Non-alcohol Users Research Articles

Prevalence and correlates of sexual violence among adolescent girls and young women: findings from a cross-sectional study in a South African university

BackgroundEpidemiological data on the prevalence and factors associated with sexual violence is critical to understanding the magnitude of the problem and designing effective interventions. Drawing from cross-sectional data from a South African university, we examined the prevalence and correlates of sexual violence among adolescent girls and young women (AGYW).MethodsWe analysed data of 451 AGYW selected using stratified sampling. Sexual violence was defined as any sexual acts, and attempt to obtain sexual acts without consent. We used adjusted and unadjusted logistic regression models to examine the factors associated with exposure to sexual violence while controlling for relevant covariates.ResultsThe lifetime and past-year prevalence of sexual violence was 37.9% and 25.3%, respectively. A higher prevalence of sexual violence was reported by heavy episodic drinkers of alcohol (lifetime 48.4% and past year 34.0%), those who received insufficient financial support (lifetime 58.0% and past year 35.8%) compared to non-users of alcohol (lifetime 27.2% and past year 17.2%),) and those who received adequate financial support (lifetime 20.8% and past year 13.1%). AGYW who reported heavy episodic use of alcohol had higher odds of reporting lifetime (AOR: 1.86; 95% CI: 1.07–3.25) and past year (AOR: 2.03; 95% CI: 1.10–3.75) experience of sexual violence compared to non-users. However, individuals who received adequate family financial support were 76% and 65% less likely to report lifetime and past year experience of sexual violence than those who received inadequate family financial support. Also, AGYW who rated themselves as very religious were 80% and 75% less likely to report lifetime and past year experience of sexual violence compared to those who were not religious.ConclusionOur study shows that sexual violence affects a large proportion of girls, requiring intervention that not only focuses on increasing social support for survivors, facilitating reporting, and ensuring perpetrators are convicted, but also target alcohol use reduction and poverty alleviation.

Oral Proliferative Verrucous Leukoplakia: Progression to Malignancy and Clinical Implications. Systematic Review and Meta-Analysis

Simple SummaryProliferative verrucous leukoplakia (PVL) was recognized in 2005 by the World Health Organization as a rare subtype of true oral leukoplakia, with unknown etiology. Since its first description in 1985, several diagnostic criteria have been proposed over the years. The aim of this systematic review is to investigate the percentage of patients diagnosed with proliferative verrucous leukoplakia who progressed to oral verrucous carcinoma (OVC) or conventional oral squamous cell carcinoma (OSCC).Aim: The aim of the present systematic review was to investigate the risk of malignant transformation of proliferative verrucous leukoplakia (PVL). Materials and Methods: the search was carried out using a combination of terms (leukoplakia OR leucoplakia) AND (multifocal OR proliferative) on the following databases: PubMed, Scopus, Web of Science (WOS Core Collection), Cochrane Library, selecting only articles published since 1985 and in the English language. Demographic, disease-related, and follow-up data extracted from the studies included in the qualitative synthesis were combined. Weighted means ± standard deviations were calculated for continuous variables, while categorical variables were reported as frequencies and percentages. Dichotomous outcomes were expressed as odd ratios (ORs) with 95% confidence intervals (CIs). Odd ratios for individual studies were combined using a random-effects meta-analysis, conducted using Review Manager 5.4 Software (Cochrane Community, Oxford, England). Results: twenty-two articles were included, with a total of 699 PVL patients, undergoing a mean follow-up of 7.2 years. Sixty-six percent of patients were females, with a mean age of 70.2 years, and 33.3% were males, with a mean age of 59.6 years. Most patients were non-smokers and non-alcohol users, and the gingiva/alveolar ridge mucosa was the most involved anatomical site by both PVL appearance and malignant transformation. A total of 320 PVL patients developed oral verrucous carcinoma (OVC) or conventional oral squamous cell carcinoma (OSCC) because of malignant transformation of PVL lesions (45.8%). A statistically significant 3.8-fold higher risk of progression to conventional OSCC was found compared to OVC in PVL patients, with women being 1.7 times more likely to develop oral cancer than men, as a consequence of PVL progression. Moreover, a statistically significant higher likelihood of developing conventional OSCC in female PVL patients than in males was found. In 46.5% of patients with PVL malignant transformation, multiple carcinomas, in different oral sites, occurred during follow-up. Conclusions: PVL is an aggressive lesion, which, in a high percentage of cases (almost 50%), undergoes malignant transformation, mainly toward OSCC. The female gender is most affected, especially in the elderly, with a negative history for alcohol and tobacco consumption.

