Demographic Correlates Research Articles

Demographic correlates, lifestyle habits, and health effects of poor sleep quality in Indian adolescent girls living in a second-tier city

Background: Insufficient sleep, poor sleep quality, and sleepiness are common problems related to learning, memory, and school performance. During puberty, sleep habits change earlier among girls in parallel to their earlier pubertal maturity. The changes occur during adolescence in response to maturational changes and increased autonomy and independence. Aims and Objectives: This study aims to estimate the prevalence of poor sleep quality among adolescent girls in a second-tier city. Materials and Methods: Cross-sectional observational study conducted in 150 school-going adolescent girls from three different schools in a second-tier city. The study was conducted using the Pittsburgh Sleep Quality Index scale for assessment of the quality of sleep and an investigator designed pro forma to analyze various lifestyle habits. Kutcher Adolescent Depression Scale 6 was used to address the depressive symptoms. Results: Prevalence of poor sleep quality was 9.2%. Pre-bed screen time of >30 min was found in 53% of girls with poor sleep quality. Overweight girls also have poor sleep quality. Good grades (>90% marks in examinations) were associated with poor sleep quality. About 8.3% of girls with poor sleep quality have one or more symptoms pertaining to depression. Conclusion: The pre-bed screen time of more than 30 min in the form of any electronic screens leads to poor sleep quality and poor sleep quality is significantly associated with being overweight. Poor sleep quality is also associated with some symptoms of depression. These all are observed in the girls living in a tier two city, awareness among adolescent girls must be spread to decrease the screen time and they should also be encouraged for better sleep hygiene.

Post-traumatic growth among pediatric transplant recipients and their caregivers: A scoping review.

Pediatric transplantation can be a stressful process for patients and caregivers. Some individuals may experience post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) as a result. Although post-traumatic stress disorder (PTSD) has been well-studied in this population, the purpose of the present scoping review is to provide a first synthesis of the existing literature on PTG in pediatric transplant populations. We conducted a literature search of PsycINFO and Scopus in May 2023. Eligible articles must have included a sample of solid organ transplant (SOT) or stem cell transplant (SCT) recipients under age 18, siblings of recipients, or caregivers; and must have examined PTG. Twenty-three studies were identified, and nine studies met inclusion criteria and were included in the review (n = 5 cross sectional; n = 4 qualitative). Cross-sectional studies examined demographic, mental health, and medical correlates of PTG in children and caregivers. PTG was correlated with PTSS among caregivers. Qualitative studies identified themes along each of the five factors of PTG. Findings overwhelmingly focused on caregiver PTG. Qualitative study findings align with the theoretical model of PTG. Additional research is needed to investigate PTG in siblings of children with a transplant and associations between PTG and medication adherence. This scoping review provides insight into positive change processes following a transplant among children and their caregivers.

Typologies of hate-motivated behavior: A latent class analysis

Hate-motivated behavior (HMB) comprises a problem for public health and criminal justice systems. The present study contributes to current science of HMB by examining (1) potential typology replication and extension and (2) demographic and attitudinal correlates of HMB subtypes. The present study was a secondary analysis of an online survey study of discriminatory behavior and well-being. Participants were adults living in the United States ( N = 289). Four HMB subtypes emerged: generalized, unmotivated, reactive, and defensive. The generalized subtype was characterized by elevated levels of prejudices, positive views toward hate groups, and the youngest age. The reactive subtype was differentiated from the defensive subtype by modestly higher HMB, racism, and positive views toward racially motivated hate groups. HMB subtypes were largely consistent with prior literature, and therefore can inform public health and criminal justice system responses to acts ranging from minor discrimination to interpersonal violence. Prevention and practice are discussed.

