Differences In Alcohol Research Articles

Alcohol and fear conditioning produce strain-specific changes in the dorsal hippocampal transcriptome of adolescent C57BL/6J and DBA/2J mice.

Adolescent sensitivity to alcohol is influenced by genetic background. Data from our laboratory suggested that adolescent C57BL/6J and DBA/2J inbred mice differed in susceptibility to alcohol-induced deficits in dorsal hippocampus-dependent contextual fear learning. To investigate the biological underpinnings of this strain difference, we examined dorsal hippocampus gene expression using RNA-sequencing after alcohol or saline administration followed by Pavlovian fear conditioning across male and female C57BL/6J and DBA/2J adolescents. Strains exhibited dramatic differences in dorsal hippocampus gene expression. Specifically, C57BL/6J and DBA/2J strains differed by 3526 transcripts in males and 2675 transcripts in females. We identified pathways likely to be involved in mediating alcohol's effects on learning, including networks associated with Chrna7, a gene encoding the nicotinic cholinergic receptor alpha 7 subunit, and Fmr1, a gene encoding the fragile X messenger ribonucleoprotein. These findings provide insight into the mechanisms underlying strain differences in alcohol's effects on learning and suggest that different biological networks are recruited for learning based on genetics, sex, and alcohol exposure.

Alcohol Abuse and Emotional Intelligence among adults of Karnataka

Emotional intelligence is the capacity of a person to successfully and appropriately react to a wide range of emotional inputs that are generated from the inner self and immediate environment. The present study was an attempt to examine the impact alcohol abuse on emotional intelligence among adults situated at Karnataka State. The research instruments used were Alcohol use disorder identification test and emotion quotient test. The statistical techniques used were Spearman’s Rank correlation and Mann Whitney U Test. The findings showed a positive link between the EI dimensions. There is a significant negative association between alcohol abuse and competency dimension of EI. The studies result indicates that there was no significant association between alcohol abuse and emotional intelligence. There is a significant difference in alcohol abuse-based on the level of education but no significant difference in Emotional intelligence based on the education level.

Combustible cigarette smokers versus e-cigarette dual users among Latinx individuals: Differences in alcohol and drug use severity.

The Latinx population in the United States (U.S.) experiences significant tobacco and other substance use-related health disparities. Yet, little is known about the couse of combustible cigarettes and e-cigarettes (dual use) in relation to substance use behavior among Latinx smokers. The present investigation compared English-speaking Latinx adults living in the United States who exclusively smoke combustible cigarettes versus dual users in terms of alcohol use and other drug use problem severity. Participants were 297 Hispanic/Latinx daily cigarette smokers (36.4% female, Mage = 35.9 years, SD = 8.87) recruited nationally across the United States using Qualtrics Panels to complete self-report measures of behavioral health outcomes. Five analysis of covariance models were conducted to evaluate differences in overall alcohol consumption, dependence, related problems, hazardous drinking, and drug use problem severity between exclusive combustible cigarette smokers (N = 205) and dual users (N = 92). Results indicated that dual users evinced greater levels of alcohol consumption, dependence, alcohol-related problems, and hazardous drinking compared to exclusive combustible cigarette smokers (ps < .001). Dual users also reported greater levels of drug use problems relative to exclusive combustible cigarette smokers (p < .001). The current findings are among the first to document that dual cigarette and e-cigarette use status (compared to exclusive combustible cigarette smoking) may serve as a clinically relevant risk indicator for a range of deleterious substance use problems among Latinx individuals. Future research is needed to corroborate these findings and examine dual-use status as a longitudinal predictor of alcohol and other substance-related problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sex differences in alcohol's effects on fronto-amygdalar functional connectivity during processing of emotional stimuli.

