Factors Associated with Serious Injuries among Adolescents in Ghana: Findings from 2012 Global School Health Survey

Introduction. Injuries are of public health concern and the leading cause of residual disability and death among teenagers, especially in low- and middle-income countries (LMICs). In Ghana, the burden of injury among adolescents is under-reported. Hence, the study sought to determine the prevalence of serious injuries (SI) and the potential factors influencing these injuries among school children in Ghana. Methods. This study was conducted in Ghana among Junior High School (JHS) and senior high school students (SHS) using the 2012 Global School-Based Student Health Survey (GSHS) data. The GSHS employed two-stage cluster sampling method. Serious injuries (SI) and independent factors were measured via self-administered questionnaires. Pearson chi-square test between each explanatory variable and serious injuries was conducted and the level of statistical significance was set at 5%. The significant variables from the chi-square test were selected for multiple logistic regression analysis. Multiple logistic regression was performed to estimate the adjusted odds ratio (AOR) at 95% confidence interval (CI). Results. The prevalence of SI in the past 12 months was 66% [CI=61.8–70.2] . The most common cause of SI was fall, 36%. The common types of injuries were cut/stab wounds and broken/dislocated bone. In the multiple logistic regression analysis, after controlling for other variables, educational level (AOR = 0.64, CI = 0.44–0.90, p < 0.015), suicidal ideation (AOR = 1.58, CI = 1.00–2.48, p < 0.002), suicidal attempt (AOR = 1.88, CI = 1.29–2.72, p < 0.001), having at least one close friend (AOR = 1.49, CI = 1.17–1.89, p < 0.002), school truancy (AOR = 1.66, CI = 1.31–2.09, p < 0.000), smoking marijuana (AOR = 2.64, CI = 1.22–5.69), and amphetamine use (AOR = 2.95, CI = 1.46–5.69) were independently associated with SI. Conclusion. The findings of the study established a high prevalence of SI among adolescents in Ghana, with cut/stab wound and broken/dislocated bone being the most reported type of injuries. This study also revealed that factors such as educational level, suicidal ideation, suicidal attempt, at least one close friend, school truancy, smoking marijuana, and amphetamine use are associated with SI among the adolescents. Therefore, pragmatic interventional programs should be targeted at these factors to curb the rate of SI among junior and senior school students.

Marijuana Use among Young Adults: Findings from the 2015-2018 National Survey on Drug Use and Health

Marijuana is the most commonly used drug for young adults. A greater understanding of risk factors associated with recent use can inform health prevention messaging. Pooled data from the 2015-2018 National Survey on Drug Use and Health were utilized among 89,446 individuals ages 18-34. Weighted logistic regression analyses, controlling for covariates, were utilized to determine conditional associations to past-30-day use. A sizeable percentage (18.5%) of individuals reported smoking marijuana in the past 30 days. Individuals who identify as African American or Multi-Racial, Gay/Lesbian, Bisexual, reported their health as poor, not covered by health insurance, reported prior drug use, or who had reported any thoughts/plans of suicide were at risk for use. Of concern, high rates of alcohol (14.7%) and cocaine (1.50%) were found among users. We believe our findings can inform harm reduction efforts and policy creation.

Tobacco and Marijuana Co-use Behaviors among Cigarillo Users

Objectives: In this study, we examine the frequency of 'simultaneous use' (smoking tobacco in close temporal proximity to smoking marijuana) and substitution (smoking a cigarillo in place of a marijuana blunt – a cigar wrapper filled with marijuana) and their association with nicotine dependence (ND) among young cigarillo users. Methods: The sample consisted of 686 cigarillo and blunt co-users who responded to a cross-sectional, Web-based survey of 14-28-year-olds recruited via social media. We used bivariate analyses and multiple linear regression to examine the association of simultaneous use and substitution with participant demographics, tobacco product use, marijuana use, and ND. Results: Most users reported simultaneous use (72.4%) and substitution (67.9%). Chasing was the most common form of simultaneous use (63%). Simultaneous users were more likely to use tobacco daily and to smoke cigarettes, and reported a lower age of initiation to marijuana and tobacco than non-simultaneous users. The most common reason for substituting (73%) was the lack of availability of marijuana. Both practices were strongly and independently associated with greater ND, adjusting for covariates. Conclusions: Simultaneous use and substitution are common co-use behaviors among cigarillo users, and may play a role in promoting increased tobacco use and nicotine dependence.

