Gender Differences in Diagnostic Remission of Posttraumatic Stress Disorder (PTSD): Proportions and Correlates of Remission in a Nationally Representative U.S. Sample.

This study examines differences in a nationally representative sample, in proportions of men and women with lifetime diagnoses of Posttraumatic Stress Disorder (PTSD) who achieved diagnostic remission and gender-specific correlates. Data from the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions-III included 1,997 adults with a lifetime PTSD diagnosis (70.8% female and 29.2% male). Of these 25.3% of women and 24.3% of men experienced remission (ns). Women who remitted were older than other women, more likely to be retired, and less likely to report disability, past homelessness, suicide attempts, criminal history, violent behavior, or parental histories of drug problems or suicide. Men who remitted were less likely than other men to be separated/divorced, disabled, incarcerated after age 15, and reported fewer violent behaviors. Remission was significantly more strongly associated among women than men with greater age, emergency room visits, trauma and less with schizotypal personality. Although women were twice as likely to be diagnosed with PTSD, there were no significant gender differences in the proportions who experienced remission. Remission was associated with diverse sociodemographic and clinical disadvantages among both men and women but only four were statistically significantly different between genders.

Oral Health Status of Residents in Jiangsu Province, China: An Epidemiologic Survey.

INTRODUCTION: This study was conducted to characterise the oral health conditions of residents in Jiangsu Province, China. METHODS: In this descriptive study, 5 groups of participants were selected by a multistage stratified equal capacity random sampling, including 3- to 5-year-olds, 12- to 15-year-olds, 35- to 44-year-olds, 55- to 64-year-olds, and 65- to 74-year-olds. The data were collected by using the fifth edition of Oral Health Surveys-Basic Methods recommended by the World Health Organization (WHO). RESULTS: In these 5 groups, the mean DMFT/dmft of coronal caries were 3.07, 0.69, 4.03, 7.15, and 11.97, respectively, resulting in prevalence rates of 59.69%, 34.98%, 52.05%, 56.86%, and 72.19%, respectively. However, the filling rates were low in all age groups (1.88%, 17.53%, 29.88%, 16.13%, and 19.36%, respectively). Only 3.58% of the 12-year-old participants had good pit and fissure sealants. The adults include three groups, 35- to 44-year-olds, 55- to 64-year-olds, and 65- to 74-year-olds, and the prevalence rates of clinical attachment loss (CAL ≥4 mm) were 32.19%, 76.47%, and 85.43%, respectively. The proportions of adult groups with implant dentures, fixed dentures, removable partial dentures, complete dentures, and substandard dentures were 0%, 26.44%, 11.11%, 0.67%, and 4.89%, respectively. Additionally, 49.64% of adults had missing teeth that were not replaced. CONCLUSIONS: Dental caries and periodontal disease were frequent and common in Jiangsu, China. But only a few of the residents sought treatment. Oral diseases continued to be a major problem for local residents.

Geographic variations in idiopathic epiretinal membranes in China.

BACKGROUND: Idiopathic epiretinal membranes (ERMs) often cause metamorphopsia and the progressive loss of central visual function, which seriously affect quality of life. We aimed to map the distribution pattern of idiopathic ERMs in China and to examine the factors affecting the surgical choices of multicenter surgeons. METHODS: A national ophthalmologist-oriented questionnaire was administered, applied with a multistage probability sampling method. Data of essential characteristics, including age, professional title, residence, and perioperative and postoperative care, were gathered. All the data are expressed as odds ratios (ORs) and 95% confidence intervals (CIs). The histogram and choropleth map were generated by Excel 2016. RESULTS: In total, 1,137 (85.2%) valid responses were returned with maximized response and completion rates. The study showed that monthly admission numbers, and preoperative and postoperative care varied significantly across different regions in China. Generally, the monthly patient admission numbers were lower in the Western region than the Eastern region. However, patients in the Eastern region had longer preoperative waiting periods and shorter hospital stays. CONCLUSIONS: The epidemiology of idiopathic ERMs varied significantly across different regions in China. The distribution pattern of ERM in China and the overview of the factors affecting the surgery approaches of multicenter surgeons were shown. The findings of this study will contribute to the formulation of medical policies, and provide insights into the healthcare environments across China.

Adverse childhood experience patterns, major depressive disorder, and substance use disorder in older adults.

