Epidemiology Commons^™

Chronic Constipation Among Community-Dwelling Older People In The East Coast Region Of Peninsular Malaysia, Patimah Abdul Wahab, Azidah Abdul Kadir, Yeong Yeh Lee, Siti Hawa Ali, Dariah Mohd Yusoff

Makara Journal of Health Research

Background: This study aimed to investigate the prevalence, symptoms, and factors associated with chronic constipation among community-dwelling older people in the East Coast region of Peninsular Malaysia. Methods: A cross-sectional study was conducted in four selected health clinics using stratified cluster sampling. A face-to-face interview was carried out among the elderly outpatients, in order to complete a structured questionnaire. Results: A total of 400 participants were included in the study. The mean age was 68.7 ± 6.4 years, and 55% of the cohort were women. The prevalence of chronic constipation was 32.3% among the sample population. The …

Factors Influencing Consumers’ Choices Of Oral Hygiene Products: A Cross-Sectional Study, Faiza Awais, Hazik Bin Shahzad, Kiran Naheed, Ayyaz Ali Khan

Makara Journal of Health Research

Background: Environment, peer-groups, and salespersons influence consumers’ purchasing decisions regarding oral hygiene products. Other influences include various cultural, social, demographic, and socioeconomic factors. This study was designed to determine factors motivating and influencing consumers while choosing oral hygiene aids. Methods: 410 patients (age, 10–70 years), who visited the outpatient department of Sheikh Zayed Medical Complex, Lahore, Pakistan, were subjected to a close-ended questionnaire survey. Factors investigated included cost, packaging, media advertisement, perceptions, and previous experiences. Results: The cost of oral-hygiene products (82%) were the biggest influence. Advertisements influenced 55% of consumers in their purchase decisions regarding oral …

Correlation Between Carotid Intima-Media Thickness And Serum Tnf-Alpha Levels In Female With Rheumatoid Arthritis Of Different Ethnicities: A Single-Centre Experience In Malaysia, Kek Xin Yi, Asrul A. Wahab, Mohamad Norazrin Mohd Abas, Siti Amira Kamarul Abdul Wahid, Faridah Hanun Othman, Mohd. Shahrir Mohamed Said

Makara Journal of Health Research

Background: Rheumatoid arthritis (RA) is a destructive chronic inflammatory disease with intra- and extra-articular manifestations. It is associated with accelerated formation of arteriosclerosis. The aim of this study was to ascertain the correlation between endothelial dysfunction using carotid intima–media thickness (cIMT) and tumor necrosis factor-alpha (TNF-α) levels among the three main ethnic groups in Malaysia: Malay, Chinese, and Indian. Methods: This cross-sectional study included 23 females with RA belonging to three different ethnic groups who were free from cardiovascular risk factors. Blood sample was taken from each patient to measure serum TNF-α level, C-reactive protein (CRP), and erythrocyte …

Dimensions Of Stress In Parents Of Children With Autistic Spectrum Disorder, Amirah Hazwani Binti Bakri, Noor Aishah Binti Rosli, Zarinah Binti Mohd Kasirun, Mohd Hairul Nizam Bin Md Nasir, Fazidah Binti Othman, Tengku Sarina Aini Binti Tengku Kasim

Makara Journal of Health Research

Background: Parents of children with Autistic Spectrum Disorder (ASD) are at an increased risk for stress and other mental health problems. While treatment is mainly focused on the child, somehow parents’ stress is exacerbated. Accordingly, the purpose of this study was to identify the sources of stress in the parents of children with ASD. Methods: The 52 parents of children with ASD who participated in the study completed the child domain (CD) and parent domain (PD) subscales of the Parenting Stress Index Fourth Edition (PSI-4). Subsequently, the scores of the PSI-4 subscales were analyzed and compared. Results: …

Factors Influencing Pre-Marital Sexual Intercourse Among Unmarried Young Individuals In Cambodia, Vanthy Mai, Sirinan Kittisuksathit

