Occasional Users Research Articles

Enhancing Clinicians' Use of Electronic Patient-Reported Outcome Measures in Outpatient Care: Mixed Methods Study.

Despite the increasing use of patient-reported outcome measures (PROMs) for collecting self-reported data among hospital outpatients, clinicians' use of these data remains suboptimal. Insight into this issue and strategies to enhance the use of PROMs are critical but limited. This study aimed to examine clinicians' use of PROM data for value-based outpatient consultations and identify efforts to enhance their use of PROMs in a Dutch university hospital. First, we aimed to investigate clinicians' use of outpatients' PROM data in 2023, focusing on adoption, implementation, and maintenance. Second, we aimed to develop insights into the organizational-level strategies implemented to enhance clinicians' use of PROM data from 2020 to 2023. This included understanding the underlying rationales for these strategies and identifying strategies that appeared to be missing to address barriers or leverage facilitators. Third, we aimed to explore the key factors driving and constraining clinicians' use of PROMs in 2023. We integrated data from 4 sources: 1-year performance data on clinicians' use of PROMs (n=70 subdepartments), internal hospital documents from a central support team (n=56), a survey among clinicians (n=47), and interviews with individuals contributing to the organizational-level implementation of PROMs (n=20). The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to analyze clinicians' adoption, implementation, and maintenance of PROMs. Strategies were analyzed using the Expert Recommendations for Implementing Change taxonomy, and results were structured around the constructs of capability, opportunity, and motivation. On average, around 2023, clinicians accessed PROM data for approximately 3 of 20 (14%) patients during their outpatient consultation, despite numerous strategies to improve this practice. We identified issues in adoption, implementation, and maintenance. The hospital's strategies, shaped organically and pragmatically, were related to 27 (37%) out of 73 Expert Recommendations for Implementing Change strategies. These strategies focused on enhancing clinicians' capability, opportunity, and motivation. We found shortcomings in the quality of execution and completeness of strategies in relation to addressing all barriers and leveraging facilitators. We identified variations in the factors influencing the use of PROMs among frequent PROM users, occasional users, and nonusers. Challenges to effective facilitation were apparent, with certain desired strategies being unfeasible or impeded. Enhancing clinicians' use of PROMs has remained challenging despite various strategies aimed at improving their capability, opportunity, and motivation. The use of PROMs may require more substantial changes than initially expected, necessitating a shift in clinicians' professional attitudes and practices. Hospitals can facilitate rather than manage clinicians' genuine use of PROMs. They must prioritize efforts to engage clinicians with PROMs for value-based outpatient care. Specific attention to their professionalization may be warranted. Tailored strategies, designed to address within-group differences in clinicians' needs and motivation, hold promise for future efforts.

Club Drugs and Psychiatric Outcomes: A Descriptive Case Series from Spain

Background: illegal drugs significantly contribute to global health issues, with health complications often occurring not only in regular users with Substance Use Disorders (SUDs) but also in first-time and occasional users. Methods: this study examines five clinical cases from a public hospital in Ibiza, Spain, where patients presented with acute psychiatric symptoms due to recreational drug use. Results: Contrary to previous studies on SUDs, our patients typically had higher education levels and stable employment. Most of them used multiple substances, with cannabis, cocaine, and alcohol being the most frequently used. There was also a common occurrence of consuming drugs with uncertain contents. Upon admission, typical symptoms included aggression, hallucinations, mood swings, and disorientation in time and space. Conclusions: Our findings underscore the significant mental health risks posed by illicit drugs, even for individuals with no prior psychiatric history. Factors like the drug’s potency, frequency and amount of use, past mental health issues, personality traits, and previous traumatic experiences might influence the onset of these symptoms.

