AUDIT Score Research Articles

Screening and Telephone-Based Intervention for Unhealthy Alcohol Use in a Diverse Federally Qualified Health Center System in Texas.

Screening and brief intervention (BI) can reduce risky alcohol use but has not been widely implemented in primary care settings. We sought to implement a screening and telephone-based program within a Federally Qualified Health Center (FQHC). Prior to this program, adult patients were routinely screened using AUDIT-C with no further systematic follow-up. We designed a team-based, tele-care-centered program to (1) follow-up positive screening results or provider referrals with full AUDIT and (2) provide a social worker-administered two-session BI for patients with AUDIT 4-12; those with high AUDIT scores received BI and were offered pharmacotherapy and/or referral for additional support. Repeat AUDIT was administered at 3-6months. From March 2021 to May 2023, 3959 patients were screened using AUDIT-C, with 632 (16%) screening positive. Mean age was 44; 47% identified as female, 58% as Hispanic/Latino; 43% received care through the county-based Medical Access Program (MAP). Men, those with commercial insurance, and English-speakers were more likely to screen positive. Using telephone outreach to direct referrals and to those screening positive, trained counselors successfully administered the full AUDIT to 412 participants. Initial AUDIT scores were ≤ 12 (n = 281, 68.2%) and > 12 (n = 131, 31.8%). Among patients who completed the initial AUDIT, mean age was 46; 32% identified as female, 86% as Hispanic/Latino, and 66% were insured through MAP. Of the 412, 400 (97%) completed one counseling session and 297 (72%) completed two. Of the 131 with initial AUDIT > 12, 19 received pharmacotherapy and 13 had one or more visits with our addiction medicine service. For the 251 patients with AUDIT data at 3-6months, the mean score change was - 4.1 (95% CI - 3.4, - 4.7). Spanish-speaking patients showed larger decreases than English-speakers; there were no other statistically significant differences. Screening and telephone-based BI reduces unhealthy alcohol use in diverse adult FQHC patients.

Compulsive sexual behavior, sexual functioning problems, and their linkages to substance use among German medical students: exploring the role of sex and trauma exposure

Sexual problems relevant to psychotherapy, such as compulsive sexual behavior (CSB) and sexual functioning problems (SFP), have been related to harmful substance use in several studies. Substance use is prevalent among medical students (MS) and is often considered a maladaptive coping strategy for stress, as well as a risk factor for mental health issues. Sexual problems and substance use share trauma exposure and post-traumatic symptoms as risk factors for their development. This study aimed to explore the interaction effects between problematic sexual behaviors, substance use, and trauma among German MS. A cross-sectional study (n = 359; 69% women, 29% men) was conducted using an online questionnaire. MS at a German university were recruited via email. CSB (CSBD-19), SFP (SBQ), harmful alcohol (AUDIT) and drug use (DAST), childhood trauma exposure (CTQ), and current post-traumatic symptoms (IES-R) were assessed. Multivariate linear and ordinal regressions, as well as path analyses, were conducted to investigate associations between the study variables. CSB was identified in 3% of all MS. The most commonly reported SFPs were decreased sexual desire and difficulties achieving orgasms among women and premature ejaculation among men. Higher CSBD scores were predicted by male sex, elevated AUDIT scores, and increased frequencies of hyperarousal (IES-R). Path analyses revealed associations between the severity of emotional/sexual abuse, the intensity of post-traumatic symptoms, and both CSBD and AUDIT scores. Among female MS, less severe emotional abuse and more severe physical abuse in childhood predicted higher frequencies of orgasmic difficulties. The frequency of SFPs was correlated with the use of benzodiazepines among female MS, with cannabis and MDMA/ecstasy among male MS, and with cocaine/crack, speed, and AUDIT among both sexes. No interaction effects were found between SFPs, substance use, or trauma-related factors in the path analyses. To some extent, there appears to be a relationship between substance use, childhood trauma exposure, and currently persisting post-traumatic symptoms with problematic sexual behaviors among MS. However, further research is required to explore these relationships in greater depth and to identify the underlying pathways. Mental health support measures should incorporate the factors of sexuality, substance use, and trauma while also exploring their relationships with workload, career-related anxieties, and other curriculum-related factors.