Amygdala function underlying emotion processing has been shown to vary with an individuals' biological sex. Expanding upon functional magnetic resonance imaging (fMRI) findings reported previously where a low level of response was the focus, we examined alcohol and sex effects on functional connectivity between the amygdala and other brain regions. The central hypothesis predicted that sex would influence alcohol's effects on frontal-limbic functional circuits underlying the processing of negative and positive facial emotions. Secondary analyses were conducted on data from a double-blind, placebo controlled, within-subjects, cross-over study in 54 sex-matched pairs (N = 108) of 18- to 25-year-old individuals without an alcohol use disorder at baseline. Participants performed an emotional faces fMRI processing task after placebo or approximately 0.7 mL/kg of ethanol. Psychophysiological interaction analyses examined functional connectivity between the amygdala with other brain regions. There were significant alcohol-by-sex interactions when processing negatively valenced faces. Whereas intoxicated men exhibited decreased functional connectivity between the amygdala and ventral and dorsal anterior cingulate, angular gyrus, and middle frontal gyrus connectivity was increased in intoxicated women. There was also a main sex effect where women exhibited less functional connectivity in the middle insula than men regardless of whether they received alcohol or placebo. For happy faces, main effects of both sex and alcohol were observed. Women exhibited less amygdala functional connectivity in the right inferior frontal gyrus than men. Both men and women exhibited greater functional connectivity in the superior frontal gyrus in response to alcohol than placebo. Alcohol's effects on amygdala functional circuits that underlying emotional processing vary by sex. Women had higher functional connectivity than men following exposure to a moderate dose of alcohol which could indicate that women arebetter than men at processing affectively laden stimuli when intoxicated.

Associations of sexual identity change and identity-attraction discordance with symptomatic alcohol and other drug use.

National studies examining alcohol and other drug use by sexual orientation have been primarily cross-sectional. Understanding changes in sexual orientation over time may further elucidate the mechanisms behind sexual orientation differences in alcohol and other drug use. This national longitudinal study examines changes in sexual orientation across four waves (2013-2019), and the associations with symptomatic alcohol and other drug use. Data from Waves 1 through 5 of the Population Assessment of Tobacco and Health (PATH) study were used to examine associations of sexual identity change/stability and sexual identity-attraction discordance/concordance from baseline to follow-up with symptomatic substance use at follow-up. We examined four outcomes: any symptomatic substance use, symptomatic alcohol use, symptomatic other drug use, and symptomatic alcohol + other drug use. Mixed effects logistic regression models were used and all analyses were weighted and stratified by sex. In models adjusting for potential confounders, greater likelihood of symptomatic alcohol and other drug use outcomes was found among males and females experiencing a change from a heterosexual to sexual minority identity and among females with new or consistent sexual identity-attraction discordance. These findings highlight important sex differences and suggest that the period of transitioning to a sexual minority identity is a particularly vulnerable period for symptomatic alcohol and other drug use. For females, incongruent sexual identity and attraction is also a risk factor. Interventions that assist individuals during this transitional period and during a time when identity and attraction are incongruent, may reduce symptomatic substance use during this period.

Contexts of social alcohol and cannabis use among sexual minority cisgender women and gender diverse individuals: Event-level differences in alcohol and cannabis use patterns based on the sexual orientations and gender identities of substance use companions

PurposeSexual minority women and gender diverse individuals assigned female at birth (SMWGD) are at elevated risk for alcohol and cannabis use disorders. It has been posited that characteristics of SMWGD’s substance use companions (i.e., sexual orientation, gender identity) may influence their own use, but few studies have tested this. The current study aimed to examine whether quantity and consequences of substance use varied based on sexual orientations and gender identities (SOGI) of SMWGD’s substance use companions. MethodsWe utilized a 30-day ecological momentary assessment study of substance use among a sample of 429 SMWGD. We examined event-level associations between characteristics of substance use companions and quantity and consequences of substance use. ResultsWhen SMWGD used alcohol/cannabis with most SOGI groups, they engaged in heavier drinking and cannabis use. Drinking with heterosexual men and SMW was associated with more drinking consequences. Drinking in settings with more SOGI groups and with both LGBTQ+ and heterosexual individuals was associated with heavier drinking and more consequences. Many contextual aspects of cannabis use settings predicted an increased likelihood of alcohol and cannabis co-use, while few contextual aspects of drinking settings were associated with co-use. ConclusionResults suggest that SMWGD engage in heavier substance use when individuals from a range of SOGI groups are present, highlighting that heavy alcohol and cannabis use is not limited to use with SMW and nonbinary individuals. Drinking in setting with more SOGI groups present (e.g., parties and bars) appears to be associated with particularly heavy drinking and consequences.

