Many drug health services receive activity-based funding (ABF), which is reliant on accurate data collection to ensure appropriate reimbursement and quality care. This article reports results of a qualitative study commissioned by NSW Health about drug health services clinical staff's experiences in meeting ABF data entry requirements.
Methods
Semi-structured interviews were conducted with drug health services clinical staff (n = 10) to investigate their experiences in meeting ABF data entry requirements.
Results
Participants identified some benefits of an ABF model, but they described many technical and conceptual barriers to complying with ABF data reporting requirements. These included making frequent data entry errors, activity categories not aligning with their interpretation of the work they did, and not always knowing what activities attracted funding.
Discussion and Conclusions
Practical measures to improve compliance include training and quality assurance opportunities, enhanced managerial and administrative support, database enhancements and increased collaboration between clinicians and technicians. Implementing these measures could result in more accurate funding for services and improve patient care.
{"title":"Activity-Based Funding in Alcohol and Other Drug Treatment Services: Clinical Staff Perspectives and Practice Implications","authors":"Ciara Smyth, Kaniz Fatema, kylie valentine, Raquel Lowe, Brett Ross, Eltham Cook, Gilbert Whitton","doi":"10.1111/dar.70033","DOIUrl":"10.1111/dar.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Many drug health services receive activity-based funding (ABF), which is reliant on accurate data collection to ensure appropriate reimbursement and quality care. This article reports results of a qualitative study commissioned by NSW Health about drug health services clinical staff's experiences in meeting ABF data entry requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with drug health services clinical staff (<i>n</i> = 10) to investigate their experiences in meeting ABF data entry requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants identified some benefits of an ABF model, but they described many technical and conceptual barriers to complying with ABF data reporting requirements. These included making frequent data entry errors, activity categories not aligning with their interpretation of the work they did, and not always knowing what activities attracted funding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Practical measures to improve compliance include training and quality assurance opportunities, enhanced managerial and administrative support, database enhancements and increased collaboration between clinicians and technicians. Implementing these measures could result in more accurate funding for services and improve patient care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"1932-1939"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olajumoke A. Olateju, Tyler Varisco, Scott Weiner, Douglas Thornton
Introduction
Buprenorphine is effective for opioid use disorder (OUD), yet adherence remains suboptimal. This study aimed to identify adherence trajectories, explore their predictors, and assess their association with opioid overdose risk and healthcare costs.
Methods
A retrospective cohort study was conducted using the Merative MarketScan Commercial Database, which includes a nationally representative sample of individuals with private, employer-sponsored health insurance in the United States. We included adults (≥ 16 years) with OUD who initiated and completed at least 30 consecutive days of buprenorphine treatment between July 2017 and June 2019, with a 180-day follow-up. Group-based trajectory modelling identified distinct adherence patterns. Multinomial logistic regression examined predictors of adherence trajectories. A discrete-time survival model estimated the association between adherence and opioid overdose risk, while generalised linear models assessed healthcare costs. Sensitivity analyses, including E-value calculations, evaluated residual confounding.
Results
Among the 5107 individuals (median [Q1-Q3] age in years: 37 [26–47]; 3185 [62.4%] male), three distinct buprenorphine adherence trajectories were identified in the follow-up period: consistent adherence (CA, 49.5%), slow-declining adherence (SDA, 28.0%) and rapidly-declining adherence (RDA, 22.5%) trajectory groups. The mean (95% CI) time to buprenorphine discontinuation among all beneficiaries was 153 (151–155) days. Compared to the CA group, SDA and RDA groups had 2.74 (95% CI 2.71–2.77) and 3.81 (95% CI: 3.76–3.86) times higher opioid overdose risk and $13,670 (95% CI $7644–$19,695) and $19,431 (95% CI $13,632–$25,229) higher healthcare spending, respectively.
Discussion and Conclusions
Consistent adherence to buprenorphine was associated with a lower risk of opioid overdose and reduced healthcare expenditures.