Environmental audit scoring evaluation: evolution of an evidence-based environmental assessment tool to support person-centered care.

Long-term care settings are at the center of strongly debated approaches to policies that shape the delivery of care and operational practices. There is advocacy for transformational change within these settings to support a person-centered approach to care delivery, but it is difficult and multifaceted involving everything from changing the level of staffing and care models to developing appropriate metrics to assess an individual's quality of life. The physical environment is a key component for accomplishing the organizational and operational goals related to person-centered care, but providers and their design teams need the appropriate tools to guide evidence-based decision-making. The Environmental Audit Scoring Evaluation (EASE) is a tool that helps lend structure to the process of developing the environment for our senior population-especially those living with dementia. This perspective article will discuss how EASE aims to align the design process to more fully support the myriad environmental elements that have a demonstrable impact on the individual, and the associated quality of life they experience. The article will also explore how EASE differs from previous planning strategies that did not prioritize residents' psychological wellbeing in conforming to current person-centered philosophies.

Efficacy of Screening and Brief Intervention for Alcohol Misuse in Opioid Agonist Maintenance Treatment: A Randomized Clinical Trial

ABSTRACT Alcohol misuse is common in persons on opioid agonist maintenance treatment (OAMT). We tested the efficacy of screening and brief intervention (SBI) for harmful/hazardous alcohol use in buprenorphine/naloxone (BNX)-assisted OAMT. It was a double-blind, parallel-group, randomized trial, where 150 participants with alcohol misuse (Alcohol Use Disorder Identification Test – AUDIT 8–19) on BNX were allocated equally to receive either a single session SBI or screening and brief advice (control). Participants were followed up at three months. The primary outcome was the change in AUDIT; other outcomes were risk transition, change in the frequency of heavy drinking, days of abstinence from alcohol, Gamma-glutamyl transferase (GGT) levels, non-prescription opioid use, and adherence to BNX. Follow-up data was gathered from 138 participants. SBI participants had a higher reduction in AUDIT scores at the follow-up (F = 129. 173, df = 1, p < .001, ηp 2 =.469). A higher proportion of participants transitioned to a low-risk category in the SBI group. The SBI group showed a higher reduction in heavy drinking and days of alcohol abstinence. Although the proportion of persons with normal serum GGT increased in both groups, the difference was not significant at the follow-up. The SBI group performed better in non-prescription opioid use and BNX adherence.

Effectiveness of exercise intervention in improving physical and mental status of patients with alcohol use disorders: A systematic review and meta-analysis.

This meta-analysis and systematic review examined the effects of an exercise intervention on alcohol dependence and physical and mental states in patients with alcohol use disorder (AUD). PubMed, Web of Science, Cochrane Library, EBSCO, and Embase. Randomized controlled trials published in English from the inception of the database until June 30, 2024, were included. All forms of exercise intervention (aerobic, resistance, yoga, mixed exercise, etc.) were included in the study, using an exercise intervention for patients with AUD and a non-exercise control group. Studies that excluded acute exercise or did not describe a specific intervention program; duplicate publications; review articles, conference articles, etc.; and studies that did not report appropriate outcome metrics. This protocol was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol standard. The risk of bias was assessed via the Cochrane risk-of-bias tool as described by the Cochrane Handbook for Systematic Reviews and Interventions. Alcohol dependence (number of drinks per day, number of drinks per week, AUDIT), physical and mental status [maximal oxygen uptake (VO2 max), resting heart rate, anxiety state, depression state, stress level]. Seventeen RCTs with a total of 1,905 patients with alcohol use disorders were included as subjects, and the results revealed that the exercise intervention had a significant effect on alcohol dependence, the number of drinks per day and the AUDIT score, the exercise intervention also had a significant effect on physical and mental status, VO2max, the resting heart rate, the anxiety state, the depression state, and the stress level. High heterogeneity in the number of drinks per day, anxiety, depression and stress outcomes (I2 > 50%), but Egger's test showed no publication bias for all outcome indicators (p > 0.05). Exercise intervention can effectively reduce alcohol dependence and significantly improve the physical and mental states of AUD patients, and exercise intervention as an adjunct to the treatment of AUD patients is significantly effective.