Homonegativity, binegativity, and transnegativity among substance use treatment practitioners in the United States

Lesbian, gay, bisexual, and transgender (LGBT) people have an elevated risk for substance use disorder relative to heterosexual and cisgender people. Scholars have predominantly explained this disparity as resulting from LGBT people’s chronic exposure to interpersonal and structural stigma and discrimination. Despite their front-line role in serving LGBT people with substance use disorder, investigations of homonegativity, binegativity, and transnegativity among substance use treatment practitioners have been limited. An online survey of 225 practitioners examined levels of homonegativity, binegativity, and transnegativity and their demographic and socio-political correlates. Levels of homonegativity were lower than those of binegativity and transnegativity. Educational attainment, connectedness to LGBT people, and having a liberal political identity were associated with lower homonegativity, binegativity and transnegativity, while religiosity was associated with higher scores in all categories. Addressing substance use treatment practitioners’ stigma toward LGBT people, particularly bisexual and transgender people, should be prioritized. Substance use treatment organizations are recommended to examine how their policies and practices may perpetuate structural stigma toward LGBT people.

Neither a problem nor my problem: Risk factors for underage drinking disengagement among college students

Objective Underage drinking disengagement (UDD; cognitive restructuring/minimizing agency) measures attitudes about the acceptability and responsibility of drinking. We examined demographic correlates of UDD, as well as the moderating effects of legal drinking status on the association between UDD and drinking. Participants College student drinkers (n = 893; Mage = 19.48, range = 18–25; White = 74.1%; female = 68.1%) from a multi-site study. Methods An online confidential survey included the UDD Scale for College Students and the AUDIT-C. Results White and multiracial, underage students, or those living with others endorsed greater cognitive restructuring disengagement than Hispanic students, legal-age students, or those living alone or with parents, respectively. Greek membership and greater “party school” perceptions were related to more cognitive restructuring and minimizing agency. The associations between UDD and alcohol use were not moderated by legal drinking age status. Conclusion Identifying and educating students at risk for UDD on the ramifications associated with underage drinking could combat drinking.

Demographic and Vocational Rehabilitation Service Correlates of Employment Outcomes in People With Substance Use Disorders During COVID-19

This study examined the demographic and vocational rehabilitation (VR) service correlates of employment outcomes (achievement of competitive employment, hourly wage, and weekly hours) among individuals with substance use disorders (SUDs) during the COVID-19 pandemic, using the Rehabilitation Services Administration Case Services Report (RSA-911) database for fiscal year 2020. Data from 9,536 individuals were analyzed. Hierarchical logistic regression and hierarchical linear regression analyses revealed that multiple demographic and VR service variables were significantly associated with achievement of competitive employment, hourly wage, and weekly work hours at exit. Particularly, having a vocational training license/certificate, employment at Individualized Plan for Employment, and having an associate or bachelor’s degree were the strongest demographic correlates of more positive employment outcomes; while short-term job supports, maintenance, and other services were the strongest VR service correlates of more positive employment outcomes. Implications of the findings were discussed to promote VR service outcomes for people with SUD in the postpandemic era.

Prevalence and Socio-demographic Characteristics of Malaria in Pregnancy among Women Attending Antenatal Care in Fort Portal Regional Referral Hospital, Uganda

Malaria infection during pregnancy poses significant risks to both maternal and fetal health, particularly in regions with high transmission rates such as sub-Saharan Africa. This study, conducted at Fort Portal Regional Referral Hospital in Uganda, aimed to comprehensively investigate the prevalence and socio-demographic correlates of malaria infection among pregnant women attending the Antenatal Care (ANC) clinic. Utilizing a robust descriptive cross-sectional design, data were collected from 400 participants through structured questionnaires and subjected to rigorous statistical analysis. The findings revealed a malaria prevalence rate of 7.8% among the study population. Further analysis unveiled compelling associations between malaria infection and various socio-demographic factors. Notably, women aged 24-45 years constituted the majority of malaria-positive cases, highlighting a vulnerable age group. Additionally, lower levels of education, unemployment or self-employment status, and urban residence were significantly associated with higher rates of malaria infection. Primigravida and women in the second trimester emerged as particularly susceptible subgroups, indicating heightened risk during specific stages of pregnancy. These findings underscore the urgent need for targeted interventions aimed at reducing malaria burden among pregnant women in the study area. Effective health education programs tailored to address the needs of vulnerable demographics, particularly primigravida and women in the second trimester, are imperative. Furthermore, the sustained distribution of insecticide-treated mosquito nets remains paramount in combating malaria transmission. These interventions, informed by the socio demographic correlates identified in this study, hold the potential to mitigate the adverse impact of malaria on maternal and fetal health, contributing to improved pregnancy outcomes and overall public health in the region. Keywords: Malaria, pregnancy, antenatal care, prevalence, socio-demographic correlates, Fort Portal Regional Referral Hospital, Uganda.