Research on Regulation Method of Variable-Air-Volume Air Conditioning System with “Personal Space”

In large public facilities, such as airport terminals or open-plan office spaces, the HVAC system typically consumes substantial amounts of energy. However, individuals often gather at specific areas while other zones are occupied by transient or occasional users. To minimize operational energy usage, this paper aims to reduce thermal comfort demands in non-targeted areas. This paper introduces a method for regulating the thermal environment around occupants exclusively in the variable-air-volume (VAV) air conditioning running mode. The investigation utilizes Airpak modeling and experimental verification techniques. Additionally, an analysis of temperature field and velocity field distributions within the room under the “personal space” operation mode is presented. The results suggest that adjusting the numbers of air vents, openings, airflow velocities, and air supply orientations can establish a comfortable thermal environment for inhabitants and reduce the overall ADPI value. The combined air supply mode leads to a 16.7% reduction in power usage compared to traditional full-space operation.

E-cigarette use and associated factors among adults aged 18-44 years in China: Findings from an online survey.

There needs to be more up-to-date evidence on the prevalence of e-cigarette use among Chinese adults. This study aims to investigate the prevalence and associated factors of e-cigarette use among adults aged 18-44 years in China. Cross-sectional design and convenience sampling were used. The data for this study were obtained from an online survey conducted in mainland China from April to May 2023. The target population was adults aged 18-44 years. Descriptive analysis was employed to report the prevalence of e-cigarette use, while adjusted multivariable logistic regression was performed to examine the association between e-cigarette use and related factors. A total of 4256 participants were included in this study; 12.9% were current e-cigarette users, 5.9% were frequent users, and 7.0% were occasional users. The descriptive analysis results indicated that males and cigarette users had a higher prevalence of e-cigarette use. Multivariable analysis showed that e-cigarette use was significantly associated with female gender (AOR=0.76, 95% CI: 0.60-0.96), those aged 25-34 years with monthly income 6000-8999 CNY (AOR=2.01; 95% CI: 1.18-3.41), those aged 25-34 years with monthly income ≥9000 CNY (AOR=2.20; 95% CI: 1.26-3.82), college or undergraduate degree (AOR=1.91; 95% CI: 1.22-3.00), urban residence (AOR=1.72; 95% CI: 1.34-2.20), being a current smoker (AOR=3.32; 95% CI: 2.64-4.16), perception of harm (AOR=0.66; 95% CI: 0.60-0.73), and perception of benefit (AOR=2.31; 95% CI: 2.04-2.61). The prevalence of current e-cigarette use among adults in China was 12.9% within our sample. In addition to sociodemographic factors, individuals with a higher perception of the harm associated with e-cigarettes were less likely to engage in e-cigarette consumption. Conversely, individuals who perceive the 'benefits' of e-cigarettes more favorably use them. Targeted interventions, such as health education, are recommended to help adults develop a correct understanding of e-cigarettes and lower the prevalence of e-cigarette use.

W25 - Motives Behind Frequency of Cannabis Use: A Comparison of Regular and Occasional Young Adult Cannabis Users

W25 - Motives Behind Frequency of Cannabis Use: A Comparison of Regular and Occasional Young Adult Cannabis Users

T24 - Cannabis Use Effects on Reaction Time in Daily Versus Occasional Users

T24 - Cannabis Use Effects on Reaction Time in Daily Versus Occasional Users

Psychosocial characteristics of the general population who habitually use hypnotics: Results from a national survey on drug use among the Japanese.

The aim of this study was to examine the characteristics of habitual hypnotic users in Japan. This nationwide, cross-sectional survey used self-administered questionnaires. Data were collected from four national surveys conducted every 2 years between 2015 and 2021. The participants were Japanese individuals who had taken prescription hypnotics in the past year or had never taken them. We divided 13,396 participants into three groups to compare the social background and status of taking medication and controlled drugs, drinking, and smoking among the three groups: people who use hypnotics habitually daily (habitual hypnotic users [HUs]), people who use them only occasionally (occasional hypnotic users [OUs]), and people who do not use them (hypnotic non-users [NUs]). We compared the perception of using hypnotics between the HU and OU groups. HUs were more likely to be older, unemployed, and to habitually use anxiolytics and analgesics than NUs. The main reasons for taking anxiolytics in HUs were alleviating insomnia and reducing anxiety, whereas the main reason for taking analgesics was improving joint pain. Additionally, the HU group had a higher proportion of habitual smokers than the OU group. There was no difference in drinking status or taking of controlled drugs among the three groups. HUs were more likely to use hypnotics and to have concerns about their side-effects than OUs. HUs were more likely to be unemployed, habitually use anxiolytics and analgesics, smoke heavily, and take hypnotic drugs with concerns regarding side-effects. These results may help encourage the appropriate use of hypnotics.

