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The Transmission of Gun and Other Weapon-Involved Violence Within Social Networks. 社会网络中枪支和其他武器暴力的传播。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv009
Melissa Tracy, A. Braga, A. Papachristos
Fatal and nonfatal injuries resulting from gun violence remain a persistent problem in the United States. The available research suggests that gun violence diffuses among people and across places through social relationships. Understanding the relationship between gun violence within social networks and individual gun violence risk is critical in preventing the spread of gun violence within populations. This systematic review examines the existing scientific evidence on the transmission of gun and other weapon-related violence in household, intimate partner, peer, and co-offending networks. Our review identified 16 studies published between 1996 and 2015 that suggest that exposure to a victim or perpetrator of violence in one's interpersonal relationships and social networks increases the risk of individual victimization and perpetration. Formal network analyses find high concentrations of gun violence in small networks and that exposure to gun violence in one's networks is highly correlated with one's own probability of being a gunshot victim. Physical violence by parents and weapon use by intimate partners also increase risk for victimization and perpetration. Additional work is needed to better characterize the mechanisms through which network exposures increase individual risk for violence and to evaluate interventions aimed at disrupting the spread of gun and other weapon violence in high-risk social networks.
枪支暴力造成的致命和非致命伤害在美国仍然是一个长期存在的问题。现有的研究表明,枪支暴力通过社会关系在人与人之间和跨地区传播。了解社会网络中的枪支暴力与个人枪支暴力风险之间的关系对于防止枪支暴力在人群中蔓延至关重要。本系统综述审查了关于枪支和其他武器相关暴力在家庭、亲密伴侣、同伴和共同犯罪网络中传播的现有科学证据。我们的回顾确定了1996年至2015年间发表的16项研究,这些研究表明,在人际关系和社会网络中接触暴力受害者或施暴者会增加个人受害和施暴者的风险。正式的网络分析发现,枪支暴力在小型网络中高度集中,在一个人的网络中接触枪支暴力与一个人自己成为枪击受害者的可能性高度相关。父母的身体暴力和亲密伴侣使用武器也增加了受害和犯罪的风险。需要进一步的工作来更好地描述网络暴露增加个人暴力风险的机制,并评估旨在破坏枪支和其他武器暴力在高风险社会网络中传播的干预措施。
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引用次数: 56
Clinician Attitudes, Screening Practices, and Interventions to Reduce Firearm-Related Injury. 临床医生的态度,筛选做法和干预措施,以减少枪支相关伤害。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv005
Paul J D Roszko, Jonathan Ameli, Patrick M Carter, Rebecca M Cunningham, Megan L Ranney

Firearm injury is a leading cause of injury-related morbidity and mortality in the United States. We sought to systematically identify and summarize existing literature on clinical firearm injury prevention screening and interventions. We conducted a systematic search of PubMed, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycInfo, and ClinicalTrials.gov for English-language original research (published 1992-2014) on clinical screening methods, patient-level firearm interventions, or patient/provider attitudes on the same. Unrelated studies were excluded through title, abstract, and full-text review, and the remaining articles underwent data abstraction and quality scoring. Of a total of 3,260 unique titles identified, 72 were included in the final review. Fifty-three articles examined clinician attitudes/practice patterns; prior training, experience, and expectations correlated with clinicians' regularity of firearm screening. Twelve articles assessed patient interventions, of which 6 were randomized controlled trials. Seven articles described patient attitudes; all were of low methodological quality. According to these articles, providers rarely screen or counsel their patients-even high-risk patients-about firearm safety. Health-care-based interventions may increase rates of safe storage of firearms for pediatric patients, suicidal patients, and other high-risk groups. Some studies show that training clinicians can increase rates of effective firearm safety screening and counseling. Patients and families are, for the most part, accepting of such screening and counseling. However, the current literature is, by and large, not high quality. Rigorous, large-scale, adequately funded studies are needed.

