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Objective: Alcohol Use Disorder (AUD) is a common, chronically relapsing condition with substantial health and economic costs. United States federal agencies have put out calls in the last decade to expand the scientific evidence base for broad biopsychosocial recovery from AUD and other substance use disorders (SUD). The present study examined the role of physical activity and exercise in early recovery from AUD, with specific attention to changes in brain-derived neurotrophic factor (BDNF) as a marker of neuroplasticity and a potential mechanism for instantiation of recovery-aligned behaviors. Method: Individuals in the first year of recovery from AUD were recruited into a 12-week study with exercise sessions and pre/post-exercise blood sample collection performed in a laboratory setting at baseline, 6 weeks, and 12 weeks. Data analyses included BDNF enzyme-linked immunosorbent assays (ELISA) to establish pre/post-exercise BDNF concentrations, estimation of the magnitude of the effect of exercise on BDNF, and prospective associations of exercise-induced BDNF change with coping, craving, consumption and mood outcome measures. Results: 26 participants were screened, 22 were eligible, 7 had entered the study, and 6 had provided at least one set of pre/post-exercise blood samples when student research ceased on March 23rd, 2020 due to COVID-19 precautions. Participants with at least one set of pre/post-exercise blood samples demonstrated a statistically significant (p=.014) increase from baseline in BDNF levels after exercise, with a large effect size (Cohen's d=1.519;Hedges' g=1.019 ). The impact of this increase from baseline on subsequent measures of coping, craving, mood, and substance use is unclear due to lack of statistical power. Conclusions: This study is the first to demonstrate that individuals recovering from AUD can increase serum levels of BDNF from baseline levels via sessions of physical exercise. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background: Nurses and other first responders are at high risk of exposure to the SARS-CoV2 virus, and many have developed severe COVID-19 infection. A better understanding of the factors that increase the risk of infection after exposure to the virus could help to address this. Although several risk factors such as obesity, diabetes, and hypertension have been associated with an increased risk of infection, many first responders develop severe COVID-19 without established risk factors. As inflammation and cytokine storm are the primary mechanisms in severe COVID-19, other factors that promote an inflammatory state could increase the risk of COVID-19 in exposed individuals. Alcohol misuse and shift work with subsequent misaligned circadian rhythms are known to promote a pro-inflammatory state and thus could increase susceptibility to COVID-19. To test this hypothesis, we conducted a prospective, cross-sectional observational survey-based study in nurses using the American Nursing Association network. Method(s): We used validated structured questionnaires to assess alcohol consumption (the Alcohol Use Disorders Identification Test) and circadian typology or chronotype (the Munich Chronotype Questionnaire Shift -MCTQ-Shift). Result(s): By latent class analysis (LCA), high-risk features of alcohol misuse were associated with a later chronotype, and binge drinking was greater in night shift workers. The night shift was associated with more than double the odds of COVID-19 infection of the standard shift (OR 2.67, 95% CI: 1.18 to 6.07). Binge drinkers had twice the odds of COVID-19 infection of those with low-risk features by LCA (OR: 2.08, 95% CI: 0.75 to 5.79). Conclusion(s): Working night shifts or binge drinking may be risk factors for COVID-19 infection among nurses. Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce.Copyright © 2023 The Authors. Alcohol: Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.
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Background Methods Results Conclusions The SARS‐CoV‐2/COVID‐19 pandemic has been associated with increased stress levels and higher alcohol use, including in pregnant and postpartum women. In the general population, alcohol use is associated with dysregulation in the autonomic nervous system (ANS), which is indexed by heart rate variability (HRV). The objectives of this study were to: (1) characterize changes in substance use during the SARS‐CoV‐2/COVID‐19 pandemic via a baseline self‐report survey followed by mobile ecological momentary assessment (mEMA) of substance use;and (2) examine the associations between momentary substance use and ambulatory HRV measures in pregnant and postpartum women.Pregnant and postpartum women were identified from the ENRICH‐2 prospective cohort study. Participants were administered a baseline structured phone interview that included the Coronavirus Perinatal Experiences (COPE) survey and ascertained the prevalence of substance use. Over a 14‐day period, momentary substance use was assessed three times daily, and HRV measurements were captured via wearable electronics. Associations between momentary substance use and HRV measures (root mean square of successive differences [RMSSD] and low frequency/high frequency [LF/HF] ratio) were examined using a mixed effects model that included within‐subject (WS) and between‐subject (BS) effects and adjusted for pregnancy status and participant age.The sample included 49 pregnant and 22 postpartum women. From a combination of a baseline and 14‐day mEMA surveys, 21.2% reported alcohol use, 16.9% reported marijuana use, and 8.5% reported nicotine use. WS effects for momentary alcohol use were associated with the RMSSD (β = −0.14;p = 0.005) and LF/HF ratio (β = 0.14;p = 0.01) when controlling for pregnancy status and maternal age. No significant associations were observed between HRV measures and instances of marijuana or nicotine use.These findings highlight the negative effect of the SARS‐CoV‐2/COVID‐19 pandemic on the psychological health of pregnant and postpartum women associated with substance use, and in turn, ANS dysregulation, which potentially puts some women at risk of developing a substance use disorder. [ FROM AUTHOR] Copyright of Alcoholism: Clinical & Experimental Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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BACKGROUND: Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health. METHODS: We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis. RESULTS: Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2-26.2) before lockdown, 25.5% (20.0-30.3) in May and 28.2% (21.2-35.2) in September. CONCLUSIONS: Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.
