Current Alcohol Use Research Articles

Association of Alcohol Consumption with Impaired Beta-Cell Function Independent of Body Mass Index Among Indian Men

Heavy alcohol consumption is linked to the development of type 2 diabetes. Alcohol's effects on the function of cells are not completely known at this time. This investigation looked into the relationships that exist between all of these different characteristics. All of the males who participated in this study were of Indian descent, and their ages ranged anywhere from 25 to 80 years old. Participants were categorized as abstainers, teetotalers, light drinkers (drinking between 0.1 and 20 grams of alcohol per day), moderate drinkers (consuming between 21.0 and 40 grams of alcohol per day), or heavy drinkers (consuming more than 41 grams of alcohol per day). Light drinkers consumed between 0.1 and 20 grams of alcohol per day. Moderate drinkers consumed between 21.0 and 40 kilos of alcohol per day. Heavy drinkers used more than 41 grams of alcohol per day. After that, the participants were separated into two groups: those with a body mass index (BMI) of less than 25 kilograms per square meter and those with a BMI of 25 kilograms per square meter or more. A number of parameters, such as age, smoking status, body mass index (BMI), waist circumference, blood pressure, lipids, and serum uric acid levels, were taken into consideration. In comparison to individuals who refrained from alcohol use, those who drank alcohol had a lower HOMA- score, and this was the case independent of their body mass index. In the group with a BMI of less than 25 \(kg/m^{2}\), both past and current alcohol use were substantially connected with HOMA-IR. However, this association was not seen in the group with a BMI of more than 25 \(kg/m^{2}\). According to the results of multiple research, drinking alcohol is associated with -cell dysfunction in boys of Indian heritage, independent of the BMI of the participants in the studies.

CORRELATES OF DENTAL CARE UTILIZATION AMONG US INFORMAL DEMENTIA CAREGIVERS

Abstract Informal dementia caregivers tend to report more negative health impacts from the caregiving role, higher levels of unmet needs, and lower levels of service utilization compared to caregivers of persons with other types of illnesses. There remains a gap in knowledge of understanding unique correlates of dental care utilization among informal dementia caregivers. As guided by the Andersen model, this study examined correlates of dental care utilization among U.S. informal dementia caregivers. Data came from the Behavioral Risk Factor Surveillance System collected in 2016, 2018, and 2020 (n=2,931). Respondents were selected when they reported providing regular care or assistance to a friend or family member who has Alzheimer’s disease, dementia, or other cognitive impairment disorder. Dental care utilization was dichotomized into “yes” versus “no” within the past year. Caregiving-related characteristics included caregiver role (e.g., spouse, adult child, other relative, and friend), intensity of care, duration of care, and type of care. Other correlates included caregiver characteristics, health behaviors, and physical and oral health needs. Findings from stepwise logistic regression models demonstrate that being a spousal caregiver, providing more than 20 hours of care per week, being male, having high school or less education, being low-income, unemployed, current smoker, having no health insurance, no current alcohol use, or less than adequate sleep was associated with a lower likelihood of vising a dentist within the past year. The findings suggest targeting spousal caregivers and those who provide intensive care to improve dental care-seeking behaviors in dementia caregiver support intervention strategies.

Understanding alcohol use and changes in drinking habits among people with a severe mental illness: a qualitative framework analysis study.

Individuals with a severe mental illness (SMI) are more likely to drink at harmful levels or abstain. While it is known that drinking patterns change over time, the reasons for this among those with a SMI are unclear. This study aimed to (i) explore the experiences with alcohol, particularly in relation to mental health symptoms, and (ii) how drinking patterns have changed over time, among individuals who have a SMI diagnosis, who either currently drink alcohol or no longer drink. One-to-one semi-structured telephone interviews were conducted to address the study aims. Current drinkers' alcohol use was assessed using the Alcohol Use Disorder Identification Test. A framework analysis was used to address the study aims with a specific focus on the differences in the experiences with alcohol use between current and former drinkers. 16 participants were interviewed, and five themes were developed. The analysis highlighted how alcohol was increasingly used to cope with (i) trauma, (ii) SMI-related symptoms, or (iii) stress. Among those with a SMI, non-drinking was facilitated through declines in SMI-related symptoms, previous negative consequences due to alcohol and changing the social environment. Current drinking habits were facilitated through changes in the reasons for drinking and adopting different alcohol moderation techniques. Among those with a SMI diagnosis and who either currently drink alcohol or no longer drink, our findings support the self-medication hypothesis and drinking motives model. However, our findings indicate the need for further development of drinking to cope with a focus on symptoms of a SMI and trauma. Our findings also have implications on specialist alcohol and mental health services, the need to improve individuals' understanding of SMI, and the need to identify reasons for drinking among those with a recent diagnosis of a SMI.