丁丙诺啡对阿片类药物使用障碍（OUD）有效，但依从性仍不理想。本研究旨在确定依从性轨迹，探索其预测因素，并评估其与阿片类药物过量风险和医疗费用的关系。方法：使用Merative MarketScan商业数据库进行回顾性队列研究，该数据库包括具有全国代表性的美国私人雇主赞助的健康保险个人样本。我们纳入了在2017年7月至2019年6月期间开始并完成至少连续30天丁丙诺啡治疗的OUD成人（≥16岁），并进行了180天的随访。基于群体的轨迹模型确定了不同的依从模式。多项逻辑回归检验了依从性轨迹的预测因子。离散时间生存模型估计了依从性与阿片类药物过量风险之间的关系，而广义线性模型评估了医疗成本。敏感性分析，包括e值计算，评估残留混淆。结果：5107例患者（中位年龄[Q1-Q3]: 37岁[26-47岁]，男性3185例[62.4%]）在随访期间发现了三种不同的丁丙诺啡依从性轨迹：一致依从性（CA, 49.5%）、缓慢下降依从性（SDA, 28.0%）和快速下降依从性（RDA, 22.5%）轨迹组。在所有受益人中，丁丙诺啡停药的平均（95% CI）时间为153（151-155）天。与CA组相比，SDA组和RDA组的阿片类药物过量风险分别高出2.74倍（95% CI 2.71-2.77）和3.81倍（95% CI 3.76-3.86），医疗支出分别高出13,670美元（95% CI 7644- 19,695美元）和19,431美元（95% CI 13,632- 25,229美元）。讨论和结论：持续坚持丁丙诺啡与阿片类药物过量风险降低和医疗支出减少有关。
{"title":"Buprenorphine Adherence Trajectories and Their Impact on Opioid Overdose and Healthcare Costs","authors":"Olajumoke A. Olateju, Tyler Varisco, Scott Weiner, Douglas Thornton","doi":"10.1111/dar.70035","DOIUrl":"10.1111/dar.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Buprenorphine is effective for opioid use disorder (OUD), yet adherence remains suboptimal. This study aimed to identify adherence trajectories, explore their predictors, and assess their association with opioid overdose risk and healthcare costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted using the Merative MarketScan Commercial Database, which includes a nationally representative sample of individuals with private, employer-sponsored health insurance in the United States. We included adults (≥ 16 years) with OUD who initiated and completed at least 30 consecutive days of buprenorphine treatment between July 2017 and June 2019, with a 180-day follow-up. Group-based trajectory modelling identified distinct adherence patterns. Multinomial logistic regression examined predictors of adherence trajectories. A discrete-time survival model estimated the association between adherence and opioid overdose risk, while generalised linear models assessed healthcare costs. Sensitivity analyses, including E-value calculations, evaluated residual confounding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 5107 individuals (median [Q1-Q3] age in years: 37 [26–47]; 3185 [62.4%] male), three distinct buprenorphine adherence trajectories were identified in the follow-up period: consistent adherence (CA, 49.5%), slow-declining adherence (SDA, 28.0%) and rapidly-declining adherence (RDA, 22.5%) trajectory groups. The mean (95% CI) time to buprenorphine discontinuation among all beneficiaries was 153 (151–155) days. Compared to the CA group, SDA and RDA groups had 2.74 (95% CI 2.71–2.77) and 3.81 (95% CI: 3.76–3.86) times higher opioid overdose risk and $13,670 (95% CI $7644–$19,695) and $19,431 (95% CI $13,632–$25,229) higher healthcare spending, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Consistent adherence to buprenorphine was associated with a lower risk of opioid overdose and reduced healthcare expenditures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"1907-1919"},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sameer Imtiaz, Sami Aftab Abdul, Huan Jiang, Cayley Russell, Farihah Ali, Iesha Henderson, Bernard Le Foll, Tara Elton-Marshall, Brooke Kinniburgh, Jürgen Rehm
Introduction
Canada is in the midst of a crisis featuring drug poisonings. Decriminalisation of personal possession of select illegal drugs was implemented in British Columbia, Canada on 31 January 2023 as one element of a public health response to reduce drug-related harms. We evaluated the short-term impacts of decriminalisation on paramedic responses to opioid poisonings and drug poisoning deaths to detect if there were early signals of change.
Methods
We sourced population-based monthly counts of drug poisonings from the provincial emergency services provider and coroners service to compute total and sex-specific age-standardised rates per 100,000 (January 2015–December 2023 [97 months pre-decriminalisation and 11 months post-decriminalisation]). Generalised additive models in an interrupted time series design were used to evaluate the short-term impacts of decriminalisation on rates of paramedic responses to opioid poisonings and drug poisoning deaths.
Results
Decriminalisation was not associated with an immediate effect (β [95% confidence interval; CI] −0.078 [−0.318, 0.163]) or trend change (β [95% CI] −0.022 [−0.082, 0.037]) in the total rate of paramedic responses to opioid poisonings, nor was it associated with an immediate effect (β [95% CI] −0.165 [−0.477, 0.147]) or trend change (β [95% CI] −0.010 [−0.082, 0.062]) in the total rate of drug poisoning deaths. These findings were consistent after stratification by sex.