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BACKGROUND: This study examined changes in reported alcohol use among women during the early stages of the COVID-19 pandemic and the relations to adverse changes in employment (e.g. job loss, furlough, reduced pay). Further, this study assessed how the relation between changes in alcohol use and experiencing an adverse change in employment was moderated by four theoretically relevant dimensions of conformity to masculine norms (CMNI, i.e. risk-taking, winning, self-reliance, and primacy of work). METHODS: The sample for the present study is a subset of a survey that was conducted in the spring of 2020 among U.S. adults and includes 509 participants who met the inclusion criteria. We assessed pandemic-related employment change status, changes in reported frequency and quantity of alcohol consumed, and four CMNI dimensions. Relations between these variables were assessed with a multinomial logistic regression path model. RESULTS: Experiencing an adverse change in employment early in the pandemic was related to increased alcohol use when moderated by the CMNI dimension primacy of work. For people higher on primacy of work, an adverse change in employment was associated with a higher likelihood of reporting an increase in frequency, but not quantity, of drinking (rather than a decrease or no change). Not experiencing an adverse change in employment early in the pandemic was associated with an increased likelihood of reporting an increase for quantity but not frequency. CONCLUSION: The results highlight the importance of considering how work-oriented women may be at risk for increasing alcohol use when confronted with changes in work status.
Subject(s)
COVID-19 , Pandemics , Adult , Humans , Female , Social Behavior , Employment , Alcohol Drinking/epidemiologyABSTRACT
Some preliminary work during the COVID-19 pandemic indicates that adult alcohol use increased, particularly for parents. This cross-sectional study examined the quantity and frequency of adults' alcohol use during the early stages of the pandemic. Additionally, the influences of gender, parenthood, COVID-19-related stressors and intimate partner violence (IPV) on alcohol consumption were examined. The sample consisted of 298 adults (98 parents) from across the United States who completed self-report surveys through Qualtrics at the beginning of the pandemic in May 2020. In the present study, all men reported higher levels of drinking compared to all women. Although stress levels did not impact alcohol consumption, findings indicate that increased IPV experiences were associated with higher levels of heavy drinking during the pandemic. Results also suggested that having children in the home particularly impacted drinking levels during the pandemic, above and beyond the influence of gender, IPV, and stress levels. These findings suggest that parenthood may have had a cascading influence on drinking experiences during the COVID-19 pandemic. Implications and recommendations for further research are discussed.
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Stakeholder and consumer participation is generally seen as a critical part of effective alcohol policy making as it has a direct impact on policy implementation. In the advent of COVID-19, the views and experiences of stakeholders and consumers were integral to how countries responded to the virus. The involvement of alcohol stakeholders and consumers raises critical questions about policy making practices. Using Grounded Theory (GT) methods amongst 20 drinkers and six alcohol stakeholders, I examined the views and experiences of stakeholders and alcohol consumers in Botswana during COVID-19. I identified two interrelated core categories of Balancing the Drinking Act and Problematic Youth Drinking that were prominent as the country dealt with the COVID-19 pandemic. First, I argue that balancing the drinking act suggests the need for government to balance alcohol regulation with the needs of drinkers. Second, I highlight that problematic youth drinking relates to an emerging yet consistent belief that young people in Botswana are collectively responsible for alcohol "problems." These key themes center consumer and stakeholder participation in alcohol policy development. Moreover, the current analysis demonstrates the interplay between alcohol use and prohibition during COVID-19, and how it might be mediated by cultural scripts used by consumers and stakeholders in Botswana.
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This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV-r) in treating patients with coronavirus disease-2019 (COVID-19) and substance use disorders (SUDs). This study included two cohorts: the first examined patients with SUDs, with and without a prescription for NMV-r, while the second compared patients prescribed with NMV-r, with and without a diagnosis of SUDs. SUDs were defined using ICD-10 codes, related to SUDs, including alcohol, cannabis, cocaine, opioid, and tobacco use disorders (TUD). Patients with underlying SUDs and COVID-19 were identified using the TriNetX network. We used 1:1 propensity score matching to create balanced groups. The primary outcome of interest was the composite outcome of all-cause hospitalization or death within 30 days. Propensity score matching yielded two matched groups of 10 601 patients each. The results showed that the use of NMV-r was associated with a lower risk of hospitalization or death, 30 days after COVID-19 diagnosis (hazard ratio (HR), 0.640; 95% confidence interval (CI): 0.543-0.754), as well as a lower risk of all-cause hospitalization (HR, 0.699; 95% CI: 0.592-0.826) and all-cause death (HR, 0.084; 95% CI: 0.026-0.273). However, patients with SUDs had a higher risk of hospitalized or death within 30 days of COVID-19 diagnosis than those without SUDs, even with the use of NMV-r (HR, 1.783; 95% CI: 1.399-2.271). The study also found that patients with SUDs had a higher prevalence of comorbidities and adverse socioeconomic determinants of health than those without SUDs. Subgroup analysis showed that the benefits of NMV-r were consistent across most subgroups with different characteristics, including age (patients aged ≥60 years [HR, 0.507; 95% CI: 0.402-0.640]), sex (women [HR, 0.636; 95% CI: 0.517-0.783] and men [HR, 0.480; 95% CI: 0.373-0.618]), vaccine status (vaccinated <2 doses [HR, 0.514; 95% CI: 0.435-0.608]), SUD subtypes (alcohol use disorder [HR, 0.711; 95% CI: 0.511- 0.988], TUD [HR, 0.666; 95% CI: 0.555-0.800]) and Omicron wave (HR, 0.624; 95% CI: 0.536-0.726). Our findings indicate that NMV-r could reduce all-cause hospitalization and death in the treatment of COVID-19 among patients with SUDs and support the use of NMV-r for treating patients with SUDs and COVID-19.
Subject(s)
COVID-19 , Substance-Related Disorders , Male , Humans , Female , COVID-19 Testing , Ritonavir/therapeutic use , COVID-19/diagnosis , COVID-19 Drug Treatment , Treatment Outcome , Substance-Related Disorders/complicationsABSTRACT
Background: Substance use is an understudied aspect of cystic fibrosis (CF) care. Even casual use of drugs or alcohol may reduce compliance with complicated treatment plans, worsen existing conditions associated with CF, or cause potential drug interactions. To understand the need for mitigation mechanisms for risky substance use in a CF population, we studied the prevalence of substance use in our adult CF clinic population to characterize relationships between substance use and health status. Method(s): In our large academic CF center, we performed a retrospective chart ion of 420 patients over a 6-year period (2015-2021). Clinical staff annually administer the Drug Abuse Screening Test (DAST-10), Alcohol Use Disorders Identification Test (AUDIT), Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder (GAD-7) to assess drug use, alcohol use, depression, and anxiety symptoms, respectively. Demographic characteristics, lung function (percentage predicted forced expiratory volume in 1 second (FEV1pp)), and anxiety and depression symptom screening scores were recorded. Because substance use can change over time, we counted each assessment date as an independent observation (n = 1434). The chi-square test (Table 1) was conducted in R/RStudio [1] to assess for associations between self-reported substance use and symptoms of depression and anxiety. Because of insufficient data, aggregate datawere used to describe the presence (PHQ-9 or GAD-7 >= 10) or absence (PHQ-9 or GAD-7 < 10) of symptoms of depression and anxiety. Result(s): Positive scores for risky use were defined as a DAST score of 1 or higher and an AUDIT score of 8 or hither. Eighty-three of 326 patients (25%) met criteria for risky substance use on at least one observation. Therewas a slight male predominance (54.2%) and wide age distribution (mean age 30 +/- 7, range 20-55);Thirty (36.1%) had a higher AUDIT score, 34 (40.9%) had a high DAST score, and 19 (22.9%) had high scores on both.We selected 2019 to evaluate single-year prevalence of positive screenings to avoid the impact of COVID. In 2019, 29 patients had at least one positive screening result (DAST,15/203, 7.3%;AUDIT, 24/193,12%;both,10/193, 5.2%). In the 6- year dataset, we did not find a statistically significant association between symptoms of depression and anxiety and indication of drug or alcohol use in self-reported users (355 observations). Conclusion(s): According to a 2020 national survey of healthy Americans, 20.8% have used illicit drugs at least once in the past year, and 10.2% meet criteria for alcohol use disorder [2], compared with 7.3% of patients in our 2019 data who have used drugs (n = 15) and 12% (n = 24) who indicated risky alcohol use. In this review, positive screening scores on the DAST and AUDIT were not associated with degree of symptoms of depression and anxiety, suggesting that substance use and symptoms of depression and anxiety were not temporally associated with each other. Future work will include analysis of the relationship between substance use and mental health in the larger University of North Carolina clinic population and linear regression to evaluate possible explanatory variables for substance use in this populationCopyright © 2022, European Cystic Fibrosis Society. All rights reserved
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Using data from a national online sample, the current study examined factors impacting changes in alcohol use immediately following the WHO pandemic declaration (March 2020), including pre-COVID risk for alcohol use disorder (AUD). Participants with pre-COVID AUD risk, who experienced at least one COVID-related problem (e.g. housing, finances), demonstrated the greatest increase in weekly drinking. However, college students at-risk for AUD pre-COVID, with academic disruptions, showed the greatest consumption increases. The findings provide insight into the complex relationships between COVID-19 related disruptions, preexisting AUD risk, and their impact on risky drinking during a critical period in the pandemic. Implications for future public health prevention and intervention responses are discussed.Copyright © 2023 Taylor & Francis.
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BACKGROUND: The pandemic caused by coronavirus disease 2019 (COVID-19) has forced governments to implement strict social mitigation strategies to reduce the morbidity and mortality from acute infections. These strategies, however, carry a significant risk for mental health, which can lead to increased short-term and long-term mortality and is currently not included in modeling the impact of the pandemic. METHODS: We used years of life lost (YLL) as the main outcome measure, applied to Switzerland as an example. We focused on suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, and social isolation, as these are known to increase YLL in the context of imposed restriction in social contact and freedom of movement. We stipulated a minimum duration of mitigation of 3 months based on current public health plans. RESULTS: The study projects that the average person would suffer 0.205 YLL due to psychosocial consequence of COVID-19 mitigation measures. However, this loss would be entirely borne by 2.1% of the population, who will suffer an average of 9.79 YLL. CONCLUSIONS: The results presented here are likely to underestimate the true impact of the mitigation strategies on YLL. However, they highlight the need for public health models to expand their scope in order to provide better estimates of the risks and benefits of mitigation.
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Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Mental Health/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Public Health/statistics & numerical data , Social Isolation/psychology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , Coronavirus Infections/mortality , Depression/epidemiology , Depression/psychology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pandemics , Pneumonia, Viral/mortality , Risk Assessment , Switzerland/epidemiology , Young AdultABSTRACT
Antiviral protease inhibitors are peptidomimetic molecules that block the active catalytic center of viral proteases and, thereby, prevent the cleavage of viral polyprotein precursors into maturation. They continue to be a key class of antiviral drugs that can be used either as boosters for other classes of antivirals or as major components of current regimens in therapies for the treatment of infections with human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, sustained/lifelong treatment with the drugs or drugs combined with other substance(s) often leads to severe hepatic side effects such as lipid abnormalities, insulin resistance, and hepatotoxicity. The underlying pathogenic mechanisms are not fully known and are under continuous investigation. This review focuses on the general as well as specific molecular mechanisms of the protease inhibitor-induced hepatotoxicity involving transporter proteins, apolipoprotein B, cytochrome P450 isozymes, insulin-receptor substrate 1, Akt/PKB signaling, lipogenic factors, UDP-glucuronosyltransferase, pregnane X receptor, hepatocyte nuclear factor 4α, reactive oxygen species, inflammatory cytokines, off-target proteases, and small GTPase Rab proteins related to ER-Golgi trafficking, organelle stress, and liver injury. Potential pharmaceutical/therapeutic solutions to antiviral drug-induced hepatic side effects are also discussed.
Subject(s)
COVID-19 , Chemical and Drug Induced Liver Injury , HIV Infections , HIV Protease Inhibitors , Humans , SARS-CoV-2 , HIV Protease Inhibitors/pharmacology , Protease Inhibitors/pharmacology , Antiviral Agents/adverse effects , Antiviral Agents/chemistry , HIV Infections/complications , HIV Infections/drug therapyABSTRACT
Objective: Drinking more and drinking to cope increase undergraduates' likelihood of experiencing alcohol-related problems (ARP; e.g., driving intoxicated). In accordance with stress-coping models of addiction, anxiety about COVID-19 may motivate undergraduates to drink to cope, leading them to experience more ARP. However, this hypothesis has not been tested. Participants and methods: During fall 2020, 358 undergraduate drinkers (Mage = 21.18; 69.80% cis-women; 62.30% White) provided data regarding COVID-anxiety, alcohol consumption, drinking to cope, and ARP during an annual student survey. Results: Mediation analysis controlling for alcohol consumption revealed greater COVID-anxiety predicted higher levels of drinking to cope; in turn, higher levels of drinking to cope were associated with more ARP. Additionally, the positive relationship between greater COVID-anxiety and experiencing more ARP was explained entirely by higher levels of drinking to cope. Conclusion: During the pandemic and beyond, university prevention and intervention initiatives should target coping motives for alcohol use to help students avoid ARP.
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Background: Recruiting underrepresented people and communities in research is essential for generalizable findings. Ensuring representative participants can be particularly challenging for practice-level dissemination and implementation trials. Novel use of real-world data about practices and the communities they serve could promote more equitable and inclusive recruitment. Methods: We used a comprehensive primary care clinician and practice database, the Virginia All-Payers Claims Database, and the HealthLandscape Virginia mapping tool with community-level socio-ecological information to prospectively inform practice recruitment for a study to help primary care better screen and counsel for unhealthy alcohol use. Throughout recruitment, we measured how similar study practices were to primary care on average, mapped where practices' patients lived, and iteratively adapted our recruitment strategies. Results: In response to practice and community data, we adapted our recruitment strategy three times; first leveraging relationships with residency graduates, then a health system and professional organization approach, followed by a community-targeted approach, and a concluding approach using all three approaches. We enrolled 76 practices whose patients live in 97.3% (1844 of 1907) of Virginia's census tracts. Our overall patient sample had similar demographics to the state for race (21.7% vs 20.0% Black), ethnicity (9.5% vs 10.2% Hispanic), insurance status (6.4% vs 8.0% uninsured), and education (26.0% vs 32.5% high school graduate or less). Each practice recruitment approach uniquely included different communities and patients. Discussion: Data about primary care practices and the communities they serve can prospectively inform research recruitment of practices to yield more representative and inclusive patient cohorts for participation.
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BACKGROUND: Telehealth has the potential to improve health care access for patients but it has been underused and understudied for examining patients with substance use disorders (SUD). VA began distributing video-enabled tablets to veterans with access barriers in 2016 to facilitate participation in home-based telehealth and expanded this program in 2020 due to the coronavirus COVID-19 pandemic. OBJECTIVE: Examine the impact of VA's video-enabled telehealth tablets on mental health services for patients diagnosed with SUD. METHODS: This study included VA patients who had ≥1 mental health visit in the calendar year 2019 and a documented diagnosis of SUD. Using difference-in-differences and event study designs, we compared outcomes for SUD-diagnosed patients who received a video-enabled tablet from VA between March 15th, 2020 and December 31st, 2021 and SUD-diagnosed patients who never received VA tablets, 10 months before and after tablet-issuance. Outcomes included monthly frequency of SUD psychotherapy visits, SUD specialty group therapy visits and SUD specialty individual outpatient visits. We examined changes in video visits and changes in visits across all modalities of care (video, phone, and in-person). Regression models adjusted for several covariates such as age, sex, rurality, race, ethnicity, physical and mental health chronic conditions, and broadband coverage in patients' residential zip-code. RESULTS: The cohort included 21,684 SUD-diagnosed tablet-recipients and 267,873 SUD-diagnosed non-recipients. VA's video-enabled tablets were associated with increases in video visits for SUD psychotherapy (+3.5 visits/year), SUD group therapy (+2.1 visits/year) and SUD individual outpatient visits (+1 visit/year), translating to increases in visits across all modalities (in-person, phone and video): increase of 18 % for SUD psychotherapy (+1.9 visits/year), 10 % for SUD specialty group therapy (+0.5 visit/year), and 4 % for SUD specialty individual outpatient treatment (+0.5 visit/year). CONCLUSIONS: VA's distribution of video-enabled tablets during the COVID-19 pandemic were associated with higher engagement with video-based services for SUD care among patients diagnosed with SUD, translating to modest increases in total visits across in-person, phone and video modalities. Distribution of video-enabled devices can offer patients critical continuity of SUD therapy, particularly in scenarios where they have heightened barriers to in-person care.
Subject(s)
COVID-19 , Substance-Related Disorders , Telemedicine , Humans , COVID-19/epidemiology , Pandemics , Substance-Related Disorders/epidemiology , TabletsABSTRACT
Background: During COVID-19, major change occurred in the governmental regulations to combat the pandemic. Lifestyle factors are changeable habits and routine behaviors with an impact on physical and mental health. With the pandemic, sudden and radical changes occurred in the lifestyle of people worldwide. The main purpose of the study is to assess the impact of COVID-19 on lifestyle factors including (dietary habits, physical activity, sleeping patterns, smoking, and alcohol use) among the Saudi population. Design and methods: This is a cross-sectional study on a convenient sample of adults residing in Saudi Arabia. An online survey was distributed via social media channels. Descriptive statistics were used to analyze the distribution of demographic variables using Chi-square χ2 tests for categorical variables and t-test for continuous variables. Bowker test, and McNemar's Test were performed to evaluate the effects of lockdown on lifestyle factors. Results: A total of 1051 participants were included in the study. There was a slight decrease in the overall diet score during the pandemic (14.98%) compared to before the pandemic (15.05%) (p-value = 0.02), indicating poorer dietary intake during the lockdown. Approximately one-fourth of the participants (26.1%) reported following specific eating habits or a restricted diet during the pandemic (p-value = 0.0001). There was increased consumption of most components of dietary intake categories, during the lockdown. An increase in physical activities for three or more times was reported. A higher proportion of respondents reported sleeping nine or more hours a day during the lockdown (10.8%). Similarly, a higher percentage of individuals reported smoking daily during the lockdown (12.2%). As of overall health status, higher percentage of respondents reported poor health status during lockdown (6.1%). Conclusion: This study revealed major changes in lifestyle factors, negative shifts were revealed in dietary habits and smoking patterns. Positive changes were shown in physical activity, drinking water, and sleeping patterns. Our findings suggest that COVID-19 played a major role in changing lifestyle factors among adults in Saudi Arabia. Healthcare providers and public health officials are encouraged to increase awareness of healthy lifestyle factors that strengthen the immune system to combat COVID-19. The Saudi population needs increased awareness programs about healthy lifestyles to be prepared during pandemics.
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Study Objective: The aim of this study is to examine the anxiety levels and coping strategies of nursing students during the covid-19 pandemic. Materials and Methodology: The data were collected as online and The study was completed with 645 students who voluntarily and completely filled in the data collection forms. Results: The average age of the participants was 21.45±1.34, and 79.7% of them were females. The most frequently used coping attitude included "turning to religion" (13.51 ±2.75) indicating an increase in religious activities in case of difficulties;the least utilized coping attitude was found "use of alcohol-drug" (4.82±2.15), indicating the use of substances effect to relieve the tension experienced. Of all the participating students, 55% reported mild, moderate, and severe anxiety levels. Conclusions: Nursing students were found to have decreased generalized anxiety scores when they used problemfocused and emotion-focused coping methods, and they were found to have increased anxiety scores when they used dysfunctional coping methods.
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OBJECTIVES/GOALS: During the pandemic, alcohol related deaths increased by 25%. To help understand how we might mitigate this negative outcome, we sought to examine the association of new diagnosis of alcohol use disorder (AUD) with SARS-CoV2 through two years of the pandemic. METHODS/STUDY POPULATION: Using a non-date-shifted TriNetX database, we conducted a retrospective cohort analysis of electronic health records of patients age ≥12 years who had been diagnosed either with COVID-19 (n=1,359,817) or other respiratory infections with no record of COVID-19 (n=2,013,031). Patients were then matched for propensity score risk for AUD, and results were analyzed by three-month intervals from January 2020 through January 2022, in blocks numbered 1-8. Results were expressed as hazard ratios (HR) and 95% confidence intervals (CI) for diagnosis of AUD from two weeks to six months following COVID-19 diagnosis. RESULTS/ANTICIPATED RESULTS: There was significant excess risk compared to control cohorts of AUD following COVID-19 diagnoses made during the first three months of the pandemic (HR (CI)): block 1: 2.41(1.89,3.08);no excess risk was seen for the remainder of 2020 (blocks 2-4) (HR1.01-1.14, NS). The excess risk increased again in 2021 as the delta and omicron variants emerged (HR and 95% CI): block 5 were: 1.26(1.11, 1.43));block 6: 1.88(1.62-2.18));block 7: 1.24(1.10,1.41);block 8: 1.12(1.0-1.25). COVID-19 diagnosis was associated with clinically-evident AUD under some pandemic circumstances. DISCUSSION/SIGNIFICANCE: COVID-19 early in the pandemic (block 1) was associated with substantial excess risk for new diagnosis of AUD, with smaller excess risk after COVID-19 during 2021 (blocks 5-7), and no excess risk otherwise. Diagnosis of COVID-19 and pandemic contextual factors are associated with increased risk for AUD.
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Trauma-exposed sexual minority women (SMW) are at elevated risk of posttraumatic stress disorder (PTSD) and hazardous drinking compared to trauma-exposed heterosexual women. To understand whether these problems might be exacerbated during times of elevated societal stress, we collected data from a New York-based sample of trauma-exposed SMW between April 2020 and August 2020, a period of notable, compounding societal stressors, including: (a) living in or near one of the first epicenters of the coronavirus disease 2019 (COVID-19) epidemic in the United States and (b) living through multiple high-profile occurrences of racism-related police violence and subsequent racial unrest. SMW (n = 68) completed online self-report questionnaires related to trauma, PTSD symptoms, and alcohol use, and a subset (n = 29) completed semi-structured qualitative interviews. PsycINFO was searched with terms related to SMW, PTSD, and alcohol use to identify studies with samples of SMW from articles published within the last 10 years to which we could compare our sample; this produced nine studies. Welch's t-tests and Chi-square analyses revealed that SMW within our sample reported significantly higher PTSD symptom severity, probable PTSD, and hazardous drinking indicators (i.e., alcohol use disorder and heavy episodic drinking) between April 2020 and August 2020 compared to similar samples (i.e., trauma-exposed SMW and general samples of SMW) assessed previously. Qualitative reports also indicated that the societal stressors of 2020 contributed to mental and behavioral health concerns. These results underscore the need for integrated PTSD and alcohol use prevention and intervention efforts for trauma-exposed SMW during times of heightened societal stress.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.2006132 .
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The rate of alcoholic hepatitis (AH) has risen in recent years. AH can cause as much as 40-50% mortality in severe cases. Successful abstinence has been the only therapy associated with long-term survival in patients with AH. Thus, it is crucial to be able to identify at-risk individuals in order to implement preventative measures. From the patient database, adult patients (age 18 and above) with AH were identified using the ICD-10 classification from November 2017 to October 2019. Liver biopsies are not routinely performed at our institution. Therefore, patients were diagnosed with AH based on clinical parameters and were divided into "probable" and "possible" AH. Logistic regression analysis was performed to determine risk factors associated with AH. A sub-analysis was performed to determine variables associated with mortality in AH patients. Among the 192 patients with alcohol dependence, there were 100 patients with AH and 92 patients without AH. The mean age was 49.3 years in the AH cohort, compared to 54.5 years in the non-AH cohort. Binge drinking (OR 2.698; 95% CI 1.079, 6.745; p = 0.03), heavy drinking (OR 3.169; 95% CI 1.348, 7.452; p = 0.01), and the presence of cirrhosis (OR 3.392; 95% CI 1.306, 8.811; p = 0.01) were identified as characteristics more commonly found in the AH cohort. Further, a higher inpatient mortality was seen in those with a probable AH diagnosis (OR 6.79; 95% CI 1.38, 44.9; p = 0.03) and hypertension (OR 6.51; 95% CI 9.49, 35.7; p = 0.02). A higher incidence of mortality was also noted among the non-Caucasian race (OR 2.72; 95% CI 4.92; 22.3; p = 0.29). A higher mortality rate despite a lower incidence of alcohol use among non-Caucasian patients may indicate healthcare disparities.