OBJECTIVES: This article investigates distinct patterns of adverse childhood experiences (ACEs) in a representative sample of US older adults, and how the ACEs patterns relate to major depression and substance use disorder (SUD). METHODS: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions III. The study sample consisted of older adults aged 55 or older (N = 11,386). The dependent variable was past-year SUD measuring any DSM-5 diagnosis for alcohol, tobacco, cannabis, and other illicit drugs. The independent variables were the classes of ACEs identified using 11 types of early adversities. The mediating variable was past-year major depressive disorder. We conducted a latent class analysis (LCA) to identify latent classes of ACEs, estimated the relationships between the ACEs classes, major depressive disorder, and SUD, and tested mediation by major depression. RESULTS: Results of the LCA identified four classes of ACEs: High Adversity (6%), Low Adversity (69%), Child Abuse (16%), and Parental Substance Use (8%). The three classes of High Adversity, Child Abuse, and Parental Substance Use showed significantly higher rates of SUD than the Low Adversity class. The High Adversity and Child Abuse classes were more likely to have major depression compared to the Low Adversity class. In addition, major depression mediated the association between ACEs and SUD for those two classes. CONCLUSION: The findings provide evidence for a long-term impact of ACEs on mental health and SUD later in life and emphasize trauma-informed care principles in interventions for older adults with SUD.

Prevalence and comorbidities of adult adhd in male military conscripts in korea: Results of an epidemiological survey of mental health in korean military service.

We assessed the prevalence/comorbidities of attention deficit hyperactivity disorder (ADHD) in Korean servicemen using the Epidemiological Survey of Mental Health in Military Service in Korea. A total of 3,441 participants were assessed for adult ADHD, depression, social anxiety, generalized anxiety, somatization, insomnia, suicidality, cigarette dependence, and alcohol dependence using a self-report scale. Participants were also asked to rank their perception of their career prospects, health status, and quality of life on a Likert scale. Participants were classified as ADHD according to the WHO A-ADHD self-report scale. Firth multiple logistic regression and Cochran-Armitage trend tests were used to identify the risks of comorbidities and trends of self-perception between the two groups. ADHD (prevalence: 2.8%) was significantly associated with social anxiety (OR, 40.52; 95% CI 25.14-65.74), generalized anxiety (OR, 28.21; 95% CI 17.37-45.69), depression (OR, 16.36; 95% CI 10.50-25.52), somatization (OR, 14.47; 95% CI 9.21-22.76), suicidality (OR, 11.03; 95% CI 6.67-17.86), and insomnia (OR, 5.92; 95% CI 3.68-9.35). Servicemen with ADHD had negative perceptions (p <0.001) of their career prospects, health status, and quality of life compared to servicemen without ADHD. It is essential to revise the enlistment criteria for individuals with ADHD or to develop management programs for servicemen with ADHD.

Genetic diversity and phylogeography of Jeju Orthohantavirus (Hantaviridae) in the Republic of Korea.

Orthohantaviruses are negative-sense, single-stranded RNA viruses harbored by rodents, shrews, moles, and bats. Of the shrew-borne orthohantaviruses in the Republic of Korea (ROK), Jeju orthohantavirus (Jeju virus, JJUV) was found on Jeju Island. This small-scale epidemiologic survey investigated the geographic distribution and molecular phylogeny of JJUV in the ROK. In 32 trapping sites, tissues of 84 Crocidura shantungensis were analyzed for JJUV RNA. JJUV RNA was detected in seven (8.3%) shrews captured on the Korean peninsula. The molecular epidemiologic survey demonstrated the prevalence of JJUV by geographic distribution. The RNA loads of JJUV were evaluated in various tissues. Entire coding sequences of tripartite genomes were recovered from two JJUV strains on the mainland. Phylogenetic relationships of the JJUV revealed a distinct geographic lineage of mainland strains from the strains on Jeju Island. This study sheds light on the molecular epidemiology, phylogeographic diversity, and virus-host co-divergence of JJUV, ROK.

Perception of treatment need among adults with substance use disorders: Longitudinal data from a representative sample of adults in the United States.