Demographic correlates of indices of psychological well-being and COVID-19 related distress among South African university students

Following the COVID-19 pandemic we sought to determine the relationships between anxiety, hopelessness, alcohol use, perceived vulnerability to infection, resilience, traumatic stress, and satisfaction with life amongst university students at three tertiary higher education institutions in South Africa. Our participants were a convenience sample (N = 803) of South African students attending three universities. Participants completed an online survey that contained a battery of psychological measures that measured fear of COVID-19, Perceived Vulnerability to Disease, Resilience, Satisfaction with Life Scale, Hopelessness, Anxiety, PTSD, Alcohol Use, Traumatic Stress, and worry about infection with COVID-19. The mean age of participants was 25 (SD = 8.22), most of whom were female (51%). An increase in age amongst respondents was significantly positively correlated with hopelessness and life satisfaction, but also significantly negatively associated with symptoms of anxiety, PTSD, and alcohol use. Multivariate analysis showed that women reported significantly higher levels of fear of COVID-19, perceived vulnerability to disease, PTSD, and COVID-19 related worries compared to men and those identifying as “other.” Students at the urban university reported higher levels of fear of COVID-19, perceived vulnerability to disease, and COVID-19 related worries but lower levels of anxiety compared to those at the peri-urban and rural university. Students at the rural institution reported greater levels of alcohol use compared to those at the other institutions. Psychological distress among students was exacerbated during the pandemic. It may be useful to identify students in the first term who are struggling academically and to direct them to both academic and counseling support services.

Demographic and socio-economic correlates of knowledge of the ovulatory cycle among tribal women in India: Evidence from the nationally representative survey (NFHS-5)

BackgroundThe knowledge of ovulatory cycle (KOC) is the basis for natural family planning methods. The absence of knowledge is a notable issue since the ovulatory cycle plays a crucial role in reproductive health and empowers women to make informed decisions that influence their lives. This study examines the knowledge of the ovulatory cycle among reproductive tribal women in India and its demographic and socio-economic determinants.MethodsThe data were derived from the National Family Health Survey conducted in 2019–2021. The effective sample size for the present study was 1,01,914 tribal women aged 15–49 years in India. Descriptive statistics along with bivariate analysis were conducted to find the preliminary results. Additionally, multivariable binary logistic regressions were conducted to determine the likelihood of KOC among tribal women across different characteristics. We conducted statistical analysis in STATA 17.0 (StataCorp) and used ArcGIS 10.8.2 for spatial mapping.ResultsOut of 1,01,914 tribal women, 78.8 per cent lack correct knowledge of the ovulatory cycle. Notably, Education level significantly influences KOC, with secondary education showing higher odds of KOC (AOR: 1.24, 95% CI:1.006–1.528) compared to no education. Christian women exhibit lower odds of having KOC (AOR: 0.749, 95% CI:0.564–0.996) compared to Hindu women. Husband/partner’s education level shows a strong association, with higher-educated partners correlating with higher odds of KOC (AOR: 2.501, 95% CI: 1.807–3.461) for higher education. Knowledge of any contraceptive method and current contraceptive use type are strongly associated with KOC. Additionally, rural residence negatively influences KOC (AOR: 1.545, 95% CI: 1.236–1.932), while exposure to mass media has a positive effect (AOR: 1.152, 95% CI: 0.975–1.362) albeit modest.ConclusionThe study highlights the need for targeted educational and awareness programs to improve KOC among tribal women in India. By addressing factors such as education, religious influences, and place of residence, we can empower these women to make informed decisions about their reproductive health, ultimately enhancing their overall well-being and quality of life. This knowledge is not only a foundation for natural family planning but also a key driver of women’s agency and autonomy in shaping their lives.