Gender differences in alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period (October 20, 2020-April 5, 2021) in China

BackgroundThis study aimed to assess the prevalence and the gender-specific risk factors of alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period in China.MethodThe Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to identify respondents with alcohol abuse/dependence. A questionnaire on basic demographics and mental distresses (learning burnout, depression symptoms, anxiety symptoms, excessive daytime sleepiness, and history of mental disorders) was used. The logistic regression model was used to explore the associations between the above characteristics and alcohol abuse/dependence.ResultsA total of 3,412 medical undergraduates were included in the analysis. Males showed a higher prevalence of alcohol abuse/dependence than females (16.6% vs 7.4%, p < 0.001). Alcohol abuse/dependence was associated with learning burnout (OR: 2.168, p < 0.001) and having a partner (OR: 1.788 p = 0.001) among female medical undergraduates. Among male medical undergraduates, excessive daytime sleepiness (OR: 1.788 p = 0.001) and older age (OR: 1.788, p = 0.001) were independently associated with alcohol abuse/dependence.ConclusionAlcohol abuse/dependence was common among medical undergraduates during the post-COVID‑19 pandemic period. Substantial gender differences in the prevalence and risk factors of alcohol abuse/dependence were found among medical undergraduates in this study, which highlighted the need for timely gender-specific screening and interventions. However, the cross-sectional design adopted in this study has limited the examination of causality, thus further longitudinal studies are warranted.

Increased coping motives during the COVID-19 pandemic widen cannabis disparities between sexual minoritized and nonminoritized young adults: A bimonthly assessment of data preceding and spanning the pandemic.

Since the start of the coronavirus pandemic, some U.S. adults have increased alcohol and cannabis use frequency to cope with distress. Among sexual minoritized young adults (SM YAs), coping-related use may be greater due to disproportionate negative social and financial consequences of the pandemic. Nonetheless, it remains unclear whether pandemic substance use has increased among SM YAs compared to non-SM YAs relative to prepandemic levels and whether heightened coping motives mediate these potential differences. A total of 563 YAs (18-24 years at baseline; 31.0% SM) provided survey data collected across 12 bimonthly assessments. Six assessments were measured in 2015 or 2016 and six across the coronavirus pandemic (2020-2021). Controlling for prepandemic assessments matched by calendar month, latent structural equation models examined group differences in alcohol and cannabis frequency and consequences across the COVID-19 period and tested coping motives as mediators of these differences. Substance use and consequences were similar during the pandemic relative to prepandemic levels across groups. Nonetheless, compared to non-SM individuals, SM participants reported greater cannabis frequency, consequences, and cannabis coping motives during the pandemic independent of prepandemic levels. Cannabis use and consequences were each explained largely by coping motives during the pandemic among SM compared to non-SM YAs. These patterns were not found for alcohol outcomes. The COVID-19 pandemic has widened cannabis disparities between SM and non-SM YAs, due in part to pandemic-related increases in coping motives. Responsive public policy is needed that may prevent and remit SM cannabis disparities during societal crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prevalence of substance use and mental health problems among transgender and cisgender U.S. adults: Results from a national probability sample

