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Davenport CJ, Craven R. Supporting older adults who misuse alcohol. Nurs Older People 2024; 36:33-41. [PMID: 38773831 DOI: 10.7748/nop.2024.e1469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 05/24/2024]
Abstract
Older adulthood is a unique time of transition often referred to as the 'golden years'. It is characterised by positive life experiences such as retirement but also by a loss of routine, identity and meaning. The literature identifies alcohol misuse as a growing issue in this population. However, the stigma, perceptions and patterns of drinking associated with alcohol misuse among older people can be a barrier to individuals seeking health advice. This article identifies that older adulthood is a period when nurses can offer health education and support using their unique relationships with patients to encourage healthy drinking behaviours.
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Affiliation(s)
- Caroline Jane Davenport
- Lecturer, Department of Nursing and Midwifery, Faculty of Health Sciences, University of Hull, Hull, England
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2
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Alfaro AJ, Greene L, Van Campen J, Zulman DM, Gould CE, Blonigen DM. Patterns and predictors of mental health service use among older veterans with alcohol use disorder who received a video-enabled tablet. Aging Ment Health 2024; 28:604-610. [PMID: 37723897 DOI: 10.1080/13607863.2023.2253448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/25/2023] [Indexed: 09/20/2023]
Abstract
Objectives: Video-based telehealth may expand access to mental health services among older veterans with alcohol use disorder (AUD). We examined the modalities through which mental health services were rendered, and predictors of video visits before and after video-enabled tablet receipt from the Veterans Health Administration. Method: 11,210 veterans aged 60 or older with a diagnosis of AUD who received a tablet between 1 April 2020 and 25 October 2021 were identified. The electronic health record was used to characterized encounters by modality of mental health care delivery in the six months pre/post tablet receipt. Logistic regression examined predictors of a video visit for mental health. Results: Phone was the most common modality; however, the proportion of video encounters increased from 8.7% to 26.2% after tablet receipt. Individuals who were older, male, and had more physical health conditions, were less likely to have a video visit. Individuals who were married, resided in urban areas, had a history of housing instability, and had more mental health conditions, were more likely to have a video visit. Conclusion: Video-enabled tablets may help older adults with AUD overcome access barriers to mental health services, although targeted support for certain groups may be necessary.
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Affiliation(s)
- Ana J Alfaro
- VA Palo Alto Health Care System, Geriatric Research, Education and Clinical Center (GRECC), Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Services, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Liberty Greene
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - James Van Campen
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Donna M Zulman
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Christine E Gould
- VA Palo Alto Health Care System, Geriatric Research, Education and Clinical Center (GRECC), Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Services, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Daniel M Blonigen
- Department of Psychiatry and Behavioral Services, Stanford University School of Medicine, Palo Alto, CA, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA
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3
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Bolt GL, Piercy H, Bradshaw J, Manning V. Smartphone-delivered approach bias modification for reducing harmful drinking amongst middle-older age adults: Secondary analyses of a single-arm pilot study. Drug Alcohol Rev 2024. [PMID: 38444082 DOI: 10.1111/dar.13827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Novel, scalable, low-cost interventions are needed to reduce harmful drinking amongst middle-older adults. Approach bias modification (ApBM) is a promising form of cognitive training for preventing/reducing alcohol use that can be delivered via smartphone. This study explored the acceptability and preliminary effectiveness of smartphone delivered and personalised ApBM amongst Australians ≥55 years, an age cohort at risk of alcohol-related harms. METHODS Secondary analyses in a middle-older adult subsample (≥55 years, n = 289) of an open-label pilot study using a retrospective, repeated measures design. We explored acceptability (adherence, user mobile acceptability ratings, free-text responses) and preliminary effectiveness (changes in drinking quantity and frequency, craving, dependence and proportion drinking within government-recommended guidelines) of two sessions/week over 4 weeks of evidence-based ApBM training, adapted to include personalisation and smartphone delivery amongst Australians ≥55 years. RESULTS Although minor adaptations to training were suggested, the intervention was acceptable amongst survey completers, with 72% training adherence. Relative to baseline, there was a significant increase in the proportion of drinking within recommended single-session and weekly guidelines post-training (from 25% to 41% and 6% to 28%, respectively, p < 0.001), with past-week standard drinks significantly decreasing by 18% (p < 0.001) and significant reductions in drinking days, mean craving and dependence scores (p < 0.001). DISCUSSION AND CONCLUSIONS Findings suggest smartphone ApBM is acceptable amongst middle-to-older aged Australians and may support this 'at risk' cohort to remain within government-recommended alcohol consumption guidelines to optimise healthy aging, although, in the context of a single-arm study, preliminary results should be interpreted cautiously.