The Relationship between Age at Initiation of Regular Drinking of Alcohol and Viral Suppression Status, and Depression Symptoms Among People Living with HIV in South-Western Uganda

Alcohol use is an important factor in achieving and maintaining viral suppression and optimal mental health among persons with HIV (PWH), however, the effect of age at first regular drinking on viral suppression and depression remains poorly understood. Here, using secondary data from the Alcohol Drinkers’ Exposure to Preventive Therapy for Tuberculosis (ADEPT-T) study, we used logistic regression analyses to explore whether there is an association between age at first regular drinking and viral suppression (< 40 copies/ml), or presence of depressive symptoms (Center for Epidemiologic Studies Depression, CES-D ≥ 16) among 262 PWH. The median age at first regular drinking was 20.5 years (IQR: 10), with high proportions starting under age 12 (12.2%) and as teens (13.4%). The majority had an undetectable viral load (91.7%) and 11% had symptoms of probable depression. We found no significant association between age at first regular drinking and viral suppression (i.e., child (aOR = 0.76 95%CI: 0.18, 3.26), adolescent (aOR = 0.74 95%CI: 0.18, 2.97) and young adult (aOR = 1.27 95%CI: 0.40, 3.97)) nor with depressive symptoms (i.e., child (aOR = 0.72 95%CI: 0.19, 2.83), adolescent (aOR = 0.59 95%CI: 0.14, 2.50) and young adult (aOR = 0.57 95%CI: 0.22, 1.53)). Age at first regular drinking among PWH did not appear to be associated with either viral suppression or the presence of depressive symptoms, suggesting interventions may best be focused on the harmful effects of current alcohol use.

Involuntary sedation of patients in the emergency department for mental health: A retrospective cohort study

BackgroundInvoluntary sedation of agitated mental health patients in the Emergency Department (ED) is standard practice to obtain accurate medical assessments and maintain safety. However, the rate of this practice and what factors are associated with the use of involuntary sedation is unknown. The purpose of this study was to obtain baseline data on involuntary sedation in our EDs. MethodsRetrospective chart review of patients with ED visits for mental health care in 2020–2021. Patients >12 years old who received both a psychiatry consultation and involuntary sedation were included. Data variables included demographics, medical and mental health diagnoses, sedatives given, substance use, ED length of stay, and disposition. The primary outcome was repeated involuntary sedation. ResultsInvoluntary sedation was used in 18.8% of the mental health patients screened for study inclusion. 334 patients were included in the study cohort and 31.6% (n = 106) required repeated involuntary sedation. Their average age was 35.5 ± 13.5 years with 58.4% men, 40.1% women, and 1.2% transgender persons. Most (90.0%, n = 299) had prior mental health diagnoses with the most common being substance use disorder (38.9%, n = 130), bipolar disorder (34.1%, n = 114), depressive disorder (29.0%, n = 97), and schizophrenia (24.3%, n = 81). Two-thirds (65.9%, n = 220) had current substance use and 41.9% (n = 142) reported current use with a chemical associated with aggression. Hospital security was called for 73.1% (n = 244). Current cocaine, methamphetamines, or alcohol use was associated with decreased odds of repeated sedation (0.52 OR, 95% CI 0.32–0.85). Prior mental health diagnosis and non-white race were associated with increased odds of repeated sedation. In the multivariable regression, the effect of race was more significant. ConclusionsInvoluntary sedation was used in 18.8% of ED patients for mental health care and almost a third were repeatedly sedated, with race being a potential risk factor for repeated sedation. ED care could benefit from evidence-based interventions to reduce the need for involuntary sedation.

