Predictors of changes in marijuana consumption in Germany during the covid-19 pandemic.

During the Covid-19 pandemic Germany experienced its first increase in the proportion of heavy cannabis users since 1995. With the expected nationwide decriminalization of cannabis before 2025, we investigate the potential causes for that increase. Data were from the 2021 European Web Survey on Drugs (EWSD) including 762 12-month marijuana users from Germany (72.9% male, mean age = 29.5 years). Both heavy and regular cannabis consumers reported an increase in marijuana consumption during the pandemic, with infrequent users reporting a decrease. Using multinomial logistic regression, we found younger individuals (OR = 0.95 [95% CI = 0.92, 0.98]) and those not pursuing or completing higher education (OR = 1.86 [1.23, 2.81]) had increased use. Additionally, using cannabis to self-medicate (OR = 2.79 [1.56, 4.99]) and purchasing marijuana (OR = 2.26 [1.35, 3.77]) was associated with increased use. We found, relative to infrequent users, both regular (OR = 4.00 [2.39, 6.72]) and notably heavy users (OR = 31.17 [12.10, 80.32]) were more likely to use cannabis to self-medicate. Both regular (OR = 4.09 [2.47, 6.77]) and especially heavy users (OR = 13.53 [6.74, 27.16]) were also more likely to purchase marijuana. Heavy users were also more likely to be past 30-day tobacco users (OR = 5.92 [2.81, 12.45]). We identified the self-reported motivation of using cannabis to self-medicate as well as act of purchasing marijuana as having the strongest relation to being a heavy user and increasing marijuana use during the Covid-19 pandemic.

Patterns of self-medication and intention to seek pharmacist guidance among older adults during the COVID-19 pandemic in Macao: a cross-sectional study.

INTRODUCTION: Self-medication was remarkably popular during the COVID-19 pandemic. In older populations, the risk of self-medication is higher. Pharmacists are well positioned to provide public health education and disease prevention. This study aims to explore the self-medication patterns and intention to seek pharmacist guidance among older adults in Macao. METHODS: A face-to-face cross-sectional survey was subsequently performed in March-April 2023 among older adults in Macao. The questionnaire was designed based on the Theory of Planned Behavior (TPB) framework. Multiple logistic regression was used to analyze predictors of self-medication behavior and multiple linear regression analysis to determine whether the TPB construct was the predictor of older adults' intention to seek guidance from pharmacists. RESULTS: A total of 412 participants completed the questionnaire. The self-medication rate among older adults in Macao was 64.2%. The most commonly used types of medications were over-the-counter and traditional Chinese medicine, mainly from government anti-pandemic packages. The majority of individuals engaged in self-medication to treat COVID-19 symptoms or prevent COVID-19 infection. The prevalent reasons for self-medication were the perceived non-seriousness of the illness. 85 years old or older and university degree were significantly associated with self-medication behavior. Older adults had moderate intention to seek pharmacist guidance on medication use. The average scores (standard deviation) were 3.43 (1.10) for Attitude, 2.69 (0.99) for Subjective Norm, 3.56 (1.04) for Perceived Behavioral Control, and 3.07 (1.43) for Intention. Attitude, Subjective Norm, and Perceived Behavioral Control were all strong predictors of intention, which explained 53% of the variance in intention. In demographic factors, age was identified as a significant predictor of intentions. CONCLUSIONS: Self-medication was widely practiced in Macao during the COVID-19 pandemic. To better control the risks associated with self-medication, the role of pharmacists is paramount. Enhancing the recognition and trust of pharmacists within society, modifying pharmacy management models, and strengthening pharmacists' self-perception of their profession are all pivotal directions areas to further enhance their role.

Digital Healthcare and Internet Derived Information Obstruction Treatment (IDIOT) Syndrome: Understanding the Link Between Clicks and Consequences.

This article explores the phenomenon of Internet Derived Information Obstruction Treatment (IDIOT) syndrome, highlighting the impact of internet-derived health information on individuals' treatment decisions. Drawing on recent studies, including the rise of IDIOT syndrome due to increased internet use and the potential risks associated with self-medication based on online information, the editorial emphasizes the importance of critically evaluating health information. Insights from research conducted in the last few years highlight the complexity of health conditions and the necessity of seeking professional medical guidance to address the various clinical conditions and their consequences. This article sets the stage for a detailed examination of the IDIOT syndrome and its implications for healthcare decision-making in the digital era.