Peer Recovery Specialists and Referrals to Treatment: Clinical Correlates Among Patients of an Opioid Overdose Recovery Program in New Jersey.

Peer recovery programs increase recovery support and treatment engagement among individuals with opioid use disorder. Peer recovery specialists (PRS) are critical in the cascade of care of treating addiction and related conditions. Work remains to help identify the benefits of PRS, particularly time spent with a PRS as a clinical indicator associated with referral to substance use treatment services. Gaps in the literature do not consider the nested hierarchical intercorrelations of opioid recovery data within multiple emergency departments. The current study examined demographic and clinical correlates with referral to substance use treatment services including prior engagement within an opioid overdose recovery program, mental health diagnosis, the number of naloxone administrations, prior overdoses, and hospital-level variability of PRS time associated with treatment referrals. This study used data collected by providers among patients who engaged in an opioid overdose recovery program. Data were collected between January 2016 and September 2020. Generalized linear mixed effect multilevel regression analyses tested the associations on clinical referral to substance use services. A total of 5655 patients participated in the study (male: 68.91%; age: mean = 37.75 ± 12.43; White non-Hispanic: 62.48%). Significant individual-level associations were identified between demographic and clinical variables and referral to substance use treatment services. At the hospital level, recovery specialist time spent with the patient also showed a positive and significant association with referral to substance use treatment services. The cross-level interaction effect displayed that any period of time spent with PRS played an important role for those patients with a greater number of prior overdoses on referral to treatment. Results provide important information on the role of PRS in the cascade of care, as well as the time spent with those in this role for both individuals with varying number of prior overdoses.

Correlates of Spirituality among African American and Black Caribbean Emerging Adults.

Spirituality is a significant cultural strength and resource for Black emerging adults. Numerous studies show that increasing numbers of emerging adults tend to identify themselves as being spiritual but not religious. However, no studies to date have identified the demographic correlates of spirituality for Black emerging adults from different ethnic groups (i.e., African American vs. Black Caribbean). Data from the National Survey of American Life was used to identify the demographic correlates of 2 indicators of spirituality (e.g., self-rated spirituality and subjective spirituality) for 802 African American and 428 Black Caribbean emerging adults using linear regression. For African Americans, being a woman predicted both greater self-rated spirituality and subjective spirituality. However, among Black Caribbeans men rated spirituality higher in importance than women. African Americans who reported higher educational attainment tended to report higher levels of self-rated spirituality and subjective spirituality. Romantic status for Black Caribbeans, whether they had no romantic involvement or a current romantic partner, was associated with lower self-ratings of spirituality. Unmarried cohabitating individuals in both ethnic groups tended to report lower levels of self-related spirituality. Unemployment for Black Caribbeans was associated with lower subjective spirituality. Findings are of interest to those who serve and work with Black emerging adults.

Willingness to provide a hair sample for drug testing: results from an anonymous multi-city intercept survey