Prevalence of and factors associated with uncontrolled hypertension among patients with early chronic kidney disease attending tertiary hospitals in Dodoma, Tanzania: a cross-sectional study

ObjectiveTo determine the prevalence of uncontrolled hypertension and its associated factors among patients with early chronic kidney disease (CKD) attending medical outpatient clinics at tertiary hospitals in Dodoma, Tanzania.DesignCross-sectional study.SettingTwo...

P199: Cluster analysis dissecting cognitive deficits in older adults with major depressive disorder and the association between neurofilament light chain

Objectives:Cognitive impairment is a growing problem with increasing burden in ageing global population. Older adults with major depressive disorder (MDD) have higher risk of dementia during ageing. Neurofilament light chain (NfL) has been proven as a potential biomarker related to dementia. The present study aims to assess the cognitive deficits in older adults with MDD and investigate their association with peripheral blood levels of NfL.Design:We enrolled 39 individuals with MDD and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer’s type. Both groups were over age 65 and with restricted Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and cognitive impairment in each domain.Result:In the MDD group, participants have higher rate of family psychiatry history and higher rate of current alcohol use habit compared with patients with neurocognitive disorders. In the neurocognitive disorders group, participants showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits similar to that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster.Conclusion:We noted the negative correlation between NfL levels and cognitive performance in MDD patients whose cognitive manifestation were more similar to that of degenerative neurocognitive disorders. NfL might be a potential marker to predict patients with MDD to develop cognitive decline especially in domains typically found in Alzheimer’s disease. Further longitudinal studies are required to validate our findings for clinical implications.

Associations of history of intimate partner violence with mental ill-health and lifestyle factors in middle-aged and older men and women in South Africa

ObjectivesThe aim of this study was to assess the association between history of intimate partner violence (IPV) exposure and mental and lifestyle factors among middle-aged and older men and women in rural South Africa. MethodsThe analysis utilized data from wave 3 of the longitudinal Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (n = 3,707, median age 66 years, range 46–118 years). History of IPV was assessed with five questions on physical, sexual, psychological, and economic IPV. Logistic regression was used to assess the association between history of IPV exposure and mental and lifestyle factors. ResultsAmong men 7.8% and among women 10.9% reported a history of IPV. In terms of mental health outcomes, in the final adjusted model, among men, exposure to 1 and/or 2–4 types of IPV were associated with depressive symptoms, insomnia symptoms, PTSD, and loneliness, while among women, exposure to 1 and/or 2–4 types of IPV was associated with insomnia symptoms and PTSD. In terms of lifestyle outcomes, in the final adjusted model, among men, 2–4 types of IPV were associated current tobacco use, current heavy alcohol use, inadequate fruit intake, and food insecurity, and among women, 1 and/or 2–4 types of IPV were associated with soft drink intake, and food insecurity. ConclusionWe found that lifetime exposure to IPV was associated with several mental and lifestyle factors in middle-aged and older men and women. Enhanced screening and treatment of IPV may reduce poor mental and health risk behavior among this aging male and female population in South Africa.

The associations of parental smoking, quitting and habitus with teenager e-cigarette, smoking, alcohol and other drug use in GUI Cohort ’98

We analyse parental smoking and cessation (quitting) associations with teenager e-cigarette, alcohol, tobacco smoking and other drug use, and explore parental smoking as a mechanism for social reproduction. We use data from Waves 1–3 of Growing Up in Ireland (Cohort ’98). Our analytic sample consisted of n = 6,039 participants reporting in all 3 Waves. Data were collected in Waves 1 and 2 when the children were 9 and 13 years old and in Wave 3 at age 17/18 years. Generalized Estimating Equations (GEE) models were used to analyse teenage substance use at Wave 3. Parental smoking was associated with significantly increased risk of all teenage substance use, adjusted odds ratios were aOR2.13 (ever e-cigarette use); aOR1.92 (ever alcohol use); aOR1.88 (current alcohol use); aOR1.90 (ever use of other drugs); aOR2.10 (ever-smoking); and aOR1.91 (current smoking). Primary caregiver smoking cessation (quitting) was associated with a lower risk for teenager current smoking aOR0.62, ever e-cigarette use aOR 0.65 and other drug use aOR 0.57. Primary caregiver smoking behaviour had greater associations than secondary, and age13 exposure more than age 9. Habitus seems to play a role and wealth was protective for teenage smoking. The findings suggest that prevention interventions should target both caregivers and their children.