Alcohol Misuse and Correlates with Mental Health Indicators among Firefighters

Background: Stress and repetitive exposures to potentially traumatizing events are inherent to first-responder professions. Firefighters and other crisis responders are often exposed to incidents in their work environments and are at risk of developing acute or posttraumatic symptomatology, depression, and anxiety, as well as harmful patterns of alcohol consumption. Most prior research and theory suggests that many firefighters use alcohol to cope with past and current stressors, and that increased drinking accompanies ongoing exposures to stressful occupational hazards. Objectives: The primary aim of this research was to examine alcohol consumption and mental health variables associated in the literature with alcohol misuse. Participants included 546 predominantly male career firefighters in the U.S. Using a cross-sectional design, we examined alcohol misuse in the context of self-reported depression, generalized anxiety, PTSD, and suicidal ideation using previously validated measures. Results: Based on the AUDIT’s recommended cut score of 8, 38.8% of our sample reported drinking at hazardous levels. Hazardous alcohol use was also significantly associated with several mental health indicators with correlations ranging from .28 to .34. Regression analyses revealed that over 14% of the variance in AUDIT scores could be explained by psychological symptom measures, and 29% of the variance in suicide risk was explained by a model using both alcohol and mental health measures. Conclusions: Findings suggest that psychological distress is associated with hazardous drinking, and that more consistent screening and referral for these issues, as well as multi-level interventions, are needed to effectively address these behavioral health concerns among firefighters.

Delay discounting of rewards and losses, alcohol use, and the influence of socioeconomic factors: A cross-sectional online study in frequent drinkers.

Delay discounting describes the devaluation of future outcomes over time and is a popular behavioral construct in addiction research. Prior studies show modest yet consistent associations between problematic alcohol use and delayed reward discounting (DRD). However, the potential confounding influence of socioeconomic status (SES, e.g., income and education) is rarely addressed. In this study, we aimed to investigate the robustness of DRD as a predictor of alcohol use after controlling for socioeconomic and demographic variables. Additionally, we aimed to test the association between delayed loss discounting (DLD) and alcohol use in a sufficiently large sample. We collected data from 341 moderate-to-heavy-drinking participants (27.92 ± 21.12 g alcohol/day, 43.48 ± 11.90 years old, 49.9% female, UK residents) in a cross-sectional online study. DRD and DLD were measured using an intertemporal choice task. Questionnaires encompassed alcohol use (AUDIT, weekly alcohol consumption), education and income, subjective measures of past and present socioeconomic status, and impulsivity. DRD, but not DLD, was significantly associated with AUDIT scores (r = 0.15) and weekly alcohol consumption (r = 0.12). DRD remained a significant yet weak predictor of AUDIT scores when controlling for education and income, but not when controlling for education and age. We replicated a small but robust association between alcohol use and DRD, but not DLD. This association appeared to be confounded by education and age, but not by income. We conclude that socioeconomic and demographic variables should systematically be accounted for in future studies investigating DRD and alcohol use.

Safety and Effectiveness of Naltrexone in the Management of Alcohol Use Disorder in Patients With Alcohol-associated Cirrhosis: First Clinical Observation From Indian Cohort

Naltrexone is a promising drug to treat alcohol use disorder with limited evidence of safety in liver diseases. An observational study was performed to study the safety, effectiveness, and tolerability of Naltrexone in the management of alcohol use disorder in patients with alcohol-associated cirrhosis. Naltrexone was started in patients with alcohol-related liver disease for the management of alcohol use disorder in 86 patients who were followed up for 4 weeks. Baseline liver parameters were compared with those at 4 weeks to establish safety of the drug. Effectiveness was determined by observing reduction in AUDIT scores, craving, number and days of drinking. Self-report of side effects was noted. After 4 weeks of starting Naltrexone there was a decrease in AST-89.86 vs 57.61, ALT-50.19 vs 27.08, SAP-121.81 vs 98.19, GGT-166.93 vs 109 and MELD 16.32 vs 12.13 (none statistically significant). There was a statistically significant reduction in Serum Bilirubin- (4.31 vs 1.98), INR (1.49 vs 1.32), self-reported craving (3.71 Vs 1.97; P= 0.01), AUDIT scores (24.13 Vs 16.91; P <0.01) and number of drinking days in last one month (10.22 Vs 4.19; P= 0.03). The reduction in all liver parameters and AUDIT scores and craving after treatment with Naltrexone supports its safety and utility in the management of alcohol use disorder in alcohol-related liver cirrhosis.