Makara Journal of Health Research

Background: Sexual behavior of young individual are recognized as one of the main health priority in society. In Cambodia, young individual who hasten to involve in sexual intercourse, contributes to their high risk of various health issues, particularly those related to sexual reproductive health. This research will identify specific characteristics that have strong relationships with pre-marital sexual intercourse among unmarried young individuals in Cambodia. Methods: A binary logistic regression in a multivariate analysis of secondary data was applied from the 2014 cambodian demographic and health survey. the data about pre-marital sexual intercourse were assessed with the CDHS questionnaire …

Does Healthy Lifestyle Contribute To Physical And Mental Health Among University Students?, Dian Caesaria Widyasari, Sherly Saragih Turnip

Makara Journal of Health Research

Background: Little is known of how a healthy lifestyle and its health outcomes are related in university students in Indonesia. This study examined the association between healthy lifestyle markers (diet, sleeping hours, physical exercise, smoking, alcohol intake) and health outcomes (perceived physical fitness, psychological distress) among undergraduate students at university in Indonesia. We also examined gender-related patterns. Methods: A total of 616 undergraduate students participated in two cross-sectional studies carried out between 2011 and 2013. Six close-ended questions were used to measure health behaviors and perceived physical fitness. The Hopkin Symptoms Checklist-25 was used to measure psychological distress. …

An Experimental Model Of Chemically-Induced Ulceration Of The Buccal Mucosa Of Mus Musculus, Erik Idrus, Pratiwi Dwi Hartanti, Dewi Fatma Suniarti, Sri Redjeki Prasetyo, Yuniardini Septorini Wimardhani, Ajiravudh Subarnbhesaj

Makara Journal of Health Research

Background: Ulceration caused by chemical agents used in dental practice for in-office or home-used is a common event, resulting in discomfort and pain. Treatments for such conditions are still being developed, requiring extensive experiments both in vitro and in vivo studies. At present, a standardized experimental mouse model for mucosal ulceration caused by a chemical inducer to study the pathogenesis of ulceration and to develop medications for treatment of ulceration is still not available. The aim of this study was to create a chemically induced model of ulceration of the buccal mucosa of mice. Methods: An in vivo …

The Roles Of Intra-Household Gendered Dominance In Unmet Need For Family Planning Across Myanmar, Win Ei Phyu, Chalermpol Chamchan

Makara Journal of Health Research

Background: Unmet need for family planning in Myanmar (estimated 15.8% by the UN in 2017) is relatively high compared to other South East Asia countries. Moreover, Social Institutions and Gender Index in Myanmar is very high and cultural norms promote childbearing. Thus, this paper was conducted to examine role of intra-household gendered dominance (IHGD) in unmet need for family planning across Myanmar to set more effective intervention for family planning. Methods: The study utilized secondary data from 2015–2016 MDHS. Total 7,652 married women in reproductive age (MWRA) were included and 16% of them had unmet need for family …

Trends Of Endometrial Cancer Among Adult Women In The United States, Fnu Kanishka

Capstone Experience: Master of Public Health

Background: Endometrial cancer also referred to as uterine corpus cancer is the fourth most common cancer diagnosed among US women. It is also one of the few cancers in the US that has an increasing incidence and mortality rate. This study examined the overall and race specific age-adjusted incidence rate as well as incidence-based mortality rate of endometrial cancer in the United States from 1975-2016.

Methods: Surveillance, Epidemiology, and End Results (SEER) 1975-2016 data were used. Overall and race specific age-adjusted incidence rate, incidence-based mortality rates and 95% confidence intervals were calculated Trend graphs were created, annual average percent change …

Maternal Knowledge, Attitude, And Practices About Traditional Food Feeding With Stunting And Wasting Of Toddlers In Farmer Families, Betty Yosephin Simanjuntak, Miratul Haya, Desri Suryani, Ali Khomsan, Che An Ahmad