The Effects of Light-to-Moderate Alcohol Consumption on the Cognitive Function of Community Nondemented Male Elderly: A Cohort Study.

Aim To investigate the effects of light-to-moderate drinking on the cognitive function of the elderly in a large elderly community cohort. Although heavy drinking is linked with impaired brain functions, the effects of light-to-moderate drinking on the cognitive function of the elderly are still controversial. Methods A total of 1469 nondemented elderly men from 15 research centers in 8 cities and provinces were included and divided into two groups: drinking (531 subjects) and nondrinking (938 subjects). Cognitive functions were assessed by the Beijing version of the Montreal Cognitive Assessment (MoCA) at baseline and one-year follow-up. Results There was no difference in total cognitive scores between the light-to-moderate drinking and nondrinking groups at baseline and follow-up. Nonalcohol users performed better naming and abstraction function at baseline and better naming function at follow-up. There was no difference in cognitive performance decline and new-onset dementia rates at follow-up. Conclusions Light-to-moderate alcohol consumption had no significant impact on the overall cognitive function and the risk of dementia in elderly men.

Prevalence and drug use correlates of extra-medical use of prescription medications for sleep among adults in the United States: Results of the 2015–2018 National Survey on Drug Use and Health

BackgroundThis paper examines the epidemiology of extra-medical use of prescription medications for sleep among a nationally representative sample of U.S. adults. MethodsWe analyzed data from the 2015–2018 National Surveys on Drug Use and Health. The sample includes 3410 U.S. adults who reported extra-medical use of prescription medications for sleep. Multinomial logistic regression models identified correlates of type of drug used [i.e., sedatives and/or tranquilizers-only (ST-only), prescription pain relievers-only (PPR-only), or sedatives, tranquilizers, and prescription pain relievers (ST + PPR)], and logistic regression models identified correlates of reasons for extra-medical use (i.e., sleep-only vs. sleep and recreational). ResultsAbout 60% (95%CI = 58.9, 63.5) of the sample reported extra-medical use of ST-only, followed by PPR-only (29.9%, 95%CI = 27.5, 32.5), and ST + PPR (8.9%, 95%CI = 7.7, 10.4). Recreational use was reported by 28.4% (95% CI = 26.5, 30.4) of the sample. The odds of extra-medical use of PPR-only (aRRR = 3.1, 95%CI = 2.1, 4.5) and ST + PPR (aRRR = 1.9, 95%CI = 1.2, 3.1) as opposed to ST-only, were greater among Non-Hispanic Blacks than Non-Hispanic Whites. Compared to non-alcohol users, those with a past-12 months diagnosis of alcohol use disorder were more likely to use ST + PPR rather than ST-only (aIRR = 2.0, 95%CI = 1.1, 3.7). Non-Hispanic Blacks (aOR = 0.6, 95%CI = 0.4, 08) and individuals living in rural areas (aOR = 0.5, 95%CI = 0.3, 09) were less likely to report extra-medical use of prescription medications for recreational reasons than Non-Hispanic Whites and those residing in large metropolitan areas, respectively. ConclusionsExtra-medical use of PPR-only and ST + PPR as an aid to sleep, is prevalent among Non-Hispanic Blacks, young adults, and those residing in rural areas. Most individuals reported that extra-medical use of prescription medications was primarily motivated by sleep reasons, rather than by sleep and recreational reasons. Potential interventions include access to sleep treatments, education on the effectiveness and risk associated with extra-medical use and co-use of prescription medications for sleep, and research on sleep-related disparities.

Immunohistochemical Expression of MMP-9, TIMP-1, and Vimentin and its Correlation With Inflammatory Reaction and Clinical Parameters in Oral Epithelial Dysplasia.

The aim of this study was to investigate the immunoexpression of matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1), and vimentin (VIM) and its association with the inflammatory reaction (IR) and clinical parameters in oral epithelial dysplasia (ED). The sample was composed of 66 cases of ED, 27 oral squamous cell carcinoma (OSCC), and 28 non-neoplastic epithelium (NNE). ED was graded according to the binary system as low-risk ED (n=42) and high-risk epithelial dysplasia (HRED: n=24). The IR was defined as the median number of inflammatory cells present on the connective tissue in 5 consecutive fields. Tissue sections of paraffin-embedded samples were immunohistochemically stained; MMP-9 and TIMP-1 expression was analyzed separately in the epithelium and the connective tissue; VIM was analyzed in the epithelium. Clinical parameters such as age, sex, lesion site and clinical presentation, alcohol/tobacco use, and malignant transformation of ED were retrospectively obtained from medical records. Nonhomogeneous leukoplakia presented higher odds (3.857; 95% confidence interval: 1.16-12.85) of being graded as HRED than did homogeneous lesions. The IR was higher in OSCC and ED than in NNE, and correlated with the epithelial expression of VIM. HRED and nonhomogeneous leukoplakias presented higher IR than did low-risk ED and homogeneous leukoplakias. Alcohol users had higher IR than nonalcohol users. Smokers had higher epithelial expression of MMP-9 and VIM. High IR in OSCC and HRED, and its positive correlation with VIM expression suggest a contribution of the IR in the progression of OSCC. Moreover, the high expression of MMP-9 and VIM in smokers implies its involvement in tobacco carcinogenesis.