Dark patterns, dark nudges, sludge and misinformation: alcohol industry apps and digital tools.

Many alcohol-industry-funded (AIF) organizations disseminate eHealth/mHealth tools that claim to assist users in making health decisions by monitoring alcohol consumption, e.g. blood alcohol calculators, AUDIT scores, consumption trackers. Previously, AIF materials were found to contain health misinformation that could increase consumption (dark nudges) or make healthy behaviour change more difficult (sludge). The accuracy and functionality of AIF tools have never been analysed, and given the history of AIF materials it is possible they contain misinformation and function as covert marketing channels to promote alcohol-industry-friendly narratives on the causes and possible solutions of alcohol-related harms. We evaluated the information accuracy and framing, behaviour change techniques (BCTs), and functions of AIF digital tools (n = 15, from the UK, Ireland, the USA, Canada, New Zealand, Australia; including Drinkaware, Drinkwise, Educ'alcool and others), compared to a non-industry-funded independent sample (n = 10). We identified misinformation and 'dark patterns' (interface design strategies for influencing users against their interest) throughout AIF tools; significantly fewer provided accurate feedback (33% vs 100%), and significantly more omitted information on cancer (67% vs 10%) and cardiovascular disease (80% vs 30%) and promoted industry-friendly narratives (47% vs 0%). AIF tools encouraged consumption through priming nudges (53%) and social norming (40%). AIF tools utilized fewer BCTs, provided users with more limited pre-set options (54%), and fewer drink choices (mean 24 vs 275). Their input structure often impeded their ability to provide guideline advice. We conclude that AIF tools contain pro-industry misinformation strategies and dark patterns that misinform users about their consumption and could 'nudge' them towards continuing to drink alcohol-characteristics of 'Dark Apps' designs.

Interhospital variability of risk-adjusted mortality rates and associated structural factors in patients undergoing emergency laparotomy: England and Wales population-level analysis.

Emergency surgical admissions represent the majority of general surgical workload. Interhospital variations in outcomes are well recognized. This analysis of a national laparotomy data set compared the best- and worst-performing hospitals according to 30-day mortality and examined differences in process and structural factors. A retrospective multicenter cohort study was performed using data from the England and Wales National Emergency Laparotomy Audit (December 2013 to November 2020). The data set was divided into quintiles based on the risk-adjusted mortality calculated using the National Emergency Laparotomy Audit score risk prediction model. Primary outcome was 30-day mortality. Hospital-level factors were compared across all five quintiles, and logistic regression analysis was conducted comparing the lowest with the highest risk-adjusted mortality quintiles. Risk-adjusted 30-day mortality in the poorest performing quintile was significantly higher than that of the best performing (11.4% vs. 6.6%) despite equivalent predicted mortality (9.4% vs. 9.7%). The best-performing quintile was more likely to be a tertiary surgical (49.5% vs. 37.1%, p < 0.001) or medical school-affiliated center (26.4% vs. 18.0%, p < 0.001). In logistic regression analysis, the strongest associations were for surgery performed in a tertiary center (odds ratio, 0.690 [95% confidence interval, 0.652-0.731], p < 0.001) and if surgery was performed by a gastrointestinal specialist (0.655 [0.626-0.685], p < 0.001). Smaller differences were seen for postoperative intensive care stay (0.848 [0.808-0.890], p < 0.001) and consultant anesthetist involvement (0.900 [0.837-0.967], p = 0.004). This study has identified significant variability in postoperative mortality across hospitals. Structural factors such as gastrointestinal specialist delivered emergency laparotomy and tertiary surgical center status appear to be associated with improved outcomes. Original Research Article; Level II.