Kesmas

Traditional foods are foods consumed by a certain ethnic group in a specific region. The habit of consuming traditional foods is usually inherited by the family members, including toddlers, of a respective generation. The study aimed to determine relationship of maternal knowledge, attitude, and practices in traditional food feeding with stunting and wasting of toddlers in the farmer families of the Central Bengkulu District. This study employed a cross-sectional design with a sample of mothers with children aged 12–59 months. The sample included a total of 115 farmer families. Data on nutritional knowledge, attitude, practices about traditional food, sex of …

Personal Exposure Of Traffic Policeman To Particulate Matter In Jakarta: Distribution Of Size, Chemical Composition, And Work Time, Doni Hikmat Ramdhan, Eka Fitriani Ahmad, Fitri Kurniasari, Zuly Prima Rizky, Hardy Atmajaya, Muhayatun Santoso

Kesmas

Particulate matter (PM) is an air pollutant that has an impact on public health, especially in an urban area. The objective of this study was to analyze the personal concentration of PM2.5 and its composition among police working in the roadside area in Jakarta. PM measurement has done to the policeman that controlled traffic on four near highway locations in Jakarta. Sioutas impactor, Leland Legacy personal pump, and quartz fiber filter were chosen to measure the fine particles. Each PM was measured for 8-hour period. PM concentration was analyzed by the gravimetric method while tracing element and black carbon in …

Sexual Dysfunction Among Women With Diabetes In A Primary Health Care At Semarang, Central Java Province, Indonesia, Lintang Dian Saraswati, Ari Udiyono, Dian Sutrisni, Muh Fauzi

Kesmas

Sexual dysfunction is associated with pain during sexual intercourse. Diabetes mellitus (DM) has been reported to be one of the causal factors for sexual dysfunction in women. This cross-sectional study was conducted to describe the status of sexual dysfunction in women with DM in the Tlogosari Kulon Primary Health Care, Semarang, Indonesia, in March 2017. A total of 103 women with DM attending the health center participated in this study. Data were collected using a questionnaire-guided interview and through measurements (blood pressure and random blood glucose test). Results showed that 74.8% of women with DM had sexual dysfunction. The proportion …

Effect Of Self-Regulated Learning For Improving Dietary Management And Quality Of Life In Patients With Type-2 Diabetes Mellitus At Dr. Ramelan Naval Hospital, Surabaya, Indonesia, Yayuk Estuningsih, Thinni Nurul Rochmah, Merryana Andriani, Trias Mahmudiono

Kesmas

Self-regulated learning is a process of learning how to manage and regulate oneself to obtain skills and knowledge without depending on others. It is expected that diabetes patients can manage their diabetes by themselves. This study aimed to analyze the effect of self-regulated learning-based educational intervention on quality of life for patients with type-2 diabetes mellitus (DM) at Dr. Ramelan Naval Hospital, Surabaya. This was a quasi-experimental study in the form of pretest and posttest with a control group design. A total of 20 patients with DM were randomly divided into intervention and control groups to undergo a 4-week intervention. …

Overweight And Obesity Status With Dental Caries Among Children Aged 7–12 Years Old In Badung District, Bali 2018, Hariani Rafitha, Putri Bungsu Machmud, Ratna Djuwita, Dwi Gayatri, Fakhrana Ariani Ayub

Kesmas

Dental caries is an infectious disease that Dental is characterized by the dental damage resulting from microorganism products in carbohydrate fermentation. Dental caries and obesity in children are multifactorial diseases associated with eating habits and certain lifestyle factors. This study aimed to assess the association between overweightness, obesity, and dental caries among children aged 7–12 years in Badung district, Bali province in 2018. The total sample of 426 children and their mothers were recruited from all first to fifth elementary grade students in three schools selected by simple random sampling. The logistic regression analysis has demonstrated a significant association between …

Users’ Perception Of The Hospital Information System In A Maternity Hospital In Lampung, Indonesia, Al Asyary, Arief Kurniawan Nur Prasetyo, Tris Eryando, Solvay Gerke

Kesmas

Hospital information systems (HIS) have been applied on a massive scale; however, user evaluation of their effectiveness, efficiency, and service quality improvements remain rare. This study aimed to describe the utility of information systems from the users’ point of view by using the Technology Acceptance Model (TAM) in a maternity hospital in Lampung, Indonesia. The study provided an overview of the features of the information system and the workflow of the user through this information system. Screenshots were taken by using Camtasia Studio 2.0 Trial Version application software for one day (two shifts) in the outpatient service. The HIS generally …

Knowledge, Attitude, Practices, And Health Beliefs Of Pregnant Women About Urinary Tract Infection And Its Associated Risk Factors: A Local Filipino Community Experience, Annalyn Navarro, Raphael Enrique Tiongco, Reynaldo Bundalian Jr.