BACKGROUND: Most individuals with substance use disorders (SUDs) do not seek treatment. Lack of perceived treatment need (PTN) is one contributing factor, but little is known about PTN over time. We estimated whether PTN changed over three years among those with SUDs in the United States and identified select variables, including sociodemographics and symptom burden, that predict malleability vs. stability of PTN. METHODS: Data were from Waves 1 (collected 2001-2002) and 2 (collected 2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC); 1695 adults who met DSM criteria for alcohol or non-alcohol SUD at Wave 1 and maintained ≥1 diagnostic symptom at Wave 2 were included. RESULTS: Most individuals with SUDs (77.2%) did not perceive a need for treatment at Wave 1 baseline. Only about 1 in 8 individuals not perceiving a need for treatment in Wave 1 came to perceive a need in Wave 2 (adjusted odds ratio = 0.18, 99% confidence interval = 0.11-0.29). In contrast, about half the individuals who perceived a need for treatment in Wave 1 no longer did so in Wave 2, despite maintaining ≥1 SUD symptom. Married respondents, and respondents with more SUD symptoms, were more likely to transition from low- to high-PTN status three years later. Respondents with incomes >$35,000 were less likely to transition to high-PTN status three years later. CONCLUSIONS: PTN was more likely to decline than increase over time. Low PTN appears to be stable among adults with SUDs in the United States, presenting a potentially enduring barrier to treatment-seeking.

Evaluation of pain incidence due to venous malformation based on data from 85 institutions in Japan.

BACKGROUND: Depending on the size and site of the venous malformation (VM), patients with VM often experience pain and swelling. VMs in the head and neck typically have lower pain rates due to complications than VMs in the limbs and trunk. We evaluated the heuristics on VM pain by statistically analyzing data of patients with VM from a multicenter database in Japan. METHODS: We collected data on age, sex, pain, lesion site, lesion depth, and lesion size for 2199 clinical cases with common VMs. We created categories for lesion depth and size and excluded multiple lesion cases that overlapped in these categories. Next, we constructed cross-tabulation tables to analyze the factors that contributed to pain. Finally, we evaluated the risk of pain in patients with VM by performing binomial logistic regression analysis based on age, sex, lesion site, lesion depth, and lesion size. RESULTS: For patients with limb and trunk VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 79%, followed by the skin and subcutis, with an incidence of 43%. For patients with head and neck VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 28%, followed by the skin and subcutis, with an incidence of 11% (P < .01). For pain incidence by lesion size, pain most frequently occurred in lesions >10 cm (67%), followed by lesions between 5 cm and 10 cm (56%) and lesions <5 cm (29%). CONCLUSIONS: Our study indicated a clear order of factors that contributed to pain: lesion site > lesion depth > lesion size. Age was also an important factor. Infants and children had low pain complication frequencies with limb and trunk VMs. As the patients aged, the pain frequency became higher, reaching 50% at almost 7 years of age.

Childhood adversity and mental health comorbidity in men and women with opioid use disorders.

INTRODUCTION: To examine gender differences in associations between mental health comorbidity and adverse childhood experiences (ACE) among adults with DSM-5 lifetime opioid use disorders (OUD). METHODS: In 2018, we analyzed 2012-13 nationally-representative data from 388 women and 390 men with OUD (heroin, prescription opioid misuse). Using weighted multinomial logistic regression, we examined factors associated with mental health comorbidity, tested a gender-by-childhood-adversity interaction term, and calculated predicted probabilities, controlling for covariates. RESULTS: Among adults with OUD, women are more likely than men to have comorbid mood or anxiety disorders (odds ratio [95% CI] 1.72 [1.20, 2.48]), and less likely to have conduct disorders. More women than men have prescription OUD (3.72 [2.24, 6.17]), and fewer have heroin use disorder (0.39 [0.27, 0.57]). Among both genders, ACE prevalence is high (>80%) and more than 40% are exposed to ≥3 types of ACE. Women more than men are exposed to childhood sexual abuse (4.22 [2.72, 6.56]) and emotional neglect (1.84 [1.20, 2.81]). Comorbid mood or anxiety disorders are associated with female gender (1.73 [1.18, 2.55]) and exposure to ≥3 types of ACE (3.71 [2.02, 6.85]), controlling for covariates. Moreover, exposure to more ACE elevates risk for comorbid mood or anxiety disorders more among women than men. CONCLUSION: Among adults with OUD, ACE alters the gender gap in risk for comorbid mood or anxiety disorders. Using gender-tailored methods to address the harmful effects ACE on the mental health of individuals with OUD may help to prevent and ameliorate the current opioid epidemic.

[Epidemiological survey of mental disorders in the rural left behind elderly aged 60 years and older in Gansu].

Objective: To investigate the prevalence, demographic characteristics and social life function of mental disorders in the rural left behind elderly aged 60 years and older in Gansu. Methods: Between November 2017 and June 2018, a multi-stage stratified cluster sampling method was used to randomly select the rural left behind elderly aged 60 years and older in Gansu, and totally 6 000 elderly were enrolled. By using the extended general health questionnaire (GHQ-12) and the American Handbook for Diagnosis and Statistics of Mental Disorders (DSM-Ⅳ) Axis Ⅰ Disorders Formal Clinical Examination Patient Edition, all the included subjects were screened and diagnosed. Functional status was assessed by the Global Assessment Function scale (GAF). Statistical analysis of the prevalence of various mental illnesses, as well as the differences in the prevalence of different gender, marital status and age groups was performed. Results: Totally, 6 000 subjects completed the survey. The adjusted current prevalence of any mental disorder was 20.11% (95%CI 17.70%-22.85%). The six most prevalent specific disorders were major depressive disorder (9.20%), pain disorder (2.71%), mood disorder due to the body condition (2.08%), generalized anxiety disorder (1.99%), anxiety disorder not otherwise specified (1.15%) and dysthymic disorder (0.84%). The lifetime prevalence of mental disorders was 20.54% (95%CI 18.40%-23.39%). The overall current prevalence of mental disorders was higher in women (242.89‰) than in men (119.55‰), and the unmarried (248.37‰) was higher than those married (187.53‰). There was no significant difference in the prevalence of mental disorders among different age groups (P>0.05). The GAF score of mental disorders was 56±11, and 71.82% was moderate to severe functional impairment. Conclusions: The prevalence of mental disorders is high in rural left-behind population aged 60 years and over in Gansu Province. Major depression is a condition that deserves special attention.

Changes in the prevalence and correlates of cocaine use and cocaine use disorder in the United States, 2001-2002 and 2012-2013.

To present nationally representative data on changes in the prevalences of 12-month cocaine use, cocaine use disorder (CocUD) and 12-month CocUD among 12-month cocaine users between 2001 and 2002 and 2012-2013. Data were derived from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the 2012-2013 NESARC-III. Between 2001 and 2002 and 2012-2013, prevalences of 12-month cocaine use and DSM-IV CocUD significantly increased and 12-month CocUD among 12-month users significantly decreased. Increases in risk of cocaine use were seen across nearly all sociodemographic subgroups while increases in CocUD were observed among women, those in the oldest age group, Whites, individuals with the lowest incomes and highest education, and those residing in urban areas. Prevalence of CocUD among users significantly declined overall and among men, individuals aged 30-44 years old, the never-married, respondents with incomes between $20,000 and $34,000, and those residing in the Midwest. Increases in coca cultivation in Colombia in recent years together with increases in the purity of cocaine entering the U.S. portend more significant increases in the rates of cocaine use and CocUD in the U.S. along with increases in cocaine-related morbidity and mortality. The results of this study support the continued monitoring of cocaine use and CocUD in the U.S., especially in view of the narrowing of the gender gap and shifts in race-ethnic, age and socioeconomic differentials seen between 2001 and 2002 and 2012-2013.

Prevalence and impact of lower urinary tract symptoms: Results of the epic survey in Egypt.

AIMS: To estimate the prevalence of lower urinary tract symptoms (LUTS), including overactive bladder (OAB), and urinary incontinence (UI), in Egypt and the impact on patients' quality of life. METHODS: A population-based, cross-sectional survey (EPIC) was conducted with a random sample of adults aged ≥18 years. Prevalence estimates were based on 2002 International Continence Society definitions. RESULTS: A total of 3600 adult men and women participated in the survey; 86% of them experienced ≥1 LUTS: storage symptoms were more frequently reported (75%) than voiding (52%) or postmicturition (42%) symptoms. The most prevalent storage symptom was nocturia (defined as ≥1 time per night) in 70% of the population. UI was reported by 21% (mixed UI [MUI]: 9%; stress UI [SUI]: 4%; urgency UI [UUI]: 5%; other UI: 3%), and 30% met criteria for OAB. Despite the high prevalence of LUTS, few individuals with UUI, MUI, SUI, or OAB took prescription medicine (12%) or consulted a healthcare professional about their symptoms (23%). CONCLUSION: High prevalence rates of LUTS and OAB were found in adult men and women in Egypt, although low healthcare utilization and low prescription medication use for symptoms were observed.