Dissecting shared e-scooters usage patterns and its impact on other transportation modes: A case study of Portland city

The study analyzed the survey data from the 2018 Portland E-scooter Pilot Program and aims to determine (i) who uses shared e-scooters and why they use them, and (ii) whether there is any association between e-scooter usage and the usage of other modes of transportation. To accomplish the first objective, the study identifies the users of shared e-scooters based on their travel behavior using an unsupervised machine learning approach, latent class analysis (LCA). The LCA model grouped e-scooter users into three distinct classes: Class 1 (Recreational Enthusiasts) −occasional and frequent users for recreation, Class 2 (Commute Riders) −frequent users for work, and Class 3 (Intermittent Joyriders) −occasional and one-time users for recreation. Furthermore, a set of ordered logit models is employed to determine the second objective based on the identified classes of e-scooter users, their socio-demographic characteristics, and the built environment variables. The results of ordered logit models revealed that compared to Commute Riders, both Recreational Enthusiasts and Intermittent Joyriders exhibit less interest in increasing the usage of available transportation modes after adopting e-scooters. Notably, low-income e-scooter users show a higher probability of increasing their usage across various transportation modes, including public transportation, driving, shared mobility services, personal bikes, shared bikes, and walking. The study offers valuable insights to guide city planners and policymakers in developing effective strategies for the deployment of e-scooters, targeting each group of users.

Water suppression 101 for benchtop NMR–An accessible guide and primer including fully interactive training videos

Benchtop NMR is enjoying a renaissance with numerous manufacturers bringing products to the market over the last decade. The improved accessibility, lower cost of ownership and ease of use (vs high field NMR), is attracting new users into NMR spectroscopy, which is highly beneficial for the field in general. As benchtop NMR systems seldom require deuterated solvents, this allows samples to be analyzed “as is”, without extraction or alteration. However, many interesting samples, be it an organic reaction mixture, beer, or a biofluid, contain one or more solvent/water signals, which often require suppression. Due to the lower spectral dispersion of benchtop NMR's (vs high field) the frequency of solvent/water is much closer to the analytes of interest, making solvent suppression more challenging. As such, there is a conundrum, where novel users wish to analyze unaltered samples but are quickly faced with the challenge of water suppression, and the wealth of options in the high field literature can be overwhelming. It is important to note that all manufacturers offer some sort of automated water suppression that can be performed with a “single click” that are sufficient for “walk-up” applications or occasional users. This primer is aimed as an accessible guide to those wishing to take the next step and is suitable for users who; 1) would like to pick the optimal water suppression approach for their sample type and 2) wish to understand how water suppression works. The guide focuses on water suppression approaches that are easy to apply, namely presaturation based sequences, binomial sequences for aggressive suppression, and WET for multiple signal suppression, across a range of samples including sucrose standards, espresso, human blood serum and wine. The primer finishes with a flow chart that can be used to guide users in choosing the optimal water suppression approach for their specific sample type, with considerations, including exchangeable signals and the preservation of macromolecular signals, amongst others. In addition, the primer includes 3 fully interactive videos based on H5P technology, focusing on how to acquire data using the approaches described here. The videos include quizzes, with a first-person-perspective of the spectrometer software with interactive elements, as if the users were acquiring the data themselves. In summary, the primer is aimed at advanced undergraduates, graduate students, new users, or users wishing to expand their water/solvent suppression skills/knowledge using benchtop NMR.

Biomarkers of metal exposure in adolescent e-cigarette users: correlations with vaping frequency and flavouring

BackgroundYouth vaping poses a significant public health concern as metals have been detected in e-cigarette aerosols and liquids. This study investigated factors associated with biomarkers of metal exposure.MethodsData were drawn...