Kesmas

Urinary tract infection (UTI) during pregnancy is assumed to be associated with increased maternal and fetal morbidity and mortality; hence, a proper assessment of knowledge and practices is crucial to formulate preventive strategies to ensure the health of both the mother and the baby. The study determined the knowledge, attitude, practices (KAP), and the beliefs of pregnant women about UTI based on the Health Belief Model. A survey questionnaire was used to gather data from pregnant women with and without UTI. The association of the pregnant women’s sociodemographic characteristics with their KAP and health beliefs was determined using Pearson’s chi-square …

Midwife’S Role In The Mother-To-Child Transmission Prevention Program In Primary Health Care In Yogyakarta, Niken Meilani, Nanik Setiyawati, Sammy Onyapidi Barasa

Kesmas

Curing and eradicating Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) are to the core principles of the United Nations’ Sustainable Development Goals (SDGs). The incidence of HIV in the world remains high. Although midwives play a pivotal role in PMTCT implementation, the factors associated with midwives’ role in its implementation are not well understood. The aim of this study was to determine factors associated with midwives’ role in implementation of PMTCT. This study used a cross-sectional design. The subjects were 80 midwives at 14 primary health care in Yogyakarta City, Indonesia. The study was conducted from April to August 2017. …

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs …

The Epidemiological Burden Of Obesity In Childhood: A Worldwide Epidemic Requiring Urgent Action, Mariachiara Di Cesare, Maroje Sorić, Pascal Bovet, J Jaime Miranda, Zulfiqar Ahmed Bhutta, Gretchen A. Stevens, Avula Laxmaiah, Andre-Pascal Kengne, James Bentham

Department of Paediatrics and Child Health

Background: In recent decades, the prevalence of obesity in children has increased dramatically. This worldwide epidemic has important consequences, including psychiatric, psychological and psychosocial disorders in childhood and increased risk of developing non-communicable diseases (NCDs) later in life. Treatment of obesity is difficult and children with excess weight are likely to become adults with obesity. These trends have led member states of the World Health Organization (WHO) to endorse a target of no increase in obesity in childhood by 2025.
Main body: Estimates of overweight in children aged under 5 years are available jointly from the United Nations Children's Fund …

Association Of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture Risk, Rebecca T. Emeny, Chiang-Hua Chang, Jonathan Skinner, James A. O'Malley, Jeremy Smith, Gouri Chakraborti, Clifford J. Rosen, Nancy E. Morden

Dartmouth Scholarship

Importance: Many prescription drugs increase fracture risk, which raises concern for patients receiving 2 or more such drugs concurrently. Logic suggests that risk will increase with each additional drug, but the risk of taking multiple fracture-associated drugs (FADs) is unknown.

Objective: To estimate hip fracture risk associated with concurrent exposure to multiple FADs.

Design, Setting, and Participants: This cohort study used a 20% random sample of Medicare fee-for-service administrative data for age-eligible Medicare beneficiaries from 2004 to 2014. Sex-stratified Cox regression models estimated hip fracture risk associated with current receipt of 1, 2, or 3 or more of 21 FADs …