Transgender individuals experience numerous health disparities relative to cisgender individuals. However, most transgender-health studies have focused on convenience samples with limited generalizability. This study utilized data from the 2016–2018 TransPop Study, the first national probability sample of transgender adults (n=274) with a cisgender comparison sample (n=1162). Using multivariable logistic regression, adjusted for demographics, we compared the prevalence of hazardous drinking, problematic drug use, serious psychological distress, suicidality, and non-suicidal self-injury between transgender and cisgender individuals and among transgender men (n=78), transgender women (n=120), and transgender nonbinary individuals (n=76). Among transgender individuals, 28.2% (95%CI 21.2–35.2) and 31.2% (95%CI 23.8–38.7) reported hazardous drinking and problematic drug use, respectively; 44.4% (95% CI 35.8–53.0) reported recent suicidal ideation, 6.9% (95% CI 2.3–11.5) reported a recent suicide attempt, and 21.4% (95% CI 14.5%-28.4%) reported recent non-suicidal self-injury. In their lifetime, 81.3% (95%CI 75.1–87.5) of transgender respondents had suicidal ideation, 42.0% (95%CI 34.2–49.8) had attempted suicide, and 56.0% (95% CI 48.2–63.8) reported non-suicidal self-injury. Most (81.5%; 95%CI 75.5–87.5) had utilized formal mental health care and 25.5% (95%CI 18.5–32.4) had sought informal mental health support. There were no differences in alcohol or drug-use outcomes between transgender and cisgender adults. Compared to cisgender adults, transgender adults had higher odds of serious psychological distress (aOR=3.1; 95%CI 1.7–5.7), suicidal ideation (recent: aOR=5.1, 95%CI 2.7–9.6); lifetime: aOR=6.7, 95%CI 3.8–11.7), lifetime suicide attempts (aOR=4.4, 95%CI 2.4–8.0), and non-suicidal self-injury (recent: aOR=13.0, 95%CI 4.8–35.1); lifetime: aOR=7.6, 95%CI 4.1–14.3). Transgender nonbinary adults had the highest odds for all outcomes, including substance use outcomes. Findings from these national probability samples support those of earlier convenience-sample studies showing mental health disparities among transgender adults relative to cisgender adults, with nonbinary individuals at highest risk. These findings also highlight variations in risk across sub-groups of transgender individuals.

The crime and the place: Robbery in the night‐time economy

AbstractThe night‐time economy (NTE) provides many opportunities for crime as there is an abundance of potential victims who are often intoxicated and clustered in a small geographical area. Previous research on NTE violence has primarily focused on assault. However, other offences are also common, such as robbery. This study focused on NTE‐related robbery using police recorded crime data relating to 1624 personal robberies (including attempts) from West Midlands Police, UK. The data was binary coded to identify and compare offence characteristics. Robbery offences in the NTE showed unique characteristics compared to robberies unrelated to this context. In particular, there were differences in alcohol, use of violence, injuries, approach style and crime locations. The findings of the current research align with theoretical frameworks from environmental criminology (e.g. crime generators and attractors), have implications for crime prevention and investigations and can feed into developing policing strategies that take into account the background context for offending.

Cross-substance primed and cue-induced craving among alcohol and cannabis co-users: An experimental psychopharmacology approach.

Co-use of alcohol and cannabis is highly prevalent and often problematic. However, mechanisms underlying their co-use remain unclear. This randomized and crossover study tests cross-substance subjective craving for alcohol and cannabis. A community sample of nontreatment-seeking alcohol and cannabis co-users (N = 30 completers, 40% female) reporting high-risk levels of alcohol and cannabis use completed two experimental sessions in their homes and were monitored remotely using internet meeting technology (i.e., Zoom). The two counterbalanced and randomized sessions were as follows: (a) consumption of a standard alcoholic beverage followed by cannabis cue exposure and (b) consumption (i.e., smoking) of a miniature cannabis cigarette (containing 18%-22% tetrahydrocannabinol), followed by alcohol cue exposure. Participants rated their subjective craving for both alcohol and cannabis at baseline, following alcohol/cannabis administration, and following the presentation of cross-substance-related cues. Repeated measures analysis of variances revealed a statistically significant difference in cannabis craving across time, such that craving for cannabis was significantly higher following cannabis cue reactivity, compared to baseline and following alcohol administration (p's < .001). Similarly, there was a statistically significant difference in alcohol craving across time, such that craving for alcohol was significantly higher following alcohol cue reactivity, compared to baseline and following cannabis administration (p's < .001). Overall, results suggest that individuals who co-use alcohol and cannabis are most sensitive to the cue-induced, rather than the pharmacologically induced effects, of substance administration on cross-substance craving. This pattern of findings does not support a complementarity model. Conversely, these results may be interpreted as indicative of a substitution model for alcohol and cannabis co-use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Selenium-Chitosan Treatment Affects Amino Acid Content and Volatile Components of Red Globe Grape during Storage