ABSTRACT Background: Hair provision for drug testing can provide secondary measurement to complement self-reported drug use data, thereby providing a more accurate representation of an individual’s drug use. Understanding factors associated with hair provision offers valuable insights into recruitment methods. Objective: To identify demographic and drug-related correlates of providing hair samples in a multi-site venue-intercept study. Methods: We utilized venue-intercept sampling for our Rapid Street Reporting study across 12 US cities between January and November 2022. Participants reported past 12-month drug use and were asked if they would provide a hair sample. We conducted multivariable (generalized linear model with logit link) analyses on demographics and drug use characteristics correlated to hair provision for drug testing. Results: Among 3,045 participants, 55.8% were male, 13.6% provided hair samples. Compared to males, those identifying as “other gender” had higher odds of hair collection (adjusted odds ratio = 2.24, 95% confidence interval: 1.28–3.80). Participants identifying as Black (aOR = 0.32, CI: 0.23–0.45) or “other race” (aOR = 0.50, 95% CI: 0.29–0.80) had lower odds of providing hair than those identifying as White. All levels of reported drug use - one drug (aOR=1.50, 95% CI: 1.15-1.96), two-three drugs (aOR=1.51, 95% CI: 1.11-2.05), four or more (aOR = 2.13, 95% CI: 1.50–3.01) – had higher odds of providing hair samples than those reporting no drug use. Similar associations applied to reporting cannabis use with or without another drug (aOR = 1.52–1.81, 95% CI: 1.15–2.38). Conclusion: Differential hair provision based on participant sex, race/ethnicity, and drug use may introduce biases in drug testing, limiting generalizability to individuals from minority backgrounds.

Longitudinal analysis of CSF HIV RNA in untreated people with HIV: Identification of CSF controllers.

Interindividual variation of human immunodeficiency virus (HIV) RNA setpoint in cerebrospinal fluid (CSF) and its determinants are poorly understood, but relevant for HIV neuropathology, brain reservoirs, viral escape, and reseeding after antiretroviral interruptions. Longitudinal multicentric study on demographic, clinical, and laboratory correlates of CSF HIV RNA in 2000 follow-up visits from 597 people with HIV (PWH) off antiretroviral therapy (ART) and with plasma HIV RNA > the lower limit of quantification (LLQ). Factors associated with CSF control (CSFC; CSF HIV RNA < LLQ while plasma HIV RNA > LLQ) and with CSF/plasma discordance (CSF > plasma HIVRNA > LLQ) were also assessed through mixed-effects models. Posthoc and sensitivity analyses were performed for persistent CSFC and ART-naïve participants, respectively. Over a median follow-up of 2.1 years, CSF HIV RNA was associated with CD4+ and CD8+ T cells, CSF leukocytes, blood-brain barrier (BBB) integrity, biomarkers of iron and lipid metabolism, serum globulins, past exposure to lamivudine, and plasma HIV RNA (model p < 0.0001). CSFC (persistent in 7.7% over 3 years) and CSF/plasma discordance (persistent in <0.01% over 1 year) were variably associated with the same parameters (model p < 0.001). Sensitivity analyses confirmed most of the previous associations in participants never exposed to ART. Persistent CSFC was associated with higher CD4+ T-cell count nadir (p < 0.001), lower serum globulins (p = 0.003), and lower CSF leukocytes (p < 0.001). Without ART, one in 13 PWH had persistently undetectable CSF HIV RNA, while persistent CSF/plasma discordance was extremely rare over years. Immune responses, inflammation, BBB permeability, and iron and lipid metabolism were all associated with HIV replication in CSF.

An observational investigation of unemployment, underemployment, and competitive integrated employment of people with intellectual and developmental disabilities in 2021-2022

BackgroundEmployment is an important component of community living, and a precursor to economic stability and independence. Despite this, research consistently demonstrates people with intellectual and developmental disabilities (IDD) have low rates of community-based employment. However, little research has been conducted to quantify competitive integrated employment, and which individuals have better employment outcomes as it relates to competitive integrated employment. ObjectiveThis study aims to explore the ways in which key service-related and demographic characteristics of individuals with IDD are associated with participation in competitive integrated employment. MethodsWe used the 2021–2022 National Core Indicators Intellectual and Developmental Disabilities In-Person Survey dataset. We conducted bivariate and multivariate analyses, using chi-square and generalized linear models, to examine the cross-sectional relationship between employment and demographic and service-related characteristics for 4629 individuals with IDD. ResultsOverall, 42% of the sample was unemployed but wanted a job, while 39% were underemployed and just 21% have competitive integrated employment. Several demographic and service-related characteristics were significantly associated with employment. After controlling for demographic and service-related correlates of employment, having an employment-related goal in one's service plan was associated with 4.5 (95% CI: 3.6–5.5) times higher odds of competitive integrated employment relative to unemployment. ConclusionsThis study underscores the value of person-centered planning for improved employment outcomes. Further research is needed to fully understand potential inequities in employment and system-level factors that are associated with competitive, integrated employment, as well as solutions to improve access to customized individual employment supports for all people with IDD.