College Students' Day-to-Day Maladaptive Drinking Responses to Stress Severity and Stressor-Related Guilt and Anger.

Stress is a common part of college students' daily lives that may influence their physical activity (PA) and alcohol use. Understanding features of daily stress processes that predict health behaviors could help identify targets for just-in-time interventions. This study used intensive longitudinal data to examine whether prior day stress processes predict current day PA or alcohol use. Participants (N=58, Mage=20.5, 59% women, 70% White) were 18-to-25-year-old students who engaged in binge drinking at least twice monthly and used cannabis or tobacco in the past year. They wore activity (activPAL4) and alcohol (Secure Continuous Remote Alcohol Monitor) monitors for 11 days to assess daily PA (e.g., step counts) and alcohol use (e.g., drinking day), and completed daily surveys about yesterday's stress, including number of stressors (i.e., frequency), stressor intensity (i.e., severity), and frequency of affective states (e.g., guilt). Multilevel models examined prior day stress predicting current day PA or alcohol use. Participants had higher odds of current day drinking (odds ratio=1.21) and greater area under the curve (B=0.08) when they experienced greater than usual stress severity the prior day. Participants had higher current day peak transdermal alcohol concentration (B=0.12) and area under the curve (B=0.11) when they more frequently experienced guilt due to stressors the prior day. College students' unhealthy response of increasing alcohol use due to stress could adversely impact health outcomes. There is a critical need for interventions addressing students' ability to effectively manage and respond to the stress-inducing, daily demands of student life.

Financial incentives for reduced alcohol use and increased isoniazid adherence during tuberculosis preventive therapy among people with HIV in Uganda: an open-label, factorial randomised controlled trial