Multi-Ancestry Sleep-By-Snp Interaction Analysis In 126,926 Individuals Reveals Lipid Loci Stratified By Sleep Duration, Raymond Noordam, Maxime M. Bos, Heming Wang, Thomas W. Winkler, Amy R. Bentley, Tuomas O. Kilpeläinen, Paul S. De Vries, Yun Ju Sung, Karen Schwander, Brian E. Cade, Alisa Manning, Hugues Aschard, Michael R. Brown, Han Chen, Nora Franceschini, Solomon K. Musani, Melissa Richard, Dina Vojinovic, Stella Aslibekyan, Traci M. Bartz, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Both short and long sleep are associated with an adverse lipid profile, likely through different biological pathways. To elucidate the biology of sleep-associated adverse lipid profile, we conduct multi-ancestry genome-wide sleep-SNP interaction analyses on three lipid traits (HDL-c, LDL-c and triglycerides). In the total study sample (discovery + replication) of 126,926 individuals from 5 different ancestry groups, when considering either long or short total sleep time interactions in joint analyses, we identify 49 previously unreported lipid loci, and 10 additional previously unreported lipid loci in a restricted sample of European-ancestry cohorts. In addition, we identify new gene-sleep interactions for known …

Developments For The Treatment Of Invasive Infections Due To Multidrug-Resistant Acinetobacter Baumannii, David Laurent, Richard Drew, Dustin Wilson

The University of Louisville Journal of Respiratory Infections

Acinetobacter baumannii is a significant pathogen in healthcare settings (specifically prominent in healthcare- and ventilator-associated pneumonia) due primarily to its virulence and resistance to a wide variety of antimicrobial drug classes, including carbapenems (CRAB). Existing therapies (notably polymyxins, minocycline, tigecycline, amikacin, and sulbactam) often result in suboptimal tissue concentrations, high rates of toxicity, and increasing rates of resistance. Although utilizing combinations of antibiotics (specifically those containing colistin) have been employed, results have been mixed, and control trials are lacking. Eravacycline is a novel tetracycline with an improved pharmacokinetic profile and more potent activity against A. baumannii relative to tigecycline. Cefiderocol …

Post-Acquisition Processing Confounds In Brain Volumetric Quantification Of White Matter Hyperintensities, Ahmed A. Bahrani, Omar M. Al-Janabi, Erin L. Abner, Shoshana H. Bardach, Richard J. Kryscio, Donna M. Wilcock, Charles D. Smith, Gregory A. Jicha

Neurology Faculty Publications

BACKGROUND: Disparate research sites using identical or near-identical magnetic resonance imaging (MRI) acquisition techniques often produce results that demonstrate significant variability regarding volumetric quantification of white matter hyperintensities (WMH) in the aging population. The sources of such variability have not previously been fully explored.

NEW METHOD: 3D FLAIR sequences from a group of randomly selected aged subjects were analyzed to identify sources-of-variability in post-acquisition processing that can be problematic when comparing WMH volumetric data across disparate sites. The methods developed focused on standardizing post-acquisition protocol processing methods to develop a protocol with less than 0.5% inter-rater variance.

RESULTS: A series …

Community-Acquired Pneumonia Pathogenesis In Patients With Chronic Obstructive Pulmonary Disease, Julio A. Ramirez, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Prospective Analysis Of Food Consumption And Nutritional Status And The Impact On The Dietary Inflammatory Index In Women With Breast Cancer During Chemotherapy, Isis Danyelle Dias Custódio, Fernanda De Paula Franco, Eduarda Da Costa Marinho, Taísa Sabrina Silva Pereira, Mariana Tavares Miranda Lima, Maria Del Carmen Bisi Molina, Nitin Shivappa, James R. Hébert, Carlos Eduardo Paiva, Yara Cristina De Paiva Maia

Faculty Publications

Considering the implications of adverse effects of chemotherapy (CT) and the potential impact of diet on patients’ recovery, this study aimed to prospectively evaluate the association between the consumption of food groups, patients’ Dietary Inflammatory Index (DII®) scores, and their nutritional status. Anthropometric and dietary assessments of 55 women with breast cancer (BC) were performed at three time points. T0 is the time point after the first CT cycle, T1 is the time point after the intermediate CT cycle, and T2 is the time point after the last CT cycle. We identified a significant increase in weight, body mass index, …