Association of alcohol use with quality of life (QoL): A community based study from Puducherry, India

BackgroundThere is a paucity of information available on the severity of alcohol use with quality of life (QoL). Hence this study aimed to assess the association of alcohol use with QoL. MethodsA community-based cross-sectional study was conducted among 316 adult men aged ≥18 years in Puducherry, South India. Individuals were selected using a multistage sampling technique. WHO AUDIT and WHO QoL BREF questionnaire were used. Multiple linear regression analysis was used to assess the independent association of alcohol use with QoL. ResultsMean (SD) age at initiation was 25.1 (8.8) years. The prevalence of probable dependence was 8.2% (95% CI 5.4–11.8%), and hazardous or harmful use was 27.8% (95% CI 24.8–35.1%). Overall mean (SD) score of QoL was lower among alcohol users compared to non-alcohol users [50.7 (10.9) vs 63.5 (10.1), p-value <0.001]. QoL score was significantly lower among alcohol users in QoL rating and health satisfaction; also in physical, psychological, social relationship, and environmental domains. High-risk alcohol users and urban residence had 11.2 and 4.1 less QoL scores respectively and educated had 7 more QoL scores compared to the reference category. ConclusionsAlcohol use is associated with low quality of life. There is a need of alcohol-deaddiction strategies to reduce alcohol use and improve their QoL.

Spatial-temporal Modelling of Oesophageal and Lung Cancers in Kenya’s Counties

Oesophageal cancer is the cancer that forms in tissues lining the oesophagus (the muscular tube through which food passes from the throat to the stomach) while Lung cancer is the cancer that forms in tissues of the lung, usually in the cells lining air passages. In this study, Data collected by the Nairobi Cancer Registry (NCR) was used to produce spatial-temporal distribution of oesophageal cancer cases for counties in Kenya. The study revealed, counties where data was available Bomet had highest relative risk of oesophageal cancer, followed by Meru, Nyeri, Embu, Nakuru, Kakamega Nairobi, Mombasa, Kiambu and Machakos counties respectively. The study revealed that smoking and alcohol use were significant risk factors of oesophageal cancer in Kenya. Generation of spatio-temporal maps and identification of the risk factors from various counties with notified oesophageal cancer cases is a major milestone since previous studies focused on specific regions. The multiplicative effect of smoking was observed to be 1.012, indicating that oesophageal cancer is 1.2% higher to those who smoke compared to non-smokers. The multiplicative effect of alcohol use was observed to be 1.0346, indicating that oesophageal cancer was 3.5% higher to alcohol users as compared to non-alcohol users. The study findings revealed that, the multiplicative effect of smoking was 1.4021, indicating that lung cancer was 40.21% higher to smokers as compared to non-smokers from the available data. The multiplicative effect of alcohol use was 1.3689 indicating that the risk of lung cancer was 36.89% higher to alcohol users compared to non-alcohol users. Clearly, counties where the data was not available the relative risks were relatively low, therefore even though the data was not available in these counties application of spatial-temporal accounting for covariates revealed that there is risk of oesophageal and lung cancer in the counties. To enhance research on oesophageal, lung and other types of cancer in Kenya the National Cancer Registry in collaboration with Counties health departments should work very closely to enhance cancer data collection to facilitate research and to inform the appropriate measures to be implemented to mitigate the increase of cancer cases.