在美国,枪支伤害是伤害相关发病率和死亡率的主要原因。我们试图系统地识别和总结临床枪支伤害预防筛查和干预的现有文献。我们对PubMed、Web of Science、护理和相关健康文献累积索引(CINAHL)、PsycInfo和ClinicalTrials.gov进行了系统搜索,以获取关于临床筛查方法、患者层面的枪支干预或患者/提供者对此的态度的英文原始研究(1992-2014)。通过标题、摘要和全文审查排除不相关研究,对剩余文章进行数据提取和质量评分。在确定的总共3 260种独特书目中,有72种被列入最后审查。53篇文章考察了临床医生的态度/实践模式;先前的培训、经验和期望与临床医生枪支筛查的规律性相关。12篇文章评估了患者干预措施,其中6篇为随机对照试验。七篇文章描述了病人的态度;所有研究的方法学质量都很低。根据这些文章,提供者很少筛选或建议他们的病人-即使是高风险的病人-关于枪支安全。以保健为基础的干预措施可能会提高儿科病人、有自杀倾向的病人和其他高危群体安全储存枪支的比率。一些研究表明,培训临床医生可以提高有效的枪支安全筛查和咨询率。大多数情况下,患者和家属都接受这种筛查和咨询。然而,目前的文献,总的来说,质量不高。需要进行严格、大规模、资金充足的研究。
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引用次数: 139
The Relationship Between Controlled Substances and Violence. 管制物质与暴力的关系。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv008
E. Mcginty, Seema Choksy, G. Wintemute
A causal relationship between controlled substances and firearm violence has been widely assumed in the United States, and federal law prohibits individuals who are "unlawful users of or addicted to any controlled substance" from purchasing or possessing firearms (68 FR 3750. 2003. Codified at 27 CFR §478.11). However, the law does a poor job of defining "unlawful users," resulting in recent calls for a revised, actionable definition. Such a definition should be informed by research evidence, but to date the epidemiologic research on the relationship between controlled substances and violence has not been comprehensively reviewed. The initial goal of this review was to summarize the best available evidence on the relationship between controlled substances and firearm violence, but only 1 study specific to firearm violence was identified. We therefore reviewed studies of this relationship using broader measures of interpersonal violence and suicide, all of which included but were not limited to firearm violence, and measures of illicit firearm carrying. Prospective longitudinal studies (n = 22) from 1990 to 2014 were identified by using searches of online databases and citation tracking. Information was extracted from each study by using a standardized protocol. Quality of evidence was independently assessed by 2 reviewers. Aggregate measures of controlled substance use were associated with increased interpersonal violence and suicide, but evidence regarding the relationship between specific substances and violence was mixed. Involvement in illegal drug sales was consistently associated with interpersonal violence. To effectively revise extant federal law and delineate appropriate prohibiting criteria, more research is needed to understand the relationship between controlled substances and firearm violence.
在美国,人们普遍认为受管制物质与枪支暴力之间存在因果关系,联邦法律禁止“非法使用或沉迷于任何受管制物质”的个人购买或拥有枪支(68 FR 3750)。2003. 编于27 CFR§478.11)。然而,法律在定义“非法用户”方面做得很差,导致最近有人呼吁修订一个可操作的定义。这种定义应以研究证据为依据,但迄今为止,关于管制物质与暴力之间关系的流行病学研究尚未得到全面审查。本综述的最初目标是总结有关受控物质与枪支暴力之间关系的最佳现有证据,但仅确定了一项针对枪支暴力的研究。因此,我们使用更广泛的人际暴力和自杀措施来回顾这一关系的研究,所有这些措施都包括但不限于枪支暴力和非法携带枪支的措施。通过在线数据库检索和引文跟踪,确定了1990年至2014年的前瞻性纵向研究(n = 22)。通过使用标准化协议从每个研究中提取信息。证据质量由2名审稿人独立评估。管制药物使用的总体测量结果与人际暴力和自杀的增加有关,但关于特定药物与暴力之间关系的证据喜忧参半。参与非法毒品销售始终与人际暴力有关。为了有效地修订现行联邦法律并划定适当的禁止标准,需要更多的研究来了解管制物质与枪支暴力之间的关系。
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引用次数: 39
Association Between Substance Use and Gun-Related Behaviors. 物质使用与枪支相关行为之间的关系。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv013
Danhong Chen, Li-Tzy Wu
Gun-related violence is a public health concern. This study synthesizes findings on associations between substance use and gun-related behaviors. Searches through PubMed, Embase, and PsycINFO located 66 studies published in English between 1992 and 2014. Most studies found a significant bivariate association between substance use and increased odds of gun-related behaviors. However, their association after adjustment was mixed, which could be attributed to a number of factors such as variations in definitions of substance use and gun activity, study design, sample demographics, and the specific covariates considered. Fewer studies identified a significant association between substance use and gun access/possession than other gun activities. The significant association between nonsubstance covariates (e.g., demographic covariates and other behavioral risk factors) and gun-related behaviors might have moderated the association between substance use and gun activities. Particularly, the strength of association between substance use and gun activities tended to reduce appreciably or to become nonsignificant after adjustment for mental disorders. Some studies indicated a positive association between the frequency of substance use and the odds of engaging in gun-related behaviors. Overall, the results suggest a need to consider substance use in research and prevention programs for gun-related violence.