Assessment of self-medication practices and safety profile of medicines utilisation among pregnant women attending antenatal clinics in Freetown, Sierra Leone: a multicentre cross-sectional study.

Background: Despite the potential foetal and maternal risks of self-medication, studies on self-medication practice and the safety profile of medicines used during pregnancy are scarce in our setting. This study determined the self-medication practice and safety profile of medicines used among pregnant women. Methods: This cross-sectional study was conducted in face-to-face interviews among 345 pregnant women at three hospitals in Sierra Leone. Data were analysed using descriptive statistics and binary logistic regression to determine the prevalence and associated factors of self-medication. Results: A total of 345 pregnant women participated in the study. The prevalence of self-medication prevalence among pregnant women with conventional and/or herbal medicine was 132 (38.3%). Also, 93 (75%) of the conventional medicines (CMs) were categorised as probably safe, of which paracetamol 36 (29.0%) was commonly used, followed by amoxicillin 23 (18.5%) and antimalarials 22 (17.7%) for common illnesses such as headache 30 (25.4%), urinary tract infection 23 (19.4%) and malaria 22 (18.6%). The most common reason for self-medication was previous experience with the disease 24 (27.3%). Luffa acutangula 19 (30.2%) was the most used herbal medicine (HM), and Oedema 30 (47.6%) was the most reported ailment. Among the HM users, 34 (54.0%) believe they are more effective than CMs. Secondary school education (AOR = 2.128, 95%CI = 1.191-3.804, p = 0.011), tertiary education (AOR = 2.915, 95%CI = 1.104-7.693, p = 0.031), monthly income of greater than NLe 1,000 (AOR = 4.084, 95% CI = 1.269-13.144, p = 0.018), and perceived maternal illness (AOR = 0.367, CI = 0.213-0.632, p = <0.001) were predictors of self-medication. Conclusion: Self-medication practice was highly prevalent and was associated with educational status, monthly income, and perceived maternal illness during pregnancy. Therefore, intervention programmes should be designed and implemented to minimise the practice and risk associated with self-medication among pregnant women.

Potential effect of ketamine in treatment for dextromethorphan use disorder exploding in Japanese young population.

In Japan, the landscape of clinical practice for substance use disorder is changing significantly, primarily due to an increase in patients using over-the-counter drugs. A major concern is the rising number of patients misusing dextromethorphan (DXM). These patients with DXM use disorders often have severe trauma-related and mood symptoms, and therefore try to cope with those symptoms by self-medicating with DXM. In this article, we propose that ketamine, which has similar psychopharmacological effects to DXM, may be a useful alternative pharmacological treatment for these patients.

Assessment of bidirectional impact of stigmatization induced self-medication on COVID-19 and malaria transmissions using mathematical modeling: Nigeria as a case study.

The continual social and economic impact of infectious diseases on nations has maintained sustained attention on their control and treatment, of which self-medication has been one of the means employed by some individuals. Self-medication complicates the attempt of their control and treatment as it conflicts with some of the measures implemented by health authorities. Added to these complications is the stigmatization of individuals with some diseases in some jurisdictions. This study investigates the co-infection of COVID-19 and malaria and its related deaths and further highlights how self-medication and stigmatization add to the complexities of the fight against these two diseases using Nigeria as a study case. Using a mathematical model on COVID-19 and malaria co-infection, we address the question: to what degree does the impact of the interaction between COVID-19 and malaria amplify infections and deaths induced by both diseases via self-medication and stigmatization? We demonstrate that COVID-19 related self-medication due to misdiagnoses contributes substantially to the prevalence of disease. The control reproduction numbers for these diseases and quantification of model parameters uncertainties and sensitivities are presented.

Prevalence of Self-Medication Among Patients With Common Dermatological Diseases in Saudi Arabia.