Prevalence of Non-tobacco Associated Tongue Squamous Cell Carcinoma - Retrospective Study

OTSCC is the most occurring cancer diagnosed in the oral cavity worldwide. There has been a rise in the occurrence of carcinoma of the tongue, especially among non-alcohol and non-tobacco users. The aim of the study is to assess the prevalence of non tobacco tongue OSCC and to correlate with the dental factors. The retrospective analysis data was collected from the dental hospital management system records of Saveetha dental college in OSCC patients without any habits from June 2019 to March 2020. The Clinical details, history and dental factors were tabulated and analysed using statistical software SPSS. Fifteen cases of OTSCC were found to be not associated with any tobacco or alcohol habits. The most prevalent age was from 51 to 60 years and more common in males. The most common site was the lateral border of the tongue. 73% of the patients were not associated with any dental factor and the most common histopathological grade was WDSCC 66%. 60% of the patients had been diagnosed with stage III OTSCC. Within the limits of this study, there is a high prevalence of WDSCC in tongue OSCC in the lateral border of tongue in male between the age group of 51-60 years commonly in males. There was not much association seen with dental factors. The present study underlines the importance of in depth analysis of other etiological factors in OTSCC, thereby facilitating a better understanding of the biology and progression.

Gender-specific associations between apolipoprotein A1 and arterial stiffness in patients with nonalcoholic fatty liver disease.

BackgroundLipid metabolism factors may play an important role in the progression of nonalcoholic fatty liver disease (NAFLD) and its related cardiovascular dysfunctions. The study aims to assess whether Apolipoprotein A-1 (ApoA1) was associated with vascular stiffness in NAFLD patients.MethodsFrom 2012 to 2013, we included 2,295 non-alcohol users with fatty liver disease (1,306 male patients) and completely excluded subjects who drank any alcohol ever to eliminate the effect of alcohol intake. The serum ApoA1 levels and the brachial-ankle pulse wave velocity (baPWV) were measured.ResultsThe baPWV in men was much higher than in female patients (1,412.79 cm/s vs. 1,358.69 cm/s, P < 0.001). ApoA1 level was positively associated with baPWV odd ratio (OR), 4.18; 95% confidence interval (CI) [1.16–15.1], P < 0.05) in patients with AST/ALT < 1 and (OR, 4.70; 95% CI [1.36–16.23], P < 0.05) in patients with AST/ALT ≥ 1 respectively. Only arterial stiffness in men was associated with ApoA1 (OR, 3.96; 95% CI [1.29–12.30], P < 0.05) in logistics regression models adjusted for age, gender, body mass index, education attainment, physical activity, smoking, history of hypertension and high-density lipoprotein. The relationship between ApoA1 and baPWV in male NAFLD patients remained significant (confidence, 156.42; 95% CI [49.34–263.50], P < 0.05) in the fully adjusted linear regression model.ConclusionThe serum ApoA1 was associated with arterial stiffness in male NAFLD patients. Increased ApoA1 level should be considered as an independent risk factor for arterial stiffness in male NAFLD patients, suggesting that NAFLD may alter arterial stiffness by “ApoA1-related” mechanism in men.

Factors Contributing to Delay in Driving Licensure Among U.S. High School Students and Young Adults

PurposeMore teens delay in driving licensure (DDL). It is conceivable they miss Graduated Driver Licensing (GDL) safety benefits. We assessed prevalence, disparities, and factors associated with DDL among emerging adults. MethodsData used were from all seven waves (W1–7) of the NEXT Generation Health Study (W1 in 10th grade [2009–2010]). The outcome variable was DDL (long-DDL [delayed >2 years], intermediate-DDL [delayed 1–2 years] versus no-DDL), defined as participants receiving driver licensure ≥1 year after initial eligibility. Independent variables included sex, urbanicity, race/ethnicity, family structure, parental education, family affluence, parental monitoring knowledge, parent perceived importance of alcohol nonuse, and social media use. Logistic regressions were conducted. ResultsOf 2,525 participants eligible for licensure, 887 (38.9%) reported intermediate-DDL and 1,078 (30.1%) long-DDL. Latinos (adjusted odds ratio [AOR] = 2.5 vs. whites) and those with lower affluence (AOR = 2.5 vs. high) had higher odds of intermediate-DDL. Latinos (AOR = 4.5 vs. whites), blacks (AOR = 2.3 vs. whites), those with single parent (AOR = 1.7 vs. both biological parents), whose parents’ education was high school or less (AOR = 3.7 vs. bachelor+) and some college (AOR = 2.0 vs. bachelor+) levels, and those with lower affluence (AOR = 4.4 vs. high) had higher odds of long-DDL. Higher mother’s monitoring knowledge (AOR = .6) was associated with lower odds of long-DDL, but not intermediate-DDL. ConclusionsSome teens that DDL “age out” of protections afforded to them by GDL driver restrictions. Minority race/ethnicity, socioeconomic status, urbanicity, and parenting factors contribute to DDL. Further study of these factors and their individual/collective contributions to DDL is needed to understand potential unintended consequences of GDL, particularly in more vulnerable youth.

Alcohol Use Disorder Increases Risk of Traumatic Brain Injury-Related Hospitalization: Insights From 3.8 Million Children and Adolescent Inpatients.