Improving figures for climate change communications: Insights from interviews with international policymakers and practitioners

Nearly 200 governments rely on the Intergovernmental Panel on Climate Change (IPCC) for scientific assessments of climate change. IPCC figures are important for conveying key findings, but can be difficult for policymakers and practitioners to understand. Best practices in graph design, summarized in the IPCC’s visual style guide, recommend conducting interviews with members of the target audience before finalizing figures. Therefore, we interviewed 20 policy makers and practitioners from different countries about three figures drafted for the second order draft of the summary for policymakers associated with IPCC’s Working Group III Sixth Assessment Report. Half were frequent users and half were occasional users of climate science, but similar comments emerged from both groups. The figures received a median rating of 3, on a scale from 1 (= not easy at all to understand) to 5 (= very easy to understand). Showing the caption did not always improve these ratings. Overall, two types of recommendations emerged. First, participants suggested focusing each figure on one key message for policymakers, and removing irrelevant details. For IPCC authors, this involves making hard choices about what to show in the figure and what to leave for the text. Additionally, participants suggested straightforward fixes such as using clear titles, labels, and captions that support the key message. Based on our findings, we present recommendations for the design of climate change figures, and examples of revised figures. These recommendations should be useful for the next round of IPCC reports, and for other organizations that communicate about climate science with policymakers and practitioners.

Biomarker Assessment of Nicotine Exposure Among Adolescent E-Cigarette Users: 2018-2019.

Despite the increasing prevalence of vaping e-cigarettes among adolescents, there remains a lack of population-level assessments regarding the objective measurement of nicotine exposure. This study analyzed a nationally representative sample of adolescents aged 13 to 17 years from Wave 5 of the Population Assessment of Tobacco and Health Study conducted between 2018 and 2019. Urinary nicotine metabolites, including cotinine and trans-3'-hydroxycotinine (3-HC), were assessed among exclusive nonnicotine e-cigarette users (n = 56), exclusive nicotine e-cigarette users (n = 200), and nonusers (n = 1059). We further examined nicotine exposure by past 30-day vaping frequency (ie, occasional [1-5 days], intermittent [6-19 days], and frequent [20+ days]) and flavor types among nicotine e-cigarette users. Multivariable linear regressions tested pairwise group effects, and biomarkers were normalized by the log transformation. Compared with nonusers, both nonnicotine and nicotine e-cigarette users exhibited higher levels of cotinine and 3-HC. Nicotine e-cigarette users had mean cotinine concentrations (61.3; 95% confidence interval, 23.8-158.0, ng/mg creatinine) approximately 146 times higher (P < .0001) than nonusers (0.4; 0.3-0.5), whereas nonnicotine users (4.9; 1.0-23.2) exhibited cotinine concentrations ∼12 times higher (P = .02). Among nicotine e-cigarette users, the levels of cotinine and 3-HC increased by vaping frequency, with cotinine increasing from 10.1 (2.5-40.1) among occasional users to 73.6 (31.8-170.6) among intermittent users and 949.1 (482.5-1866.9) among frequent users. Nicotine exposure was not significantly different by flavor type. E-cigarette use poses health-related risks resulting from nicotine exposure among adolescents. Comprehensive regulations of e-cigarette products and marketing, vaping prevention, cessation, and public policies are needed to prevent youth from developing nicotine addiction.

Influence of Dietary Seafood on the Prevention of Ocular Disorders: A Clinical Analysis

Age-related macular degeneration, retinal dysfunction, dry eye syndromes, cataract formation, and the prevalence of other vision defects are directly related to nutrients in the diet. People consuming seafood are less prone to several vision disorders. The present study was designed to validate the view. In this study, 712 visitors to tertiary eye care for eye check-ups were interviewed using a standard questionnaire, and from them, 264 persons were identified with some ocular defects. The identified cases were further screened based on their dietary habits with seafood. The isolated cases were clinically examined, and the development of ocular defects such as macular edema, optic neuropathy, myopia, double vision, dry eye syndrome, and color blindness was recorded. The results show that the respondents taking one or another type of three fishes regularly have a low impact on visual disorders. Respondents with fish intake above 500 g/week were less affected by all five ocular disabilities tested when compared with occasional users. Among the total respondents, the percentage of visual defects was seen in 62.12% in seafood users, but among the non-seafood users, the presence of visual defects was 89.6%. Statistical analysis using the Pearson population correlation coefficient, ρ (rho), further confirmed the relationship between eye wellness and a seafood diet. The omega-3 fatty acids linked with vision were also high in the fish consumed by the people. This study confirms that a regular seafood diet is good for eye health and can prevent the epidemics of several eye diseases. As fish intake contains a good amount of long-chain polyunsaturated omega-3 fatty acids, people who consume fish in their diet are less susceptible to advanced macular degeneration and other vision impairments responsible for age-related blindness.