SMSs as an alternative to provider-delivered care for unhealthy alcohol use: study protocol for Leseli, an open-label randomised controlled trial of mhGAP-Remote vs mhGAP-Standard in Lesotho

BackgroundThe World Health Organization’s (WHO) Mental Health Gap Action Programme (mhGAP) is a validated intervention that can be provided by non-specialised healthcare workers to individuals with unhealthy alcohol use. However, it typically requires several in-person sessions at a health facility, which may limit its feasibility and effectiveness in remote settings. This trial compares mhGAP-Standard, a 4 to 6 in-person session intervention, to mhGAP-Remote, a 1 in-person session intervention followed by 8 week of short message service (SMS) in Lesotho. We hypothesise that mhGAP-Remote is superior to mhGAP-Standard in reducing alcohol use (as detailed by the primary and secondary outcomes below).MethodsThis is a two-arm randomised open-label multicentre superiority trial. Participants allocated to mhGAP-Standard receive 4 in-person sessions using motivational interviewing, identifying triggers, and alternative behaviours, with the option of two additional booster sessions. Participants in the mhGAP-Remote arm receive 1 in-person session covering the same content, followed by standardised SMSs over 8 weeks that reinforce intervention content. Non-specialist providers deliver the intervention and receive weekly supervision. Adults (Nplanned = 248) attending participating health facilities for any reason and who meet criteria for unhealthy alcohol use based on the Alcohol Use Disorders Identification Test ([AUDIT] score ≥ 6 for women, ≥ 8 for men) are individually randomised to the two arms (1:1 allocation, stratified by participant sex and age (≥ 50 vs < 50 years old). Follow-up assessments occur at 8, 20, and 32 weeks post-randomisation. The primary outcome is change in self-reported alcohol use (continuous AUDIT score), from baseline to 8 weeks follow-up. Change in the AUDIT from baseline to 20 and 32 weeks follow-up is a secondary outcome. Change in the biomarker phosphatidylethanol (secondary), liver enzyme values in serum (exploratory), and HIV viral load (for people with HIV only; exploratory) are also evaluated from baseline throughout the entire follow-up period. A linear regression model will be conducted for the primary analysis, adjusted for the stratification factors. Three a priori sensitivity analyses for the primary outcome are planned based on per protocol treatment attendance, recovery from unhealthy alcohol use, and clinically significant and reliable change.DiscussionThis trial will provide insight into feasibility and effectiveness of a shortened and primarily SMS supported version of mhGAP, which is especially relevant for settings where regular clinic attendance is a major barrier.Trial registrationclinicaltrials.gov NCT05925270. Approved on June 29th, 2023.

Status of LGBTQ+ Inclusion: Multi-Institution Assessment of US Radiology Residencies

IntroductionAn inclusive residency program is crucial to the recruitment and retention of competitive and diverse applicants. The radiology lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) inclusion audit was published in 2022, which provided a road map for assessing the inclusivity of a program’s policies, facilities, culture, and engagement. In this multi-institutional trial, we detail the results of the LGBTQ+ inclusion audit for nine US radiology residency programs. MethodsA volunteer cohort of academic radiology programs was recruited through the Radiology Residency Education Research Alliance. The LGBTQ+ inclusion audit was modified to apply to a multi-institutional study. Participating programs performed the audit from December 2023 to February 2024. Pre- and postaudit surveys were distributed to capture participants subjective assessment of inclusivity at their programs. ResultsNine US radiology residency programs completed the audit. Audit scores ranged from 6 out of 10 to 9 out of 10; no program received a perfect 10 out of 10 score. Inclusive facilities and institutional culture scored highly, with eight of nine programs reporting all milestones met in these areas. The lowest-performing areas were department culture and community engagement with only three of nine and four of nine programs reporting “all milestones met.” After the audit, programs overall reported improved self-perceived inclusivity, with postaudit survey scores increasing in areas related to department policy, inclusive facilities, and LGBTQ+ community outreach. DiscussionParticipating radiology residency programs demonstrated an overall high level of LGBTQ+ inclusivity; however, all programs identified inclusion shortcomings in department policy and practice. Intentional review of a department can be a helpful tool to promote a welcoming and healthy environment for a diverse radiology practice.

Analysis of the Effect of Coal and Mineral Mining Safety Management System (SMKP Minerba) Implementation on the Mineral Exploration Drilling Company’s Safety Mining Performance at PT.