Alcohol use is common among people with HIV and is a risk factor for tuberculosis disease and non-adherence to isoniazid preventive therapy (IPT). Few interventions exist to reduce alcohol use and increase IPT adherence in sub-Saharan Africa. The aim of this study was to test the hypothesis that financial incentives conditional on point-of-care negative urine alcohol biomarker testing and positive urine isoniazid testing would reduce alcohol use and increase isoniazid adherence, respectively, in people with HIV who have latent tuberculosis infection and hazardous alcohol use. We conducted an open-label, 2×2 factorial randomised controlled trial in Uganda. Eligible for the study were non-pregnant HIV-positive adults (aged ≥18 years) prescribed antiretroviral therapy for at least 6 months, with current heavy alcohol use confirmed by urine ethyl glucuronide (biomarker of recent alcohol use) and a positive Alcohol Use Disorders Identification Test-Consumption (AUDIT-C; ≥3 for women, ≥4 for men) for the past 3 months' drinking, no history of active tuberculosis, tuberculosis treatment, or tuberculosis preventive therapy, and a positive tuberculin skin test. We randomly assigned participants (1:1:1:1) initiating 6 months of IPT to: no incentives (group 1); or incentives for recent alcohol abstinence (group 2), isoniazid adherence (group 3), or both (group 4). Escalating incentives were contingent on monthly point-of-care urine tests negative for ethyl glucuronide (groups 2 and 4), or positive on IsoScreen (biomarker of recent isoniazid use; groups 3 and 4). The primary alcohol outcome was non-hazardous use by self-report (AUDIT-C <3 for women, <4 for men) and phosphatidylethanol (PEth; past-month alcohol biomarker) <35 ng/mL at 3 months and 6 months. The primary isoniazid adherence outcome was more than 90% bottle opening of days prescribed. We performed intention-to-treat analyses. This trial is registered with ClinicalTrials.gov (NCT03492216), and is complete. From April 16, 2018, to Aug 2, 2021, 5508 people were screened, of whom 680 were randomly assigned: 169 to group 1, 169 to group 2, 170 to group 3, and 172 to group 4. The median age of participants was 39 years (IQR 32-47), 470 (69%) were male, 598 (90%) of 663 had HIV RNA viral loads of less than 40 copies per mL, median AUDIT-C score was 6 (IQR 4-8), and median PEth was 252 ng/mL (IQR 87-579). Among 636 participants who completed the trial with alcohol use endpoint measures (group 1: 152, group 2: 159, group 3: 161, group 4: 164), non-hazardous alcohol use was more likely in the groups with incentives for alcohol abstinence (groups 2 and 4) versus no alcohol incentives (groups 1 and 3): 57 (17·6%) of 323 versus 31 (9·9%) of 313, respectively; adjusted risk difference (aRD) 7·6% (95% CI 2·7 to 12·5, p=0·0025). Among 656 participants who completed the trial with isoniazid adherence endpoint measures (group 1: 158, group 2: 163, group 3: 168, group 4: 167), incentives for isoniazid adherence did not increase adherence: 244 (72·8%) of 335 in the isoniazid incentive groups (groups 3 and 4) versus 234 (72·9%) of 321 in the no isoniazid incentive groups (groups 1 and 2); aRD -0·2% (95% CI -7·0 to 6·5, p=0·94). Overall, 53 (8%) of 680 participants discontinued isoniazid due to grade 3 or higher adverse events. There was no significant association between randomisation group and hepatotoxicity resulting in isoniazid discontinuation, after adjusting for sex and site. Escalating financial incentives contingent on recent alcohol abstinence led to significantly lower biomarker-confirmed alcohol use versus control, but incentives for recent isoniazid adherence did not lead to changes in adherence. The alcohol intervention was efficacious despite less intensive frequency of incentives and clinic visits than traditional programmes for substance use, suggesting that pragmatic modifications of contingency management for resource-limited settings can have efficacy and that further evaluation of implementation is merited. National Institute on Alcohol Abuse and Alcoholism. For the Runyankole translation of the abstract see Supplementary Materials section.

Abstract 16854: Successful Retention of Vulnerable Populations in New York City: The BETTER-BP Randomized Trial

Introduction: Clinical trial retention in safety-net practices is challenging. To better understand reasons for loss to follow-up, we analyzed data from an ongoing clinical trial in the NYC public hospital system. Methods: We analyzed the first 185 participants enrolled in the BETTER-BP study, an ongoing randomized trial of wireless antihypertensive medication adherence monitoring with a financial incentive lottery to promote medication taking behavior. BETTER-BP enrolls participants from two NYC public hospitals (Bellevue and Gouverneur) and follow-up lasts 12 months. We reported the rate of loss to follow-up at 12 months and assessed baseline characteristics (age, sex, race, ethnicity, insurance status, BMI, blood pressure, comorbidities, and substance use) of those lost vs. retained. ANOVA was used for continuous variables, and the Chi-squared test for categorical variables. Results: Median age was 55.0 (47.5, 62.5) years, 59% were female, 59% Hispanic, and 26% Non-Hispanic Black. Three quarters were Medicaid-insured or uninsured. There were 155 participants retained at 12 months (83.8% retention rate). Characteristics of those retained vs. lost to follow-up are shown in the Table. Participants who were lost to follow-up were more likely to report current alcohol use (43.3% vs. 36.8%, p &lt; 0.001) and illicit substance use (16.7% vs. 3.9%, p &lt; 0.001). Notably, missingness in alcohol use and illicit substance use was also higher among those lost to follow up. Other baseline characteristics were similar between the two groups. Conclusion: Overall retention was high (&gt;80%). Alcohol and illicit drug use were associated with loss to follow up and may serve as markers for future strategies to mitigate attrition.

Food desert residence has limited impact on veteran fecal microbiome composition: a U.S. Veteran Microbiome Project study.