Concurrent E-cigarette Use While Enrolled in a Smoking Cessation Program: Associations Between Frequency of Use, Motives for Use, and Smoking Cessation.

Trial evidence suggests that e-cigarettes may aid in quitting smoking, while observational studies have found conflicting results. However, many observational studies have not adjusted for important differences between e-cigarette users and non-users. We aimed to determine the association between e-cigarette use frequency and motivation to use e-cigarettes to quit smoking, and smoking cessation using data from Canada's largest smoking cessation program. Participants who completed a baseline assessment and 6-month follow-up questionnaire were divided post hoc into four groups based on their self-reported e-cigarette use during the 30 days before baseline: (1) non-users; (2) users of e-cigarettes not containing nicotine; (3) occasional users; and (4) frequent users. Occasional and frequent users were further divided into two groups based on whether they reported using e-cigarettes to quit smoking. Abstinence at 6-month follow-up (7-day point prevalence abstinence) was compared among groups. Adjusted quit probabilities were significantly higher (both p < .001) for frequent baseline e-cigarette users (31.6%; 95% CI = 29.3%, 33.8%) than for non-users (25.8%; 25.3% and 26.3%) or occasional users (24.2%; 22.5% and 26.0%). Unadjusted proportions favored non-users over occasional users (p < .001), but this was not significant after adjustment (p = .06). People using e-cigarettes to quit smoking were not likelier than other users to be successful, but were likelier to report frequent e-cigarette use during follow-up. Frequent baseline e-cigarette use predicted successful smoking cessation, compared to occasional and non-users. Use of e-cigarettes to quit did not predict smoking cessation but was associated with continued use during follow-up, perhaps due in part to planned transitions to e-cigarettes. Prior observational studies investigating e-cigarette use for smoking cessation have found that occasional users have poorer outcomes than either frequent or non-users. Consistent with these studies, occasional users in our data also had poorer outcomes. However, after adjustment for variables associated with cessation success, we found that cessation probabilities did not differ between occasional and non-users. These findings are consistent with trial data showing the benefit of e-cigarette use among people trying to quit smoking. Results of this study suggest that differences between trials and previous observational studies may be because of unaddressed confounding in the latter.

Travel behaviour differences among people with disabilities: A cluster analysis of accessible taxi users before and during the COVID-19 pandemic

IntroductionPeople with disabilities (PWD) represent the largest minority group in Canada. Many municipalities have implemented paratransit services and subsidized accessible taxi services to provide affordable and equitable transport choices for PWD. However, few scholars have examined who is using these services and how they use them, making it challenging to assess the social impacts of paratransit projects. This study helps to address this knowledge gap through its examination of the differences in travel behaviour among PWD who use accessible taxi services in Toronto, Canada. Specifically, our study engages four research questions: (1) who are accessible taxi service users? (2) how are individuals using accessible taxi services? (3) are there different groups of users based on their travel behaviour? and, (4) how has travel behaviour changed in relation to the COVID-19 pandemic? MethodsThis article employs a cluster analysis to categorize users based on their travel habits and patterns and examines the impact of the COVID-19 pandemic on their travel behaviour. Study data includes approximately one million trips made by 40,000 users between June 2018 and June 2021. ResultsThe study identifies five distinct user profiles among accessible taxi users. During the pandemic, there was a significant decrease in the number of PWD using accessible taxi services, particularly for occasional users. Conversely, the percentage of users who made health-related trips increased. Additionally, the findings suggest that PWD who continued or started using accessible taxi services during the pandemic are more likely to be among the most socially disadvantaged groups. ConclusionsThis study can help transit service providers and policymakers better understand the different types of paratransit users and improve services. Additionally, the findings contribute to the existing literature on addressing transport-related social exclusion in Toronto, which is largely focused on population groups with low-income and affordability issues, and not disability.