Correlates of Alcohol-Related Treatment Among American Indians and Alaska Natives with Lifetime Alcohol Use Disorder.

BACKGROUND: To describe sociodemographic and selected psychiatric disorder patterns and estimate correlates of seeking alcohol treatment among American Indians and Alaska Natives (AIAN) and non-Hispanic Whites (NHW) with lifetime alcohol use disorder (AUD). METHODS: Data come from the 2012 to 2013 U.S. National Epidemiologic Survey on Alcohol and Related Conditions-III. We retrospectively identified participants who completed information on lifetime AUD, race/ethnicity, and seeking alcohol treatment or help for AUD. We used a generalized linear model with a log link and Poisson distribution to estimate prevalence ratios (PRs) among adults with DSM-5 lifetime AUD. We included the following correlates: race/ethnicity, sex, age, personal annual income, marital status, education, urban/rural status, U.S. region, any illegal drug use disorder, nicotine use disorder, and select mood-, anxiety-, personality-, and trauma-related disorders. RESULTS: Among AIAN, the prevalence of lifetime AUD was 46.6%. Among AIAN with lifetime AUD, 33.8% sought alcohol-related treatment. Among individuals with lifetime AUD, AIAN were associated with greater alcohol-related treatment-seeking compared to NHW (adjusted PR = 1.41 [95% CI 1.26 to 1.58]). Among AIAN with AUD, being male and age 35 to 64 were statistically significant correlates of seeking treatment or help for AUD. CONCLUSIONS: A relatively higher proportion of AIAN than NHW with AUDs sought alcohol treatment. Among individuals with lifetime AUD, significant demographic and psychiatric disorder correlates of treatment are present, showing that certain groups are less likely to seek treatment or help for alcohol-related issues. Among AIAN with AUD, these correlates may reflect distinct patterns of seeking alcohol-related treatment, which can inform more effective treatment promotion efforts with this population.

Self- and other-directed forms of violence and their relationship with lifetime DSM-5 psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol Related Conditions-III (NESARC-III).

A combined history of violence toward self and others has been reported in clinical and incarcerated populations. Psychiatric disorders have been implicated as risk factors. This study examines the lifetime prevalence of this combined violence in the general population and its associations with DSM-5 psychiatric disorders in comparison with other- and self-directed violence. Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) were analyzed, including 36,309 U.S. adults ages 18 and older. Violent behavior was defined by suicide attempts; recurrent suicidal behavior; gestures, threats, or self-mutilating behavior (self-directed); and multiple items of violence toward others (other-directed) in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression examined these violence categories in association with sociodemographics and lifetime DSM-5 psychiatric disorders. Results show that approximately 18.1% of adults reported violent behavior, including self-directed only (4.4%), other-directed only (10.9%), and combined self- and other-directed violence (2.8%). DSM-5 psychiatric disorders significantly associated with the violence typology include alcohol, tobacco, cannabis, and other drug use disorders; mood disorders; posttraumatic stress disorder; and schizotypal, antisocial, and borderline personality disorders. Findings extend the clinical literature regarding the co-occurrence of self- and other-directed violent behaviors to the general population.

Differences by Veteran/civilian status and gender in associations between childhood adversity and alcohol and drug use disorders.