1239 Mind Blown: Exploding Head Syndrome as a Side Effect of Marijuana

Introduction Marijuana use is increasing the United States and has been associated with increased sensory perception, euphoria, and altered cognition. Exploding head syndrome is a parasomnia characterized by loud explosion-like noises occurring prior to or during sleep. This the first report to link marijuana use with the occurrence of EHS. Report of Case A 45-year-old man with depression, anxiety and multisubstance abuse reported two years of neuropsychiatric symptoms including: “fireworks going off in my brain,” visual hallucinations, and sudden arousals characterized by panic and vertigo. He reported bouts of occupational stress and severe anxiety previously treated with clonazepam for six months, but discontinued it due to poor clinical response. Normal findings were reported on a previous work-up including: MRI, EEG, and head CT Scan. During his visit, he reported that he had been smoking marijuana three times a day for 24 years. One month prior to his visit he discontinued marijuana, stopped clonazepam, and started using mirtazapine with improvement in all aforementioned symptoms. During the same month, he relapsed and smoked marijuana once with a sudden return of all previously described symptoms on the night following its use. These symptoms then resolved and did not recur again until 9 months later, after another episode of weekend marijuana use. An in-lab polysomnogram revealed an apnea-hypopnea index 2.2 per hour, increased alpha intrusion throughout the study, and no epileptiform activity. No parasomnias were observed during rapid-eye-movement (REM) or non-REM sleep. Conclusion The etiology of EHS remains elusive. A review of the research has proposed five major theories and case reports suggest a complex etiology. Given the temporal correlation with marijuana use and symptom resolution with its cessation, we presume that EHS resulted from a complex interplay between neurons susceptible to cannabinoids and their derivatives.

Seorang Perempuan Perokok Tembakau dan Mariyuana dengan Pneumotoraks Spontan Primer Akibat Blep Multipel yang Pecah

Background: Primary spontaneous pneumothorax (PSP) can be caused by a ruptured blep emfisematus subpleural. People who smoke tobacco and marijuana simultaneously arise PSP will be more risky than just smoking tobacco. Pneumothorax in cannabis smokers may occur due to coughing at the time was holding their breath, when they were smoking marijuana. Case: We report the case of 33-year-old woman with recurrent shortness of breath as a result of primary spontaneous pneumothorax in the right hemithorax. The patient’s tobacco and marijuana smokers. Patients had undergone previous pleurodesis. Chest X-ray picture of the lines conveniently indicates lung collapse and air-fluid level in the right hemithorax. Thoracoscopic showed a large bronchopleural fistula. During thoracotomy found one bronkopeural fistula, three large blep, and more than 15 small blep. Then do the suturing of fistula and blep. Patients recover in a short time and in good condition during treatment. Conclusion: Tobacco and marijuana smoking is a risk factor that is synergistic to the occurrence of primary spontaneous pneumothorax. These patients consume both are irregular but have resulted in multiple blep that can rupture and cause a pneumothorax.

PERCEPTION OF HARMS AND BENEFITS ASSOCIATED WITH MARIJUANA USE AMONG ADOLESCENTS IN ST KITTS-NEVIS - CARIBE

ABSTRACT Objective: this investigation examined adolescents’ perception of the harms and benefits of marijuana use and how regulatory changes may affect their intent to use marijuana. Method: this cross-sectional survey gathered data from 268 15 to 17 years old students who were enrolled in public secondary schools in St Kitts-Nevis - Caribe. Results: forty five percent of the students perceive that there is no risk if marijuana is smoked once or twice. One out of every 4 students felt that there is great risk if marijuana is used regularly. About half of the students felt that marijuana helps persons their age to cope with emotional difficulties. Students who have used marijuana have a low perception of the risks associated with marijuana use and are seven times more likely to continue using marijuana, if it were legal and they were 18 years of age. Conclusion: most of the students perceive that there is no personal harm associated with smoking marijuana. Students are not sure whether the benefits of using marijuana are greater than the risks. A noticeable proportion of students were unsure of the harms and benefits associated with marijuana use. It is recommended that suitable educational and preventative programmes be implemented in schools.