与枪支有关的暴力是一个公共卫生问题。这项研究综合了药物使用与枪支相关行为之间关系的研究结果。通过PubMed、Embase和PsycINFO搜索,发现了1992年至2014年间发表的66项英文研究。大多数研究发现,药物使用与枪支相关行为的几率增加之间存在显著的双变量关联。然而,它们在调整后的关联是混合的,这可能归因于许多因素,如物质使用和枪支活动定义的变化、研究设计、样本人口统计学和所考虑的特定协变量。与其他枪支活动相比,较少的研究确定了药物使用与枪支获取/拥有之间的显著关联。非物质协变量(如人口统计学协变量和其他行为风险因素)与枪支相关行为之间的显著关联可能已经缓和了物质使用与枪支活动之间的关联。特别是,物质使用和枪支活动之间的关联强度在精神障碍调整后趋于明显降低或变得不显著。一些研究表明,药物使用频率与参与枪支相关行为的几率之间存在正相关关系。总的来说,研究结果表明,有必要在枪支相关暴力的研究和预防项目中考虑药物使用问题。
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引用次数: 28
Epidemiologic Evidence to Guide the Understanding and Prevention of Gun Violence. 指导理解和预防枪支暴力的流行病学证据。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv018
D. Webster, M. Cerdá, G. Wintemute, P. Cook
Gunfire from assaults, suicides, and unintentional shootings exacts an enormous burden on public health globally. The epidemiologic reviews in this special issue enhance our understanding of various forms of gun violence, inform interventions, and help chart directions for future research. The available science, however, is limited to answer many important questions necessary for mounting successful efforts to reduce gun violence. Certain data are lacking, and there are numerous analytical challenges to deriving unbiased estimates of policy impacts. Significant investments in research over the long term are warranted to answer questions central to successful prevention of gun violence.
袭击、自杀和非故意枪击造成的枪击给全球公共卫生造成了巨大负担。本期特刊中的流行病学综述增进了我们对各种形式的枪支暴力的理解,为干预措施提供了信息,并为未来的研究指明了方向。然而,现有的科学只能回答许多重要的问题,而这些问题是成功减少枪支暴力所必需的。某些数据是缺乏的,而且在对政策影响进行公正估计方面存在许多分析上的挑战。为了回答成功预防枪支暴力的核心问题,有必要对长期研究进行大量投资。
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引用次数: 20
What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries? 我们对火器立法与火器相关伤害之间的联系了解多少?
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 Epub Date: 2016-02-10 DOI: 10.1093/epirev/mxv012
Julian Santaella-Tenorio, Magdalena Cerdá, Andrés Villaveces, Sandro Galea

Firearms account for a substantial proportion of external causes of death, injury, and disability across the world. Legislation to regulate firearms has often been passed with the intent of reducing problems related to their use. However, lack of clarity around which interventions are effective remains a major challenge for policy development. Aiming to meet this challenge, we systematically reviewed studies exploring the associations between firearm-related laws and firearm homicides, suicides, and unintentional injuries/deaths. We restricted our search to studies published from 1950 to 2014. Evidence from 130 studies in 10 countries suggests that in certain nations the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths. Laws restricting the purchase of (e.g., background checks) and access to (e.g., safer storage) firearms are also associated with lower rates of intimate partner homicides and firearm unintentional deaths in children, respectively. Limitations of studies include challenges inherent to their ecological design, their execution, and the lack of robustness of findings to model specifications. High quality research on the association between the implementation or repeal of firearm legislation (rather than the evaluation of existing laws) and firearm injuries would lead to a better understanding of what interventions are likely to work given local contexts. This information is key to move this field forward and for the development of effective policies that may counteract the burden that firearm injuries pose on populations.