Flavor is an essential attribute of grapes, but it quickly deteriorates and loses its quality. This study examined the effects of the selenium-chitosan treatment on the amino acid content and volatile components of freshly harvested grapes stored at 0°C. The amount and composition of precursors such as fatty acids and amino acids have an important influence on the formation of aroma compounds. In this article, the amino acids, volatile components, and some enzyme activities of different treated grapes were analyzed. The results of the analysis of free amino acid composition indicated that the selenium-chitosan treatment significantly reduced the loss of amino acid content by inhibiting the activities of glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), and pyruvate dehydrogenase (PDH). The analysis also revealed that the significant differences in alcohol and aldehyde compounds primarily accounted for the variation in volatile components between treatments. The selenium-chitosan treatment slowed the decline in the content of aldehyde compounds and inhibited the increase in the range of alcohol compounds. These findings demonstrated that treatment with 25 mg L-1 selenium mixed with 1.0% chitosan solution has a positive effect on maintaining the flavor of Red Globe grapes. This treatment is worthy of future promotion.

(075) Partnered Sexual Desire Influences Sex-related Alcohol and Drug Expectancies and Subsequent Sex-linked Substance Use

Abstract Introduction The use of recreational substances in a sexual context (sex-linked substance use) is common among young adults, with up to a third indicating that that they used alcohol, cannabis, or both during their recent partnered sexual activity (Willis et al., 2021; Herbenick et al., 2018). Sex-linked substance use (SLSU) is associated with a variety of positive and negative clinical outcomes including increased sexual pleasure, but also greater risk for condomless sex. Expectations of how one will behave and feel during sex while under the influence have been shown to predict SLSU habits. Contextual factors like relationship status may contribute to these expectancies, with studies finding that young women who are casually dating have more positive sexual expectancies of alcohol compared to women who are not dating or are in a long-term relationship (e.g., Patrick et al., 2014; Pedersen et al., 2009). Given the relationship between SLSU, relationship status, and sexual expectancies, it is likely that other contextual factors of a relationship, like partnered sexual desire, may play a role in sexual outcomes of women’s substance use. However, little is known about how partnered sexual desire is related to either substance sex-related expectancies in college-aged women. Objective To investigate how relationship status and partnered sexual desire is related to differences in alcohol and drug sexual expectancies and SLSU. Methods We surveyed 512 women (mean age 20.09, SD = 1.56) in the Midwestern US. Participants completed the Brief Comprehensive Expectancies of Alcohol and Drug scales, assessing their alcohol and drug expectancies, including sex-related expectancies (e.g., “to be a better lover” and to “enjoy sex more”); the Sexual Desire Inventory, assessing partnered and solitary sexual desire; and reported their relationship status, frequency of SLSU, and demographics. Using independent sample t-tests and multivariate general linear models, we examined how relationship status and partnered &amp; solitary sexual desire interacted to predict differences in alcohol and drug sex-related expectancies and SLSU. Results Contrary to previous research findings, relationship status alone was not related to either alcohol or drug sex-related expectancies or SLSU. However, there was a marginally significant interaction between relationship status and sexual expectancies in predicting women’s SLSU. Specifically, the association between more positive sexual expectancies and higher frequency of SLSU was relatively stronger in partnered women. Moreover, regardless of relationship status, women who reported higher levels of partner desire reported more positive sexual alcohol and drug expectancies. Additionally, women who reported more positive sexual alcohol and drug expectancies reported more frequent SLSU. In contrast, solitary sexual desire was not a significant predictor of either substance-related sexual expectancies. Conclusions Our results indicate that partnership and partnered desire may interact with alcohol and drug sexual expectancies to predict women’s SLSU. These findings question the predominant assumption that women’s use of substances in sexual settings is primarily in casual sexual contexts and points to the need for targeted interventions to address the functions of SLSU in the context of women’s long-term relationships. Clinically, these findings reinforce the value of including our patient’s partner when addressing sexual dysfunction secondary to substance use. Disclosure No

Drinking context, alcohol use, and subjective responses during binge drinking episodes measured by high-resolution ecological momentary assessment (HR-EMA).