ObjectivesWe conducted a cross-sectional study to identify the demographic predictors of traumatic brain injury (TBI), and the risk of association of psychiatric comorbidities including alcohol use disorder (AUD) and TBI-related hospitalizations in the children and adolescent population.MethodsWe included 3,825,523 children and adolescent inpatients (age 8-18 years) using the nationwide inpatient sample (NIS) database (2010-2014), and 61,948 inpatients had a primary diagnosis of TBI. These inpatients were grouped by comorbid AUD (N = 2,644). Multivariable logistic regression model adjusted for demographics, and psychiatric comorbidities including other substance use disorders (SUDs) was used to evaluate the odds ratio (OR) of AUD as a risk factor for TBI-related hospitalization.ResultsThe majority of the TBI inpatients were adolescents (12-18 years, 82.2%), males (71.2%), and whites (59.2%). Males had three times higher odds (95% CI 3.14-3.26) for TBI-related hospitalization compared to females. Among psychiatric comorbidities, mood (4.1%) and anxiety (2.2%) disorders were prevalent in TBI inpatients, and were not associated with increased odds for TBI-related hospitalization. Among SUD, alcohol and tobacco use (4.4% each), and cannabis use (3.5%) were prevalent, and among all substances, AUD was associated with higher odds (OR 3.5, 95% CI 3.35-3.67) of TBI-related hospitalization. These patients with TBI and comorbid AUD also had higher odds for abusing stimulants (OR 5.11, 95% CI 3.85-6.77), cannabis (OR 4.69, 95% CI 4.12-5.34), and tobacco (OR 3.77, 95% CI 3.34-4.27).ConclusionAUD is an independent risk factor for TBI-related hospitalization with an increased risk of 50% in the children and adolescent population compared to non-alcohol users. TBI inpatients with AUD are prevalent in white, and male adolescents. These at-risk populations are also at higher risk of comorbid mood disorders and increased substance use including stimulants, cannabis, and tobacco.

Study on the relationship between urinary polycyclic aromatic hydrocarbons metabolites and pulmonary function in community population

Objective: To investigate the relationship between urinary polycyclic aromatic hydrocarbons(PAHs) metabolites and pulmonary function in community population. Methods: A total of 4 812 participants were recruited from two communities in Wuhan city from April to May 2011 and two communities in Zhuhai city in May 2012. Information of demographic characteristics and life style was collected by semi-structural questionnaire. Physical examination was performed and pulmonary function was measured. Morning urine was also collected. The concentration of 12 urinary PAHs metabolites was tested and classified into four types by chemical structure, including hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene and hydroxypyrene. The level of pulmonary function in different group of urinary PAHs metabolites was compared by using covariance analysis. The association of the urinary PAHs metabolites and pulmonary function was analyzed by using generalized linear model, and the interaction of different population characteristics and life style on the association was analyzed. Results: The age of participants was(51.99±13.64) years old, and 67.66% (n=2 565) of the population were women. The M (P(25), P(75)) of concentration of total urinary PAHs metabolites was 5.72 (3.91,8.72) μg/mmol Cr. After controlling for variables including age, gender, city, Waist-to-Hip Ratio, smoking status, drinking situation, physical activity, cooking meals at home or not, kitchen ventilation and exposure to dust as confounding factors, generalized linear model showed that each 1-unit increase in log-transformed levels of hydroxynaphthalene, hydroxyfluorene, hydroxyphenanthrene, hydroxypyrene and total PAHs was associated with 26.83 (95%CI: -48.18, -5.48) , 21.86 (95%CI: -40.49, -3.23), 26.18(95%CI: -48.27, -4.09), 34.95 (95%CI: -55.95, -13.94), and 35.23 (95%CI: -58.93, -11.54) ml reduction of FVC and 29.36 (95%CI: -47.23, -11.48), 20.79 (95%CI: -36.39, -5.19), 22.65 (95%CI: -41.15, -4.15), 31.44(95%CI: -49.03, -13.85), and 33.20 (95%CI: -53.04, -13.36) ml reduction of FEV(1) respectively (all P values<0.05). Compared to non-alcohol users and participants with home cooking, the association was more evident in alcohol users and participants without home cooking(P for interaction<0.05). Conclusion: The exposure to PAHs was associated with decreased pulmonary function, and the association was more evident in alcohol users and participants without home cooking.