Discussion and Conclusions
Decriminalisation of select illegal drugs was not associated with significant changes in drug poisonings in the first 11 months of its implementation. However, the direction of effects was encouraging from a public health standpoint.
{"title":"The Short-Term Impacts of Decriminalisation of Personal Possession of Select Illegal Drugs on Drug Poisonings in British Columbia, Canada (2015–2023)","authors":"Sameer Imtiaz, Sami Aftab Abdul, Huan Jiang, Cayley Russell, Farihah Ali, Iesha Henderson, Bernard Le Foll, Tara Elton-Marshall, Brooke Kinniburgh, Jürgen Rehm","doi":"10.1111/dar.70036","DOIUrl":"10.1111/dar.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Canada is in the midst of a crisis featuring drug poisonings. Decriminalisation of personal possession of select illegal drugs was implemented in British Columbia, Canada on 31 January 2023 as one element of a public health response to reduce drug-related harms. We evaluated the short-term impacts of decriminalisation on paramedic responses to opioid poisonings and drug poisoning deaths to detect if there were early signals of change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We sourced population-based monthly counts of drug poisonings from the provincial emergency services provider and coroners service to compute total and sex-specific age-standardised rates per 100,000 (January 2015–December 2023 [97 months pre-decriminalisation and 11 months post-decriminalisation]). Generalised additive models in an interrupted time series design were used to evaluate the short-term impacts of decriminalisation on rates of paramedic responses to opioid poisonings and drug poisoning deaths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Decriminalisation was not associated with an immediate effect (<i>β</i> [95% confidence interval; CI] −0.078 [−0.318, 0.163]) or trend change (<i>β</i> [95% CI] −0.022 [−0.082, 0.037]) in the total rate of paramedic responses to opioid poisonings, nor was it associated with an immediate effect (<i>β</i> [95% CI] −0.165 [−0.477, 0.147]) or trend change (<i>β</i> [95% CI] −0.010 [−0.082, 0.062]) in the total rate of drug poisoning deaths. These findings were consistent after stratification by sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Decriminalisation of select illegal drugs was not associated with significant changes in drug poisonings in the first 11 months of its implementation. However, the direction of effects was encouraging from a public health standpoint.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"1856-1865"},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natasha Reid, Jayden Logan, Yasmine Wong, Zachary Munn, Chelsea Vanderpeet, Nicole Hayes, the Australian FASD Guidelines Consortium
Introduction
The Australian Guide to the Diagnosis of fetal alcohol spectrum disorder (FASD), developed in 2016, is currently under review. This study aimed to understand how the Guide is used in practice and identify factors influencing its implementation.
Methods
A cross-sectional online survey was conducted with Australian health practitioners involved in the assessment and diagnosis of FASD. The Clinician Guideline Determinants Questionnaire was used. Quantitative data were summarised descriptively and content analysis was applied to open-ended questions.
Results
Of 333 survey sessions, 232 participants consented and 136 completed the survey. Most respondents were paediatricians (n = 54, 37%) or psychologists (n = 49, 33%). Although most clinicians felt confident using the Guide, only 44.1% agreed it clearly described the underlying evidence, and just 21% felt it adequately reflected patient preferences. Key enablers included clear, easy-to-follow guidance (n = 45, 36.3%); ease of access (n = 18, 14.5%) and familiarity with the Guide (n = 14, 11.3%). Common barriers were lack of access to appropriate clinicians, time and cost constraints (n = 25, 24.8%); concerns about the evidence base (n = 16, 15.8%); and lack of familiarity or skills (n = 8, 7.9%).
Discussion and Conclusions
Findings highlight strong clinician engagement with the 2016 Guide but also identify areas for improvement, particularly around evidence transparency and alignment with person-centred care. By engaging with stakeholders and improving guidelines based on clinician feedback, we can improve the quality of care and support for individuals with FASD and their families.
