Objective: Cigarettes, alcohol, cannabis, inhalants and cocaine are the most commonly used substances among high school students in Jamaica. However, there is limited evidence on their co-use and whether the use of one drug predicts the use of the others (multiple substance use). This study aimed to determine whether cannabis use predicts the co-use of the other substances. Methods: We analysed data from the National Secondary School Survey 2013, Jamaica, using inferential statistics to determine associations. Results: Lifetime cannabis use was significantly associated with lifetime cigarette use for males (X 2 = 282.72, p = 0.000) and females (X 2 = 434.32, p = 0.000). Similarly, it was significantly associated with: (a) lifetime use of alcohol for males (X 2 = 88.62, p = 0.000) and females (X 2 = 99.48, p = 0.000); (b) lifetime use of inhalants for males (X 2 = 13.28, p = 0.00) and females (X 2 = 49.56, p = 0.00); and (c) lifetime cocaine use for males (X 2 = 9.78, p = 0.00) and females (X 2 = 64.54, p = 0.00). Past-month (recent) use of cannabis was significantly associated with past-month use of cigarettes and alcohol, but not inhalants, for males and females. Logistic regression results showed that lifetime cannabis use was a risk factor for lifetime use of cigarettes (adjusted odds ratio [AOR]: 11.38; 95% confidence interval [CI]: 9.02, 14.37) and alcohol (AOR: 5.84; 95% CI: 4.11, 8.30), but a strong protective factor against lifetime use of inhalants and cocaine. Past-month use of cannabis was a strong protective factor against pastmonth use of cigarettes and alcohol. Conclusion: Lifetime cannabis use was significantly associated with multiple substance use and was shown to be a risk factor for lifetime use of cigarettes and of alcohol. However, adolescents who reported recent (past-month) use of cannabis were less likely to report recent use of alcohol and cigarettes. These findings suggest the need for research to further explore the role cannabis plays in multiple drug use and offer more concrete explanations for its role.

Prompt diagnosis and early treatment of Tuberculosis (TB) cases is an important strategy in TB prevention and control. Thus, passive case finding of TB suspects, sputum examination for diagnosis, and prompt treatment using Directly Observed Treatment Short Course (DOTS) are key elements in the national guideline for TB control programme. The aim of this study is to determine the time interval between diagnosis of smear-positive TB cases and the commencement of treatment in DOTS facilities in southern Nigeria. The study was carried out in 20 healthcare facilities supported by TB Control Assistance Program (TB-CAP) involved in TB management in southern Nigeria, which comprised tertiary, secondary, and primary healthcare facilities including public and private facilities. Data were collected through review of clients' and facility records covering July-September 2009. Data collected were sociodemographic characteristics, sputum-smear result, date of diagnosis, and date of commencement of treatment. Data were analyzed using SPSS version 15.0 software. Of the total 2,507 TB suspects examined for Acid-Fast Bacillus (AFB), 323 were diagnosed to be Sputum-Smear-Positive (SS+ve), However, 269 new smear positive cases were commenced on treatment within the period, thus 54 (17.0%) of the new SS+ve cases defaulted initially. One hundred and two (38%) of them commenced TB treatment within 3 days of smear examination for diagnosis, while 59 (22%) commenced 4-6 days after diagnosis. The study revealed significant delay in commencement of TB treatment for most new smear positive TB cases in southern Nigeria and underlines the need to further explore factors responsible for delay in commencement of TB treatment following diagnosis.The journal issue has a unique new feature for reaching to the journal's website without typing a single letter. Each article on its first page has a "Quick Response Code". Using any mobile or other hand-held device with camera and GPRS/other internet source, one can reach to the full text of that particular article on the journal's website. Start a QR-code reading software (see list of free applications from http://tinyurl.com/ yzlh2tc) and point the camera to the QR-code printed in the journal. It will automatically take you to the HTML full text of that article. One can also use a desktop or laptop with web camera for similar functionality. See