Abstract P523: Effect Of Alcohol And Tobacco Among Those With Thyroid Problems

Background: This study documents the effect that alcohol and tobacco have on those with thyroid problems who participated in an 8 week lifestyle education program. Methods: Participants from the a depression and anxiety educational program were studied. Those who chose to participate met once a week for 8 weeks for a 2 hour program. It consisted of a 45 minute DVD presentation followed by a small group discussion. No doctor patient relationship was established. The program was offered by certified facilitators and focused on educating participants on healthy behaviors such as exercise, plant-based diets, sleep hygiene and others. Each participant answered the Depression and Anxiety Assessment Test (registration TX 7-398-022) both pre and post program. It assessed depression level based on DSM-5 [The Diagnostic and Statistical Manual of Mental Disorders Volume 5] criteria, use of tobacco and alcohol as well as clinical history including thyroid function. The degree of morbid thoughts was ranked from 0-3 ([0] having none or rare; [1] having them 1/4 of the days; [2] being 1/2 of the days; [3] being almost every day in a period of 2 weeks). Results: From n=6118 participants that finished the 8 week program, n=561 participants had thyroid problem those participants were used in the study. The group mean age was 53, SD 15.0, and 82.7% were female. From this group, n=42 (7.5%) were using alcohol and n=44 (7.8%) were tobacco users. Among the those using alcohol, baseline mean depression was 14.67 (SD 6.6), suicidal ideation score was 1.2 at the end of the program mean depression was 9.62 (SD 6.6, p &lt; .001), and suicide thoughts were 0.33. Among the tobacco users, baseline mean depression was 16.23 (SD 6.8) suicidal thought were 1.50 at the end of the program mean depression was 8.84 (SD 5.8, p &lt; .001), 0.34 for suicide thoughts. Among the non-tobacco users, baseline mean depression was 12.44 (SD 7.3), suicidal thoughts was 0.86 at the end of the program depression was 7.95 (SD 6.6, p &lt; .001), and suicidal thoughts were 0.25. Among the non-alcohol users, baseline mean depression was 12.58 (SD 7.4), suicidal thoughts was 0.88 at the end of the program mean depression was 7.89 (SD 6.5, p &lt; .001), suicidal thoughts were 0.25. Conclusion: The findings suggest this program is effective at reducing depression, suicidal thoughts, among individuals with thyroid dysfunction who use alcohol or tobacco; however greater benefit may be achieved by abstaining from both substances.

Investigating differences in sex, race/ethnicity, and impulsivity across substance user profiles: a person-centered approach

Although substance use is considered normative in college, continued examination of factors associated with problematic use is merited. This study identified latent substance user classes and examined their relations with sex, race/ethnicity, impulsivity-like facets, and substance use outcomes among 702 undergraduate students. Non-Alcohol Abstaining Users (NAA), Minimal Users (MU), and Polysubstance Users (PSU) emerged from latent class analysis. Variable-centered analyses indicated that substance user classes did not differ by sex. Students in the Asian and Other groups were at greater odds of being in the MU class than either NAA or PSU class, compared to White students. Differential patterns of impulsigenic trait levels emerged across latent classes. The present study highlights the utility of integrating person- and variable-centered approaches in studying heterogeneous substance use behaviors among college students. College PSU are particularly at risk for problematic outcomes, thus warranting preventive intervention that may target impulsigenic traits or polysubstance use.

Prevalence and associated factors of alcohol use patterns among university students in Uganda.

Introductionmajority of alcohol use pattern studies among university students are from developed countries. Information about the different alcohol use patterns and their correlates among university students in sub-Saharan Africa is limited. The aim of this study was to examine the prevalence and cardinal demographic and psychosocial factors associated with specific alcohol use patterns among Ugandan university students.Methodsa cross section study conducted over 5-months among university students using a standardized socio-demographic questionnaire screened for alcohol use problems, depression symptoms and academic stress using the alcohol use disorders identification test (AUDIT), self-reporting questionnaire (SRQ-20) and the higher education stress inventory (HESI) respectively. Multivariate multinomial regression models were used to determine factors independently associated with a specific alcohol use pattern with low-risk drinkers as the reference group.Resultsa thousand out of 1200 students completed all study requirements for which 60% were males; median age was 22.3 (SD=2.36). The prevalence estimates of any alcohol use, low-risk drinking, heavy episodic drinking and alcohol misuse were 31%, 17.3%, 4.5% and 8.9% respectively. In comparison to low-risk drinkers, students reporting heavy episodic drinking were more likely to report high levels of academic stress (P-value <0.10). Those with alcohol misuse were more likely to be males and with significant depression symptoms (P-value ≤0.05). Non-alcohol users were more likely to report high levels of academic stress (P-value ≤0.05).Conclusionthe prevalence of maladaptive alcohol use patterns is high among Ugandan university students. Integrating peer led psychological interventions into student health services is desperately needed.

