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Iglesias, Katia
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Iglesias, Katia
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- PublicationAccès libreTrajectories of drug use among French young people: Prototypical stages of involvement in illicit drug use(2016)
; Gmel, GerhardAims: This study investigated patterns and trajectories of substance use, with a special focus on illicit drugs other than cannabis. It examined both patterns and trajectories of use among a general population-based sample. Methods: We used data from the 2011 French ESCAPAD survey of French 17-year-olds to assess exposure and age of initiation of 14 licit and illicit drugs (N=23,882). Latent class analysis (LCA) and survival analyses were performed. Results: The results of the LCA showed that patterns of illicit drug use clearly distinguished between two groups of other illicit drugs: 1) amphetamines/speed, cocaine, ecstasy/MDMA, magic mushrooms, poppers, and solvents; 2) crack/freebase, GHB/GBL, heroine, LSD, and ketamine. Survival analyses highlighted that trajectories involved the first group before the second one. Conclusions: Prototypical drug use patterns and trajectories should include a distinction between two groups of illicit drugs. Preventive actions should focus on young people in their early teens, since very young users are more likely to progress to illicit drug use, and further studies should include this distinction instead of aggregating other illicit drugs into a single category. - PublicationAccès libreNot in Education, Employment, or Training Status Among Young Swiss Men. Longitudinal Associations With Mental Health and Substance Use(2015)
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Methods As part of the Cohort Study on Substance Use Risk Factors, 4,758 young Swiss men in their early 20s answered questions concerning their current professional and educational status, personality, substance use, and symptomatology related to mental health. Descriptive statistics, generalized linear models for cross-sectional comparisons, and cross-lagged panel models for longitudinal associations were computed.
Results NEET youth were 6.1% at baseline and 7.4% at follow-up with 1.4% being NEET at both time points. Comparisons between NEET and non-NEET youth showed significant differences in substance use and depressive symptoms only. Longitudinal associations showed that previous mental health, cannabis use, and daily smoking increased the likelihood of being NEET. Reverse causal paths were nonsignificant.
Conclusions NEET status seemed to be unlikely and transient among young Swiss men, associated with differences in mental health and substance use but not in personality. Causal paths presented NEET status as a consequence of mental health and substance use rather than a cause. Additionally, this study confirmed that cannabis use and daily smoking are public health problems. Prevention programs need to focus on these vulnerable youth to avoid them being disengaged. - PublicationAccès libreIndependent and combined associations of risky single-occasion drinking and drinking volume with alcohol use disorder: Evidence from a sample of young Swiss men(2015)
; Daeppen, Jean-BernardBackground
Risky single-occasion drinking (RSOD) is a prevalent and potentially harmful alcohol use pattern associated with increased alcohol use disorder (AUD). However, RSOD is commonly associated with a higher level of alcohol intake, and most studies have not controlled for drinking volume (DV). Thus, it is unclear whether the findings provide information about RSOD or DV. This study sought to investigate the independent and combined effects of RSOD and DV on AUD.
Methods
Data were collected in the longitudinal Cohort Study on Substance Use Risk Factors (C-SURF) among 5598 young Swiss male alcohol users in their early twenties. Assessment included DV, RSOD, and AUD at two time points. Generalized linear models for binomial distributions provided evidence regarding associations of DV, RSOD, and their interaction.
Results
DV, RSOD, and their interaction were significantly related to the number of AUD criteria. The slope of the interaction was steeper for non/rare RSOD than for frequent RSOD.
Conclusions
RSOD appears to be a harmful pattern of drinking, associated with increased AUD and it moderated the relationship between DV and AUD. This study highlighted the importance of taking drinking patterns into account, for both research and public health planning, since RSO drinkers constitute a vulnerable subgroup for AUD. - PublicationAccès libreCharacterizing the vulnerability of frequent emergency department users by applying a conceptual framework: a controlled, cross-sectional study(2015)
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Frequent emergency department (ED) users meet several of the criteria of vulnerability, but this needs to be further examined taking into consideration all vulnerability’s different dimensions. This study aimed to characterize frequent ED users and to define risk factors of frequent ED use within a universal health care coverage system, applying a conceptual framework of vulnerability.