Background: In Indonesia, mining companies such as PT X, which has an IUJP for mineral exploration drilling, must implement SMKP Minerba. This system, which is aligned with government guidelines, includes seven elements such as Policy, Planning, Organization, Implementation, Evaluation, Documentation, and Review. Research purposes: The objective is to analyse the effect of implementing the Mineral and Coal Mining Safety Management System (SMKP Minerba) on the work safety performance of Mineral Exploration Drilling Company at PT X. Research methods: This study used a descriptive quantitative method and a case study approach, to analyse SMKP Minerba documents, including Mining Safety Performance records. Descriptive statistics, simple linear regression, and Pearson Correlation assessed variable impacts and relationships. From 144 engineers, the Slovin formula required a minimum sample of 98. Research result: The study reported that the Internal Audit of the Mineral and Coal Mining Safety Management System (SMKP Minerba) achieved a score of 84.1%. Mining safety performance was evaluated across four key indicators. Worker Participation, Leadership Responsibility, Incident Analysis and Statistics, Occupational Diseases and Incidents, and Risk Control Efforts, yielding an overall score of 0.78 out of 1, placing it in the "Planned" category. Pearson correlation analysis indicated a positive association between Position, Tenure, and SMKP Audit Scores with Mining Safety Performance. ANOVA demonstrated a significant impact of Position and Tenure on Mining Safety Performance. Conclusion: The study found that employees holding higher positions, possessing longer tenure, and achieving higher SMKP audit scores exhibited superior mining safety performance. The application of SMKP Minerba positively influences the safety performance in mining operations at PT X, contributing to the sustainable enhancement of mining safety practices in Indonesia.

Brief intervention protocol by telephone delivered by nurses to patients with harmful alcohol use in primary health care: A feasibility trial

AimThe aim of this study is to examine the feasibility of a brief intervention protocol by telephone performed by nurses in primary health care facilities. MethodsA nonrandomized single-arm feasibility study was performed. The proposed intervention of this study is the Brief Intervention carried out by the nurse delivered by telephone, synchronously with alcohol users. The brief intervention is a motivational approach based on the FRAMES model, with its components being: Feedback, Responsibility, Advice, Menu of options, Empathy and Self-efficacy. To assess the feasibility of the protocol, we evaluated the procedure for enrolling participants, the acceptability of the protocol to participants, the satisfaction of the participants, convenience and treatment continuity. The quantitative data analysis was carried out in the R software, using descriptive statistics, categorical variables were reported by frequencies and percentages. For continuous variables, medians, means, standard deviations and range values were computed. ResultsWe followed the participants (n = 165) from baseline (T0) until 3 months (T1) and 6 months (T2) after the brief intervention. The partial effect suggests a reduction in alcohol consumption, and statistically significant differences were observed from baseline before the BI, with a decrease of 0.66 points in AUDIT scores at T1. Among the patients who completed the 3-month follow-up, 48 % reported a positive experience of receiving the brief intervention by the nurses, and 44 % reported a decrease in alcohol consumption. ConclusionsBrief intervention delivered by telephone was considered feasible and acceptable by primary health care patients, and they perceived improvement in their alcohol consumption after receiving the BI performed by nurses.

Changes in alcohol consumption during the COVID-19 among first-year university students in Spain, considering the risk of problematic use – UniHcos project

The aim of this study was to evaluate the possible impact of the COVID-19 pandemic on prevalence rates and self-reported changes in patterns of alcohol use among first-year university students in Spain, considering the risk of problematic alcohol use. A serial cross-sectional study based on the uniHcos project was carried out. Data from 10 518 first-year university students (73.3% female, mean age 19 (SD = 1.6)) collected between 2012 and 2022 were analysed. The evolution of the pooled prevalence rates during the time series was analysed and the risk of problematic alcohol consumption was assessed using the AUDIT. Also, self-reported changes in alcohol use patterns during the pandemic were assessed. According to the results, during the COVID-19 pandemic, the prevalence of alcohol use in the past 30-days was reduced (76.3% in 2019 vs. 63.7% in COVID-19) increasing again in the New Normal period. Thus, a similar pattern in the practice of binge drinking was observed. Regarding the AUDIT score, 21.7% (95%CI 20.9, 22.6) of the students had harmful alcohol consumption, with a higher proportion among males. In the multivariable logistic models, a higher AUDIT score was significantly associated (p-value < 0.001) with being male and living with roommates. According to self-reported changes in consumption patterns during the COVID-19 pandemic, a higher proportion of participants with harmful use reported an increase in alcohol consumption compared to those at low-risk (43% vs 19%). Finally, despite the overall reduction in drinking prevalence during COVID-19, changes were not equal for all students and depended on their previous level of problematic drinking, highlighting that this should be considered in the development of strategies against alcohol use in this population.