Social and economic inequities can have a profound impact on human health. The inequities could result in alterations to the gut microbiome, an important factor that may have profound abilities to alter health outcomes. Moreover, the strong correlations between social and economic inequities have been long understood. However, to date, limited research regarding the microbiome and mental health within the context of socioeconomic inequities exists. One particular inequity that may influence both mental health and the gut microbiome is living in a food desert. Persons living in food deserts may lack access to sufficient and/or nutritious food and often experience other inequities, such as increased exposure to air pollution and poor access to healthcare. Together, these factors may confer a unique risk for microbial perturbation. Indeed, external factors beyond a food desert might compound over time to have a lasting effect on an individual's gut microbiome. Therefore, adoption of a life-course approach is expected to increase the ecological validity of research related to social inequities, the gut microbiome, and physical and mental health.

Sexual Orientation and Gender Identity Reporting in Highly Cited Current Alcohol Research.

Purpose: This study aimed to measure the frequency of high-quality and transparent sexual orientation and gender identity (SOGI) data collection and reporting in highly cited current alcohol use research, using the extant literature to identify community-informed priorities for the measurement of these variables. Methods: A single search to identify alcohol use literature was conducted on PubMed with results restricted to primary research articles published between 2015 and 2022. The 200 most highly cited studies from each year were identified and their titles and abstracts reviewed against inclusion criteria after deduplication. After full-text review, study characteristics and data indicating quality of SOGI reporting were extracted. The fidelity of the results was verified with a random sample before analyses. Results: The final sample comprised 580 records. Few studies reported gender identity (n = 194; 33.4%) and, of these, 7.2% reported the associated gender identity measure. A two-stage approach to measure gender was adopted in 3 studies, one study used an open-ended question with a free-text response option, and 13 studies recorded nonbinary gender identities (reported by 0.9% of the whole sample). Nineteen (3.3%) studies reported sexual orientation and more than half of these provided the sexual orientation measure. Eight of the 20 studies that reported sexual orientation and/or gender identity measures were classified as sexual and gender minority specialist research. Conclusions: Culturally competent SOGI reporting is lacking in highly cited current alcohol research. SOGI measures should be disclosed in future research and should provide free-text response options.

Uncontrolled Hypertension, Treatment, and Predictors among Hypertensive Out-Patients Attending Primary Health Facilities in Johannesburg, South Africa.

Hypertension is a poorly controlled risk factor for cardiovascular disease in South Africa, particularly among patients receiving care in the public sector who are mostly from low socioeconomic backgrounds. This cross-sectional study investigated uncontrolled hypertension, treatment, and predictors among hypertensive out-patients attending primary health care facilities in Johannesburg, South Africa. The WHO STEPwise approach to the surveillance of non-communicable diseases was used to collect data, including sociodemographic and lifestyle factors, health status, and measurements for anthropometry and blood pressure along with self-reported adherence to treatment, estimated through the general medication adherence scale. Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg in diagnosed patients receiving anti-hypertensive treatment. Overweight and obesity were defined as a body mass index ≥25 and ≥30 kg/m2, respectively. Logistic regression models were used to assess the predictors of uncontrolled hypertension. Four hundred (n = 400) hypertensive out-patients (mean age: 50 ± 8 years) participated in this study, with most living in poor sociodemographic environments. The prevalence rate of uncontrolled hypertension was 57%. Obesity (62% vs. 42%, p ≤ 0.0001), salt consumption (90% vs. 55%, p ≤ 0.0001), alcohol intake (42% vs. 19%, p ≤ 0.0001), a smoking habit (23% vs. 4%, p ≤ 0.0001), alternative medicine use (51% vs. 40%, p = 0.043), and comorbidities (64% vs. 36%, p ≤ 0.0001) were higher in the uncontrolled group than the controlled group, whereas the prevalence of physical activity (38% vs. 15%, p ≤ 0.0001) was high in the controlled group vs. the uncontrolled. Overall, 85% of the patients moderately adhered to treatment, only 2% exhibited high adherence, and 13% demonstrated low adherence; over half of the patients received tri-therapy treatment. The predictors of uncontrolled hypertension are a number of prescribed antihypertensive therapies [adjusted odds ration = 2.39; 95% confidence interval: 1.48-3.87], treatment adherence [0.46; 0.21-0.97], salt consumption [28.35; 7.87-102.04], physical activity [0.22; 0.13-0.37], current alcohol use [2.10; 1.22-3.61], and current cigarette smoking [4.79; 1.88-12.18]. The high prevalence of uncontrolled hypertension in this study suggests a need to optimize prescriptions, adherence to BP-lowering medications, and lifestyle modifications. The management of comorbidities such as diabetes could offer considerable benefits in controlling blood pressure.