Methods A controlled, cross-sectional study comparing frequent ED users to a control group of non-frequent users was conducted at the Lausanne University Hospital, Switzerland. Frequent users were defined as patients with five or more visits to the ED in the previous 12 months. The two groups were compared using validated scales for each one of the five dimensions of an innovative conceptual framework: socio-demographic characteristics; somatic, mental, and risk-behavior indicators; and use of health care services. Independent t-tests, Wilcoxon rank-sum tests, Pearson’s Chi-squared test and Fisher’s exact test were used for the comparison. To examine the -related to vulnerability- risk factors for being a frequent ED user, univariate and multivariate logistic regression models were used.
Results We compared 226 frequent users and 173 controls. Frequent users had more vulnerabilities in all five dimensions of the conceptual framework. They were younger, and more often immigrants from low/middle-income countries or unemployed, had more somatic and psychiatric comorbidities, were more often tobacco users, and had more primary care physician (PCP) visits. The most significant frequent ED use risk factors were a history of more than three hospital admissions in the previous 12 months (adj OR:23.2, 95%CI = 9.1-59.2), the absence of a PCP (adj OR:8.4, 95%CI = 2.1-32.7), living less than 5 km from an ED (adj OR:4.4, 95%CI = 2.1-9.0), and household income lower than USD 2,800/month (adj OR:4.3, 95%CI = 2.0-9.2).
Conclusions Frequent ED users within a universal health coverage system form a highly vulnerable population, when taking into account all five dimensions of a conceptual framework of vulnerability. The predictive factors identified could be useful in the early detection of future frequent users, in order to address their specific needs and decrease vulnerability, a key priority for health care policy makers. Application of the conceptual framework in future research is warranted. - PublicationAccès libreAssociations between perceived discrimination and health status among frequent Emergency Department users(2015)
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Methods : In total, 250 adult frequent ED users were interviewed in Lausanne University Hospital. From a previously published questionnaire, we assessed 15 dichotomous sources of perceived discrimination. Vulnerability was assessed using health status: objective health status (evaluation by a healthcare practitioner including somatic, mental health, behavioral, and social issues - dichotomous variables) and subjective health status [self-evaluation including health-related quality of life (WHOQOL) and quality of life (EUROQOL) - mean-scores]. We computed the prevalence rates of perceived discrimination and tested associations between perceived discrimination and health status (Fischer's exact tests, Mann-Whitney U-tests).
Results : A total of 35.2% of the frequent ED users surveyed reported at least one source of perceived discrimination. Objective health status was not significantly related to perceived discrimination. In contrast, experiencing perceived discrimination was associated with worse subjective health status (P<0.001).
Conclusion : Frequent ED users are highly likely to report perceived discrimination during ED use, and this was linked to a decrease in their own rating of their health. Hence, discrimination should be taken into account when providing care to such users as it may constitute an additional risk factor for this vulnerable population. Perceived discrimination may also be of concern to professionals seeking to improve practices and provide optimal care to frequent ED users. - PublicationAccès libreMesurer l’exposition au stress dans l’entreprise : le questionnaire des stresseurs organisationnels et sociaux (QSOS)(2014)
; Sutter, P.-E.Objectif
La mesure du stress professionnel, problématique désormais incontournable dans le monde de l’entreprise, reste peu consensuelle, les outils visant à l’évaluer présentant des failles méthodologiques ou conceptuelles. Cette étude vise à développer un outil de mesure de l’exposition au stress professionnel afin de pallier le manque de questionnaires validés, accessibles et généraux en langue française.
Méthode
Deux entreprises (n = 129 et n = 142) ont complété le questionnaire d’exposition aux stresseurs organisationnels et sociaux (QSOS) lors d’un audit de performance sociale. Des mesures de validité convergente (Job Content Questionnaire [JCQ] de Karasek, engagement organisationnel, implication organisationnelle) et de fidélité (test–retest dans une des entreprises) ont également été incluses.
Resultats
Les résultats montrent que l’ajustement des données au modèle est acceptable, le QSOS s’organisant en six dimensions (incertitude, manque de reconnaissance, relations interpersonnelles, communication, changements et valeurs, job design). La validité convergente et la fidélité se sont quant à elles montrées optimales, le QSOS étant fortement corrélé au JCQ (r = 0,75, p < 0,001), à l’engagement organisationnel (r = 0,48, p < 0,001) et à l’implication organisationnelle (r = 0,45, p < 0,001) et aucune différence statistiquement significative n’étant mise en évidence entre le test et le retest.