Introduction  Self-medication is defined as the use of a medication or product to treat, alleviate, or prevent a condition or symptom of an illness or to promote health. Self-management is increasingly used for dermatological diseases, especially chronic inflammatory skin diseases. Hence, it is crucial to be aware of its prevalence and the leading factors of its usage. Therefore, this study aims to estimate the prevalence of self-treatment for dermatological diseases and to determine possible factors associated with its practice.  Methodology  This is a cross-sectional online-based questionnaire study that was conducted in King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia. In this study, we included all first-visit and follow-up patients diagnosed with vitiligo, eczema, alopecia areata, and psoriasis. Data analysis was conducted using JMP Statistical Discovery Software, version 15 (JMP Statistical Discovery LLC, Cary, NC).  Results  Of the 203 patients who participated in this study, 91 (44.8%) had vitiligo. Moreover, topical corticosteroids were the most commonly used medications in self-treatment and included mometasone and hydrocortisone, which were used by 143 (41.3%) and 50 (14.5%) patients, respectively. Thirty patients (16.2%) improved with self-treatment, whereas 52 (28.1%) had no improvement. In addition, the most common reason for self-treatment was having mild symptoms of the disease in 97 patients (30.1%).  Conclusion  This study revealed that the prevalence of self-treatment among various dermatological diseases was 53.2%. Topical corticosteroids were the most commonly used conventional medicines, whereas the most common alternative medications used were honey and henna. We found that the most common reason for self-treatment was mildness of the dermatological disease. Family and friends were the most common sources of information.

Unused, leftover and expired medicine and disposal practices among health sciences faculty students in Burdur, Turkey.

Objective: To evaluate the opinions of university-level Health Sciences students about unused, leftover and expired medicine, as well as their disposal practices, and to classify the medicines. METHODS: The cross-sectional study was conducted from April 1 to May 31, 2023, at the Faculty of Health Sciences, Burdur Mehmet Akif Ersoy University, Turkey, and comprised those studying at the Nursing, Nutrition Dietetics and Physical Therapy and Rehabilitation departments. Data was collected using Google Forms. The Anatomical Therapeutic Chemical classification was used for classifying pharmaceutical active ingredients. Data was analysed using SPSS 24. RESULTS: Of the 373 participants, 272(73%) were females and 101(27%) were males. The overall mean age was 20.8±2.8 years. There were 348(93.3%) subejcts who reported having a total of 845 boxes of leftover and unused medicines in their homes (2.3±1.9 per capita), while 25(6.7%) participants had none. The medicines were stored in the kitchen 261(61.5%) as the storage area, and in the refrigerator 181(40.2%) as the storage unit. The expired medicine was disposed of in the garbage in 328(86.1%) cases. Self-medication was prevalent in 325(87.1%) cases. Anatomical Therapeutic Chemical classification analysis showed that paracetamol, acetylsalicylic acid, paracetamol+caffeine and metamizole sodium was the most common group of leftover and unused medicines 283(81.3%). Conclusion: High prevalence of unused and leftover medicine, disposal of medicine in household garbage, and selfmedication behaviour indicated a serious public health and environmental problem.

Prevalence and predictors of self-medication with antibiotics in Ethiopia: a systematic review and meta-analysis.

INTRODUCTION: Antibiotic self-medication is a global public health concern contributing to antibiotic resistance. This systematic review and meta-analysis aim to assess the prevalence of antibiotic self-medication and its associated factors in Ethiopia. METHODS: A comprehensive search of electronic databases was conducted from MEDLINE (PubMed), Scopus, Google Scholar and Web of Science to identify relevant studies published between 2000 and 2024. Adult households, undergraduate university students and health care professionals who had taken antibiotics without a prescription in the household setting were included in this review. The primary outcome of this review is antibiotic self- medication. The random-effects model was used to estimate pooled prevalence rates. The outcome measure was analyzed with STATA version 17 software. RESULTS: A total of nine studies were included in the Meta-analysis, comprising a sample size of 5908 participants. The pooled prevalence of antibiotic self-medication among Ethiopians was found to be 46.14 with 95% Confidence Interval [35.71, 56.57]. The most frequently used classes of self-medicated antibiotics were penicillins, followed by tetracyclines. Community pharmacies were the source of information that individuals utilized. The most common reported reasons for antibiotic self-medication include previous experience of treating a similar illness, to save cost, lack of time and avoiding waiting time for medical services. Participants having less than high school educational level was the most commonly reported factor associated with self-medication antibiotics. CONCLUSION: Antibiotic self-medication is a prevalent practice in Ethiopia. This underscores the need for targeted interventions such as educating people about the risks associated with using antibiotics without medical guidance, which results in a reduction in antibiotic resistance.