{"title":"Understanding the Determinants of Use of the Australian Guide to Diagnosis of Fetal Alcohol Spectrum Disorder: Informing the Review, Development and Dissemination of New National Clinical Practice Guidelines","authors":"Natasha Reid, Jayden Logan, Yasmine Wong, Zachary Munn, Chelsea Vanderpeet, Nicole Hayes, the Australian FASD Guidelines Consortium","doi":"10.1111/dar.70030","DOIUrl":"10.1111/dar.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Australian Guide to the Diagnosis of fetal alcohol spectrum disorder (FASD), developed in 2016, is currently under review. This study aimed to understand how the Guide is used in practice and identify factors influencing its implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey was conducted with Australian health practitioners involved in the assessment and diagnosis of FASD. The Clinician Guideline Determinants Questionnaire was used. Quantitative data were summarised descriptively and content analysis was applied to open-ended questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 333 survey sessions, 232 participants consented and 136 completed the survey. Most respondents were paediatricians (<i>n</i> = 54, 37%) or psychologists (<i>n</i> = 49, 33%). Although most clinicians felt confident using the Guide, only 44.1% agreed it clearly described the underlying evidence, and just 21% felt it adequately reflected patient preferences. Key enablers included clear, easy-to-follow guidance (<i>n</i> = 45, 36.3%); ease of access (<i>n</i> = 18, 14.5%) and familiarity with the Guide (<i>n</i> = 14, 11.3%). Common barriers were lack of access to appropriate clinicians, time and cost constraints (<i>n</i> = 25, 24.8%); concerns about the evidence base (<i>n</i> = 16, 15.8%); and lack of familiarity or skills (<i>n</i> = 8, 7.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Findings highlight strong clinician engagement with the 2016 Guide but also identify areas for improvement, particularly around evidence transparency and alignment with person-centred care. By engaging with stakeholders and improving guidelines based on clinician feedback, we can improve the quality of care and support for individuals with FASD and their families.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"2080-2090"},"PeriodicalIF":2.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jamie Bryant, Anthony Shakeshaft, Nicholas Lintzeris, Paul Haber, Michael Farrell, Joshua Dizon, Megan Freund
Introduction
Understanding the characteristics of individuals seeking treatment for alcohol use is essential for developing effective interventions. This study aimed to: (i) describe the characteristics of individuals accessing treatment at Australian outpatient alcohol and other drug (AOD) treatment centres; and (ii) identify characteristics associated with more harmful alcohol use at treatment commencement.
Methods
Clients from 34 community-based AOD centres completed surveys on demographic, substance use, health-related quality of life and social characteristics. A linear mixed model and two negative binomial models were used to examine factors associated with higher AUDIT scores (indicting more hazardous or harmful alcohol consumption), frequency of drinking days and heavy drinking days in the last 14 days.
Results
Participants (n = 1130) were predominantly male (65%), reported concurrent drug use (62%), self-referred for treatment (57%) and wanted to cease alcohol use completely (42%) or drink moderately (39%). Female gender, unemployment, being a victim or perpetrator of violence, poorer physical and mental health, self-referral and a goal to cease alcohol use were associated with higher AUDIT scores. Those reporting home duties, retirement, disability/carer pension, student or other employment had lower AUDIT scores. Older age, poorer physical and mental health, and treatment in Western Australia and Queensland were associated with more drinking and heavier drinking days. A goal to cease alcohol use was linked to 23% and 17% lower drinking days and heavy drinking days. Self-referral was associated with more heavy drinking days.
Discussion and Conclusion
Individuals seeking treatment for AOD use have diverse needs that should inform tailored and holistic treatment.
{"title":"Factors Associated With Alcohol Use Among Individuals Commencing Treatment at Community-Based Outpatient Treatment Centres in Australia","authors":"Jamie Bryant, Anthony Shakeshaft, Nicholas Lintzeris, Paul Haber, Michael Farrell, Joshua Dizon, Megan Freund","doi":"10.1111/dar.70034","DOIUrl":"10.1111/dar.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Understanding the characteristics of individuals seeking treatment for alcohol use is essential for developing effective interventions. This study aimed to: (i) describe the characteristics of individuals accessing treatment at Australian outpatient alcohol and other drug (AOD) treatment centres; and (ii) identify characteristics associated with more harmful alcohol use at treatment commencement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clients from 34 community-based AOD centres completed surveys on demographic, substance use, health-related quality of life and social characteristics. A linear mixed model and two negative binomial models were used to examine factors associated with higher AUDIT scores (indicting more hazardous or harmful alcohol consumption), frequency of drinking days and heavy drinking days in the last 14 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 1130) were predominantly male (65%), reported concurrent drug use (62%), self-referred for treatment (57%) and wanted to cease alcohol use completely (42%) or drink moderately (39%). Female gender, unemployment, being a victim or perpetrator of violence, poorer physical and mental health, self-referral and a goal to cease alcohol use were associated with higher AUDIT scores. Those reporting home duties, retirement, disability/carer pension, student or other employment had lower AUDIT scores. Older age, poorer physical and mental health, and treatment in Western Australia and Queensland were associated with more drinking and heavier drinking days. A goal to cease alcohol use was linked to 23% and 17% lower drinking days and heavy drinking days. Self-referral was associated with more heavy drinking days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Individuals seeking treatment for AOD use have diverse needs that should inform tailored and holistic treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"2066-2079"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Increasing harms associated with nitrous oxide use have raised concerns, but limited evidence exists to inform harm reduction. This study aimed to identify how nitrous oxide is sourced, the products/forms used, awareness of health risks, engagement in harm reduction and experience of neurological symptoms.