Discussion
Cette étude propose un outil de mesure validé de l’exposition aux stresseurs organisationnels et sociaux dans l’entreprise, répondant aux failles conceptuelles et méthodologiques pointées jusqu’alors. Il s’agit d’un premier pas vers l’élaboration d’un outil de mesure intégratif de l’exposition au stress professionnel., Purpose of the study
There is little consensus on how to best evaluate exposure to occupational stress – one of today's significant occupational health concerns. The many methodological and conceptual tools necessary are still matter for debate. This study aimed to develop a general, validated, French language questionnaire to assess exposure to occupational stress, thus providing researchers and practitioners with a tool that has long been missing.
Methods
Employees from two companies (n = 129 and n = 142) filled in the questionnaire on organizational and social stressors (QSOS) as part of a social performance audit. This included measuring convergent validity using 3 additional questionnaires (on organizational commitment, organizational involvement, and Karasek's Job Content Questionnaire [JCQ]), and measuring reliability via a test–retest involving one of the companies.
Results
Data fitted the model quite well. The QSOS was split into 6 parts: uncertainty, lack of recognition, interpersonal relations, communication, change and values, and job design. Convergent validity and accuracy were very good. The QSOS was highly correlated to JCQ (r = 0.75, P < 0.001), organizational commitment (r = 0.48, P < 0.001) and organizational involvement (r = 0.45, P < 0.001). There was no statistically significant difference between the test and the retest.
Discussion
This study proposes a general, validated questionnaire to measure organizational and social stressors in companies. It addresses some of the methodological and conceptual issues raised in previous studies. This is a first step towards the development of an integrative tool in French for measuring exposure to occupational stress. - PublicationAccès libreCase management for frequent users of the emergency department: study protocol of a randomised controlled trial(2014)
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Methods/Design We aim to recruit, during the first year of the study, 250 patients who visit the emergency department of the University Hospital of Lausanne, Switzerland. Eligible patients will have visited the emergency department 5 or more times during the previous 12 months. Randomisation of the participants to the intervention or control groups will be computer generated and concealed. The statistician and each patient will be blinded to the patient’s allocation. Participants in the intervention group (N = 125), additionally to standard emergency care, will receive case management from a team, 1 (ambulatory care) to 3 (hospitalization) times during their stay and after 1, 3, and 5 months, at their residence, in the hospital or in the ambulatory care setting. In between the consultations provided, the patients will have the opportunity to contact, at any moment, the case management team. Participants in the control group (N = 125) will receive standard emergency care only. Data will be collected at baseline and 2, 5.5, 9, and 12 months later, including: number of emergency department visits, quality of life (EuroQOL and WHOQOL), health services use, and relevant costs. Data on feelings of discrimination and patient’s satisfaction will also be collected at the baseline and 12 months later.
Discussion Our study will help to clarify knowledge gaps regarding the positive outcomes (emergency department visits, quality of life, efficiency, and cost-utility) of an intervention based on case management care. - PublicationAccès libreIs the Relationship Between Major Depressive Disorder and Self-Reported Alcohol Use Disorder an Artificial One?(2014)
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Methods: As part of the Cohort Study on Substance Use Risk Factors, 4352 male Swiss alcohol users in their early twenties answered questions concerning their alcohol use, AUD and MDD at two time points. Generalized linear models for cross-sectional and longitudinal associations were calculated.
Results: For cross-sectional associations, depressive participants reported a higher number of AUD symptoms (β = 0.743, P < 0.001) than non-depressive participants. Moreover, there was an interaction (β = −0.204, P = 0.001): the relationship between alcohol use and AUD was weaker for depressive participants rather than non-depressive participants. For longitudinal associations, there were almost no significant relationships between MDD at baseline and AUD at follow-up, but the interaction was still significant (β = −0.249, P < 0.001).
Conclusion: MDD thus appeared to be a confounding variable in the relationship between alcohol use and AUD, and self-reported measures of AUD seemed to be overestimated by depressive people. This result brings into question the accuracy of self-reported measures of substance use disorders. Furthermore, it adds to the emerging debate about the usefulness of substance use disorder as a concept, when heavy substance use itself appears to be a sensitive and reliable indicator. - PublicationAccès libreAn 8-Item Short Form of the Inventory of Dimensions of Emerging Adulthood (IDEA) Among Young Swiss Men(2014)
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