Characterization in the rat of the individual tendency to rely on alcohol to cope with distress and the ensuing vulnerability to drink compulsively.

Only some vulnerable individuals who recreationally drink alcohol eventually develop the compulsive drinking pattern that characterizes alcohol use disorder. A new frontier in biomedical research lies in understanding the neurobehavioural mechanisms of this individual vulnerability, a necessary step towards developing novel effective therapeutic strategies. Translational research has been hindered by the lack of valid, reliable and robust approaches that enable the study of the influence of the reliance on alcohol to cope with stress or self-medicate negative emotional states on the subsequent transition to alcohol use disorder. We have therefore developed a behavioural task in the rat that enables the investigation of the neural and cellular basis of the exacerbation of the vulnerability to develop compulsive alcohol drinking by the use of alcohol to develop an adjunctive, anxiolytic, polydipsic drinking behaviour in a schedule-induced polydipsia procedure. Hence, in our task, alcohol is introduced in the schedule-induced polydipsia context after several weeks of training with water so that rats are exposed to alcohol for the first time in a distressing context and learn to drink alcohol as a coping strategy. Capitalizing on this protocol, we have consistently been able to identify a subpopulation of rats that were unable to learn to cope with negative states by drinking water and relied on alcohol to do so. This maladaptive reliance on alcohol drinking to cope with distress has been shown to be associated with an exacerbation of the subsequent transition to compulsive drinking. Furthermore, these vulnerable rats reached blood alcohol levels comparable to that of intoxication in humans, thereby developing two key features of alcohol use disorder, namely excessive alcohol intake and compulsive drinking. Altogether, this behavioural task provides a novel and unique tool for the investigation of the neurobehavioural mechanisms underlying the exacerbation of the individual vulnerability to developing compulsive alcohol drinking by the use of alcohol as a strategy to cope with distress, and for the evaluation of the efficacy of potential therapeutic strategies in a personalized medicine approach. This procedure, which focuses on an understudied but key factor of the development of alcohol use disorder, may become widely used as it benefits the fields of alcohol, emotion regulation and stress, the interest in which has substantially increased since the evidence of a profound exacerbation of alcohol use and alcohol-related negative consequences by the distress and social isolation engendered by the various measures implemented worldwide in response to the COVID-19 pandemic.

Excessive Self-Medication with Prescription NSAIDs: A Cross-Sectional Study in Kosovo.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain, fever, and inflammation. Although most are usually classified as prescription-only medicines, in many countries they are frequently purchased for self-medication purposes. This study explores NSAID-usage patterns in Kosovo, aiming for a safer and more effective medicinal use. The study employed a dual approach to collect data. First, NSAID sales were analyzed in a convenience sample of ten community pharmacies across diverse regions in Kosovo in 2023. Second, data on NSAID-usage patterns and patient awareness were systematically gathered from 410 patients during routine pharmacist-patient interactions. The four most commonly purchased NSAIDs according to sales analysis were diclofenac (33.1%), ketoprofen (27.6%), ibuprofen (17.0%) and nimesulide (12.7%). A significant 74.8% of NSAIDs were bought without prescriptions, particularly among younger adults (20-39 years), who accounted for 82.8% of such purchases. The predominant reason for NSAID use was headache (43.8%). Although many of the patients suffered from occasional (33.7%) or frequent (12.6%) stomachaches and took acid-lowering medicines, the majority (85.9%) could not recall any NSAID adverse reactions. This study exposes widespread self-medication and a significant lack of awareness regarding potential risks of NSAIDs, particularly among young adults. To address these issues, it is critical to improve dispensing practices through increased pharmacist awareness and stricter law enforcement.

Understanding pre-hospital disease management of fever and diarrhoea in children-Care pathways in rural Tanzania.