Differences in Patterns of Care and Referral Between Proton and Photon Therapy

PurposeTo report demographic and clinical characteristics of patients who were more likely to receive proton beam therapy (PBT) than photon therapy from facilities with access to proton centers. Materials and MethodsWe utilized the national cancer database to identify the facilities with access to PBT between 2004 and 2015 and compared the relative usage of photons and PBT for demographic and clinical scenarios in breast, prostate, and nonsmall cell cancer. ResultsIn total, 231 facilities with access to proton centers accounted for 168 323 breast, 39 975 lung, and 77 297 prostate cancer patients treated definitively. Proton beam therapy was used in 0.5%, 1.5%, and 8.9% of breast, lung, and prostate cases. Proton beam therapy was correlated with a farther distance traveled and longer start time from diagnosis for each site (P < .05).For breast, demographic correlates of PBT were treatment in the west coast (odds ratio [OR] = 4.81), age <60 (OR = 1.25), white race (OR = 1.94), and metropolitan area (OR = 1.58). Left-sided cancers (OR = 1.28), N2 (OR = 1.71), non-ER+/PR+/Her2Neu− cancers (OR = 1.24), accelerated partial breast irradiation (OR = 1.98), and hypofractionation (OR = 2.35) were predictors of PBT.For nonsmall cell cancer, demographic correlates of PBT were treatment in the south (OR = 2.6), metropolitan area (OR = 1.72), and Medicare insurance (OR = 1.64). Higher comorbid score (OR = 1.36), later year treated (OR = 3.16), and hypofractionation (not SBRT) (OR = 3.7) were predictors of PBT.For prostate, correlates of PBT were treatment in the west coast (OR = 2.48), age <70 (OR = 1.19), white race (OR = 1.41), metropolitan area (OR = 1.25), higher income/education (OR = 1.25), and treatment at an academic center (OR = 33.94). Lower comorbidity score (OR = 1.42), later year treated (OR = 1.37), low-risk disease (OR = 1.45), definitive compared to postoperative (OR = 6.10), and conventional fractionation (OR = 1.64) were predictors of PBT. ConclusionEven for facilities with established referrals to proton centers, PBT utilization was low; socioeconomic status was potentially a factor. Proton beam therapy was more often used with left-sided breast and low-risk prostate cancers, without a clear clinical pattern in lung cancer.

Using Mobile Technology for Family-Based Prevention in Families with Low Incomes: Lessons from a Randomized Controlled Trial of a Childhood Obesity Prevention Program

Researchers are increasingly using web-based technologies to deliver family-based, prevention programming. Few studies have examined the success of such approaches for families with low incomes. The purpose of this study was to describe the level of in-class and online engagement in a childhood obesity prevention program for parents with low incomes, to examine the demographic correlates of parent engagement, and to examine dosage effects on parental feeding outcomes as a function of online exposure. All participants attended in-class nutrition education classes (Eating Smart · Being Active) as part of the Expanded Food and Nutrition Education Program (EFNEP) in Colorado and Washington State (classes were offered in English and Spanish). Participants in this analysis were 168 parents from a larger cluster randomized controlled trial who had been randomly assigned to also receive a newly developed, mobile-based version of an efficacious, feeding-focused, childhood obesity prevention program. Results showed that despite high levels of in-person attendance (70%), participants only accessed 47% of the videos (online content). Older parents and parents of girls showed higher levels of in-person attendance; currently employed parents showed lower levels. Online engagement varied as a function of ethnicity and acculturation: non-Hispanic parents accessed the most videos, low-acculturated Hispanic parents accessed the second most, and highly acculturated Hispanic parents accessed the least. In contrast, low-acculturated Hispanic parents showed the highest in-person attendance. For all but one outcome, significant online program effects were found only for parents who accessed at least half of the videos. Implications for mobile-based, family-based prevention programs for parents with low incomes are considered.ClinicalTrials.gov Identifier: NCT03170700; Registration Date: March 08, 2017.