Transition from nonuse to use of alcohol or binge drinking among adolescents: Secondary analysis of a randomized controlled trial

ObjectiveThe objective of this study was to evaluate the predictors of the transition from nonuse of alcohol to the first use of alcohol and the first episode of binge drinking. MethodsData were drawn from a randomized controlled trial conducted with seventh- and eighth-grade students from 72 public schools over a 21-month period in six cities in Brazil. A total of 3298 students who reported that they had never consumed alcoholic beverages and had never engaged in binge drinking at baseline were included in this study. The two binary outcomes were tested concomitantly via structural equation modeling. Maximum likelihood estimates for logistic regression models were performed to evaluate how baseline data regarding risk factors, such as sociodemographic characteristics (socioeconomic status, gender, and age), school experiences (violence and perception of academic performance), and social variables (family and friends), affected the initiation of alcohol use and binge drinking at 9- and 21-month follow-up assessments. ResultsOlder age, the perpetration of violent behaviors at baseline and the absence of the father living with the adolescent were predictors of both alcohol use initiation and binge drinking initiation. The #Tamojunto program showed iatrogenic effect for first alcohol use. ConclusionsThe results indicate the need to develop and implement effective alcohol prevention programs that consider the main characteristics in the prediction model for alcohol consumption and binge drinking, including early intervention for aggressive behaviors at school and parental alcohol use.

Cannabis and Alcohol Co-Use in a Smoking Cessation Pharmacotherapy Trial for Adolescents and Emerging Adults.

The co-use of cannabis and alcohol among tobacco-using youth is common. Alcohol co-use is associated with worse tobacco cessation outcomes, but results are mixed regarding the impact of cannabis on tobacco outcomes and if co-use leads to increased use of non-treated substances. This secondary analysis from a youth smoking cessation trial aimed to (1) evaluate the impact of cannabis or alcohol co-use on smoking cessation, (2) examine changes in co-use during the trial, and (3) explore secondary effects of varenicline on co-use. The parent study was a 12-week, randomized clinical trial of varenicline for smoking cessation among youth (ages 14-21, N = 157; Mage = 19, 40% female; 76% White). Daily cigarette, cannabis, and alcohol use data were collected via daily diaries during treatment and Timeline Follow-back for 14 weeks post-treatment. Baseline cannabis co-users (68%) had double the odds of continued cigarette smoking throughout the trial compared with noncannabis users, which was pronounced in males and frequent cannabis users. Continued smoking during treatment was associated with higher probability of concurrent cannabis use. Baseline alcohol co-users (80%) did not have worse smoking outcomes compared with nonalcohol users, but continued smoking was associated with higher probability of concurrent drinking. Varenicline did not affect co-use. Inconsistent with prior literature, results showed that alcohol co-users did not differ in smoking cessation, whereas cannabis co-users had poorer cessation outcomes. Youth tobacco treatment would benefit from added focus on substance co-use, particularly cannabis, but may need to be tailored appropriately to promote cessation. Among youth cigarette smokers enrolled in a pharmacotherapy evaluation clinical trial, alcohol and/or cannabis co-use was prevalent. The co-use of cannabis affected smoking cessation outcomes, but more so for males and frequent cannabis users, whereas alcohol co-use did not affect smoking cessation. Reductions in smoking were accompanied by concurrent reductions in alcohol or cannabis use. Substance co-use does not appear to affect all youth smokers in the same manner and treatment strategies may need to be tailored appropriately for those with lower odds of smoking cessation.

Singing Style, Vocal Habits, and General Health of Professional Singers.

Introduction For the singer, the voice is a medium used to express feelings that capture the listener. Every singing style has specific demands, and a vocal alteration may prevent the singer from meeting them. Objective To compare the singing style, the vocal habits, and the general health data of professional singers. Methods Cross-sectional, quantitative and retrospective study of a survey database. Data on the singing style, the vocal habits, and the health conditions and history of 57 professional singers, 31 female singers and 26 male singers, aged from 19 to 57 years old (average of 32 years old), from a mid-sized town were analyzed Results There was a prevalence of female (54 ± 2%) popular singers (91 ± 2%), in the adult age (51 ± 2%), nonsmokers (89 ± 2%), nonusers of alcohol (77 ± 2%), with respiratory problems (53 ± 2%), mainly rhinitis (23 ± 2%), and without other health problems. There was a significant use of alcohol in males ( p = 0.010); among the alcohol users, there was a significant presence of respiratory problems ( p = 0.046), of pharyngitis/tonsillitis ( p = 0.003), and of gastroesophageal reflux (GER) ( p = 0.043); there was a significant presence of GER in subjects reporting endocrine problems ( p = 0.023), of gastritis ( p = 0.023), and of pharyngitis/tonsillitis ( p = 0.030). Conclusion There was a predominance of adult professional popular female singers, with complaints of respiratory issues (with a higher prevalence of rhinitis), without other general health issues, of nonsmokers, and of nonusers of alcohol.