OBJECTIVE: Many children in sub-Saharan Africa die from infectious diseases like malaria, pneumonia, and diarrhoea that can be prevented by early diagnosis, effective and targeted treatment. This study aimed to gain insights into case management practices by parents before they present their children to hospital. METHODS: We conducted a cross-sectional study among 332 parents attending a district hospital with their under-fives symptomatic with fever and/or diarrhoea between November 2019 and July 2020 in rural Tanzania. Timely and targeted treatment was defined as seeking health care within 24 h of fever onset, and continued fluid intake in case of diarrhoea. RESULTS: The main admission diagnoses were acute respiratory infections (61.8%), malaria (25.3%), diarrhoea (18.4%) and suspected sepsis (8.1%). The majority of children (91%) received treatment prior to admission, mostly antipyretics (75.6%), local herbal medicines (26.8%), and antibiotics (17.8%)-half of them without prescription from a clinician. For diarrhoea, the use of oral rehydration solution was rare (9.0%), although perceived as easily accessible and affordable. 49.4% of the parents presented their children directly to the hospital, 23.2% went to a pharmacy/drug shop and 19.3% to a primary health facility first. Malaria symptoms began mostly 3 days before the hospital visit; only 25.4% of febrile children visited any health facility within 24 h of disease onset. Prior use of local herbal medicine (AOR = 3.2; 95% CI 1.4-7.3), visiting the pharmacy (adjusted Odds Ratio [AOR] = 3.1; 95% confidence interval [CI]: 1.0-9.8), the dispensary being the nearest health facility (AOR = 3.0; 95% CI: 1.5-6.2), and financial difficulties (AOR = 2.2; 95% CI 1.1-4.5) were associated with delayed treatment. CONCLUSION: This study suggests that antipyretics and antibiotics dispensed at pharmacies/drug shops, as well as use of local herbal medicines, delay early diagnosis and treatment, which can be life-threatening. Pharmacies/drug shops could be integrated as key focal points for sensitising community members on how to respond to paediatric illnesses and encourage the use of oral rehydration solutions.

Pharmacist's knowledge and attitude towards self-medication practices: a cross-sectional study for the development and validation of questionnaire.

BACKGROUND: Pharmacists play an essential role in self-medication by providing guidance and counselling services to consumers; hence, it is necessary to assess pharmacists' awareness and attitude towards self-medication to promote responsible self-medication practices. OBJECTIVE: To develop a valid and reliable instrument to assess the knowledge and attitude of pharmacists towards self-medication practices and their role in promoting responsible self-medication. METHOD: A questionnaire was developed in English after a relevant literature review, which was further administered to a sample of 105 community pharmacists. The reliability of the questionnaire was assessed using the Karl-Pearson correlation and Cronbach alpha statistics. Content validity was evaluated by subject experts. The dimensional structure of items was assessed through exploratory factor analysis and confirmatory factor analysis (CFA). KEY FINDINGS: The final questionnaire comprises 27 items for knowledge and attitude with a Karl-Pearson correlation value of 0.896 and Cronbach alpha value of 0.814 (24 items), indicating good internal consistency and reproducibility. Factor analysis identified five factors: namely, (i) attitude towards providing guidance and advice to consumers to promote responsible SMP, (ii) attitude towards shared responsibility for promoting rational medicine supply and use, (iii) knowledge of the advantages and disadvantages of SMP, (iv) knowledge of the definition of self-medication, (v) attitude towards professional competency of a pharmacist as a healthcare provider. CFA results demonstrate good model fit with the value of Chi-square (184.56), CFI (0.937), RMSEA (0.054), and SRMR (0.075). Model validity measures ensure satisfactory validity and reliability. CONCLUSIONS: The findings demonstrate a valid and reliable measure for assessing the knowledge and attitude of pharmacists towards self-medication.

Ego Function Assessment and Internet Addiction.

This study examined the relationship between trauma, ego functioning, and internet addiction. We recruited 323 participants via Amazon Mechanical Turk, a crowdsourcing platform that can be used for survey research. We gave participants the Internet Addiction Test, the Life Events Checklist, the Ego Function Assessment questionnaire, and a demographic questionnaire. Our results indicate that 41.5% reported no internet addiction, with the majority of our sample reporting behaviors that were consistent with internet addiction: mild internet addiction = 37.8%, moderate internet addiction = 19.8%, and severe internet addiction = 0.9%. The constrictive factor of ego functioning was significantly worse in those with internet addiction. Path analysis showed that the constrictive factor of ego functioning partially mediated the relationship between a self-reported history of trauma and the presence of self-reported internet addiction.