Health-Related Quality of Life of Adolescents and Children With Type 1 Diabetes in the Jazan Region of Saudi Arabia.

Type 1 diabetes mellitus (T1DM) is increasingly prevalent among Saudi Arabian youth, particularly in the Jazan region. This chronic condition necessitates lifelong insulin therapy and poses significant daily management challenges for affected adolescents. Despite the high incidence rates, there is a notable lack of research into how T1DM impacts the health-related quality of life (HRQoL) of these individuals. This study aimed to assess HRQoL and its demographic correlates in T1DM patients in the Jazan region of Saudi Arabia. In this cross-sectional study, 236 T1DM patients completed the Pediatric Quality of Life Inventory Diabetes Module 3.0 (PedsQL DM). The HRQoL across domains of diabetes symptoms, treatment barriers, adherence, worry, and communication was compared by gender, nationality, age, education, residence, and healthcare follow-up using t-tests and ANOVA. Multivariate regression identified predictors of overall HRQoL. Most respondents were female (51.3%), 42.8% were between the ages of seven and 12 years, and 94.5% were Saudi nationals. Males reported better HRQoL than females, with fewer symptoms, treatment barriers, and better communication (all p<0.05). Non-Saudis had better treatment adherence, communication, and overall HRQoL than Saudis (all p<0.05). Older children (13-18 years) reported lower treatment barriers than younger children (three to six years) (p<0.05). Those with intermediate education had lower treatment barriers than those with preliminary education (p = 0.038). Only the female gender (-0.171, p = 0.009) independently predicted poorer overall HRQoL. This study revealed disparities in HRQoL among T1DM children and adolescents. Males, non-Saudis, older children, and those with more education had better HRQoL. Females were at particular risk for poorer outcomes. Targeted interventions are needed to address this region's demographic disparities in diabetes-related HRQoL.

Prevalence and Correlates of Post-Diagnosis Alcohol Use among Cancer Survivors.

Alcohol is a risk factor for cancer and may pose unique risks for cancer survivors. Population-based studies of confirmed cancer cases are needed to estimate the extent of drinking among cancer survivors and to understand which survivors are most at risk of alcohol-related health problems. Cancer survivors who resided in the Puget Sound Surveillance, Epidemiology, and End Results (SEER) region, were ages 21 to 74 years at diagnosis, and were 6 to 17 months post-diagnosis at the start of the recruitment period (April 2020-December 2020) were sent a survey that included demographics, substance use, mental health, and cancer-related items. Data from returned surveys (n = 1,488) were weighted to represent the characteristics of the Puget Sound SEER region. We estimated the prevalence of post-diagnosis alcohol use as well as demographic, behavioral, and clinical correlates of three levels of drinking: any drinking, drinking exceeding cancer prevention guidelines, and hazardous drinking. The weighted prevalence of any drinking, drinking exceeding cancer prevention guidelines, and hazardous drinking was 71%, 46.2%, and 31.6%, respectively. Higher income and cannabis use were associated with increased odds of all three drinking levels. Lower physical health quality of life, having non-colorectal gastrointestinal cancer, and receiving chemotherapy within the last month were associated with decreased odds of all three drinking levels. The prevalence of any drinking and at-risk drinking was higher than in previous studies and differed based on sociodemographic, substance use, and cancer-related factors. Findings highlight the importance of identifying and addressing risky alcohol use in cancer care settings.