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Affiliation(s)
- Georgia L Bolt
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
- Neuropsychology Department, Austin Health, Melbourne, Australia
| | - Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
| | - Jennifer Bradshaw
- Neuropsychology Department, Austin Health, Melbourne, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
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Liu J, Ouyang N, Mizrahi A, Kornides ML. Social Distancing in the COVID-19 Pandemic: Associated Factors, Health Outcomes, and Implications. FAMILY & COMMUNITY HEALTH 2024; 47:80-94. [PMID: 37681938 DOI: 10.1097/fch.0000000000000367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Social distancing has reemerged as a public health measure for containing the spread of COVID-19. This integrative review aims to analyze the historical use of social distancing, the current application during COVID-19, individual factors that affect social distancing practices, and consequential health outcomes. We analyzed relevant literature from searches conducted on Scopus, PubMed, and PsycINFO. We found that resources, culture, age, gender, and personality are associated with the degree to which people practice social distancing. Furthermore, social distancing changes our lifestyles and behavior and results in multifaceted health outcomes, including decreased physical activity and sunlight exposure, increased weight gain, and impaired sleep quality. On the positive side, social distancing has been linked to reduced crime rates and environmental damage, as well as better social and family ties. Future interventions may be utilized to increase adherence to social distancing practices and to mitigate the negative health effects of social distancing.
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Affiliation(s)
- Jianghong Liu
- Department of Family and Community Health, School of Nursing (Dr Liu), School of Nursing (Ms Ouyang and Dr Kornides), School of Arts and Sciences (Ms Mizrahi), University of Pennsylvania, Philadelphia; and Yale University, New Haven, Connecticut (Ms Ouyang)
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5
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Davy-Mendez T, Sarovar V, Levine-Hall T, Lea AN, Leibowitz AS, Luu MN, Flamm JA, Hare CB, Dumoit Smith J, Iturralde E, Dilley J, Silverberg MJ, Satre DD. Racial, ethnic, and age disparities in the association of mental health symptoms and polysubstance use among persons in HIV care. PLoS One 2023; 18:e0294483. [PMID: 38015975 PMCID: PMC10684077 DOI: 10.1371/journal.pone.0294483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/31/2023] [Indexed: 11/30/2023] Open
Abstract
We characterized polysubstance use burden and associations with mental health problems across demographic subgroups of PWH. In 2018-2020, as part of a primary care-based intervention study, PWH in care at three medical centers in Kaiser Permanente Northern California were screened for depression (PHQ-9≥10), anxiety (GAD-2≥3), and substance use (Tobacco, Alcohol, Prescription medication, and other Substance use [TAPS]≥1 per substance). We used Poisson regression to estimate prevalence ratios (PRs) comparing polysubstance use prevalence (TAPS≥1 for ≥2 substances) between PWH with positive screens for depression or anxiety vs. neither, among all PWH, and stratified by race/ethnicity and age (restricted to men), adjusting for sociodemographics, CD4, and HIV load. Screened PWH (N = 2865) included 92% men, 56% White, 19% Black, and 15% Hispanic PWH, with a median age of 55 years. Overall, polysubstance use prevalence was 26.4% (95% CI 24.9%-28.1%). PWH with depression or anxiety (n = 515) had an adjusted polysubstance use PR of 1.26 (1.09-1.46) vs. PWH with neither (n = 2350). Adjusted PRs were 1.47 (1.11-1.96), 1.07 (0.74-1.54), and 1.10 (0.85-1.41) among Black, Hispanic, and White men, respectively. Adjusted PRs did not differ by age group. Interventions should consider jointly addressing mental health and substance use problems and potential drivers, e.g. stigma or socioeconomic factors.
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Affiliation(s)
- Thibaut Davy-Mendez
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Varada Sarovar
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Tory Levine-Hall
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Alexandra N. Lea
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Amy S. Leibowitz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Mitchell N. Luu
- Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Jason A. Flamm
- Sacramento Medical Center, Kaiser Permanente Northern California, