Current Alcohol Users Research Articles

Prevalence of post-traumatic stress disorder and associated factors among police officers in Central Gondar Zone, North West Ethiopia, 2023: institutional-based cross-sectional study.

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that follows exposure to a traumatic or stressful life event. Police officers are exposed to a number of traumatic events that put them at risk of developing post-traumatic stress disorder. Previous studies have found the prevalence of post-traumatic stress disorder among police officers to be varied and inclusive. However, in Ethiopia, little is known about the prevalence of post-traumatic stress disorder and associated factors among police officers. Therefore, assessing the prevalence and associated factors of post-traumatic stress disorder among police officers might have a plausible role in future investigations. The aim of this study was to assess the prevalence of post-traumatic stress disorder and associated factors among police officers in Central Gondar Zone, North West Ethiopia, 2023. An institutional-based cross-sectional study was conducted in Central Gondar Zone by using self-administered and semi-structured questionnaires. A multi-stage cluster sampling technique was employed to select a sample of 634 participants. Post-traumatic stress disorder was assessed using the PTSD Checklist DSM-5. The collected data were coded and entered using Epi data Software version 4.6.02 and then exported to STATA version 14 for analysis. Bivariable and multivariable logistic regression analyses were done to identify factors associated with post-traumatic stress disorder. Statistically significant results were declared at a 95% confidence interval (CI) of a p-value less than 0.05. The prevalence of post-traumatic stress disorder was found to be 15.2%, with a 95% CI of 12.5% to 18.3%. In the multivariate analysis, female (AOR = 3.36, 95% CI 1.95-5.78), being directly exposed to traumatic events (AOR = 2.01, 95% CI 1.16-3.48), current alcohol use (AOR = 2.90, 95% CI 1.65-5.12), and having poor social support (AOR = 4.25, 95% CI 1.58-11.36) were factors significantly associated with post-traumatic stress disorder. According to this study, police officers suffered from a significant burden of post-traumatic stress disorder. Female sex, police personnel directly exposed to traumatic events, current alcohol users, and those who had poor social support were found to be strongly associated with post-traumatic stress disorder. Therefore, early detection and intervention are crucial to mitigating the overall problem.

Uncontrolled hypertension among adult patients at ambulatory primary care: Frequency and factors associated in urban and peri-urban Bobo–Dioulasso, Burkina Faso

IntroductionThis study described the different stages of uncontrolled hypertension, and assessed independently of the socio-demographic parameters, the non-modifiable and modifiable factors associated with uncontrolled hypertension at ambulatory care, in urban and peri-urban primary health care centres (PHCCs) of Bobo–Dioulasso, Burkina Faso. MethodsA sample of 380 hypertensive adults were consecutively interviewed from January to February 2022, in 20 public PHCCs, in Bobo-Dioulasso. Sociodemographic, non- and modifiable lifestyle, anthropometric and blood pressure parameters were collected. Descriptive, comparative and logistic regression tests were performed. ResultsThe participants’ mean age was 56.2 ± 10.4 years and frequency of uncontrolled hypertension stage I, II and III was respectively 40.3 %, 23.3 % and 7.9 %. Those with family history of hypertension was 42.4 %. Participants with monotherapy, bi-therapy and tri-therapy represented 51.6 %, 42.6 % and 2.1 % respectively, while 38.2 % declared to be uncompliant with the therapy. About 36 % were current alcohol users, 29.7 % physically inactive, 23.7 % ate less than three servings of fruits and vegetables (FV), 15.3 % were obese, and 12.9 % current tobacco users. In logistic regression analysis, the presence of family history of hypertension [adjusted odds ratio (aOR) = 2.1; p = 0.005], use of bi-/tri-therapy (aOR = 1.7; p = 0.044), daily intake of less than three FV servings (aOR = 1.9; p = 0.025); non-adherence with therapy (aOR = 3.3, p = 0.0001) and obesity (aOR = 4.5; p = 0.003) were associated with uncontrolled hypertension. ConclusionUncontrolled hypertension was high at ambulatory primary care. For its efficient management in secondary prevention, a tailored in-hospital strategy including permanent education for a healthier lifestyle practice is needed; and should be complementary strengthened with specific community-based interventions.

Alcohol use and its associated factors among Ethiopian military personnel

BackgroundStudies indicate that alcohol use is more prevalent in the military and that such use is related to coping mechanisms for stress. Alcohol use could result in health and social...

Non-communicable diseases and its risk factors among the transgender population in Kerala: a cross-sectional study

BackgroundNon-communicable diseases (NCDs) are high on the priority list of the Kerala government, and exploring the extent to which transgender and gender diverse (TGD) community members benefit from the services of national programmes for NCDs can provide valuable insights on improving the inclusivity of the health system as it moves towards Universal Health Coverage. This study was conducted to explore the prevalence of NCD risk factors as well as facilitators and barriers to NCD management among the TGD population in Kerala.MethodsA multiple methods study, including a cross-sectional survey of 120 self-identifying TGD people that included an adaptation of the WHO STEPS questionnaire, as well as in-depth interviews with thirteen individuals, was conducted in three districts of Kerala to explore the barriers and facilitators to NCD prevention and management.ResultsThe results are presented using the key dimensions emerging out of the Diederichsen framework. A range of discrimination faced by TGD people in Kerala traps them in situations of low educational outcomes with consequent disadvantages in the job market when they search for livelihoods. This results in a large proportion of our sample living away from families (69 percent), and finding themselves in precarious jobs including sex work (only 33 percent had a regular job), with all these aforementioned factors converging to marginalise their social position. This social position leads to differential risk exposures such as increased exposure to modifiable risk factors like alcohol (40 percent were current alcohol users) and tobacco use (40.8 percent currently used tobacco) and ultimately metabolic risk factors too (30 and 18 percent were hypertensive and diabetic respectively). Due to their differential vulnerabilities such as the discrimination that TGD people are subjected to (41.7 percent had faced discrimination at a healthcare centre in the past one year), those with higher exposure to risk factors often find it hard to bring about behavioural modifications and are often not able to access the services they require.ConclusionsThe disadvantaged social position of TGD people and associated structural issues result in exacerbated biological risks, including those for NCDs. Ignoring these social determinants while designing health programmes is likely to lead to sub-optimal outcomes.

Association between tobacco and alcohol consumption behavioral variation and healthcare expenses among Chinese older adults

ABSTRACT Previous studies have identified associations between tobacco/alcohol consumption behaviors and healthcare expenses globally. Knowledge related to Chinese older adults, however, remains limited. This study examined the associations of tobacco and alcohol consumption behavioral variation with both outpatient and inpatient healthcare expenses among Chinese older adults. Drawing upon three waves of the Chinese Longitudinal Healthy Longevity Survey (2011–2012, 2014, and 2018), propensity score matching and ordered logistic regression served as the primary statistical analyses. Current smokers had lower odds of inpatient healthcare expenses than did non-current smokers (adjusted odds ratio [AOR] = 0.88, 95% CI: 0.78, 0.99; p < 0.05). Former smokers had higher odds of reporting both outpatient and inpatient healthcare expenses, compared with non-former smokers (all p < 0.05). Current alcohol users were less likely to report having both outpatient and inpatient healthcare expenses than non-former alcohol users (all p < 0.01). Former alcohol consumers had higher odds of reporting outpatient healthcare expenses than non-former alcohol consumers (AOR = 1.22, 95% CI: 1.09, 1.37; p < 0.01). Counterintuitive evidence should be carefully interpreted regarding implications for policymaking. Public health interventions should focus on the mechanisms underlying these associations between smoking/alcohol consumption behaviors and healthcare expenses among Chinese older adults.

Factors Associated With Abstinence Among Young Adult Smokers Enrolled in a Real-world Social Media Smoking Cessation Program.

Social media platforms are promising to provide smoking cessation support. This study aimed to identify baseline factors associated with cigarette smoking abstinence among young adult smokers enrolled in a real-world social media-based smoking cessation program. We analyzed data from young adult smokers (aged 18-30 years) participating in a publicly available Facebook-based smoking cessation program serving the San Francisco Bay Area. The analytic sample consisted of 248 participants who completed both the baseline and follow-up surveys at 3 months. Multivariable logistic regression analysis determined baseline factors significantly associated with self-reported 7-day cigarette smoking abstinence at 3 months. Participants were race/ethnically diverse, well-educated, and 47.6% reported LGB + sexual identity. Those who reported dual use of cigarettes and e-cigarettes in the past 30 days (vs. cigarette use only), current alcohol users (vs. non-users), and those aged 25-30 years (vs. 18-24 years) were significantly less likely to report 7-day abstinence at 3 months. Non-daily smokers (vs. daily smokers) and those with high desire to quit smoking (vs. low to moderate desire) were more likely to report abstinence. Results also showed reduction in the percentage of e-cigarette and other tobacco product use among participants. Social media interventions may be more effective for young adult non-daily smokers and those with high desire to quit smoking. Smoking cessation programs may help reduce use of other tobacco products among treatment-seeking smokers. Smoking cessation interventions for young adults need to explicitly address dual use of cigarettes and e-cigarettes and use of alcohol. Findings of this study highlight the need for future interventions to address dual use of cigarettes and e-cigarettes and use of alcohol to improve cigarette smoking abstinence outcomes. The reduction in the use of other tobacco products among program participants indicates that social media smoking cessation programs may exert a broader positive influence on overall tobacco consumption. The large number of LGB+ smokers participating in the program suggests social media is a promising cessation channel for this hard-to-reach group, warranting further study.

Lifestyle factors, viral hepatitis, and hepatocellular carcinoma in Uganda.

571 Background: The effect of lifestyle factors, namely alcohol use, cigarette smoking, and other forms of tobacco use on hepatocellular carcinoma (HCC) remains unclear. We assessed the independent associations of lifestyle factors with HCC among individuals with and without viral hepatitis. Methods: In a hospital-based case-control study recruiting from Mulago and Lacor hospitals in Uganda from March 2015 to August 2021, HCC cases were confirmed by clinical and ultrasound criteria, with biochemical and pathology confirmation on a subset. Controls were frequency matched by age and sex and from the same hospitals. Demographic, clinical and lifestyle data were collected using standardized instruments. Alcohol content of local drinks was standardized, and intensity categorized as light, moderate, or heavy based on CDC definitions. We analyzed alcohol (use status (current, former, never), duration (years), frequency (drinks/week)), cigarette smoking (status (current, former, never), cumulative (pack‐years), duration (years), intensity (cigarettes/day), and time since cessation), other tobacco use (tobacco chewing and pipe-smoking), and viral hepatitis (HBV surface antigen (HBsAg) and HCV antibody (HCVAb)). We used logistic regression models (Stata 18.0) to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CIs) controlling for age, sex, family history of HCC, socioeconomic status, and Schistosomiasis (urine Circulating Cathodic Antigen (CCA)). Stratified analyses were performed separately by HBV and HCV status. Results: Among 596 HCC cases and 1,277 controls, the median age (IQR) was 43 (32-56) and 45 (31-54) years, 410 (68.8%) and 832 (65.0%) were males, 460 (24.6%) and 442 (23.7%) current or former alcohol users, 96 (5.1%) and 251 (13.4%) current or former cigarette smokers, and 177 (9.45%) and other tobacco users, respectively. Other tobacco users were more likely to be heavy (⩾10 pack-years) cigarette smokers (aOR=5.10; 95% CI: 2.41-10.79), heavy (&gt;14 drinks/week for males and &gt;7 drinks/week for females) alcohol drinkers (aOR=5.25; 95% CI: 2.84-9.68), farmers (aOR=1.61; 95% CI: 1.01-2.57) and lower socioeconomic status (aOR=3.23; 95% CI: 1.76-5.94). HCC risk was associated with HBV (aOR=18.66; 95% CI: 12.96-27.88), HCV (aOR= 4.03; 95% CI:2.31-7.02), and other tobacco use (aOR=1.86; 95%CI: 1.13-3.08). The observed HCC risk with other tobacco use, and the null associations with heavy alcohol use (aOR= 0.89; 95% CI: 0.60-1.31) and heavy cigarette smoking (aOR=0.74, 95% CI:0.34-1.60), were homogenous by HCV status (positive versus negative), and similarly by HBV status. Conclusions: Viral hepatitis (HBV and HCV), and lifestyle factors (tobacco chewing and pipe-smoking) were strongly associated with HCC. Further research should explore the role of tobacco chewing and pipe-smoking in HCC risk in Uganda and similar settings in Sub-Saharan Africa.

PD-L1 immunohistochemical expression considering HPV status in oropharyngeal squamous cell carcinoma.

This systematic review aims to determine whether the presence of human papillomavirus (HPV) influences the immunohistochemical expression of programmed cell death-1 ligand (PD-L1) in oropharyngeal squamous cell carcinoma (OPSCC). PD-L1 immunohistochemical expression varies in OPSCC, and the presence of HPV is a plausible explanation for this variability. Comprehending these findings is crucial, as high PD-L1 expression in the tumor microenvironment of OPSCC can help identify patient subgroups that could be suitable for immunotherapy. Therefore, a systematic review was conducted following PRISMA guidelines (CRD42023437800). An electronic literature search was performed without time or language restrictions. The search included PubMed/MEDLINE, Embase, Scopus, Web of Science, https://clinictrials.gov, and relevant journals. A meta-analysis was performed using RStudio. Fourteen studies involving 1,629 participants were included. The sample consisted predominantly of males (81.26%) with a mean age of 58.3 years. Concerning clinical and pathological characteristics, the most frequently described anatomical location was the tonsils (68.54%), and most participants were either current or former smokers (78%) and alcohol users (79%). Advanced TNM IV was the most common stage. Regarding histopathological characteristics, HPV 16 was the only type mentioned, and half of the cases were detected through immunohistochemistry. The SP142 clone (35.7%) and the pattern of membrane immunostaining in tumor cells (71%) were the most commonly employed methods. The most prevalent findings were positive expression of PD-L1 (64.28%) and negative HPV status (57.14%). The association between PD-L1 positivity and HPV positivity (78.57%) was confirmed by meta-analysis. The conclusion was that HPV-positive status has an impact on immunohistochemical expression of PD-L1 in OPSCC.

The Joint Effect of Education and Alcohol Use on 100% Alcohol-attributable Hospitalization or Death in Canada.

Individuals with low socioeconomic position (SEP) experience disproportionately greater alcohol-attributable harm than individuals with high SEP despite similar or less alcohol use (i.e., the alcohol harm paradox). We examined the sex/gender- specific independent and joint effects of education and heavy drinking or volume of alcohol use on 100% alcohol-attributable hospitalization or death. We conducted a cohort study among 199,125 current and former alcohol users aged 15-64 years from population-representative Canadian Community Health Surveys (2000-2008) linked to hospitalization and mortality records through 2017. We estimated the sex/gender-specific associations between education and heavy drinking or volume of alcohol use and incident 100% alcohol-attributable hospitalization or death using multivariable Fine and Gray subdistribution hazard models with competing risk (non-100% alcohol-attributable deaths), assessing additive interactions using the Synergy Index (S). Overall, heavy drinking prevalence and volume of alcohol use were similar or lower in individuals with lower education compared with higher education. Lower education levels compared with a bachelor's degree or above were associated with increased 100% alcohol-attributable hospitalization or death [e.g., less than high school, men: hazard ratio (HR) = 2.78; 95% CI = 2.17, 3.56; women: HR = 2.98; 95% CI = 2.00, 4.44]. We found superadditive joint effects between low education and heavy drinking (men: S = 1.22; 95% CI = 1.14, 1.30; women: S = 1.34; 95% CI = 0.88, 2.04) and low education and higher volume of alcohol use (e.g., excess volume, men: S = 1.30; 95% CI = 1.05, 1.62; women: S = 1.41; 95% CI = 0.77, 2.58), with larger inequities in women than men with similar alcohol use. Our study is consistent with the hypothesis that increased vulnerability to alcohol use among individuals with lower education partially explains the alcohol harm paradox in Canada.

Risk and protective factors for cannabis use among young people - a population based survey

Abstract Background Cannabis is the most commonly used illicit substance in Ireland and globally, with its use most likely to occur in adolescence when the developing brain is more vulnerable to cannabis-related harm. This study aims to ascertain the prevalence of and determine the risk and protective factors for cannabis use among adolescents in the North East of Ireland. Methods This study is a cross-sectional, secondary analysis of the 2021 Planet Youth survey. The population comprised a sample of 4404 adolescents aged 15-16 in Cavan, Monaghan and North Dublin. The outcome of interest was cannabis use in the last 30 days. Independent variables were selected a priori following a literature review. Associations between cannabis use and the independent variables were explored using logistic regression. Results The prevalence of current cannabis use among study participants was 7.3%. The odds of cannabis use were higher among current alcohol users (aOR 2.68, CI 1.79-4.02), smokers (aOR 3.17, CI 2.18-4.60), e-cigarette users (aOR 2.72, CI 1.87-3.96), adolescents who did not perceive its use as harmful (aOR 2.24, CI 1.51-3.32), felt their parents were not against cannabis (aOR 3.71, CI 2.43-5.66), had cannabis-using peers (aOR 9.81, CI 5.76-16.71) or felt peer pressure to use cannabis (aOR 1.91, CI 1.09-3.33). Low parental supervision was associated with higher odds of cannabis use. There was no association between gender and cannabis use. Conclusions This study identified five risk factors and three protective factors associated with cannabis use which can be targeted by policymakers when designing drug prevention strategies.

Khat chewing and associated factors among public secondary school students in Harar town, Eastern Ethiopia: a multicenter cross-sectional study.

Khat is a huge, evergreen tree that grows at high altitudes throughout the Arabian Peninsula and in the region stretching from eastern to southern Africa. Cathinone, cathine, and norephedrine are psychoactive ingredients contained in khat. Ethiopian teenagers, especially those in secondary school, frequently use khat. This use of khat may lead to students frequently missing class and experiencing subpar academic performance. However, the study area lacks information regarding the prevalence of khat use and the factors associated with it. This study's primary goal is to determine the prevalence of khat chewing and related factors among secondary school students in public schools in Harar, Eastern Ethiopia, in 2022. A multicenter cross-sectional study design was employed from June 01-June 30, 2022, in three public secondary schools in Harar town in a sample of 485 students. Systematic random sampling was used to choose the study sample. Data were gathered using self-administered questionnaires, and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess khat chewing. Epidata version 4.6 was used to enter the data, while STATA version 14 was used to analyze them. To determine the factors related to khat chewing, bivariate and multivariate logistic regression analysis was conducted, and statistical significance was determined at a 95% confidence level with a P-value under 0.05. Out of 485 eligible participants, 455 responded to this survey, giving a response rate of 93.8%. Overall, 33.2% (95% CI: 29.2%-37.6%) of the sample's participants reported currently chewing khat. Age ranged from 20 to 25 years (AOR = 2.04; 95% CI: 1.19-3.48), male students (AOR = 7.03; 95% CI: 4.35-12.57), current alcohol user (AOR 6.48; 95% CI: 2.30-18.28), presence of chewer friends (AOR 3.86; 95% CI: 2.38-6.24), and depression (AOR 1.84, 95%CI: 1.02-3.30), were strongly associated with khat chewing at a p-value of < 0.05. Khat chewing was very common among students in Eastern Ethiopia's public secondary schools. Ages between 20 and 25 years, being a male, being current alcohol users, having chewer buddies, and depression are all significantly linked to khat use. Thus, schools should create and implement audience-specific behavioral change communication to deter and stop students from chewing khat. Additionally, it is important to ban the sale of khat to young adults and adolescents, promote medical care for khat users, and foster peer advocacy for support services.

No difference in COVID-19 treatment outcomes among current methamphetamine, cannabis and alcohol users

BackgroundPoor outcomes of COVID-19 have been reported in older males with medical comorbidities including substance use disorder. However, it is unknown whether there is a difference in COVID-19 treatment outcomes between patients who are current cannabis users, excessive alcohol drinkers and those who use a known hazardous stimulant such as methamphetamine (METH).MethodsElectronic medical records (EMR) of COVID-19 patients with current METH (n = 32), cannabis (n = 46), and heavy alcohol use (n = 44) were reviewed. COVID-19 infection was confirmed by positive SARS-CoV-2 PCR test, current drug use was confirmed by positive urine drug testing, and alcohol use was identified by a blood alcohol concentration greater than 11 mg/dl.Multivariate linear regression models as well as the firth logistic regression models were used to examine the effect of substance use group (METH, cannabis, or alcohol) on treatment outcome measures.ResultsA total of 122 patients were included in this analysis. There were no significant differences found between drug groups in regards to key SARS-CoV-2 outcomes of interest including ICU admission, length of stay, interval between SARS-CoV-2 positive test and hospital discharge, delirium, intubation and mortality after adjusting for covariates. About one-fifth (21.9% in METH users, 15.2% in cannabis users, and 20.5% in alcohol users) of all patients required ICU admission. As many as 37.5% of METH users, 23.9% of cannabis users, and 29.5% of alcohol users developed delirium (P = 0.4). There were no significant differences between drug groups in COVID-19 specific medication requirements. Eight patients in total died within 10 months of positive SARS-CoV-2 PCR test. Two patients from the METH group (6.3%), two patients from the cannabis group (4.3%), and four patients from the alcohol group (9.1%) died.DiscussionThe study outcomes may have been affected by several limitations. These included the methodology of its retrospective design, relatively small sample size, and the absence of a COVID-19 negative control group. In addition, there was no quantification of substance use and many covariates relied on clinical documentation or patient self-report. Finally, it was difficult to control for all potential confounders particularly given the small sample size.ConclusionDespite these limitations, our results show that current METH, cannabis, and heavy alcohol users in this study have similar treatment outcomes and suffer from high morbidity including in-hospital delirium and high mortality rates within the first-year post COVID-19. The extent to which co-morbid tobacco smoking contributed to the negative outcomes in METH, cannabis, and alcohol users remains to be investigated.

Cardiovascular Health Practice among Adults in a Municipality in Kathmandu District, Nepal

Background and Aims: Worldwide, cardiovascular diseases lead to the death of around 17.9 million annually in which 85% of those deaths is due to heart attack and stroke. However, most cardiovascular diseases are preventable with modification of behavioural risk factors. Hence, this study was conducted to find out cardiovascular health practice among adults in urban city of Kathmandu.&#x0D; Methods: A cross-sectional study design was used where data was collected through an in-person interview technique among randomly selected 236 adults residing in Budhanilkantha Municipality of Kathmandu District. Semi-structured interview schedule based on WHO Stepwise approach and literature review was used to collect data. Data was analysed using descriptive statistics (frequency, percentage, median, Interquartile Range) and inferences were drawn with an application of the chi-square test.&#x0D; Results: Among 236 samples, the majority (81.8%) of the adults had good practice of cardiovascular health. However, few adults (22%) consumed WHO recommended fruits and vegetables and only a quarter of them (36.4%) monitored blood cholesterol. Among them (24.1%) were current alcohol users and (25.4%) were current smokers. More than half (52.1%) were physically active. The practice of cardiovascular health was significantly associated with marital status (p&lt;0.001) of the adults.&#x0D; Conclusion: Although, most of the adults adopted the practice to maintain cardiovascular health, their adherence to monitoring blood cholesterol, adequate intake of the recommended number of fruits and vegetables, and physical activity is low. Hence, awareness programs focusing these facets would be helpful.

A Study of Hypertension and Related Biophysical and Health-related Lifestyle Behaviors in Patients Suffering from Schizophrenia.

Schizophrenia is a life-shortening disease. The standardized mortality ratio has been higher than that of the general population, and it has doubled what it was 3-4 decades ago. This rise is mostly attributed to the increased cardiovascular risk associated with high second-generation antipsychotic (SGA) use. Evidence from the first-generation antipsychotic (FGA) era shows a lower prevalence of hypertension (HTN) but data regarding SGAs is scarce. The purpose of the study was to assess the prevalence of HTN and related factors using standardized methodology in patients with schizophrenia on treatment with SGAs. A cross-sectional study through convenient sampling was done. Blood pressure, anthropometry, physical activity, and health-related lifestyle factors were assessed using the standard World Health Organization (WHO) methodology of cardiovascular survey methods and the Global Physical Activity Questionnaire (GPAQ) version 2. The prevalence of HTN, obesity, inadequate physical activity, and other demographic and clinical correlates like antipsychotic use, duration of illness, and family history of non-communicable diseases (NCDs) were studied. The prevalence of HTN is 20.50%, and it increases with age. SGAs with the use of a single agent are the most common. In total, 45.50% of persons with schizophrenia have a positive family history of a NCD; 22.00% and 07.50% are current tobacco and alcohol users, respectively; and 70% have abdominal obesity, and 54% have generalized obesity. Waist circumference, obesity, and family history of NCDs are significant correlates of HTN. A family history of NCDs is the most significant predictor. The prevalence of HTN is lower than that of the general population despite the high prevalence of SGA use, obesity, and inadequate physical activity.

Alcohol misuse, health-related behaviors, and burnout among clinical therapists in China during the early Covid-19 pandemic: A Nationwide survey.

This study aimed to assess the extent of alcohol use and misuse among clinical therapists working in psychiatric hospitals in China during the early COVID-19 Pandemic, and to identify associated factors. An anonymous nationwide survey was conducted in 41 tertiary psychiatric hospitals. We collected demographic data as well as alcohol use using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and burnout using the Maslach Burnout Inventory Human Services Survey. In total, 396 clinical therapists completed the survey, representing 89.0% of all potential participants we targeted. The mean age of participants was 33.8 years old, and more than three-quarters (77.5%) were female. Nearly two-fifths (39.1%) self-reported as current alcohol users. The overall prevalence of alcohol misuse was 6.6%. Nearly one-fifth (19.9%) reported symptoms of burnout with high emotional exhaustion in 46 (11.6%), and high depersonalization in 61 (15.4%). Multiple logistic regression showed alcohol use was associated with male gender (OR = 4.392; 95% CI =2.443-7.894), single marital status (OR = 1.652; 95% CI =0.970-2.814), smoking habit (OR = 3.847; 95%CI =1.160-12.758) and regular exercise (OR = 2.719; 95%CI =1.490-4.963). Alcohol misuse was associated with male gender (OR = 3.367; 95% CI =1.174-9.655), a lower education level (OR = 3.788; 95%CI =1.009-14.224), smoking habit (OR = 4.626; 95%CI =1.277-16.754) and high burnout (depersonalization, OR = 4.848; 95%CI =1.433-16.406). During the COVID-19 pandemic, clinical therapists' alcohol consumption did not increase significantly. Male gender, cigarette smoking, and burnout are associated with an increased risk of alcohol misuse among clinical therapists. Targeted intervention is needed when developing strategies to reduce alcohol misuse and improve clinical therapists' wellness and mental health.

Does urban-rural disparity exist in nicotine and alcohol dependence among Chinese older adults?