Subjective responses to alcohol play a key role in the development and maintenance of risky drinking and alcohol use disorder (AUD). The social and environmental context where drinking occurs may moderate alcohol's subjective effects, but ecologically valid studies of these associations are limited. The present study used high-resolution ecological momentary assessment (HR-EMA) targeting real-world binge drinking episodes to examine associations among drinking context, alcohol consumption, and subjective responses to alcohol. Young adult heavy drinkers (N = 61; 57% male) completed two smartphone-based, 3-hr HR-EMA of drinking context (social context and location), alcohol use, and subjective responses (alcohol stimulation, sedation, feeling, liking, and wanting more). Analyses examined the associations between drinking context and subjective alcohol responses, accounting for demographic characteristics and individual differences in alcohol consumption. Most (85%) participants reported binge drinking during real-world drinking events. Estimated blood alcohol concentration (eBAC) and alcohol stimulation and reward (liking, wanting) were greater when participants drank with others (vs. alone) and in a bar/restaurant (vs. other location). Sedation was higher when drinking alone versus with others. The present study extends prior laboratory-based research and shows that subjective responses during naturalistic binge drinking episodes may be influenced by drinking context. Drinking with others and in bars and restaurants may increase alcohol consumption, enhance alcohol's rewarding effects, and lead to more alcohol-related harm in at-risk drinkers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Evaluating signs of hippocampal neurotoxicity induced by a revisited paradigm of voluntary ethanol consumption in adult male and female Sprague-Dawley rats

BackgroundBinge alcohol drinking is considered a prominent risk factor for the development of alcohol-use disorders, and could be model in rodents through the standard two-bottle preference choice test. The goal was to recreate an intermittent use of alcohol during 3 consecutive days each week to ascertain its potential impact on hippocampal neurotoxicity (neurogenesis and other neuroplasticity markers), and including sex as a biological variable, given the well-known sex differences in alcohol consumption.MethodsEthanol access was granted to adult Sprague–Dawley rats for 3 consecutive days per week, followed by 4 days of withdrawal, during 6 weeks, mimicking the most common pattern of intake in people, drinking over the weekends in an intensive manner. Hippocampal samples were collected to evaluate signs of neurotoxicity.ResultsFemale rats consumed significantly more ethanol than males, although intake did not escalate over time. Ethanol preference levels remained below 40% over time and did not differ between sexes. Moderate signs of ethanol neurotoxicity were observed in hippocampus at the level of decreased neuronal progenitors (NeuroD + cells), and these effects were independent of sex. No other signs of neurotoxicity were induced by ethanol voluntary consumption when measured through several key cell fate markers (i.e., FADD, Cyt c, Cdk5, NF-L) by western blot analysis.ConclusionsOverall, the present results suggest that even though we modeled a situation where no escalation in ethanol intake occurred across time, mild signs of neurotoxicity emerged, suggesting that even the use of ethanol during adulthood in a recreational way could lead to certain brain harm.

Similarities and Differences in Alcohol & Other Drug Dependence Among Hispanic/Latino Subgroups: A Disaggregation Approach