Methods
Data were collected via annual interviews (2021–2023) with cross-sectional convenience samples of Australians who regularly used ecstasy/MDMA and/or other illicit stimulants and reported past 6-month use of nitrous oxide (2021 n = 379; 2022 n = 315; 2023 n = 284).
Results
The most commonly reported source of nitrous oxide in the past 6 months was convenience stores, followed by 24/7 delivery services. Sourcing from these retailers was also associated with heavier use. Reported use of larger cylinders (> 8 g) increased from 6% in 2021 to 26% in 2023. While most respondents demonstrated awareness of neurological risk (e.g., brain damage 63%; nerve damage 20%), only one-fifth identified the risk of Vitamin B12 depletion and 17% were unaware of any risks. Almost one-third (30%) reported limiting use per session, 36% limited frequency and 36% took no precautions. Reports of neurological symptoms rose from 5% in 2021 to 14% in 2023 among cross-sectional samples, with few (n ≤ 5) receiving treatment.
Discussion and Conclusions
Findings suggest increasing use of larger cylinders, alongside increasing neurological harms. Given the evolving regulatory and risk environment, close surveillance of usage and market trends is needed. The findings reinforce the need for balanced regulation and targeted education of retailers, clinicians and consumers to reduce harmful patterns of use and encourage early intervention.
导言：与使用一氧化二氮相关的危害日益增加引起了人们的关注，但现有的减少危害的证据有限。这项研究旨在确定一氧化二氮的来源、使用的产品/形式、对健康风险的认识、参与减少危害和神经系统症状的经历。方法：通过年度访谈（2021-2023）收集数据，这些横断面方便样本是经常使用摇头丸/MDMA和/或其他非法兴奋剂并报告过去6个月使用一氧化二氮的澳大利亚人（2021 n = 379; 2022 n = 315; 2023 n = 284）。结果：过去6个月报告的一氧化二氮最常见的来源是便利店，其次是24/7送货服务。从这些零售商那里采购也与更频繁的使用有关。据报道，大气缸（bbb80 g）的使用率从2021年的6%增加到2023年的26%。虽然大多数受访者表示意识到神经系统风险（例如，脑损伤63%；神经损伤20%），但只有五分之一的人认识到维生素B12缺乏的风险，17%的人不知道任何风险。近三分之一（30%）的人报告限制每次使用，36%的人限制频率，36%的人没有采取预防措施。在横断面样本中，神经系统症状的报告从2021年的5%上升到2023年的14%，接受治疗的病例很少（n≤5）。讨论和结论：研究结果表明越来越多地使用更大的钢瓶，同时增加神经损伤。鉴于不断变化的监管和风险环境，需要密切监测使用情况和市场趋势。研究结果表明，有必要对零售商、临床医生和消费者进行平衡的监管和有针对性的教育，以减少有害的使用模式，并鼓励早期干预。
{"title":"Nitrous Oxide Sourcing, Use and Harms: Insights From Australians Who Use Ecstasy/MDMA and Other Illicit Stimulants","authors":"Jodie Grigg, Simon Lenton, Amy Peacock, Jessamine Soderstrom, Cate King, Natalie Thomas, Rachel Sutherland","doi":"10.1111/dar.70032","DOIUrl":"10.1111/dar.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Increasing harms associated with nitrous oxide use have raised concerns, but limited evidence exists to inform harm reduction. This study aimed to identify how nitrous oxide is sourced, the products/forms used, awareness of health risks, engagement in harm reduction and experience of neurological symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected via annual interviews (2021–2023) with cross-sectional convenience samples of Australians who regularly used ecstasy/MDMA and/or other illicit stimulants and reported past 6-month use of nitrous oxide (2021 <i>n</i> = 379; 2022 <i>n</i> = 315; 2023 <i>n</i> = 284).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most commonly reported source of nitrous oxide in the past 6 months was convenience stores, followed by 24/7 delivery services. Sourcing from these retailers was also associated with heavier use. Reported use of larger cylinders (> 8 g) increased from 6% in 2021 to 26% in 2023. While most respondents demonstrated awareness of neurological risk (e.g., brain damage 63%; nerve damage 20%), only one-fifth identified the risk of Vitamin B12 depletion and 17% were unaware of any risks. Almost one-third (30%) reported limiting use per session, 36% limited frequency and 36% took no precautions. Reports of neurological symptoms rose from 5% in 2021 to 14% in 2023 among cross-sectional samples, with few (<i>n</i> ≤ 5) receiving treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Findings suggest increasing use of larger cylinders, alongside increasing neurological harms. Given the evolving regulatory and risk environment, close surveillance of usage and market trends is needed. The findings reinforce the need for balanced regulation and targeted education of retailers, clinicians and consumers to reduce harmful patterns of use and encourage early intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"2113-2126"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A few decades ago, non-drinking was uncommon amongst young people in many countries, and non-drinkers typically reported more psycho-social problems than moderate drinkers. Since then, non-drinking has become common amongst Norwegian adolescents. Considering this normalisation of non-drinking, our study examined: (i) whether psycho-social problems still differ between non-drinkers, moderate drinkers and heavy drinkers; and (ii) whether psycho-social problems differ by parental drinking status amongst non-drinkers and moderate drinkers.