Background China is a large country with substantial urban-rural disparity. With the increasing concerns related to the rapid growth of the older adult population and problems related to smoking and alcohol consumption, this study aims to examine the potential urban-rural disparity associated with nicotine or alcohol dependence among Chinese older adults. Methods We used three waves of the Chinese Longitudinal Healthy Longevity Survey and included older adults who were 65 years old or above (CLHLS; n = 18,207). The Heckman two-step selection procedure was applied to reduce potential selection bias. The first and the second steps of the Heckman two-step selection procedure all included multivariable logistic regressions. Results In the final study sample, approximately 8.1% and 4.0% of older adults reported nicotine and alcohol dependence, respectively. In the first step of the Heckman selection procedure, urban residents were less likely to become current smokers and alcohol users than rural residents (all p < .05). However, urban-rural disparity was not associated with either nicotine or alcohol dependence (all p > .05). Conclusions We did not observe the urban-rural disparity in nicotine and alcohol dependence among Chinese older adults. Chinese policymakers should continue to strengthen national policy to combat smoking and alcohol consumption, especially older adults.

Strong chū-hai, a Japanese ready-to-drink high-alcohol-content beverage, and hazardous alcohol use: A nationwide cross-sectional study.

A new ready-to-drink premixed high-alcohol-content beverage, called strong chū-hai, was launched in Japan, and more recently, in Taiwan and Australia. We aimed to examine the popularity and association of strong chū-hai with individual alcohol use, both of which remained unclear. We conducted a cross-sectional study using data from the Japan "Society and New Tobacco" Internet Survey conducted from February 1 to 28, 2022, in Japan. We enrolled 27,993 respondents (aged 15 to 81 years; male 48.5%), including 15,083 current alcohol users. Using inverse probability weighting of data from the 2016 Comprehensive Survey of Living Conditions on Health and Welfare, we estimated the weighted proportions of strong chū-hai users among all respondents and constructed multivariable logistic regression models to estimate the weighted odds ratios (OR) and 95% confidence intervals (CI) of strong chū-hai use for hazardous and harmful alcohol use, defined as a score ≥8 of the Alcohol Use Disorder Identification Test, among current alcohol users. Among all respondents, 56.2% (weighted proportions: past, 35.9%; and current, 20.3%) drank strong chū-hai. Among drinkers, both past and current strong chū-hai use, compared to never use, were associated with hazardous and harmful alcohol use (past, OR 1.73, 95% CI 1.42 to 2.12; current, OR 2.19, 95% CI 1.79 to 2.69). Our study found that more than half of the respondents experienced strong chū-hai consumption, suggesting that it is widely used in Japan. In addition, both past and current strong chū-hai use were associated with hazardous and harmful alcohol use among current alcohol users.

ASSESSMENT OF RISK FACTORS OF DIABETES MELLITUS IN THE URBAN FIELD PRACTICE AREA OF A TERTIARY CARE HOSPITAL OF SOUTHERN ODISHA: A CROSS-SECTIONAL STUDY

Objective: Diabetes is a chronic state of hyperglycemia which results in complications involving organs such as eyes, kidneys, nerves, heart, and blood vessels. Identifying the risk factors at an early stage can help in reducing the complications and co-morbidities of the disease. Hence, the study is carried out to assess the socio-demographic profile and associated risk factors of adult patients with diabetes mellitus. Methods: It was a cross-sectional study carried out in the urban field practice area of M.K.C.G Medical College for a period of 2 years. Multistage simple random sampling was used to select 160 known diabetic cases. Data were collected using a pre-tested questionnaire and anthropometric measurements were taken. Data were analyzed in SPSS version 17 and appropriate statistical tests were used. Results: The mean age of study participants was 53.94. About 41.88% and 21.25% were current tobacco and alcohol users, respectively. Inadequate fruit and vegetable consumption, mixed type diet, obesity in the form of increased body mass index, and waist hip ratio and sedentary life style were found to be the predisposing factors of the disease. Conclusion: Early identification of at risk individuals and appropriate intervention to increase physical activity, bring about changes in dietary habits, maintenance of correct body weight could help to prevent or delay the onset of the disease to a great extent.