PURPOSE: To examine differences by US military Veteran status and gender in associations between childhood adversity and DSM-5 lifetime alcohol and drug use disorders (AUD/DUD). METHODS: We analyzed nationally representative data from 3119 Veterans (n = 379 women; n = 2740 men) and 33,182 civilians (n = 20,066 women; n = 13,116 men) as provided by the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). We used weighted multinomial logistic regression, tested interaction terms, and calculated predicted probabilities by Veteran status and gender, controlling for covariates. To test which specific moderation contrasts were statistically significant, we conducted pairwise comparisons. RESULTS: Among civilians, women had lower AUD and DUD prevalence than men; however, with more childhood adversity, this gender gap narrowed for AUD and widened for DUD. Among Veterans, in contrast, similar proportions of women and men had AUD and DUD; with more childhood adversity, AUD-predicted probability among men surpassed that of women. Childhood adversity elevated AUD probability among civilian women to levels exhibited by Veteran women. Among men, Veterans with more childhood adversity were more likely than civilians to have AUD, and less likely to have DUD. CONCLUSIONS: Childhood adversity alters the gender gap in AUD and DUD risk, and in ways that are different for Veterans compared with civilians. Department of Defense, Veterans Affairs, and community health centers can prevent and ameliorate the harmful effects of childhood adversity by adapting existing behavioral health efforts to be trauma informed, Veteran sensitive, and gender tailored.

Epidemiologic Survey of Japanese Encephalitis Virus Infection, Tibet, China, 2015.

We investigated Japanese encephalitis virus (JEV) prevalence in high-altitude regions of Tibet, China, by using standard assays to test mosquitoes, pigs, and humans. Results confirmed that JEV has spread to these areas. Disease prevention and control strategies should be used along with surveillance to limit spread of JEV in high-altitude regions of Tibet.

Gender differences in the effects of childhood adversity on alcohol, drug, and polysubstance-related disorders.

PURPOSE: To examine gender differences in the associations between childhood adversity and different types of substance use disorders and whether gender moderates these relationships. METHODS: We analyzed data from 19,209 women and 13,898 men as provided by Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether gender moderates the associations between childhood adversity and DSM-IV defined lifetime occurrence of alcohol, drug, and polysubstance-related disorders. We used multinomial logistic regression, weighted to be representative of the US adult civilian, noninstitutionalized population, and we calculated predicted probabilities by gender, controlling for covariates. To test which specific moderation contrasts were statistically significant, we conducted pair-wise comparisons corrected for multiple comparisons using Bonferroni's method. RESULTS: For each type of substance use disorder, risk was increased by more exposure to childhood adversity, and women had a lower risk than men. However, moderation effects revealed that with more experiences of childhood adversity, the gender gap in predicted probability for a disorder narrowed in relation to alcohol, it converged in relation to drugs such that risk among women surpassed that among men, and it widened in relation to polysubstances. CONCLUSIONS: Knowledge regarding substance-specific gender differences associated with childhood adversity exposure can inform evidence-based treatments. It may also be useful for shaping other types of gender-sensitive public health initiatives to ameliorate or prevent different types of substance use disorders.

Alternative Approaches to Assessing Nonresponse Bias in Longitudinal Survey Estimates: An Application to Substance-Use Outcomes Among Young Adults in the United States.

We evaluated alternative approaches to assessing and correcting for nonresponse bias in a longitudinal survey. We considered the changes in substance-use outcomes over a 3-year period among young adults aged 18-24 years (n = 5,199) in the United States, analyzing data from the National Epidemiologic Survey on Alcohol and Related Conditions. This survey collected a variety of substance-use information from a nationally representative sample of US adults in 2 waves: 2001-2002 and 2004-2005. We first considered nonresponse rates in the second wave as a function of key substance-use outcomes in wave 1. We then evaluated 5 alternative approaches designed to correct for nonresponse bias under different attrition mechanisms, including weighting adjustments, multiple imputation, selection models, and pattern-mixture models. Nonignorable attrition in a longitudinal survey can lead to bias in estimates of change in certain health behaviors over time, and only selected procedures enable analysts to assess the sensitivity of their inferences to different assumptions about the extent of nonignorability. We compared estimates based on these 5 approaches, and we suggest a road map for assessing the risk of nonresponse bias in longitudinal studies. We conclude with directions for future research in this area given the results of our evaluations.

Gender and race/ethnic differences in the persistence of alcohol, drug, and poly-substance use disorders.