Methods
Data stem from the European School Survey Project on Alcohol and Other Drugs (ESPAD). The Norwegian 2024 subsample included 3471 15–16-year-olds. Psycho-social problems included anxiety and depressive symptoms and weak social support from friends and family. Parental drinking status distinguished between families with at least one non-drinking parent and families where both parents were drinkers. Mean values of non-drinkers (46% of the sample) were compared to mean values of moderate (42%) and heavy drinkers (12%) using analysis of variance and F-tests.
Results
Compared to moderate drinkers, non-drinkers reported significantly fewer anxiety and depressive symptoms, and significantly better social support from family and friends, whereas heavy drinkers reported significantly more psycho-social problems. Amongst non-drinkers, there was no significant difference in psycho-social problems by parental drinking status. Amongst moderate drinkers, those with non-drinking parents reported significantly poorer support from friends and family than others.
Discussion and Conclusions
This study lent empirical support to the hypothesis that in a context of normalised non-drinking amongst adolescents, psycho-social deviance amongst non-drinkers is not observed.
{"title":"Normalisation of Non-Drinking and Implications for Psycho-Social Problems","authors":"Elin K. Bye, Ingeborg Rossow, Inger Synnøve Moan","doi":"10.1111/dar.70031","DOIUrl":"10.1111/dar.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A few decades ago, non-drinking was uncommon amongst young people in many countries, and non-drinkers typically reported more psycho-social problems than moderate drinkers. Since then, non-drinking has become common amongst Norwegian adolescents. Considering this normalisation of non-drinking, our study examined: (i) whether psycho-social problems still differ between non-drinkers, moderate drinkers and heavy drinkers; and (ii) whether psycho-social problems differ by parental drinking status amongst non-drinkers and moderate drinkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data stem from the European School Survey Project on Alcohol and Other Drugs (ESPAD). The Norwegian 2024 subsample included 3471 15–16-year-olds. Psycho-social problems included anxiety and depressive symptoms and weak social support from friends and family. Parental drinking status distinguished between families with at least one non-drinking parent and families where both parents were drinkers. Mean values of non-drinkers (46% of the sample) were compared to mean values of moderate (42%) and heavy drinkers (12%) using analysis of variance and F-tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to moderate drinkers, non-drinkers reported significantly fewer anxiety and depressive symptoms, and significantly better social support from family and friends, whereas heavy drinkers reported significantly more psycho-social problems. Amongst non-drinkers, there was no significant difference in psycho-social problems by parental drinking status. Amongst moderate drinkers, those with non-drinking parents reported significantly poorer support from friends and family than others.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This study lent empirical support to the hypothesis that in a context of normalised non-drinking amongst adolescents, psycho-social deviance amongst non-drinkers is not observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"2106-2112"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessandro Crocetti, Nichole Lister, Florentine Martino, Jennifer Browne, Kathryn Backholer, Peter Miller, Emma Jane Pristov, Matthew Dunn
Introduction
Alcohol-related user-generated content (UGC)—created by influencers and peers—appears to play a central role in shaping young people's alcohol-related attitudes and behaviours. However, the nature and extent to which UGC facilitates the promotion of alcohol remains under-examined. There is limited evidence on how alcohol companies utilise social media platforms to engage users and incentivise the promotion of their brands and products. Therefore, this study aimed to examine the nature and extent of alcohol promotion via UGC on Instagram and TikTok posts.
Methods
This content analysis examined 1848 public user-generated Instagram (n = 1148) and TikTok (n = 700) posts, focusing on major alcohol tags and hashtags over a 7-year period. Posts were systematically coded for account type, sentiment, product placement and indicators of marketing (e.g., sponsorship or undisclosed marketing).