BackgroundHispanic/Latino (H/L) heritage civilians out-number all other non-White ethnic groups in the United States. When studied as one group, H/L diversity is ignored, including rates of drug misuse. This study's aim was to examine H/L diversity regarding drug dependence by disaggregating how the burdens of active alcohol or other drug dependence (AODD) might change if we were to address syndromes drug by drug. MethodStudying non-institutionalized H/L residents from the National Surveys on Drug Use and Health (NSDUH) 2002-2013 probability samples, we utilized online Restricted-use Data Analysis System variables to identify ethnic heritage subgroups and active AODD via computerized self-interviews. We estimated case counts of AODD with analysis-weighted cross-tabulations and variances from Taylor series. Radar plots disclose AODD variations when we simulate the reductions of drug-specific AODD one by one. ResultsFor all H/L heritage subgroups, the most substantial AODD decline might be achieved by reducing active alcohol dependence syndromes, followed by declines of cannabis dependence. The burdens due to active syndromes attributed to cocaine and pain relievers vary somewhat across subgroups. For the Puerto Rican subgroup, our estimates reveal potentially important burden reduction if active heroin dependence can be decreased. ConclusionA sizeable reduction in the H/L population health burden attributable to AODD syndromes might be achieved via the effective decline of alcohol and cannabis dependence among all subgroups. Future research includes a systematic replication with recent NSDUH survey data, as well as various stratifications. If replicated, the need for targeted drug-specific interventions among H/L will become unequivocal.

98. Disparities in trauma care: the association of insurance status with diagnostic and therapeutic procedure administration in spine trauma

<h3>BACKGROUND CONTEXT</h3> Research has suggested substantial disparities in the care of uninsured patients, manifesting as greater delays in care, fewer procedures conducted and greater postoperative complication rates when compared to insured patients. The manifestation of such disparities in the acute trauma setting pertaining to the spine is less understood and remains an issue of debate. <h3>PURPOSE</h3> To investigate the association of lack of insurance with the probability of diagnostic and therapeutic procedure administration to patients undergoing spine trauma in Level I-IV trauma centers. <h3>STUDY DESIGN/SETTING</h3> This was a retrospective cohort study. <h3>PATIENT SAMPLE</h3> A total of 222,602 patients who were registered in National Trauma Data Bank (NTDB) from 2011 to 2019 and initially evaluated in the emergency department of Level I-IV trauma centers in the United States for spine trauma were included. <h3>OUTCOME MEASURES</h3> The outcome measures were rates of select diagnostic and therapeutic procedures being administered to patients. <h3>METHODS</h3> We performed a retrospective cohort study involving spine trauma patients aged 18 to 64 years who were registered in the National Trauma Data Bank (NTDB) between 2011 and 2019. Patients who were missing insurance information, dead on arrival, or had an injury severity score (ISS) less than 9 were excluded. Baseline patient characteristics were compared using bivariate analysis, and multivariate logistic analysis was employed to investigate the association of insurance status with mortality and probability of select diagnostic and therapeutic procedures, adjusting for age, sex, race, ethnicity, ISS, presence of shock, mechanism of injury, intent of injury, Glasgow Coma Scale (GCS) motor score, significantly different comorbidities and year of admission. <h3>RESULTS</h3> Overall, 39,421 patients (17.71%) were uninsured and 183,181 patients (82.29%) were insured. Comorbidity analyses revealed significant differences in alcoholism, bleeding disorder, congestive heart failure, current smoker status, chronic renal failure, stroke, diabetes mellitus, functionally dependent health status, history of myocardial infarction, hypertension, respiratory disease, cirrhosis, and dementia. No differences existed in terms of ISS (17 vs 17; p=0.95), but the uninsured were more likely to present in shock (6.41% vs 5.62%; p <0.001). Mortality rate was greater in uninsured patients compared to their insured counterparts (7.19% vs. 4.70%; p < 0.001). Multivariable logistic regression analysis demonstrated an association of uninsured status with decreased likelihood of receiving magnetic resonance imaging of the spine (odds ratio [OR] = 0.98; p < 0.001) and operative spinal fixation (OR=0.98; p <0.001) and with increased likelihood of receiving computed tomography (CT) of the spine (OR=1.02, p 0.001) compared to insured patients. There were no differences in the likelihood of receiving plain radiography (OR=1.00; p=0.80) or packed red blood cell (PRBC) transfusion within 4 hours (OR=1.00; p=0.21). Subgroup analysis of Level I trauma centers demonstrated persistent insurance-based disparities in the likelihood of operative spinal fixation (OR=0.98; p <0.001) and withdrawal of care (OR=1.01; p <0.001) for the uninsured. <h3>CONCLUSIONS</h3> In summary, lack of insurance was associated with decreased probability of select diagnostic and therapeutic procedures and increased probability of withdrawal of care in spine trauma, with such disparities more pronounced for resource-intensive procedures such as MRI and operative fixation. Differences in care, especially pertaining to therapeutic procedures, continue to persist in Level I trauma centers. Disparities in diagnostic and therapeutic work-up in the acute post-trauma setting may contribute to insurance-based disparities in spine trauma outcomes. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Differences in Alcohol and Other Drug Use and Dependence Between Transgender and Cisgender Participants from the 2018 Global Drug Survey.