枪支在全世界造成死亡、伤害和残疾的外部原因中占很大比例。通过管制枪支的立法往往是为了减少与枪支使用有关的问题。然而,对哪些干预措施是有效的缺乏明确性仍然是政策制定的一大挑战。为了应对这一挑战,我们系统地回顾了探索枪支相关法律与枪支杀人、自杀和非故意伤害/死亡之间关系的研究。我们将搜索范围限制在1950年至2014年发表的研究。来自10个国家130项研究的证据表明,在某些国家,同时实施针对多种枪支限制的法律与减少枪支死亡有关。限制购买(如背景调查)和获得(如更安全的储存)枪支的法律也分别与亲密伴侣谋杀和儿童枪支意外死亡的发生率较低有关。研究的局限性包括其生态设计、执行过程中固有的挑战,以及研究结果对模型规范缺乏稳健性。对枪支立法的实施或废除(而不是对现有法律的评估)与枪支伤害之间的联系进行高质量的研究,将有助于更好地了解在当地情况下哪些干预措施可能奏效。这些信息是推动这一领域向前发展的关键,也是制定有效政策的关键,这些政策可能会抵消枪支伤害给人口带来的负担。
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引用次数: 164
Risks and Targeted Interventions: Firearms in Intimate Partner Violence. 风险和针对性干预:亲密伴侣暴力中的枪支。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv007
A. Zeoli, Rebecca Malinski, Brandon S. Turchan
The use of firearms in intimate partner violence (IPV) is widely recognized as an important public health threat. However, what we know about the risks of firearm access on IPV outcomes is limited. Therefore, we conducted a systematic review to determine the state of knowledge on 1) the risks of firearm access and use in IPV and 2) the effectiveness of interventions designed specifically to reduce firearm violence in intimate relationships. Only studies published in English in peer-reviewed journals from 1990 through 2014 were included. Results of the review suggest that, when violent intimates have access to firearms, IPV increases in severity and deadliness; however, increases in severity may not be due to firearm use. Additionally, statutes prohibiting persons under domestic violence restraining orders from accessing firearms are associated with reductions in intimate partner homicide, but certain provisions of these laws and their enforcement may impact their effectiveness. Future research should focus on elucidating the link between firearm access and increased IPV severity and on investigating whether and which specific provisions of domestic violence restraining order laws impact the laws' effectiveness. Additionally, more evaluations of initiatives designed to improve the enforcement of domestic violence restraining order firearm prohibitions are needed.
在亲密伴侣暴力(IPV)中使用火器被广泛认为是一个重要的公共卫生威胁。然而,我们对枪支获取对IPV结果的风险了解有限。因此,我们进行了一项系统综述,以确定以下方面的知识状况:1)IPV中枪支获取和使用的风险;2)专门为减少亲密关系中的枪支暴力而设计的干预措施的有效性。仅包括1990年至2014年在同行评议期刊上发表的英文研究。审查结果表明,当暴力亲密者获得枪支时,IPV的严重性和致命性增加;然而,严重程度的增加可能不是由于使用枪支。此外,禁止遭受家庭暴力限制令的人获得枪支的法规与减少亲密伴侣杀人有关,但这些法律的某些条款及其执行可能会影响其有效性。未来的研究应侧重于阐明枪支获取与IPV严重程度增加之间的联系,以及调查家庭暴力限制令法律的具体规定是否以及哪些具体规定影响了法律的有效性。此外,还需要对旨在改善家庭暴力限制令和枪支禁令执行情况的倡议进行更多的评估。
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引用次数: 70
Effectiveness of Interventions to Promote Safe Firearm Storage. 促进枪支安全储存的干预措施的有效性。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv006
A. Rowhani-Rahbar, J. Simonetti, F. Rivara
Despite supportive evidence for an association between safe firearm storage and lower risk of firearm injury, the effectiveness of interventions that promote such practices remains unclear. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, we conducted a systematic review of randomized and quasi-experimental controlled studies of safe firearm storage interventions using a prespecified search of 9 electronic databases with no restrictions on language, year, or location from inception through May 27, 2015. Study selection and data extraction were independently performed by 2 investigators. The Cochrane Collaboration's domain-specific tool for assessing risk of bias was used to evaluate the quality of included studies. Seven clinic- and community-based studies published in 2000-2012 using counseling with or without safety device provision met the inclusion criteria. All 3 studies that provided a safety device significantly improved firearm storage practices, while 3 of 4 studies that provided no safety device failed to show an effect. Heterogeneity of studies precluded conducting a meta-analysis. We discuss methodological considerations, gaps in the literature, and recommendations for conducting future studies. Although additional studies are needed, the totality of evidence suggests that counseling augmented by device provision can effectively encourage individuals to store their firearms safely.