Prostate Cancer Screening Disparities in Persons Experiencing Homelessness

<h3>Purpose/Objective(s)</h3> Persons experiencing homelessness (PEH) face barriers to cancer screening, leading to cancer diagnosis at more advanced stages. Data on prostate specific antigen (PSA) screening in this population is scarce. The aim of this study was to 1) assess PSA testing rates in PEH and identify factors associated with screening and 2) compare PSA screening rates in PEH with persons not experiencing homelessness (non-PEH). <h3>Materials/Methods</h3> This is an IRB approved study of PEH and non-PEH cared for at a large metropolitan hospital system from 2014 to 2021. We identified PEH from a prospective institutional registry which started screening for homelessness in January 2014. Homelessness was defined by either the presence of the Z-code for homelessness (Z59) within the medical record, the listed address was matched to homeless shelters or other transitional housing, or the patient identified as homeless. Institutional CPT and HCPCS billing codes for PSA testing were available beginning 01/01/2017 and cross-referenced to identify patients who underwent PSA testing at least once between 01/01/2017 and 12/31/2021. We extracted PSA testing information for a matched cohort of non-PEH based on sex, age, county of residence, and date of last encounter for comparison. We included men ages 50-69 that lived in our institution's county or an immediately adjacent county. The primary outcome was to assess the rate of PSA testing in the past 5 years in accordance with national screening guidelines (USPSTF, AUA, ACS) and to identify factors associated with PSA testing in PEH. <h3>Results</h3> A total of 9,249 PEH were identified, with 1,605 eligible for PSA screening (men between ages 50-69) within the study timeframe; 3,421 non-PEH were eligible for screening comparison. The median age of PEH was 58.0 years old and the majority of PEH were Black (50%) or White (43%). 67% of PEH were current tobacco users, 52% current alcohol users, and 34% current illicit drug users. Medicaid was the most common insurance (51%) followed by Medicare (19%) and private insurance (4%). PEH were less likely to have a PCP (58% vs 81%, p<0.001) and had a significantly lower PSA testing rate (13% vs 34%, p<0.001) compared to non-PEH. On univariate analysis, PEH were more likely to be Black (p<0.001), single (p<0.001), unemployed (p<0.001) and have Medicaid/no insurance (p<0.001). On multivariate analysis, each of these associations remained significant; most notably, lack of a PCP (OR=1.78; 95% CI 1.35-2.30, p<0.001) or PSA testing (OR=1.63; 95% CI, 1.25-2.14, p<0.001) were associated with increased odds of being homeless. Within the homeless population, multivariate analysis showed that having a PCP (OR=2.58; 95% CI, 1.64-4.05) significantly increased the odds of getting PSA testing. <h3>Conclusion</h3> PEH experience low rates of prostate cancer screening. Interventions to increase screening in this population, including increased PCP access, are warranted.

Prevalence, awareness, treatment, and control of type 2 diabetes mellitus among the adult residents of tehran: Tehran Cohort Study

BackgroundThe prevalence of type 2 diabetes mellitus has increased in the past decades. We investigated the prevalence of diabetes and its awareness, treatment, and control among adult residents of Tehran.MethodsWe used the recruitment phase data of the Tehran Cohort study, enrolling a random sample of adult residents of Tehran aged ≥35 years. Diabetes was defined as self-report, current use of glucose-lowering medications, and/or fasting plasma glucose (FPG) ≥126mg/dl. Impaired fasting glucose (IFG) was defined as an FPG of 100-125mg/dl. Awareness was defined as diabetes self-report, treatment as receiving glucose-lowering medications, and glycemic control as FPG <126mg/dl. The age- and sex-weighted estimates were calculated using the 2016 national census. Logistic regression models were used to determine the factors associated with diabetes awareness, treatment, and control.ResultsA total of 8151 participants were included. Age- and sex-weighted prevalence of diabetes mellitus and IFG were 16.7% (95% CI: 15.1–18.4) and 25.1% (95% CI: 23.1–27.1), respectively. Diabetes was more prevalent in the eastern and central districts of Tehran. Advanced age (OR per 1-year increase: 1.026, 95% CI: 1.021-1.030), male sex (OR: 1.716, 95% CI: 1.543-1.909), higher BMI levels (OR for BMI ≥35 vs. <20 kg/m2: 4.852, 95% CI: 3.365-6.998), pre-existing hypertension (OR: 1.552, 95% CI: 1.378-1.747), dyslipidemia (OR: 1.692, 95% CI: 1.521-1.883), and chronic kidney disease (OR: 1.650, 95% CI: 1.019-2.673) were associated with an increased odds of diabetes mellitus. On the contrary, diabetes mellitus was less likely in current tobacco (OR: 0.872, 95% CI: 0.765-0.994) and alcohol users (OR: 0.836, 95% CI: 0.703-0.994) compared to non-users. Among diabetic individuals, 82.8% were aware of their condition, 71.9% received treatment, and 31.7% of treated patients had adequate glycemic control. Advanced age and pre-existing comorbidities, including hypertension and dyslipidemia, were associated with higher diabetes awareness and treatment. Furthermore, advanced age, higher levels of education, and female sex were determinants of better glycemic control among treated diabetic participants.ConclusionThere is a high prevalence of diabetes and IFG among adult residents of Tehran. Additionally, more than two-thirds of treated diabetics living in Tehran remain uncontrolled.