Determinants of waterpipe smoking in Iranian adults: results from the IROPICAN study.

Waterpipe smoking has become increasingly popular in Western countries, particularly among young individuals. This study aims to identify the factors influencing waterpipe smoking by focusing on consumption patterns. We utilized data from a multicenter case-control study (IROPICAN) conducted in Iran. Multivariate logistic regression estimated the adjusted odds ratio and 95% confidence intervals as a measure of association between waterpipe smoking and different factors. Among 3,477 subjects were included, 11.8% were waterpipe smokers. Most of <50 years old smokers were occasional (80%), while daily smokers were often >50 years (85%). Around 59% of occasional users started it before 30 years old. Low education, low SES, alcohol consumption, cigarette smoking, secondhand smoke exposure, and opium use were associated with waterpipe smoking. Stratified analysis by frequency pattern showed an association between occasional smoking with age 0.97 (0.96-0.98), university degree 0.36 (0.17-0.76), urban dwellers 1.40 (1.06-1.86) and between high SES and daily smoking 0.34 (0.17-0.69). Our results offer valuable information to policymakers for developing waterpipe smoking control measures. The occasional waterpipe smoking results may be generalized to the younger people in Western countries.

Cannabis use and incident atrial fibrillation in a longitudinal cohort

BackgroundCannabis use is increasing worldwide. While prior studies have reported an association between cannabis use and a higher risk of atrial fibrillation (AF), most were cross-sectional and generally relied on diagnostic coding to identify cannabis users, which may not be representative of the typical recreational cannabis user. ObjectiveThe purpose of this study was to examine the association between recreational cannabis use and lifetime AF risk. MethodsWe evaluated the AF risk of participants of the UK Biobank cohort who completed the cannabis use lifestyle questionnaire. Cannabis exposure was categorized as “Occasional Use” for less than 100 times used, “Frequent Use” for more than 100 times used, and “Never” users. AF events were identified using International Classification of Diseases codes. Cox models were used to estimate the hazard ratios (HRs) between cannabis use and incident AF and were subsequently adjusted for age, sex, race, alcohol, coffee, smoking, education, and baseline cardiovascular comorbidities. ResultsA total of 150,554 participants (mean age 63.4 ± 7.7 years; 86,487 (57.4%) female; and 33,442 (22.2%) using cannabis at least once) were followed for a mean period of 6.1 ± 0.6 years. After multivariable adjustment, there were no statistically significant differences in incident AF among occasional users (HR 0.98; 95% confidence interval 0.89–1.08) nor frequent users (HR 1.03; 95% confidence interval 0.81–1.32) as compared with never users. ConclusionIn a large prospective cohort study, there was no evidence that cannabis use was associated with a higher risk of incident AF. An evaluation of cannabis ingestion methods and quantification was not possible using the current data set.

Bus Line Shift Behaviour: Evidence of Influential Factors based on Smart Card Data

This paper aims to analyse the factors that influence the behaviour in relation to bus line shift with the support of large-scale smart card datasets, focussing on a case study of the public transport network in Belo Horizonte, Brazil. We developed a binary discrete choice model to assess the factors affecting the changes of the bus line, including the time of day, peak periods, day of the week, number of trips taken by users, type of user, and destination of the trip. We address some research gaps identified in the recent literature by examining factors that influence user behaviour in addition to uncovering urban mobility patterns. The results of a Logit choice model are discussed considering the attributes of the service and of the journey to support evidence-based policy making for adapting bus service design, drawing insights from extensive smart card dataset analysis. Our findings indicate that users are generally inclined to bus line shifts than using the same lines, with such changes occurring more frequently during late hours and inter-peak periods compared to the morning and afternoon peak hours. Additionally, regular users are more likely to change lines than occasional users, and trips with discounts and smart card usage for transfers on trips home tend to involve different lines. Several policy measures can be considered to mitigate passenger discomfort associated with changing bus lines and to reduce operational costs arising from multiple lines serving the same locations. These include investing in promotional efforts to enhance the image of specific bus lines, prioritising certain lines during the day to minimise travel times and retain passengers on the same bus, adjusting line frequencies to reduce the need for transfers, and offering additional incentives to frequent users. Implementing discounts in corridors with shorter travel times can also encourage passengers to remain on the same buses.