尽管有证据支持安全储存枪支与降低枪支伤害风险之间的关联,但促进此类做法的干预措施的有效性仍不清楚。在系统评价和荟萃分析首选报告项目(PRISMA)清单的指导下,我们对安全枪支储存干预措施的随机和准实验对照研究进行了系统评价,从开始到2015年5月27日,我们预先搜索了9个电子数据库,没有语言、年份或地点的限制。研究选择和数据提取由2名研究者独立完成。Cochrane协作组织的评估偏倚风险的特定领域工具被用于评估纳入研究的质量。2000年至2012年期间发表的7项临床和社区研究均采用了提供或不提供安全装置的咨询,符合纳入标准。所有提供安全装置的3项研究都显著改善了枪支储存实践,而没有提供安全装置的4项研究中有3项未能显示出效果。研究的异质性妨碍了进行荟萃分析。我们讨论了方法学上的考虑,文献中的空白,以及对开展未来研究的建议。虽然还需要进一步的研究,但总的证据表明,通过提供设备来增加咨询可以有效地鼓励个人安全保管枪支。
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引用次数: 127
Risk factors for homelessness among US veterans. 美国退伍军人无家可归的危险因素。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2015-01-01 Epub Date: 2015-01-16 DOI: 10.1093/epirev/mxu004
Jack Tsai, Robert A Rosenheck

Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans.

30多年来,美国退伍军人的无家可归问题一直是研究的焦点。遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目,这是第一个系统评价,总结了美国退伍军人无家可归风险因素的研究,并评估了这些风险因素的证据。从1987年到2014年发表的31项研究分为三类:更严格的研究,不那么严格的研究,以及比较无家可归的退伍军人和无家可归的非退伍军人的研究。最强和最一致的风险因素是物质使用障碍和精神疾病,其次是低收入和其他与收入相关的因素。有一些证据表明,社会孤立、不良的童年经历和过去的监禁也是重要的风险因素。退伍军人,尤其是那些在全志愿部队出现后服役的人,比其他成年人更有可能无家可归。与其他无家可归的成年人相比,无家可归的退伍军人通常年龄更大,受教育程度更高,更有可能是男性,已婚或已经结婚,并且有医疗保险。需要更多的研究同时解决退伍军人无家可归的军事前,军事和军事后的风险因素。这篇综述将物质使用障碍、精神疾病和低收入作为政策和项目的目标,努力结束退伍军人的无家可归。
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引用次数: 188
Alcohol and drug misuse, abuse, and dependence in women veterans. 女性退伍军人的酒精和药物滥用、滥用和依赖。
IF 5.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2015-01-01 Epub Date: 2015-01-21 DOI: 10.1093/epirev/mxu010
Katherine J Hoggatt, Andrea L Jamison, Keren Lehavot, Michael A Cucciare, Christine Timko, Tracy L Simpson

We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care.

我们对包括国民警卫队/预备役成员在内的女性退伍军人的药物滥用、滥用和依赖进行了系统的文献回顾。我们确定了1980年至2013年间发表的837篇文章。在56项纳入的研究中,32项报告了酒精滥用、酗酒或其他不健康的酒精使用不符合滥用或依赖的诊断标准,33项报告了药物滥用或诊断为酒精或药物使用障碍的发生率。酒精滥用的比例从4%到37%不等,酗酒的比例从7%到25%不等;在退伍军人健康管理局(VA)医疗保健系统的门诊患者中,物质使用障碍的比例从3%到16%不等。比较女性退伍军人和平民的研究报告显示,在酗酒和酗酒方面没有明显差异。女性退伍军人的药物滥用率普遍低于男性退伍军人。药物滥用与更高的创伤率、精神和医疗状况以及更高的死亡率和自杀率有关。大多数研究只包括退伍军人事务部的患者,许多研究只使用退伍军人事务部的医疗记录数据;因此,报告的药物滥用率可能不能反映真实的流行情况。比率也因评估方法、数据来源和所研究的亚组而异。需要进一步努力制定流行病学上有效的流行率估计,以掌握女性退伍军人,特别是那些不使用退伍军人护理的退伍军人滥用药物的真正健康负担。
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引用次数: 61
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