Inflammation And Acute Traffic-Related Air Pollution Exposures Among A Cohort Of Youth With Type 1 Diabetes, Robin C. Puett, Jeff D. Yanosky, Murray A. Mittleman, Jessica Montresor-Lopez, Ronny A. Bell, Tessa L. Crumee, Dana Dabeleae, Lawrence M. Dolan, Ralph B. D'Agostino Jr, Santica M. Marcovina, Catherine Pihokeri, Kristi Reynolds, Elaine Urbina, Angela D. Liese

Faculty Publications

Background: Evidence remains equivocal regarding the association of inflammation, a precursor to cardiovascular disease, and acute exposures to ambient air pollution from traffic-related particulate matter. Though youth with type 1 diabetes are at higher risk for cardiovascular disease, the relationship of inflammation and ambient air pollution exposures in this population has received little attention.

Objectives: Using five geographically diverse US sites from the racially- and ethnically-diverse SEARCH for Diabetes in Youth Cohort, we examined the relationship of acute exposures to PM2.5 mass, Atmospheric Dispersion Modeling System (ADMS)-Roads traffic-related PM concentrations near roadways, and elemental carbon (EC) with biomarkers of inflammation …

Exploring The Hispanic Health Paradox In Mental Health Outcomes: Evidence From The Us-Mexico Border, Laryssa Mykyta, Suad Ghaddar, Leonel Vela

Health & Biomedical Sciences Faculty Publications

Background: Research has established that Hispanic immigrants experience better health outcomes than their US-born counterparts. However, it is unclear whether the immigrant advantage holds for mental health. The purpose of this study is to examine mental health disparities by nativity status in an underserved Hispanic population along the southern border.

Methods: We collected data (N=713, weighted 733,644 adults) in four counties (90% Hispanic) along the Texas-Mexico border from March through August 2018 utilizing a dual-frame sampling design (random-digit dial telephone survey and field survey in randomly-selected colonias). We assessed several mental health outcomes (depression, anxiety, poor mental health …

Plasma Cysteine/Cystine And Glutathione/Glutathione Disulfide Redox Potentials In Hiv And Copd Patients., Walter H. Watson, Jeffrey D. Ritzenthaler, Paula Peyrani, Timothy L. Wiemken, Stephen P. Furmanek, Andrea Reyes-Vega, Tom J. Burke, Yuxuan Zheng, Julio A. Ramirez, Jesse Roman

Faculty and Staff Scholarship

Chronic obstructive pulmonary disease (COPD) is prevalent in patients infected with HIV. The purpose of this study was to test the hypothesis that systemic oxidation correlates with loss of lung function in subjects with COPD, and that HIV infection can contribute to creating such an environment. Subjects were recruited at the University of Louisville in the following groups: HIV-infected (n = 36), COPD (n = 32), HIV and COPD (n = 28), and uninfected controls with normal lung function (n = 34). HIV infection was assessed by viral load and CD4 cell counts. Pulmonary function was determined by spirometry …

Statistical Methods Useful In Clinical Simulation And Medical Education Scholarship, Zuber D. Mulla, J. Hector Aranda, Donovan Rojas, Sanja Kupesic Plavsic

Marshall Journal of Medicine

The objective of this paper is to introduce selected statistical and epidemiologic topics that are of interest to interdisciplinary teams of healthcare quality professionals, educators, technical staff, and researchers who participate in clinical simulation scholarship. Four research vignettes in the setting of a hypothetical clinical simulation training workshop are presented. The first vignette illustrates the utility of exact logistic regression when analyzing a small dataset. The second underscores the importance of using an appropriate method to account for the repeated measurement of an outcome. The third illustrates the use of the intraclass correlation coefficient to measure inter-rater reliability. The final …

Is There Less Opioid Abuse In States Where Marijuana Has Been Decriminalized, Either For Medicinal Or Recreational Use? A Clin-Iq, Aaron M. Wendelboe, Richard Mathew, Tana Chongsuwat, Elizabeth Rainwater, Mark A. Wendelboe, Elizabeth Wickersham Md, Ann F. Chou

Journal of Patient-Centered Research and Reviews

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship …