Stress and excessive alcohol consumption among insured and uninsured adults during the COVID-19 pandemic.

Aim: This study examined the relationships between stress, excessive drinking, including binge and heavy drinking, and health insurance status among a regionally representative sample of adults living in Northern Larimer County, Colorado, during the COVID-19 pandemic. Subject and methods: Data from 551 adults aged 18 to 64 years (62.98% aged 45 to 65 years; 73.22% female; 92.98% non-Hispanic White) were used. The sample was weighted by age and binary sex. A series of logistic regressions were applied to examine bivariate associations among stress, drinking, and health insurance status, with and without accounting for the effects of sociodemographic and health-related covariates. Stratified analyses were applied to explore differential associations of stress and drinking among individuals with different health insurance coverage. Results: A total of 23.23% of the adult sample reported binge drinking, and 16.15% reported heavy drinking; 10.53% of the sample reported both binge and heavy drinking. Individuals with higher levels of stress were more likely to report binge drinking (OR: 1.65; 95% CI: 1.65, 1.68) and heavy drinking (OR: 2.61; 95% CI: 2.54, 2.67), after adjusting for sociodemographic and health-related covariates. Relative to individuals with private health insurance coverage, adults enrolled in Medicaid and those without health insurance coverage were more susceptible to the effect of stress on binge and heavy drinking. Conclusion: Our results highlighted a need for continuing statewide and/or national efforts in closing the insurance coverage gap and providing affordable marketplace health insurance in the hope of preventing excessive drinking due to high levels of stress during a challenging time.

"Emotional drinking" during quarantine by COVID-19 in Chile: the role of depressive symptoms on problematic alcohol consumption

Aim: To assess the pattern of alcohol consumption in the Chilean adult population in association with depressive symptoms in the context of the COVID-19 quarantine. Method(s): A correlational and transversal study was conducted. Alcohol consumption and depressive symptoms were measured through an online survey, including the PHQ-9 Chilean version and the item banks for alcohol use of the Patient-Reported Outcomes Measurement Information System (PROMIS). Mediational analysis models were conducted to assess whether the relationship between depressive symptoms and problematic drinking was mediated by drinking to cope with negative emotions. Result(s): 32% of the sample reported depression, 84% acknowledge having been drunk during the previous 30 days and 18% acknowledge an increase in the amount of alcohol use. The presence of depressive symptomatology positively predicts problematic alcohol consumption during the quarantine;however, when it includes analyzing the reasons for drinking alcohol, this relationship becomes negative and shows a significant mediation effect in the relationship between depressive symptomatology and problematic drinking through increased drinking to control negative emotions. Conclusion(s): The findings suggest that during quarantine, the increase in problematic drinking is related to depressive symptoms associated with an increased urge to drink to cope with negative emotions.Copyright © 2022 Taylor & Francis Group, LLC.

Changes in anxiety and depression symptoms during the Covid-19 lockdown in the Netherlands. The moderating role of pre-existing mental health, employment situation and alcohol consumption.

PURPOSE: Evidence suggests an increase of depression and anxiety symptoms during the Covid-19 pandemic but most studies relied on cross-sectional designs and/or small samples, and they often overlooked subgroup effects in the impact of the lockdown. We investigated the effect of the pandemic on depression and anxiety symptoms, and whether it differed by employment situation and alcohol consumption. METHODS: This longitudinal study used 23 waves of the Covid-Questionnaire (April 2020-July 2021), within the Lifelines cohort from the Netherlands (n = 76,254). Depression and anxiety symptoms were combined in a "mental health score". Linear fixed-effects models were fitted to analyse trends in mental health throughout the observation period. The moderating role of pre-existing mental health, employment situation, and alcohol consumption was tested. RESULTS: Depression and anxiety symptoms fluctuated considerably during the observation period, with clear peaks in winter 2021, during the strictest lockdown period. Moreover, temporal patterns differed by employment situation and alcohol consumption patterns, suggesting that various subgroups reacted to the pandemic and the lockdown in different ways. CONCLUSION: Lockdowns increased depression and anxiety symptoms in the Netherlands. The effect was particularly strong for unemployed individuals, those with risky alcohol consumption patterns and those with pre-existing mental health disorders.

Characteristics and Outcomes of Patients Admitted for Acute Alcoholic Hepatitis Before and During the COVID-19 Pandemic

Purpose: Despite known increases in alcohol use, changes in alcohol-associated liver disease rates during COVID-19 have not been well characterized. We compared the incidence and outcomes of hospitalized patients with acute alcoholic hepatitis (AH) before and during COVID-19. Method(s): We identified patients admitted with AH at two tertiary care centers by retrospective chart review in pre-COVID-19 (4/1-6/31/2019) and during COVID-19 (4/1-6/31/2020) time periods using strict criteria (total bilirubin>3.0, AST 35-500, ALT 49-500, and heavy drinking within 60 days of admission). Severe AH was defined as Maddrey's discriminant function (MDF) >= 32. Univariable comparisons were performed using Chi-square and Wilcoxon rank sum tests as appropriate. Result(s): Inpatient admissions for AH increased from 0.13% (90 of 69610) pre- COVID-19 to 0.25% (160 of 63021) during COVID-19 (P<.001). During COVID-19, AH patients had lower rates of polysubstance abuse (40% vs 18%, P<.001) compared to pre-COVID-19 (Table 1). Mental health and substance abuse (MHSA) consult rate was 52% pre- and during COVID-19. Relapse medication use rate was 8% and did not differ significantly between time periods. In severe AH (N=127) frequency of steroid treatment (39% vs 48%, P=0.31), evaluation for (12% vs 16%, P=0.61) or receipt of liver transplant (2% vs 4%, P=1.00) were similar pre- and during COVID-19. Compared to pre-COVID-19, AH patients during COVID-19 had significantly lower rates of all-cause 90-day readmission (59% vs 42%, P=0.02), but there was no difference in rates of 90-day readmission for AH (27% vs 22%, P=0.47), inpatient mortality (11% vs 9%, P=0.66) and 12-month mortality (30% vs 23%, P=0.23). Conclusion(s): Inpatient admission rates for AH nearly doubled during COVID-19. Polysubstance abuse was less common among patients with AH during COVID-19, but 90-day readmission rates remained high pre- and during COVID-19. Low rates of both MHSA consult and relapse medication use indicate a need for greater attention to inpatient alcohol treatment. (Table Presented).

ARTERIAL THROMBOSIS AND ACUTE MYELOID LEUKEMIA - IS THERE A CONNECTION?

Background: Arterial thrombotic events (ATE) are important cause of noncancer-related deaths among patients with cancer. It is estimated that the prevalence of ATE among those patients is between 2-5%. However, data regarding acute myeloid leukemia (AML) related ATE are scarce and far less available than those related to venous thrombotic events. Aims: To determine the incidence of ATE in nonM3-AML patients and to underline the potential risk factors for ATE development. Methods: The single center, retrospective, cohort study was carried out in University Clinical Center of Serbia. Adult patients, who were diagnosed with nonM3-AML between January 2009. and December 2021. were included. In all patients the occurrence of ATE (e.g. a heart attack, a stroke, critical limb ischemia) was assessed during the active treatment and the three months following the last chemotherapy session. Diagnosis of ATE was established using clinical, laboratory and radiological methods. Patients who experienced venous thromboembolism during the treatment period were excluded. Demographic data, presence of obesity, smoking status, history of thrombosis, baseline laboratory findings (complete blood count, fibrinogen, D-dimer, PT, aPTT, LDH), leukemia-related parameters (cytogenetics (including ELN risk stratification), flow cytometry), Khorana score, ECOG PS, HCT CI score, concurrent COVID-19 were collected from patients' health records. The methods of descriptive (mean ± standard deviation, median (range), frequency (%)) and analytic statistics (Student's t-test, chi-squared test) were used. Results: A total of 545 patients (293 males (53.8%)) were included in the study. Median age of the study population was 58 (range: 18-81) years. ATE was noted in 18/545 (3.3%) subjects with following distribution: ischemic stroke 12/18 (66.7%), myocardial infarction 5/18 (27.8%), and acute lower extremity arterial thrombosis 1/18 (5.5%). ATE was diagnosed most commonly during the induction (8 (44.4%) patients), reinduction (3 (16.7%) patients) and consolidation (4 (22.2%) patients) cycles. However, cases of ATE were noted at diagnosis (1 (5.6%) patient), after transplantation (1 (5.6%) patient) or at relapse (1 (5.6%) patient) as well. ATE were significantly more frequent among patients with previous history of thromboembolic events (p = 0.016). Moreover, ATE were more common in patients with adverse cytogenetic abnormalities (p < 0.001). Other examined parameters did not significantly differ between those with and without ATE. Summary/Conclusion: The incidence of arterial thrombosis in our group was 3.3% which is in accordance with the previously published studies. Since the great number of already known risk factors for the arterial thrombosis are modifiable (e.g. smoking, diet, physical activity, excessive drinking?) it is important to actively work on the reduction on those risk factors, especially if the patient has the history of previous thromboembolic event and/or suffer from high risk AML. Prophylactic therapy with antiplatelet agents is aggravated due to the lack of firmer evidences and the presence of thrombocytopenia. Therefore further studies regarding this issue are needed.

Alcohol Use and misuse during the COVID-19 pandemic

GPs can play a pivotal role in the identification and management of alcohol problems at any time, and their role is even more important during the COVID-19 pandemic as more and more patients are resorting to alcohol to manage the stress and anxiety created by the pandemic. © 2021 Medicine Today Pty Ltd. All rights reserved.

Sociability of Alcohol Consumption and Alcoholism in Times of COVID-19 Crisis

COVID-19 has changed the social context, but also our ability to act in it. This new normal also influenced the patterns of alcohol consumption. In this sense, the main goal of this paper is a theoretical analysis of COVID-19 context of sociability of alcohol consumption. The paper analyses the ways of establishing the individual meaningfulness of alcohol consumption. The stratification of collective patterns in the context of a pandemic is analysed and the implications of stratification on future drinking patterns, but also on the potential risks of higher alcoholism rates in the future are theo-retically considered. The analysis is based on previous research on the habits of alcohol consumption during quarantine. The rate of alcohol consumption in the studies did not differ significantly from that before quarantine. In some cases, a lower rate of alcohol consumption has been reported. However, the rate of excessive drinking, and socially unregulated drinking, individual drinking, and drinking of a larger number of alcoholic beverages on occasion was on the rise. The theoretical explanation that can be set on the basis of previous research supports the fact that society is responsible for regulating the acceptable alcohol consumption. In the absence of social/cultural influences, an individual consumes alcohol for his own pleasure-it is directed towards himself and not towards society. If this social and value meaningfulness of alcohol consumption is lost, the individual will have a higher risk of developing alcohol dependence. Society is a protec-tive factor in the development of alcohol dependence. During the COVID-19 pandemic, most individuals did not consume alcohol because of the social patterns that that consumption implies (or is an integral part of), but they consumed it because of internal anxiety. The use of alcohol for the purpose of calming the anxiety caused by the pandemic, without an individual reflection on the sociability of alcohol consumption, is a potential public health problem of the future.

DRINKING FREQUENCY DURING COVID-19 WITHIN A LONGITUDINAL FRAMEWORK: CONSIDERING THE ROLE OF SOCIAL AND PANDEMIC-SPECIFIC STRESSORS

Purpose: The frequency of alcohol use has increased substantially in the United States since the Covid-19 pandemic began. These increases have occurred in parallel with increases in various other psychosocial stressors as well as intimate partner violence (IPV). It is important to understand how these public health issues co-occur, as well as the extent to which these stressors predict drinking frequency longitudinally. Methods: Participants (N = 323) were recruited from MTurk and completed an online survey in April/May 2020 (Time 1) and again one year later (Time 2). Individuals self-reported their alcohol use frequency, Covid-specific stress, general stress, depression symptoms, IPV, and discrimination experiences. Marginalized racial groups were over sampled such that 37.6% identified as Black, 24.9% as Asian, 25.2% White not Hispanic, 8.2% White Hispanic, and 4.0% American Indian or Alaskan Native. 58.5% of participants were women, 39.0% were men, and 2.4% identified another way. Data and results: Covid-19 specific stress, IPV, and discrimination experiences were associated with higher drinking frequency at Time 1 and Time 2. Neither general stress nor depression symptoms were associated with drinking frequency. Results of a multiple regression analysis indicate that only Covid-19 specific stress (p = .044) and IPV (p = .034) were associated with higher drinking frequency at Time 2 when controlling for Time 1 drinking frequency. Drinking frequency did not differ based on race or gender. Among those who reported alcohol use at Time 1, 21.7% reported that their drinking increased since Covid-19 began, 23.2% reported that it decreased, and 55.1% reported that it did not change. At Time 2, 24.3% of reported that their drinking increased since Time 1, 22.8%reported that it decreased, and 51.3%reported that it did not change. Conclusions: Results provide insight into the psychosocial stressors that are associated with drinking frequency during the Covid-19 pandemic. Specifically, findings indicate that Covid-19 specific stress and IPV predict more frequent drinking one year later, after accounting for baseline drinking. Interestingly, general stress and depression symptoms were not associated with drinking frequency. Covid-19 specific stress and IPV are notable public health issues, and also have implications for problem drinking behavior further, highlighting the importance of targeting them in prevention and intervention programming.

CITIZEN-SOLDIERS: RESPONSE TO COVID-19 AND CIVIL UNREST AND ASSOCIATIONS WITH ALCOHOL USE

Significance: Reserve/National Guard (R/NG) soldiers, with both civilian and military identities, roles, and responsibilities, have recently been called upon to assist with the COVID-19 response and civil unrest/protests. Responding to these politically charged emergencies involving US citizens may be stressful and may increase soldiers' problematic alcohol use. This work examined if responding to the COVID-19 pandemic and civil unrest impacts R/NG soldiers' problematic alcohol use and the extent to which psychological hardiness smight buffer these effects. Methods: A subset of data (N = 130 male soldiers) were drawn from the 5th follow-up of Operation: SAFETY (Soldiers and Families Excelling Through the Years), an ongoing longitudinal study of US Army R/NG soldiers. Soldiers were asked if they had been activated or mobilized (yes/no) for: 1.) the COVID-19 pandemic and/or 2.) civil unrest/protests. Problematic alcohol use was assessed by AUDIT total score and 3 subscales scores, as well as a measure of frequent heavy drinking (FHD). We used separate regression models to examine the relations between responding to these events and each alcohol-related outcome. Final models controlled for age and current military rank (enlisted vs. officer). Lastly, psychological hardiness was examined as a protective factor. Results: Approximately one in four soldiers were activated/mobilized to address COVID-19 (28%) and/or civil unrest/protests (23%). In unadjusted and adjusted models, COVID-19 response was associated with significantly higher total AUDIT score (aOR: 1.59, 95% CI: 1.17, 2.15), the alcohol dependence subscale score (aOR: 8.39, 95% CI: 2.61, 26.92), and the alcohol-related harm subscale score (trend, p = .05). Activation/mobilization to address civil unrest/protests was also associated with significantly higher total AUDIT score (aOR: 2.08, CI:1.54, 2.82), the alcohol dependence subscale score (aOR:12.90, CI: 3.93, 42.42), the alcohol-related harm subscale score (aOR: 4.68, CI: 1.78, 12.29), and frequent heavy drinking (aOR:1.44, CI:1.10, 1.88). Psychological hardiness was a significant protective factor against increased alcohol use. Conclusions: Responding to COVID-19 and civil unrest/ protests is associated with increased alcohol use among male R/NG soldiers. As the relief efforts continue, it is important that soldiers be evaluated for problematic alcohol use and efforts to build resiliency to stress via psychological hardiness should be increased.

COVID-SPECIFIC IPV AND HAZARDOUS DRINKING AMONG LGBQ+ STUDENTS

The COVID-19 pandemic represents a “perfect storm” as far as risk for intimate partner violence (IPV). Further, abusive partners may engage in novel forms of coercive control during the pandemic, such as pressuring their partners to engage in behaviors that place them at risk for COVID-19 infection (e.g., not wearing a mask, attending a social gathering). Individuals already at elevated risk for IPV, such as LGBQ+ individuals, are also likely more vulnerable to experiencing these novel forms of IPV. Further, experiences of IPV are likely to be associated with several negative health outcomes, including hazardous drinking. The current study examined the frequency of experiencing five forms of COVID-specific IPV, and the association of COVID-specific IPV with hazardous drinking among a sample of 500 dating/partnered LGBQ+ college students attending eight US universities. Participants completed an online survey in the fall of 2020 as part of a larger study on IPV among LGBQ+ college students. Most participants were women (72.4%), followed by men (13.6%), and trans or gender diverse (TGD;12.8%). Most described their sexual orientation as bisexual/pansexual (66.8%), followed by lesbian (9.4%), asexual (8.4%), gay (6.8%), or another sexual identity (e.g., demisexual, queer;8.6%). Additionally, most were White and non-Latinx (65.7%) followed by Latinx (14.4%), multiracial/multiethnic (7.2%), and Asian/Asian American (5.8%). A total of 19.4% of participants reported experiencing at least one form of COVID-specific IPV from their partners, including being pressured to not socially distance (9.6%), to attend a large gathering (9.4%), to not wear a mask (7.2%), to see their partner when their partner may have been exposed to COVID-19 (7.2%), and to engage in sexual activity with their partner when their partner may have been exposed to COVID-19 (3.2%). Individuals who had experienced COVID-specific IPV were significantly more likely to report past six-month hazardous drinking on the AUDIT-5 than those who had not experienced COVID-specific IPV (34.2% versus 20.1%). Future work should evaluate the role of IPV, including novel forms of coercive control during the COVID-19 pandemic, on negative health outcomes, including alcohol use, particularly among already vulnerable and marginalized populations. Tailored interventions may be necessary to adequately address the health needs of these populations during the pandemic.

A MULTIMODAL MOBILE SLEEP INTERVENTION TO REDUCE DRINKING AND ALCOHOL-RELATED HARM AMONG HEAVY-DRINKING YOUNG ADULTS

Purpose: Young adults report the highest rates of heavy drinking and are a priority population for alcohol prevention and early intervention. Yet, current alcohol interventions for young adults have modest effects, and young adults rarely self-identify for help with their drinking. Thus, other onramps to alcohol preventive services are needed. Young adults are concerned about sleep and health so embedding alcohol-related content within other health programs and connecting alcohol use to health outcomes may be a useful strategy. We conducted a randomized-controlled trial to test 3 sleep intervention components for promoting alcohol and sleep behavior change. Methods & Data: We randomized 120 young adults (18-25 years) who reported recent heavy drinking using a 1:1:2 ratio to 1 of 3, 2-week interventions: (1) 2-module mobile sleep hygiene advice (A;n = 30), (2) advice + sleep/alcohol daily diary self-monitoring (A+SM;n = 30), or (3) advice, selfmonitoring, personalized sleep/alcohol feedback (A+SM+F;n = 60). All wore sleep and alcohol biosensors. At intake, week 4, and week 12, participants completed the Timeline Followback Interview for alcohol use, measures of sleep disturbance, sleep-related impairment, and alcohol-related consequences. Nearly half (44%) completed enrollment and/or follow-up during the COVID-19 pandemic, but results are summarized for the whole sample. Results: The sample included 51% female, 80% white, 16% Hispanic, and 73% students. Over the past 4 weeks at intake, they consumed 86.58 ± 43.21 total drinks (primary outcome) and drank a maximum of 11.82 ± 4.84 drinks. All subjects significantly reduced total number of drinks over time, but there was no significant group effect on this outcome. There were group effects on sleep disturbance [p = 0.05] and sleep-related impairment [p = 0.02], which favored A+SM+F vs. A (d = 0.53 and d = 0.67, respectively). An overall group effect approached significance (p = 0.069) for alcohol related consequences driven by fewer consequences observed in A+SM+F vs. A (d = 0.52). Treatment satisfaction (0-4 scale) (3.53 ± 0.61), treatment completion (98%), and follow-up retention were high (96%) and did not vary by group. Conclusions: Results provide support for the feasibility and acceptability of brief sleep interventions that integrate alcohol content in heavy-drinking young adults. Findings also suggest that personalized feedback about sleep, alcohol use, and their association may be promising for improving sleep and alcohol-related harmin this high-risk group.

UNDERSTANDING AFFECTIVE REWARDS FROM ALCOHOL IN CONTEXT: THE CASE OF VIRTUAL SOCIAL INTERACTIONS

The current project explores affective rewards from alcohol in the context of virtual social interactions. The COVID-19 pandemic brought with it a radical shift toward the digital world. In light of pandemic- related changes in drinking and also emotional well-being, it becomes imperative to understand the cognitive and affective processes involved in virtual interactions and the impact of alcohol in these novel social spaces. The current study leverages an eye tracking and an alcohol administration paradigm to examine the impact of alcohol on self-focused attention and affect, as well as the interplay between self-focused attention and affective processes, in the context of a virtual social exchange. Heavy social drinkers (N = 246) were randomly assigned to receive either a moderate dose of alcohol (target BAC = 0.08%) or a non-alcoholic beverage. After beverage consumption, participants engaged in a virtual video call in pairs. Participants viewed video feed in split screen, displaying both themselves and their interaction partner, and their gaze behavior was continuously tracked using the EyeLink 1000. Participants' affect was repeatedly assessed throughout their experimental sessions. Results indicated that, on average, participants spent substantially more time looking at their conversation partner vs. themselves during the video call, b = 2.49, p < 0.0001. Of particular note, there was a significant relationship between gaze direction and alcohol, b = -0.46, p = 0.015. Specifically, relative to sober participants, those consuming alcohol spent more time looking at themselves and less at their conversation partners. There was also a significant relationship between gaze direction and negative affect, b = -0.29, p = 0.015, such that those who spent especially large proportions of their time gazing at themselves vs. their conversation partner reported higher levels of negative affect following the virtual exchange. Lastly, the powerful mood-enhancing properties of alcohol that are typically observed in in-person interaction did not emerge in this online context. Results carry potential implications for understanding factors that increase risk for hazardous drinking and negative affectivity in our increasingly virtual world.

Whole Health Options in Pain Education (wHOPE): A Multi-Site Pragmatic Trial of a VA Whole Health Team Approach to Pain Management in Veterans

Methods: Target enrollment in the wHOPE (Whole Health Options in Pain Education) trial is 750 veterans with moderate to severe chronic pain from five geographically diverse VA facilities across the U.S. We are creating an inclusive and generalizable sample through few exclusion criteria, over-sampling and stratified randomization, prioritizing women veterans and those prescribed opioids, while closely monitoring racial and ethnic diversity. The primary aim of the trial is to determine whether a Whole Health Team (WHT) (interdisciplinary Whole Health/integrative pain team) is superior to Primary Care Group Education (PC-GE, abbreviated group Cognitive Behavioral Therapy for Chronic Pain), and whether both are superior to Usual Primary Care (UPC) in decreasing pain interference and secondarily, in improving quality of life and use of non-pharmacological modalities to manage chronic pain. An implementation evaluation and budget impact analysis will provide information about feasibility, maintenance, and sustainability. Descriptive statistics characterized wHOPE study participants including COVID-19-related impacts. Results: To date, of 248 randomized participants, mean age is 60.2 (SD+/-12.3) years;39% women;23% Black or African American and 9.2% Hispanic/Latinx;27% were prescribed opioids. Roughly half endorsed moderate to severe depression, moderate PTSD symptoms, and 58% reported sleep difficulties. Roughly 20% engaged in hazardous drinking and 10% problem drug use. At baseline, veterans reported high rates of non-pharmacological and CIH pain management, e.g., mindfulness (42%);spinal manipulation (32%). As a result of COVID, wHOPE participants reported worsening: mental and emotional health (73%);access to healthcare (59%);pain intensity (48%) and use of tobacco (44%) and cannabis products (36%). Background: To conduct a pragmatic trial to establish evidence for the VA Whole Health model for chronic pain care. Conclusion: This ongoing multi-site pragmatic trial in a diverse group of veterans with chronic pain and high rates of comorbidity indicates high baseline use of CIH and substantial negative COVID-related impacts.

Impact of COVID-19 on the Capacity to Self-Manage Health and Chronic Conditions

Background: At the outbreak of the pandemic in Chicago, there were disruptions in daily life, communication and delivery of healthcare services. Our objective was to investigate mental well-being, lifestyle behaviors, self-management capacity and healthcare utilization during the early months of the COVID-19 pandemic among older adults with one or multiple chronic conditions. Methods: Telephone interviews were conducted as part of the ongoing COVID-19 & Chronic Conditions (C3) study between March and May 2020. Participants were recruited from local academic and safety net clinics and participated in existing research studies prepandemic. Self-report items assessed perceived stress due to coronavirus, self-management capacity and healthcare utilization. Validated measures assessed well-being, alcohol consumption, physical activity and self-efficacy. Results: The average age of participants (N=565) was 62.4, most were female (61.4%), and over half (n=310) were non-White or Latinx. One in five (20.7%) participants were stressed about the coronavirus most or all the time. Almost a quarter (22.3%) engaged in hazardous drinking and 79.7% reported insufficient physical activity. Nearly one in four participants (23.7%) avoided seeking medical care due to worry about COVID-19. In multivariable analyses, women reported more stress than men. Greater COVID-19 related stress and low health activation were associated with less physical activity, lower self-efficacy, greater difficulty managing health/medications and more avoidance of medical care. Conclusion: Consequences of COVID-19 on the mental wellbeing, lifestyle and ability of adults with chronic conditions to manage health were apparent in the initial months of the pandemic. As the C3 study is ongoing, it will be possible to examine pre- and postpandemic factors over time to understand the influence of the pandemic on the overall health trajectories of older adults.

Binge drinking in Japan during the COVID-19 pandemic: Prevalence, correlates and association with preventive behaviors.

BACKGROUND: There is some evidence that alcohol use may have changed during the coronavirus pandemic. However, as yet, there has been comparatively little focus on heavy/excessive drinking. This study examined binge drinking (BD) in Japan during the coronavirus pandemic and its association with COVID-19 preventive behaviors. METHOD: Data were analyzed from an online sample of 1452 individuals aged 18 and above that were collected one year after the beginning of the pandemic. Self-reported information was obtained on current and pre-pandemic BD and a range of sociodemographic and health-related variables. Logistic regression analysis was used to examine associations. RESULTS: Just under one-third of the sample (29.3%) reported past-month BD. More individuals reduced rather than increased BD during the pandemic (11.5% > 6.5%). Worsening household finances and depressive symptoms were associated with both current and increased BD, while young age (18-29) was linked to both increased and decreased BD. Individuals who binged had significantly lower odds for engaging in several COVID-19 preventive behaviors including wearing a mask (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.76), hand washing (OR: 0.58, 95%CI: 0.44-0.76) and avoiding crowds/staying at home (OR: 0.72, 95%CI: 0.55-0.93). CONCLUSION: BD is prevalent in Japan during the coronavirus pandemic and associated with poorer adherence to COVID-19 preventive behaviors. Increasing public awareness of the potentially detrimental effects of heavy alcohol use during the ongoing pandemic is now a public health priority.

Assessment of the Quality of Life and Living Conditions of the Rural Population of the Kazakhstan during the COVID-19 Pandemic

BACKGROUND: Low availability of medical care and low level of comfort living in rural areas, underdeveloped infrastructure, and difficult working conditions lead to the deterioration of health of rural residents. Rural areas are characterized by less comfortable living conditions than in the city, which can affect health-related quality of life. AIM: The purpose of this study was to assess the satisfaction of the population with the quality of life in rural areas as well as to study the quality of life of the rural population of the Republic of Kazakhstan related to health. METHODS: This study was a one-stage cross-sectional study. Online questionnaire was asked by 411 local residents, of which only 302 were suitable for processing. RESULTS: The results showed that almost a third of the respondents are unemployed (27.2%). In the course of the survey, respondents could subjectively assess their own health, for example, almost a third of respondents (35.76%) assess their health as “poor” and “below average.” At the same time, 18.21% of respondents are not satisfied with the quality of medical services provided in rural areas. The coefficients of correlation between the desire to move to the city and age, income level, family composition, marital status, and type of housing were established. The universal social functioning-36 index was 0.6 (±0.02) for women and 0.55 (±0.033) for men CONCLUSIONS: We can say that the quality of life of the rural population remains quite low. This is evidenced by low income, high unemployment, and the problem of drinking water. Quarantine measures related to COVID-19 also had an impact on the increase in unemployment, however, during the quarantine, there is a deterioration in mental health indicators among men compared to women. The results of the study confirmed that the issue of accessibility of medical services remains very urgent for rural residents.

Relationship between high-risk alcohol consumption and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroconversion: a prospective sero-epidemiological cohort study among American college students.

AIMS: To estimate the associations between high-risk alcohol consumption and (1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroconversion, (2) self-reported new SARS-CoV-2 infection and (3) symptomatic COVID-19. DESIGN: Prospective cohort study. SETTING: Indiana University Bloomington (IUB), IN, USA. PARTICIPANTS: A total of 1027 IUB undergraduate students (64% female), aged 18 years or older, residing in Monroe County, Indiana, seronegative for SARS-CoV-2 at study baseline. MEASUREMENTS: Primary exposure was high-risk alcohol consumption measured with an Alcohol Use Disorders Identification Test (AUDIT) questionnaire score of 8 or more. Primary outcome was SARS-CoV-2 seroconversion since baseline, assessed with two SARS-CoV-2 antibody tests, at baseline (September 2020) and end-line (November 2020). Secondary outcomes were (a) self-reported new SARS-CoV-2 infection at the study end-line and (b) self-reported symptomatic COVID-19 at baseline. FINDINGS: Prevalence of high-risk alcohol consumption was 32 %. In models adjusted for demographics, students with high-risk alcohol consumption status had 2.44 [95% confidence interval (CI) = 1.35, 4.25] times the risk of SARS-CoV-2 seroconversion and 1.84 (95% CI = 1.04, 3.28) times the risk of self-reporting a positive SARS-CoV-2 infection, compared with students with no such risk. We did not identify any association between high-risk alcohol consumption and symptomatic COVID-19 (prevalence ratio = 1.17, 95% CI = 0.93, 1.47). Findings from sensitivity analyses corroborated these results and suggested potential for a dose-response relationship. CONCLUSIONS: Among American college students, high-risk alcohol consumption appears to be associated with higher risk for severe acute respiratory syndrome coronavirus 2 seroconversion/infection.

Meaning in life and stress-related drinking: A multicohort study of college students during the COVID-19 pandemic.

During the COVID-19 pandemic, college students have experienced heightened stressors and reported stress-related drinking. To identify potential protective factors among college students, we investigate the possibility that finding meaning and purpose in one's life may lessen the strength of the association between stress and alcohol consumption in a multicohort sample of college students (N = 694; 64.8% women) recruited between November 2019 and September 2021. Consistent with expectations, negative binomial regressions revealed significant interactions, such that higher stress was only associated with more past-month alcohol use among individuals who reported low levels of meaning in life. The buffering role of meaning in life appeared to be robust; interaction results held when investigating both general perceived stress and COVID-specific stress, and did not vary by cohort. Although longitudinal and experimental research are needed, findings indicate that finding meaning and purpose in one's life may help college students to navigate heightened periods of stress with more adaptive coping strategies that do not result in drinking to cope. Findings highlight the potential utility of meaning-promoting strategies in college alcohol interventions.

Changes in Alcohol Consumption during the COVID-19 Pandemic Are Dependent on Initial Consumption Level: Findings from Eight European Countries.

Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of the pandemic), and how changes in consumption translate into possible changes in the prevalence of heavy drinking. We used data from the European Survey on Alcohol use and COVID-19 (ESAC) conducted in Czechia, Denmark, Finland, Germany, Norway, Poland, Spain, and the UK (N = 31921). Past-year alcohol consumption and changes in consumption were measured by AUDIT-C. Drinking habits were compared according to percentiles of pre-pandemic consumption levels, below versus above the 90th percentile. Across countries, drinkers in the highest 10% for pre-pandemic consumption increased their drinking during the pandemic, whereas absolute changes among those initially drinking below this level were modest. The percentage of people reporting >28 alcohol units/week increased significantly in seven of eight countries. During the first months of the COVID-19 pandemic, alcohol consumption in the upper decile of the drinkers increased as did the prevalence of heavy drinkers, in contrast with a declining consumption in other groups in the sample.

'You drink at home so they can go to work safely': A case study exploring alcohol marketing during the COVID-19 pandemic.

Alcohol marketing is linked to heavy consumption. Researchers have begun to examine how the alcohol industry has adapted its marketing practices during the 2020 Global COVID-19 pandemic. In Canada, Nova Scotia's culture of heavy drinking has been identified as a cause for concern by community, health care and government. This case study examines how one alcohol company coopted the facilities, staff, logos and fundraising efforts of a local health charity to market the sale and home delivery of a 6% alcohol by volume product via social media. This case study details the marketing practices of the alcohol brand, suggests why the marketing practices are problematic and concludes with recommendations for health promotion practice as well as suggestions for future research.