Results
Of the posts analysed, 37% originated from influencers accounts. Five percent were identified as sponsored content, while 10% showed characteristics of undisclosed marketing. Half featured alcohol as the main focus, with 64% including branded products. Most posts (78%) expressed pro-brand sentiment, 53% showed positive drinking experiences and 20% portrayed camaraderie. Only 2% contained anti-brand sentiment or depicted negative consequences of alcohol consumption.
Discussion and Conclusions
The disparity between disclosed (5%) and suspected undisclosed promotional content (10%) highlights transparency and regulatory issues. UGC predominantly carried a celebratory tone, reinforcing a pro-alcohol narrative that influences young users' attitudes towards drinking. Stronger regulatory frameworks, independent monitoring and content transparency tools are urgently needed to mitigate young people's exposure to covert alcohol promotion.
{"title":"Alcohol Promotion via User-Generated Content on Instagram and TikTok: A Content Analysis","authors":"Alessandro Crocetti, Nichole Lister, Florentine Martino, Jennifer Browne, Kathryn Backholer, Peter Miller, Emma Jane Pristov, Matthew Dunn","doi":"10.1111/dar.70027","DOIUrl":"10.1111/dar.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Alcohol-related user-generated content (UGC)—created by influencers and peers—appears to play a central role in shaping young people's alcohol-related attitudes and behaviours. However, the nature and extent to which UGC facilitates the promotion of alcohol remains under-examined. There is limited evidence on how alcohol companies utilise social media platforms to engage users and incentivise the promotion of their brands and products. Therefore, this study aimed to examine the nature and extent of alcohol promotion via UGC on Instagram and TikTok posts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This content analysis examined 1848 public user-generated Instagram (<i>n</i> = 1148) and TikTok (<i>n</i> = 700) posts, focusing on major alcohol tags and hashtags over a 7-year period. Posts were systematically coded for account type, sentiment, product placement and indicators of marketing (e.g., sponsorship or undisclosed marketing).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the posts analysed, 37% originated from influencers accounts. Five percent were identified as sponsored content, while 10% showed characteristics of undisclosed marketing. Half featured alcohol as the main focus, with 64% including branded products. Most posts (78%) expressed pro-brand sentiment, 53% showed positive drinking experiences and 20% portrayed camaraderie. Only 2% contained anti-brand sentiment or depicted negative consequences of alcohol consumption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The disparity between disclosed (5%) and suspected undisclosed promotional content (10%) highlights transparency and regulatory issues. UGC predominantly carried a celebratory tone, reinforcing a pro-alcohol narrative that influences young users' attitudes towards drinking. Stronger regulatory frameworks, independent monitoring and content transparency tools are urgently needed to mitigate young people's exposure to covert alcohol promotion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"2019-2029"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kirrilly Thompson, Gianluca Di Censo, Jacqueline Bowden, Neophytos Georgiou, Mark Thompson, Victoria Cock, Blaire Brewerton, Courtney Ryder
Introduction
Homelessness and alcohol dependence can be barriers to accessing essential services such as health care, housing, and social supports. Managed alcohol programs (MAP) have emerged as an effective harm reduction strategy for people experiencing homelessness and alcohol dependence. The aim of the present study was to evaluate the short-term impacts of the first MAP run in South Australia outside of COVID-19 restrictions and the first in Australia to be conducted in a healthcare setting. It was designed to be culturally appropriate for Aboriginal and Torres Strait Islander clients.
Methods
Descriptive quantitative analysis and an inductive content analysis of case notes for 21 clients who stayed at least one night in the South Australian MAP.
Results
Clients were mostly Aboriginal, female, of middle age and managing multiple health conditions. The median stay was 15 nights per client. The MAP contributed to client wellbeing broadly across five interconnected areas: culture, housing, medical support, government system navigation, and the building of capacity, resilience, and social connectedness.
Discussion and Conclusions
The South Australian MAP provided various interconnected short-term benefits relevant to people experiencing homelessness and alcohol dependence in general and Aboriginal peoples additionally experiencing the on-going impacts of colonisation in particular. This evaluation supports international literature on the value of MAPs as an effective harm reduction approach to co-occurring homelessness and alcohol dependence and strengthens evidence for the feasibility, acceptability, and benefits of MAPs in Australia.