P1945High levels of unawareness and suboptimal management of hypertension in India: data from a large community based study

Abstract Background Hypertension is the most common cause of the rising cardiovascular disease (CVD) epidemic in India. However, despite availability of proven therapies management remains sub-optimal. Purpose To determine the hypertension control rates and associated factors among adults with known hypertension in urban and rural India. Methods We conducted a representative population based cross-sectional survey among 12243 participants aged ≥30 years residing in rural and urban North and South India. Participants were selected using a multistage cluster random sampling technique. Trained personnel collected the data using an interviewer administered questionnaire, measured blood pressure, conducted anthropometry and collected bio-samples. Hypertension was defined as known hypertension (self-report of physician diagnosis) or systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. Control was defined as SBP &lt;140 mmHg and DBP &lt;90 mmHg among those with known hypertension. The associations were measured using logistic regression. Results The mean (±SD) age of participants was 47.7 (±12.5) years, women comprised 54%. The age-standardized prevalence of hypertension was 29.0% (95% CI: 28.2- 29.8) and known hypertension was 14.0% (13.4- 14.6). Among all hypertensives 38.6% (37.0–40.2) were on treatment and 26.2% (24.6–28.0) had their blood pressure controlled, while among known hypertensives 79.8% (77.8–81.7) were on treatment and 55.7% (53.3–58.1) had their blood pressure controlled. In multivariate analysis, participants from North Indian site [OR: 1.9 (1.6–2.3)], urban residents [1.3 (1.1–1.6)], younger participants [1.5 (1.2–1.8)], men [2.0 (1.5–2.6)], those with low socio-economic status [1.6 (1.1–2.3)], without comorbidities and those without a family history hypertension were more likely to be unaware about their hypertensive status and less likely to take treatment. Hypertension control was significantly higher in participants from South Indian site [1.5 (1.2–1.0)], the highly educated [1.6 (1.1–2.4)], those without heart diseases [1.8 (1.1–3.1)], those without central obesity [1.4 (1.1–1.9)], physically active individuals [1.5 (1.1–2.0)] and current non-alcohol users [1.9 (1.3–2.6)]. Conclusions Many individuals with hypertension remain unaware and sub-optimally managed. This warrants the implementation of tailored public education to raise awareness, complemented by active screening for the early detection and effective management of hypertension, in order to stem the rising tide of preventable CVD in India. Acknowledgement/Funding Unrestricted educational grant from Eli Lilly under the Lilly NCD Partnership

Determinants of alcohol use among people living with HIV initiating isoniazid preventive therapy in Ethiopia

BackgroundHepatotoxicity, an adverse effect of isoniazid preventative therapy (IPT), is exacerbated by alcohol consumption. Although the WHO recommends IPT for people living with HIV (PLHIV), it is contraindicated in regular alcohol users. The objective of this study was to identify the prevalence and determinants of alcohol use among PLHIV initiating IPT in Ethiopia. MethodsBaseline data (July 2013-May 2015) from 316 participants in the Enhance Initiation and Retention in IPT Care for HIV (ENRICH) study were used to assess the prevalence of alcohol use. Multinomial logistic regression was used to identify determinants of non-hazardous and hazardous alcohol use, compared to no alcohol use. ResultsOverall, 41.8% of participants reported alcohol use, of which 45.5% reported hazardous use. Compared to non-alcohol users, hazardous users were younger (adjusted odds ratio [AOR]: 1.06; 95% confidence interval [95% CI]: 1.02, 1.11), more likely to be male (AOR: 6.40; 95% CI: 3.17, 12.93), Orthodox (AOR: 3.96; 95% CI: 1.74, 9.00), have larger support networks (AOR: 3.82; 95% CI: 1.61, 9.06), and report greater amount (AOR: 14.80; 95% CI: 5.76, 38.02) and frequency (AOR: 5.91; 95% CI: 2.75, 12.67) of khat use. ConclusionsAlcohol use was prevalent in this population, and current WHO guidelines would exclude a substantial proportion of the population from receiving IPT. PLHIV in this region would benefit from routine screening for alcohol and khat use, and from substance use education and counseling while receiving IPT until it can be determined whether alcohol users can safely receive IPT.