Habitual fish oil supplementation, genetic susceptibility of kidney stones and the risk of new-onset kidney stones

We aimed to assess the association between habitual fish oil use and new-onset kidney stones in participants with different levels of genetic risks of kidney stones. 477,311 participants free of kidney stones at baseline from the UK Biobank cohort were included. Fish oil use was collected by both food frequency questionnaires and 24-h dietary recalls. A genetic risk score (GRS) for kidney stones was calculated based on 20 single-nucleotide polymorphisms associated with kidney stones. The primary outcome was new-onset kidney stones. During a median follow-up of 12.0 years, 5,637 cases of kidney stones were documented. Participants with high genetic risks of kidney stones had a higher risk of new-onset kidney stones (vs. low or intermediate risks; adjusted HR, 1.52; 95 %CI:1.44-1.60). Compared with non-users, habitual use of fish oil was associated with a lower risk of new-onset kidney stones (adjusted HR, 0.84, 95 %CI, 0.78-0.92) in participants with low or intermediate genetic risks, but not in those with high genetic risks of kidney stones (adjusted HR, 1.02, 95 %CI, 0.93-1.12; P-interaction =0.001). Among those with low or intermediate genetic risks of kidney stones, compared with fish oil constant nonusers, the adjusted HRs (95 %CI) for kidney stones were 0.89 (0.75-1.06), 0.72 (0.58-0.90), and 0.79 (0.64-0.97), for fish oil occasional users, modestly constant users, and moderately and highly constant users (P for trend = 0.001), respectively. Habitual fish oil use was associated with a lower risk of new-onset kidney stones in participants with low or intermediate genetic risk of kidney stones.

Abstract 17236: Risk of Incident Atrial Fibrillation Associated With Recreational Cannabis Use

Background: Cannabis use is increasing worldwide as legalization becomes more common. Prior studies have reported an association between cannabis use and increased risk of atrial fibrillation (AF). However, these have been cross-sectional and generally relied on diagnostic coding to identify cannabis users, which may not be representative of the typical recreational cannabis user. Goals: To examine the association between recreational cannabis use and AF risk. Methods: We utilized the UK Biobank, a prospective cohort study with serial assessments of lifestyle and medical diagnoses. Those who completed the cannabis use questionnaire and without prevalent AF were analyzed. Cannabis exposure was ascertained by self-reported lifetime use. AF events were identified using healthcare coding. Cox proportional hazard regression models were used to estimate the hazard ratios between the cannabis use groups and incident AF. Models were adjusted for age, sex, race, alcohol, coffee, smoking, education, and baseline cardiovascular comorbidities. Results: 157,305 participants (mean age 55.9 ± 7.7 years, 57.0% female, and 22.1% having used cannabis at least once) were followed for a mean 13.5 ± 1.7 years. Before multivariable adjustment, AF risk was found to be lower among occasional cannabis users (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.66 to 0.75, p &lt; 0.001) and frequent cannabis users (HR 0.63, 95% CI 0.53 to 0.75, p &lt; 0.001) compared to never users. However, after multivariable adjustment and compared to no cannabis use, neither occasional nor frequent cannabis use was associated with statistically significant differences in incident AF (HR 0.98, 95% CI 0.91 to 1.05, p = 0.58 and HR 0.98, 95% CI 0.82 to 1.18, p = 0.86 respectively) (Figure). Conclusions: Contrary to previous evidence relying on healthcare coding of cannabis use, this large prospective cohort study failed to reveal any evidence that cannabis use was associated with an increased risk of AF.