Risk Assessment Score and Chi-Square Automatic Interaction Detection Algorithm for Hypertension Among Africans: Models From the SIREN Study.

This study aimed to develop a risk-scoring model for hypertension among Africans. In this study, 4413 stroke-free controls were used to develop the risk-scoring model for hypertension. Logistic regression models were applied to 13 risk factors. We randomly split the dataset into training and testing data at a ratio of 80:20. Constant and standardized weights were assigned to factors significantly associated with hypertension in the regression model to develop a probability risk score on a scale of 0 to 1 using a logistic regression model. The model accuracy was assessed to estimate the cutoff score for discriminating hypertensives. Mean age was 59.9±13.3 years, 56.0% were hypertensives, and 8 factors, including diabetes, age ≥65 years, higher waist circumference, (BMI) ≥30 kg/m2, lack of formal education, living in urban residence, family history of cardiovascular diseases, and dyslipidemia use were associated with hypertension. Cohen κ was maximal at ≥0.28, and a total probability risk score of ≥0.60 was adopted for both statistical weighting for risk quantification of hypertension in both datasets. The probability risk score presented a good performance-receiver operating characteristic: 64% (95% CI, 61.0-68.0), a sensitivity of 55.1%, specificity of 71.5%, positive predicted value of 70.9%, and negative predicted value of 55.8%, in the test dataset. Similarly, decision tree had a predictive accuracy of 67.7% (95% CI, 66.1-69.3) for the training set and 64.6% (95% CI, 61.0-68.0) for the testing dataset. The novel risk-scoring model discriminated hypertensives with good accuracy and will be helpful in the early identification of community-based Africans vulnerable to hypertension for its primary prevention.

Electronic cigarette use and cigarette smoking associated with inadequate sleep duration among U.S. young adults

ObjectiveNicotine use can influence inadequate sleep, but less is known about the associations of exclusive and dual use of electronic cigarettes (e-cigarettes) with combustible cigarettes in U.S. young adults. This study assessed the associations between current exclusive e-cigarette use, exclusive cigarette smoking, and dual e-cigarette and combustible cigarette use and inadequate sleep duration among U.S. young adults. MethodsWe performed a secondary analysis of 2020 Behavioral Risk Factor Surveillance System (BRFSS) data including 13,978 U.S. young adults ages 18–24 years. Inadequate sleep duration was assessed categorically using the National Sleep Foundation's age-specific recommendations that define <7 h as inadequate sleep. Weighted logistic regression models were performed while adjusting for participants' sex, race/ethnicity, education level, annual household income level, body mass index, current physical activity, mental health status, disability status, current alcohol use, and current smokeless tobacco use. ResultsConcerning use patterns, 11.8% of young adults were exclusive e-cigarette users, 4.7% were exclusive cigarette smokers, and 3.8% were dual e-cigarette and combustible cigarette users. Exclusive e-cigarette users (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.16–1.72), exclusive cigarette smokers (AOR = 1.63, 95%CI = 1.22–2.18), and dual product users (AOR = 2.03, 95%CI = 1.44–2.86) were at increased odds of having inadequate sleep duration compared to non-users, while adjusting for the covariates. Additionally, dual product users were at increased odds (AOR = 1.52, 95%CI = 1.06–2.19) of reporting inadequate sleep duration compared to exclusive e-cigarette users, while adjusting for the covariates. ConclusionsCurrent e-cigarette and cigarette use may influence inadequate sleep among U.S. young adults. Tobacco cessation efforts may encourage increased sleep health.