The aim of this study was to determine whether perception of risk and accessibility of cannabis predicted the age of initiation of cannabis use among Jamaican secondary school students. Data from a nationally representative sample were analysed. Descriptive statistical analysis was done while binary logistic regression was used to compute point estimates and confidence intervals (CIs). The median age of initiation was 13 years. Gender was a predictor of age of initiation, with females having 39% less risk of initiating cannabis use at the age of 13 years or younger before adjusting for covariates (crude odds ratio [COR]: 0.61; 95% CI: 0.48, 0.77), which increased to 42% reduced risk of initiating cannabis use at the age of 13 years or younger after adjusting for covariates (adjusted OR [AOR]: 0.58; 95% CI: 0.39, 0.85). There was a significant inverse association between grade level in school and age of initiation of cannabis use, with 11 th grade students having a significantly reduced risk of commencing cannabis use at the age of 13 years or younger (COR: 0.41; 95% CI: 0.23, 0.70; AOR: 0.41; 95% CI: 0.23, 0.72). Participants who perceived cannabis use as moderately harmful were 67% less likely to initiate cannabis use at the age of 13 years or younger compared to participants who thought it was not harmful (AOR: 0.33; 95% CI: 0.12, 0.88). Perceptions of access to cannabis did not predict age of initiation of cannabis use. Being female, being in the 11 th grade and the perception that cannabis use was moderately harmful significantly reduced the risk of initiating cannabis use at the age of 13 years or younger.

The aim of this study was to determine whether perception of risk and accessibility of cannabis predicted the age of initiation of cannabis use among Jamaican secondary school students. Data from a nationally representative sample were analysed. Descriptive statistical analysis was done while binary logistic regression was used to compute point estimates and confidence intervals (CIs). The median age of initiation was 13 years. Gender was a predictor of age of initiation, with females having 39% less risk of initiating cannabis use at the age of 13 years or younger before adjusting for covariates (crude odds ratio [COR]: 0.61; 95% CI: 0.48, 0.77), which increased to 42% reduced risk of initiating cannabis use at the age of 13 years or younger after adjusting for covariates (adjusted OR [AOR]: 0.58; 95% CI: 0.39, 0.85). There was a significant inverse association between grade level in school and age of initiation of cannabis use, with 11 th grade students having a significantly reduced risk of commencing cannabis use at the age of 13 years or younger (COR: 0.41; 95% CI: 0.23, 0.70; AOR: 0.41; 95% CI: 0.23, 0.72). Participants who perceived cannabis use as moderately harmful were 67% less likely to initiate cannabis use at the age of 13 years or younger compared to participants who thought it was not harmful (AOR: 0.33; 95% CI: 0.12, 0.88). Perceptions of access to cannabis did not predict age of initiation of cannabis use. Being female, being in the 11 th grade and the perception that cannabis use was moderately harmful significantly reduced the risk of initiating cannabis use at the age of 13 years or younger. RESUMENEl objetivo de este estudio fue determinar si la percepción del riesgo y la accesibilidad al cannabis predecían la edad de iniciación del uso de cannabis entre los estudiantes de escuela secundaria en Jamaica. Se analizaron los datos de una muestra nacionalmente representativa. Se realizó un análisis estadístico descriptivo, y se utilizó una regresión logística binaria para computar las estimaciones puntuales y los intervalos de confianza (IC). La edad promedio de iniciación fue de 13 años. El género fue un predictor de la edad de iniciación, presentando las hembras un riesgo 39% menor de iniciar el uso de cannabis a la edad de 13 años o más joven,

Objective: Marijuana misuse by adolescents is a social and public mental health problem in Jamaica and globally. Research has suggested that family structure is one of the factors that influences adolescents' consumption of marijuana. This study was undertaken to determine if family structure and parental monitoring had any association with marijuana use among adolescents in Jamaica. Methods: Data from a nationally representative sample collected in Jamaica's National Secondary School Survey 2013 were analysed. The study sample consisted of 3365 grades 8-12 students from 38 secondary schools. Descriptive and inferential statistics were computed using PSPP software. Results: A significantly higher proportion of male (24.4%) than female (16.9%) adolescents reported lifetime use of marijuana. There was no significant difference in the proportions of male and female adolescents regarding marijuana use over the past one year (15.5% versus 10.4%) or over the past 30 days (8.7% versus 5.4%). There were significant differences in lifetime use of marijuana among adolescents from different family structures (Chi-square = 442.63, p = 0.00). The differences were not between one-parent families and two-parent families. Parental monitoring of adolescents' school work was strongly protective against lifetime marijuana use. Adolescents whose parents paid attention very closely (adjusted odds ratio [AOR]: 0.34; 95% confidence intervals [95% CI]: 0.22, 0.52), closely (AOR: 0.49; 95% CI: 0.32, 0.99) and somewhat closely (AOR: 0.63; 95% CI: 0.41, 0.99) to what they did at school were all significantly less likely to have ever used marijuana. Conclusion: Lifetime marijuana use among adolescents was associated with family structure but not from the perspective of one-parent families versus two-parent families. Parental monitoring of adolescents' school activities significantly protected against lifetime use of marijuana.