secretion of oestrone, which in turn causes the endometrium to develop to the post-menstrual phase, and. (2) Prolan B, which causes the formation of the corpus luteum and the secretion of Progesterone, which advances the development of the endometrium to that of the pre-menstrual phase.The pituitary then might be termed the conductor of the instruments of the menstrual orchestra, directing its harmony, but, from what score must the conductor beat the tempo? What music is to be played?In plainer terms, is there a higher nervous sexual centre, which controls the hormone function of the ipituitary?Hohlweg and Junkmann have suggested by their experiments on castrated rats, into which implants of hypophyseal tissue have been made, that the pituitary is controlled extrinsically by fine nerve connections to the brain via the pituitary stalk.Theobald has recently put forward an hypothesis from evidence of a clinical nature, which postulates that there are one or more centres in the brain, probably in the hypothalmic region, which regulate the functions of the reproductive tract, through afferent and efferent neuro-hormonic stimuli. He considers the efferent route to be composed by: (1) The hormones of the anterior lobe, and (2) Nervous impulses to the generative organs; and the afferent pathway to be composed of: (1) The hormones of the ovary. (2) Impulses transmitted from the external generative organ. (3) Impulses transmitted from the higher special centres.This hypothesis is rather novel and attractive, yet it requires the corroboration of more fundamental study.It, however, causes a swing of the pendulum in the opposite direction, in focussing the attention of investigators of this subject, to a higher centre or centres, which may be the final link in the chain whereby the phenomena of menstruation, ovulation, pregnancy and parturition can be more adequately explained

Improved bounds on sizes of generalized caps in AG(n,q)AG(n,q)

An $m$-general set in $AG(n,q)$ is a set of points such that any subset of size $m$ is in general position. A $3$-general set is often called a capset. In this paper, we study the maximum size of an $m$-general set in $AG(n,q)$, significantly improving previous results. When $m=4$ and $q=2$ we give a precise estimate, solving a problem raised by Bennett.Comment: Revised version. To appear in SIAM Journal on Discrete Mathematic

Pharmacy-based alcohol-misuse services: current perspectives

Context: Globally, the use of alcohol is a leading cause of mortality and morbidity. Opportunistic screening and brief interventions (SBIs) have been shown to be effective in reducing alcohol consumption in certain primary care settings and provide a means of reaching some of those who do not seek treatment for alcohol-related problems. Further, community pharmacies have the potential to reach consumers at an early stage of their alcohol use and incorporate intervention and advice into their role in providing medications. Aim: The purpose of this review was to inform pharmacists and stakeholders of the evidence base for SBI in community pharmacy settings. To date, there has been limited research on the effectiveness of alcohol SBI in community pharmacies, with a systemic review only identifying two randomized trials. Methods: This narrative review reports on the period 2007-2017, covering feasibility studies, pilot programs, and surveys of consumers and pharmacy staff attitudes relating to alcohol SBI in this setting. Studies were identified via MEDLINE, CINAHL, Google Scholar, and reference lists of relevant publications. Findings: The findings indicated that the provision of community pharmacy alcohol SBI requires training in communication and intervention skills and in some cases increasing confidence and alcohol-related knowledge. Consumers were generally receptive to the SBI approach but requested private areas for delivery of such. Conclusion: The high prevalence of "at risk" alcohol use in many countries and the low level of treatment seeking by this group means that novel approaches to engage opportunistically with these people is imperative in reducing alcohol-related harms. However, before committing routine health funding, these novel approaches need rigorous evaluation

Deliberate self-harm, substance use and negative affect in nonclinical samples: A systematic review

BACKGROUND AND METHOD: A systematic literature review was conducted to examine associations between self-harm, substance use, and negative affect in nonclinical samples. RESULTS: Forty-two articles describing 36 studies were identified that met the inclusion criteria. Findings indicated that individuals who engage in substance use are significantly more likely to engage in self-harm. It was also found that negative affective states such as depression and anxiety are consistently associated with self-harm. CONCLUSIONS: These findings provide some guidance in identifying those who are at increased risk of self-harm. Reducing these risk factors could be an important strategy in preventing self-harm behavior in the general population