Combined Use of Phosphatidylethanol and the Audit Test for Detecting of Alcohol Abuse

Aim: To estimate the prevalence of alcohol abuse among men by using combined the direct biochemical marker phosphatidylethanol (PEth) and the AUDIT questionnaire (Alcohol Use Disorders Identification Test). Subjects and Methods: The concentration of PEth was determined in 136 blood samples of men aged 15 - 65 years. The blood was obtained from the laboratory of the medical advisory centre, where it was submitted for routine biochemical analysis. Immediately before blood sampling, clients were asked to complete the AUDIT questionnaire. Determination of the concentration of PEth was carried out using the method of high performance liquid chromatography - tandem mass spectrometry (HPLC - MS). Statistical data processing was carried out using the Statistica 10.0 program. Results: Discrimination by the level of alcohol consumption using the concentration of PEth showed that the proportion of abstinents (practically not drinking alcohol) among men was 20.6 %; the proportion of moderate drinkers was 63.1 %; the proportion of alcohol abusers was 16.3 %. The highest average concentration of PEth, as well as the proportion of those who abuse alcohol, was observed in the age groups of 50 - 59 and 60+ years. The distribution by level of alcohol consumption according to the total score of the AUDIT test was as follows: abstinents - 17.9 %; moderate drinkers - 69.6 %; alcohol abusers - 12.5 %. The highest average test score, as well as the highest share of alcohol abusers, was observed in the age group 50 - 59 years. Correlation analysis did not reveal any relationship between the concentration of PEth in the blood and the total score of the AUDIT test in any of the age groups of men. Conclusion: The results indicate a fairly high prevalence of alcohol abuse among men. Alcohol-related problems are especially high among middle-aged men. The outcomes suggest a low concordance between the concentration of PEth in the blood and the AUDIT score.

Sports betting and hazardous alcohol use among young adults: added risks of betting and drinking on the same day

Background. Sports betting is growing in popularity at alarming rates, especially among young adults. However, sports betting is not yet widely considered as a public health concern due in part to scarce examination of health correlates. The present study entailed cross-sectional examination of associations between problem sports betting and indices of hazardous alcohol use and negative alcohol-related consequences, and whether associations were moderated by same-day drinking and sports betting. Method. The sample comprised 221 young adults aged 18-29 with representation from 36 different states in the U.S. (Mage =24.4; 77.7% male; 64.6% white). Eligibility criteria included betting on sports at least twice in the past month. Results. Zero truncated negative binomial hurdle models revealed that problem sports betting scores were significantly associated with hazardous alcohol use (i.e. AUDIT scores) for those who drank at least once in the past 3-months. Problem sports betting was also associated with any (vs. no) negative alcohol-related consequences, as well as number of negative consequences young adults experienced. Both count models were moderated by same-day drinking and sports betting such that positive associations were amplified among those who more frequently drank and bet on sports on the same day. Conclusions. Findings provide early-stage evidence for a link between problem sports betting and alcohol-related problems among young adults, especially those who more frequently engage in both behaviors within the same timeframe. These results highlight the need for more research on sports betting from a public health lens as the prevalence of this addictive behavior continues to rise.

Investigating the association between discrimination, internalizing symptoms, and alcohol use among Latino/a immigrants in the United States.