{"title":"Evaluation of a Residential Managed Alcohol Program for Aboriginal Peoples Experiencing Homelessness and Alcohol Dependence: Short-Term Impacts of an Australian Trial","authors":"Kirrilly Thompson, Gianluca Di Censo, Jacqueline Bowden, Neophytos Georgiou, Mark Thompson, Victoria Cock, Blaire Brewerton, Courtney Ryder","doi":"10.1111/dar.70025","DOIUrl":"10.1111/dar.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Homelessness and alcohol dependence can be barriers to accessing essential services such as health care, housing, and social supports. Managed alcohol programs (MAP) have emerged as an effective harm reduction strategy for people experiencing homelessness and alcohol dependence. The aim of the present study was to evaluate the short-term impacts of the first MAP run in South Australia outside of COVID-19 restrictions and the first in Australia to be conducted in a healthcare setting. It was designed to be culturally appropriate for Aboriginal and Torres Strait Islander clients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Descriptive quantitative analysis and an inductive content analysis of case notes for 21 clients who stayed at least one night in the South Australian MAP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clients were mostly Aboriginal, female, of middle age and managing multiple health conditions. The median stay was 15 nights per client. The MAP contributed to client wellbeing broadly across five interconnected areas: culture, housing, medical support, government system navigation, and the building of capacity, resilience, and social connectedness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The South Australian MAP provided various interconnected short-term benefits relevant to people experiencing homelessness and alcohol dependence in general and Aboriginal peoples additionally experiencing the on-going impacts of colonisation in particular. This evaluation supports international literature on the value of MAPs as an effective harm reduction approach to co-occurring homelessness and alcohol dependence and strengthens evidence for the feasibility, acceptability, and benefits of MAPs in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"2061-2065"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jürgen Rehm, Daniela Correia, Ahmed S. Hassan, Jakob Manthey, Pol Rovira, Kevin D. Shield, Carina Ferreira-Borges, Maria Neufeld, Mindaugas Štelemėkas
Introduction
Although increases in alcohol excise taxation have been identified as one of the ‘best buys’ of the World Health Organization to reduce alcohol consumption and attributable harm, excise tax shares—the proportion of excise tax included in retail prices of alcoholic beverages—remain low in Europe. Revenue derived from alcohol excise taxation, and how it is affected by changes in alcohol excise taxation, has not yet been widely explored.
Methods
We conducted a search for revenues generated from alcohol excise taxation in all European Union (EU) countries and the United Kingdom between 2017 and 2022. We then calculated the average excise tax share for alcoholic beverages for 2022. Using regression analysis, we predict tax revenue per capita from the tax share, type of alcohol excise taxation, recorded and unrecorded consumption and prevalence of past-year drinking. To illustrate the potential for revenue increases, we conducted a case study on Germany.
Results
In 2022, average revenue from alcohol excise taxation (119 euros per capita) and excise tax share (17.3%) were low in the EU countries and the United Kingdom, but showed sizable variation. The association between excise tax share and revenue from excise taxation was very high, with a Pearson correlation of 0.888 (0.720–0.958; df = 16; p < 0.0001). In regression analyses, only the excise tax share significantly predicted tax revenue.
Discussion and Conclusions
Marked revenue gains could be achieved in several countries having low tax shares by instituting increases in excise tax share, with only small effects on consumer prices.
{"title":"Alcohol Excise Taxation, Tax Share and Revenue in the European Union and the United Kingdom in 2022: An Overview and Modelling Analysis","authors":"Jürgen Rehm, Daniela Correia, Ahmed S. Hassan, Jakob Manthey, Pol Rovira, Kevin D. Shield, Carina Ferreira-Borges, Maria Neufeld, Mindaugas Štelemėkas","doi":"10.1111/dar.70028","DOIUrl":"10.1111/dar.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although increases in alcohol excise taxation have been identified as one of the ‘best buys’ of the World Health Organization to reduce alcohol consumption and attributable harm, excise tax shares—the proportion of excise tax included in retail prices of alcoholic beverages—remain low in Europe. Revenue derived from alcohol excise taxation, and how it is affected by changes in alcohol excise taxation, has not yet been widely explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a search for revenues generated from alcohol excise taxation in all European Union (EU) countries and the United Kingdom between 2017 and 2022. We then calculated the average excise tax share for alcoholic beverages for 2022. Using regression analysis, we predict tax revenue per capita from the tax share, type of alcohol excise taxation, recorded and unrecorded consumption and prevalence of past-year drinking. To illustrate the potential for revenue increases, we conducted a case study on Germany.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2022, average revenue from alcohol excise taxation (119 euros per capita) and excise tax share (17.3%) were low in the EU countries and the United Kingdom, but showed sizable variation. The association between excise tax share and revenue from excise taxation was very high, with a Pearson correlation of 0.888 (0.720–0.958; df = 16; <i>p</i> < 0.0001). In regression analyses, only the excise tax share significantly predicted tax revenue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Marked revenue gains could be achieved in several countries having low tax shares by instituting increases in excise tax share, with only small effects on consumer prices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 7","pages":"2003-2012"},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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