Novel Psychoactive Substance Use and Psychological Trauma: A Multimethodological Analysis.

BACKGROUND: Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. METHOD: This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. RESULTS: Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). CONCLUSIONS: Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS.

Prevalence, practice, determinants and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria: A community-based cross-sectional study.

Objectives: Health hazards such as adverse drug reactions and prolonged morbidity are fallouts of self-medication among young people in sub-Saharan Africa. The aim of this study was to assess the prevalence, practice, determinants, and adverse effects of self-medication among young people living in a suburban community of Ekiti, Nigeria. Methods: This survey was a descriptive, cross-sectional study of 602 young people aged 16-24 years., who were randomly selected in the community. A predesigned self-administered questionnaire was used for data collection. The study was conducted from 1st March to 31st May 2023. The independent variables measured include the sociodemographic characteristics, while the dependent variables are the practice of self-medication and factors that predisposes to self-medication. The general characteristics of the participants were analyzed using descriptive statistics. The categorical variables were reported as frequency distribution and proportions with 95% confidence intervals and were compared using the Chi-square test or Fisher's exact test. A p-value of <0.05 was considered statistically significant. Results: Over 30% (31.7%) of the participants engage in self-medication. A larger proportion of the people who practiced self-medication lived a trekking distance of less than 1 km from the nearest health facility with a doctor (p = 0.044). The practice of self-medication was statistically related with being a student when compared with gainfully employed and unemployed people (p = 0.006). Fever (39.8%), abdominal pain (17.3%) and headaches (16.2%) were the topmost three ailments that necessitated self-medication. Antimalarials (44.0%), antibiotics (25.1%), and antipyretics (16.8%) were high on the list of drugs used for self-medication. Headache (34.0%) was the most common adverse reaction from self-medication among the participants studied. Conclusion: Adverse reactions and drug addiction were negative fallouts of self-medication, which can affect the health of young people as they grow into adulthood. Therefore, monitoring of drug outlets must be taken seriously by government agencies to prevent the worsening of the negative effects of self-medication.

Prevalence and Determinants of the Use of Antibiotics by Self-Medication in the Pediatric Population in Oujda, Morocco.

OBJECTIVE: Antibiotic resistance driven by antibiotic self-medication and inappropriate use of antibiotics is a growing global health threat. Our study aimed to describe parents' self-medication practices with antibiotics, determine the factors favoring their use in the pediatric population, and assess parents' knowledge of the role of antibiotics and antimicrobial resistance. MATERIALS AND METHODS: We conducted a cross-sectional study over two months (September and October 2023). Data collection was performed using a questionnaire-guided interview. We included 460 parents of children consulting or hospitalized in the Pediatric Department of the University Hospital Mohammed VI in Oujda, Morocco. RESULTS: A total of 62% of parents questioned were mothers. Self-medication with antibiotics was noted in 313 families (68%). Parents used antibiotics mainly to treat cough (43%) and fever (24%). Betalactams were the antibiotic class most used by parents (72%). Information on dosage and methods of antibiotic administration was provided by pharmacy staff but was not respected by most parents (78%). Efficacy of treatment (58%), saving consultation costs and time (47%), and the ease of obtaining treatment without a prescription (42%) were reported in the majority of cases as reasons for using antibiotics by self-medication. In our context, the probability of self-medicating with antibiotics in the pediatric population is increased by female gender (OR=1.04), low level of education (OR=1.02), low socio-economic status (OR=1.09), and buying antibiotics without a prescription (OR=1.22). CONCLUSION:  Although antibiotic self-medication in children is a worldwide phenomenon, influenced by several geographical, cultural, and economic factors, there is an urgent need to promote a global health strategy.

The Moderating Role of Health Status on the Association Between Depressive Symptoms and Cannabis Vaping.