Social, Psychological, Demographic, and Trauma-Related Factors Associated with Daily Tobacco Use Among Emerging Adults

ABSTRACT Background Tobacco use continues to be a leading cause of morbidity and mortality in the United States. Rates of tobacco use among college students remain steady with one in ten using some form of tobacco. Specific social and demographic correlates to use are needed to effectively address continued use. Purpose The purpose of the present study was to examine specific factors associated with daily tobacco use among college students. Methods The National College Health Assessment was disseminated in classrooms to students at one urban, Midwestern university. Results Results indicated 8.4% of college students used some form of tobacco daily. The final model found gender and marijuana use predicted daily tobacco use. Discussion Based on the prevalence rates found in the present study, it is evident that public health professionals are growing concerned regarding the significant adverse health effects of tobacco use. Translation to Health Education Practice Health education programs targeting college students engaged in risky behaviors could help reduce tobacco use on college campuses. Health education interventions that address smoking cessation, alcohol, and drug abuse, and mental health support could effectively reduce daily tobacco use on college campuses.

Demographic, clinical, biomarker, and neuropathological correlates of posterior cortical atrophy: an international cohort study and individual participant data meta-analysis

Posterior cortical atrophy is a rare syndrome characterised by early, prominent, and progressive impairment in visuoperceptual and visuospatial processing. The disorder has been associated with underlying neuropathological features of Alzheimer's disease, but large-scale biomarker and neuropathological studies are scarce. We aimed to describe demographic, clinical, biomarker, and neuropathological correlates of posterior cortical atrophy in a large international cohort. We searched PubMed between database inception and Aug 1, 2021, for all published research studies on posterior cortical atrophy and related terms. We identified research centres from these studies and requested deidentified, individual participant data (published and unpublished) that had been obtained at the first diagnostic visit from the corresponding authors of the studies or heads of the research centres. Inclusion criteria were a clinical diagnosis of posterior cortical atrophy as defined by the local centre and availability of Alzheimer's disease biomarkers (PET or CSF), or a diagnosis made at autopsy. Not all individuals with posterior cortical atrophy fulfilled consensus criteria, being diagnosed using centre-specific procedures or before development of consensus criteria. We obtained demographic, clinical, biofluid, neuroimaging, and neuropathological data. Mean values for continuous variables were combined using the inverse variance meta-analysis method; only research centres with more than one participant for a variable were included. Pooled proportions were calculated for binary variables using a restricted maximum likelihood model. Heterogeneity was quantified using I2. We identified 55 research centres from 1353 papers, with 29 centres responding to our request. An additional seven centres were recruited by advertising via the Alzheimer's Association. We obtained data for 1092 individuals who were evaluated at 36 research centres in 16 countries, the other sites having not responded to our initial invitation to participate to the study. Mean age at symptom onset was 59·4 years (95% CI 58·9-59·8; I2=77%), 60% (56-64; I2=35%) were women, and 80% (72-89; I2=98%) presented with posterior cortical atrophy pure syndrome. Amyloid β in CSF (536 participants from 28 centres) was positive in 81% (95% CI 75-87; I2=78%), whereas phosphorylated tau in CSF (503 participants from 29 centres) was positive in 65% (56-75; I2=87%). Amyloid-PET (299 participants from 24 centres) was positive in 94% (95% CI 90-97; I2=15%), whereas tau-PET (170 participants from 13 centres) was positive in 97% (93-100; I2=12%). At autopsy (145 participants from 13 centres), the most frequent neuropathological diagnosis was Alzheimer's disease (94%, 95% CI 90-97; I2=0%), with common co-pathologies of cerebral amyloid angiopathy (71%, 54-88; I2=89%), Lewy body disease (44%, 25-62; I2=77%), and cerebrovascular injury (42%, 24-60; I2=88%). These data indicate that posterior cortical atrophy typically presents as a pure, young-onset dementia syndrome that is highly specific for underlying Alzheimer's disease pathology. Further work is needed to understand what drives cognitive vulnerability and progression rates by investigating the contribution of sex, genetics, premorbid cognitive strengths and weaknesses, and brain network integrity. None.