AIMS: To examine gender and racial/ethnic differences in the effect of substance use disorder (SUD) type on SUD persistence. METHODS: Data were provided by 1025 women and 1835 men from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether gender and race/ethnicity (Non-Hispanic White, Black, Hispanic) moderate the effects of DSM-IV defined past-12 month SUD type (alcohol, drug, poly-substance) on SUD persistence at 3-year follow-up, controlling for covariates. Using gender-stratified weighted binary logistic regression, we examined predictors of SUD persistence, tested an SUD type by race/ethnicity interaction term, and calculated and conducted Bonferroni corrected pairwise comparisons of predicted probabilities. RESULTS: SUD persistence rates at 3-year follow-up differed for SUD type by gender by race/ethnicity sub-group, and ranged from 31% to 81%. SUD persistence rates were consistently higher among poly-substance users; patterns were mixed in relation to gender and race/ethnicity. Among women, alcohol disordered Hispanics were less likely to persist than Whites. Among men, drug disordered Hispanics were less likely to persist than Whites. Also, Black men with an alcohol or drug use disorder were less likely to persist than Whites, but Black men with a poly-substance use disorder were more likely to persist than Hispanics. CONCLUSIONS: The effect of SUD type on SUD persistence varies by race/ethnicity, and the nature of these relationships is different by gender. Such knowledge could inform tailoring of SUD screening and treatment programs, potentially increasing their impact.

Higiene bucal, caries dental y necesidades de tratamiento en escolares de 5, 7 y 12 años, municipio de Istmina, Chocó, Colombia (2013) / Oral Hygiene, Dental Caries and Treatment Needs in 5, 7 and 12 Year-Old School Children in the Village of Istmina, Chocó, Colombia (2013)

Antecedentes: Es necesario identificar la situación de salud bucal en grupos específicos para establecer programas efectivos. Objetivo: Describir el estado de higiene bucal, caries dental y de necesidades de tratamiento en escolares de 5, 7 y 12 años del municipio de Istmina (Chocó, Colombia). Métodos: Se realizó un estudio descriptivo en 294 escolares (48 % niñas), seleccionados por conveniencia, de 6 instituciones educativas oficiales. Por medio de encuesta y examen clínico se recogió información sociodemográfica, de uso de elementos de higiene bucal, grado de higiene bucal, índices ceo-d y COP-D (y sus componentes) y necesidades de tratamiento. Se efectuó análisis descriptivo univariado y bivariado e inferencia! mediante chi cuadrado. Resultados: Dos terceras partes de la población analizada tenían una higiene oral deficiente (mayor porcentaje en niños y en escolares de 7 años). El promedio ceo-d M fue de 2,5 ± 3,2, lo cual equivale a una prevalencia y experiencia de caries dental del 57 % y 59 % respectivamente. El promedio COP-D M file de 0,6 ± 1,2, con una prevalencia y experiencia de caries dental del 24 % y 28 % respectivamente. El índice de caries significativa fue de 1,9 ± 1,5. El 47 % requería obturaciones (promedio de 1,9 ± 1,5). Se presentaron diferencias significativas por edad y sexo tanto para caries dental como para necesidades de tratamiento. Conclusiones: Los indicadores de caries dental estaban en consonancia con las metas internacionales. Se identificaron algunas diferencias según factores sociodemográficos que requieren estudios a mayor profundidad desde la perspectiva de determinantes sociales.

Background There is a need to identify the oral health situation in every specific group in order to implement effective programs. Objective: To describe the oral hygiene status and treatment needs in 5, 7 and 12 year-old school children in the village of Istmina (Chocó, Colombia). Methods: A descriptive study was carried out in 294 school children (48% girls) selected for convenience reasons from six public schools. Clinical examinations were conducted, and surveys applied in order to gather information on sociodemographic, use of oral hygiene elements, oral hygiene level, ceo-d index and COP-d indexes (and its components), and treatment needs. A descriptive univariate analysis and an inferential bivariate analysis were conducted based on a Chi-square statistics. Results: Two thirds of the studied population had poor oral hygiene habits (a greater percentage was found in 7 year-old boys). The average ceo-d M index was 2.5 ± 3.2, which indicates a dental caries prevalence and experience of 57% and 59%, respectively. The average COP-DM index was 06 ± 1.2, with a dental caries prevalence and experience of 24% and 28%, respectively.The significant dental caries index was 1.9 ± 1.5; 47% of them required obturations (average: 1.9 ± 1.5). Signifi cant differences were found as per age and gender, both for dental caries and treatment needs. Conclusions: Dental caries indicators were similar to the expected international goals. Some differences were identified based on some sociodemographic factors, which requires more in-depth studies under a social determinant perspective.