Purpose: The purpose of this study was to compare five gender groups (cisgender women, cisgender men, transgender women, transgender men, people with nonbinary/other identities) on measures of use of and dependence on seven substances. Methods: A two-stage approach to assessing gender allowed 126,648 participants from the 2018 Global Drug Survey (GDS) to be classified to one of these five gender groups. Participants were asked to disclose use of each substance in the preceding 12 months. The Alcohol Use Disorders Identification Test and the Severity of Dependence Scale were used to assess dependence. Multivariable logistic regression generated odds ratios (ORs) to measure the association between gender and each substance use/dependence outcome, with cisgender women as the reference group. Results: The sample comprised 43,331 cisgender women, 81,607 cisgender men, 215 transgender women, 254 transgender men, and 1241 people with nonbinary/other identities. Relative to cisgender women, nonbinary/other participants reported greater odds of last 12-month use of all substances (adjusted odds ratio [AOR] = 1.66-2.30), except alcohol (lower odds; AOR = 0.42), and greater odds of dependence on cannabis (AOR = 2.39), 3,4-methylenedioxymethamphetamine (AOR = 1.64) and alcohol (AOR = 3.28), adjusting only for age (all p < 0.05). Conclusion: Transgender 2018 GDS respondents, particularly those with nonbinary/other identities, had greater odds of reporting most substance use outcomes than cisgender women. These findings suggest that a nuanced approach to gender reporting in surveys and treatment centers is required to understand the needs of transgender people who use substances.

Inbred mouse strain differences in alcohol and nicotine addiction-related phenotypes from adolescence to adulthood

Understanding the genetic basis of a predisposition for nicotine and alcohol use across the lifespan is important for public health efforts because genetic contributions may change with age. However, parsing apart subtle genetic contributions to complex human behaviors is a challenge. Animal models provide the opportunity to study the effects of genetic background and age on drug-related phenotypes, while controlling important experimental variables such as amount and timing of drug exposure. Addiction research in inbred, or isogenic, mouse lines has demonstrated genetic contributions to nicotine and alcohol abuse- and addiction-related behaviors. This review summarizes inbred mouse strain differences in alcohol and nicotine addiction-related phenotypes including voluntary consumption/self-administration, initial sensitivity to the drug as measured by sedative, hypothermic, and ataxic effects, locomotor effects, conditioned place preference or place aversion, drug metabolism, and severity of withdrawal symptoms. This review also discusses how these alcohol and nicotine addiction-related phenotypes change from adolescence to adulthood.

Examining Differences in Alcohol and Smoking Behaviors between Parenting and Nonparenting Lesbian Women

Background The transition to parenthood is a significant life event that has implications for health behaviors and health. Few studies have examined alcohol use and smoking by parenthood status (nonparent vs. parent) among women who identify as lesbian. Methods This study used data from two longitudinal studies, the Chicago Health and Life Experiences of Women Study (n = 135) and the U.S. National Longitudinal Lesbian Family Study (n = 116), to compare problem drinking and cigarette smoking trajectories among lesbian-identified women by parenthood status. We used mixed models to investigate differences in problem drinking and cigarette smoking in three waves of data in each study. Results Lesbian parents reported significantly less problem drinking, but not cigarette smoking, than nonparent lesbian women. When considering the interaction between parental status and time, problem drinking was significantly higher among nonparents than parents at each time interval. Conclusions Parenthood was associated with positive changes in drinking among lesbian women; however, more research is needed to understand how to support smoking cessation among parenting lesbian women.