Internalizing symptoms associated with anxiety and depression have been correlated with harmful alcohol use among Latino/as, but little attention has been paid to assessing the association between perceived discrimination and harmful alcohol use. The present study was designed to investigate the association between perceived discrimination, internalizing symptoms associated with anxiety and depression, and harmful alcohol use among Latino/a immigrants living in the United States (US). Our sample included 426 Latino/a immigrants. Their mean age was 40.05 years (SD = 6.50), 65.50% were women, 80.00% had a partner, 54.20% lived on less than $2,000 a month, and 41.50% reported having attained a college degree. Perceived discrimination was assessed using the Perceived Discrimination Scale, anxious symptoms were assessed using the GAD-7, depressive symptoms were assessed using the CES-D short form, and harmful alcohol use was assessed using AUDIT. We estimated a linear regression model using cross-sectional, self-reported data. The model was statistically significant, R 2 = 0.38, F (8, 425) = 32.09, p < 0.01. Discrimination was significantly associated with AUDIT scores, (β = 0.21, p < 0.01) after accounting for covariates and for symptoms of anxiety and depression. Our results indicate that experiences of discrimination in the US are associated with increased harmful alcohol use even after controlling for other variables. These findings may be useful in designing coping interventions specifically for Latino/a immigrants to reduce the risk of alcohol use disorder. This study also has political and public health implications for acknowledging the detrimental health consequences of experiencing discrimination, providing support to the position that reducing racism and discrimination represent important public health priorities.

Tuberculose résistante au Burkina Faso : audit organisationnel et enquête de satisfaction

Drug-resistant tuberculosis is a public health priority and shortcomings in health services can make matters worse. The aim of the study was to carry out an organizational audit inspired by the accreditation standards of the Agence nationale d&#8217;accr&#233;ditation et d&#8217;&#233;valuation en sant&#233; (ANAEH) (French National Agency for Health Accreditation and Assessment) for the management of resistant tuberculosis patients and to determine the level of patient satisfaction in order to identify any failings and possible solutions. The overall audit score was 63.2 percent for the Centre hospitalier universitaire Yalgado Ou&#233;draogo (CHUYO) (Yalgado Ou&#233;draogo University Hospital) and 59.8 percent for the Centre de lutte anti-tuberculose (CLAT) (French Tuberculosis Prevention Center). The problems raised were related to &#8220;intake, equipment, and infrastructure,&#8221; &#8220;patient rights and information,&#8221; and &#8220;management and administration.&#8221; Overall, patients were satisfied with their care. The majority of them noted that the care centers were safe and equipped with toilets that, in addition to improving hygiene, should take account of the specific nature of different illnesses and genders. The patients indicated that their privacy was relatively well respected, but that the quality of the meals provided remains unsatisfactory. Treatment was free, notwithstanding certain paraclinical examinations. Most of the patients and service providers were unaware of the cost of tuberculosis treatment. Non-compliance with treatment, thought to stem from the adverse side effects of anti-tuberculosis drugs, was cited as the main cause of resistance. A number of operational shortcomings exist in the management of patients with resistant tuberculosis, stemming from unfamiliarity with the treatment protocol. The application of the patient-centered approach could allow for the fight against tuberculosis, especially its resistant form, to be waged more effectively.

Neighborhood Walkability Is Associated With Global Positioning System-Derived Community Mobility of Older Adults.

Neighborhood walkability may encourage greater out-of-home travel (ie, community mobility) to support independent functioning in later life. We examined associations between a novel walkability audit index and Global Positioning System (GPS)-derived community mobility in community-dwelling older adults. We compared associations with the validated Environmental Protection Agency (EPA) National Walkability Index and further examined moderation by clinical walking speed. Participants were 146 older adults (Mean = 77.0 ± 6.5 years, 68% women) at baseline of a randomized trial to improve walking speed. A walkability index (range: 0-5; eg, land-use mix, crosswalks, and so on) was created using Google Street View audits within 1/8-mile of the home. Participants carried a GPS device for 5-7 days to derive objective measures of community mobility (eg, time spent out of home, accumulated distance from home). Each 1 SD (~1.3-point) greater walkability audit score was associated with a median 2.16% more time spent out of home (95% confidence interval [95% CI]: 0.30-4.03, p = .023), adjusting for individual demographics/health and neighborhood socioeconomic status. For slower walkers (4-m walking speed <1 m/s), each 1 SD greater audit score was also associated with a median 4.54 km greater accumulated distance from home (95% CI: 0.01-9.07, p (interaction) = .034). No significant associations were found for the EPA walkability index. Walkability immediately outside the home was related to greater community mobility, especially for older adults with slower walking speeds. Results emphasize the need to consider the joint influence of local environment and individual functioning when addressing community mobility in older populations.