Objective: Cannabis vaping is increasing among college students. There is little information on risk factors for vaping cannabis. Consistent with the self-medication hypothesis, experiencing depressive symptoms and having a chronic medical condition (CMC) are associated with cannabis use among young adults. Individuals who experience both risk factors may be at higher risk for cannabis vaping. This study examined cross-sectional associations between depressive symptoms, CMC status, and cannabis vaping, and identified the moderating role of CMC status on depressive symptoms and cannabis vaping. Method: College students (N = 3,742) self-reported on depressive symptoms, CMC status, and lifetime and current cannabis vaping (i.e., cannabis vaporizers; electronic nicotine devices to use cannabis). Data were collected Fall 2017 until Spring 2021. The sample was predominantly female (70.9%) and White (75.4%). Regression analyses were used. Results: Greater depressive symptoms were related to increased likelihood of cannabis vaping across outcomes. Having a CMC was related to lifetime history of cannabis vaporizing. CMC status moderated the associations between depressive symptoms and lifetime cannabis vaporizing. Depressive symptoms were only a risk factor for cannabis vaporizing among college students without a CMC, not those with a CMC. Conclusions: Interventions that teach adaptive ways of coping with depressive symptoms and the potential demands of managing a CMC in college are needed. Comprehensive programs for college students, with and without CMCs, are needed to support those with comorbid depression and cannabis vaping use.

Impact assessment of self-medication on COVID-19 prevalence in Gauteng, South Africa, using an age-structured disease transmission modelling framework.

OBJECTIVE: To assess the impact of self-medication on the transmission dynamics of COVID-19 across different age groups, examine the interplay of vaccination and self-medication in disease spread, and identify the age group most prone to self-medication. METHODS: We developed an age-structured compartmentalized epidemiological model to track the early dynamics of COVID-19. Age-structured data from the Government of Gauteng, encompassing the reported cumulative number of cases and daily confirmed cases, were used to calibrate the model through a Markov Chain Monte Carlo (MCMC) framework. Subsequently, uncertainty and sensitivity analyses were conducted on the model parameters. RESULTS: We found that self-medication is predominant among the age group 15-64 (74.52%), followed by the age group 0-14 (34.02%), and then the age group 65+ (11.41%). The mean values of the basic reproduction number, the size of the first epidemic peak (the highest magnitude of the disease), and the time of the first epidemic peak (when the first highest magnitude occurs) are 4.16499, 241,715 cases, and 190.376 days, respectively. Moreover, we observed that self-medication among individuals aged 15-64 results in the highest spreading rate of COVID-19 at the onset of the outbreak and has the greatest impact on the first epidemic peak and its timing. CONCLUSION: Studies aiming to understand the dynamics of diseases in areas prone to self-medication should account for this practice. There is a need for a campaign against COVID-19-related self-medication, specifically targeting the active population (ages 15-64).

Gut tumors in flies alter the taste valence of an anti-tumorigenic bitter compound.

The sense of taste is essential for survival, as it allows animals to distinguish between foods that are nutritious from those that are toxic. However, innate responses to different tastants can be modulated or even reversed under pathological conditions. Here, we examined whether and how the internal status of an animal impacts taste valence by using Drosophila models of hyperproliferation in the gut. In all three models where we expressed proliferation-inducing transgenes in intestinal stem cells (ISCs), hyperproliferation of ISCs caused a tumor-like phenotype in the gut. While tumor-bearing flies had no deficiency in overall food intake, strikingly, they exhibited an increased gustatory preference for aristolochic acid (ARI), which is a bitter and normally aversive plant-derived chemical. ARI had anti-tumor effects in all three of our gut hyperproliferation models. For other aversive chemicals we tested that are bitter but do not have anti-tumor effects, gut tumors did not affect avoidance behaviors. We demonstrated that bitter-sensing gustatory receptor neurons (GRNs) in tumor-bearing flies respond normally to ARI. Therefore, the internal pathology of gut hyperproliferation affects neural circuits that determine taste valence postsynaptic to GRNs rather than altering taste identity by GRNs. Overall, our data suggest that increased consumption of ARI may represent an attempt at self-medication. Finally, although ARI's potential use as a chemotherapeutic agent is limited by its known toxicity in the liver and kidney, our findings suggest that tumor-bearing flies might be a useful animal model to screen for novel anti-tumor drugs.