Suicide ideation and behavior and ATOD use among bisexual high school students

ABSTRACT Background Research has indicated that sexual minorities have higher prevalence rates for ATOD use and suicide ideation and behavior compared to heterosexual youth. Yet, most studies to date have combined gay, lesbian, and bisexuals into one category. This study sought to assess the uniqueness of bisexuality to assess the risk of ATOD use and suicide ideation and behavior among bisexual high school students. Methods Data for this study were derived from the 2019 Centers for Disease Control’s Youth Risk Behavior Survey (YRBS). Chi-square analysis was conducted to determine the prevalence of ATOD use and suicide ideation and behavior. Logistic regression was then used to estimate the association between ATOD use and suicide ideation and behavior among bisexual adolescents. Results This study found that ever use an electronic vape product, non-medical use of prescription drugs, and current alcohol and marijuana use were significant predictors for suicide ideation and behavior. Conclusions Based on our results, we believe that it is important to address the relationship of substance use as a risk factor for suicide and ideation and behavior of bisexual adolescents, as bisexual adolescents may need more emotional support as they come to understand their sexual identity.

Effects of current alcohol use on brain volume among older adults in the Gothenburg H70 Birth Cohort study 2014–16

Brain gray- and white matter changes is well described in alcohol-dependent elderly subjects; however, the effect of lower levels of alcohol consumption on the brain is poorly understood. We investigated the impact of different amounts of weekly alcohol consumption on brain structure in a population-based sample of 70-year-olds living in Gothenburg, Sweden. Cross-sectional data from 676 participants from The Gothenburg H70 Birth Cohort Study 2014–16 were included. Current alcohol consumers were divided into seven groups based on self-reported weekly amounts of alcohol consumption in grams (g) (0–50 g/week, used as reference group, 51–100 g/week, 101–150 g/week, 151–200 g/week, 201–250 g/week, 251–300 g/week, and > 300 g/week). Subcortical volumes and cortical thickness were assessed on T1-weighted structural magnetic resonance images using FreeSurfer 5.3, and white matter integrity assessed on diffusion tensor images, using tract-based statistics in FSL. General linear models were carried out to estimate associations between alcohol consumption and gray- and white matter changes in the brain. Self-reported consumption above 250 g/week was associated with thinning in the bilateral superior frontal gyrus, the right precentral gyrus, and the right lateral occipital cortex, in addition to reduced fractional anisotropy (FA) and increased mean diffusivity (MD) diffusively spread in many tracts all over the brain. No changes were found in subcortical gray matter structures. These results suggest that there is a non-linear relationship between alcohol consumption and structural brain changes, in which loss of cortical thickness only occur in non-demented 70-year-olds who consume more than 250 g/week.

Marital status, marital transition and health behaviour and mental health outcomes among middle-aged and older adults in Thailand: A national longitudinal study

ObjectivesThe aim of this study was to assess the longitudinal association between marital status, marital transition, mental ill-health, and health risk behaviours among middle-aged and older adults in Thailand. MethodsWe analyzed prospective cohort data of participants 45 years and older from three consecutive waves in 2015, 2017, and in 2020 (analytic sample, n = 2863) of the Health, Aging and Retirement in Thailand (HART) study. Sociodemographic and health variables were assessed by self-report. ResultsBeing single was positively associated with current smoking among men and transitioning to widowed or divorced was associated with incident current smoking among women. Divorced or separated was positively associated with current alcohol use among men and transitioning to marriage was associated with incident alcohol use among women.Being single or widowed was positively associated with underweight and negatively associated with obesity among women. Men who were divorced, single, or widowed had higher odds of having depressive symptoms and among women, transitioning to being widowed or divorced or separated was associated with incident depressive symptoms. Among both men and women, being divorced, single or widowed were positively associated with poor quality of life/happiness, and among men being divorced, single or widowed was positively associated with loneliness, and among women, being single or widowed was positively associated with loneliness. Among men, being single was positively associated with having an emotional or psychiatric disorder. ConclusionWe found among men and/or women that being unmarried was associated with several health risk behaviours and mental-ill health indicators.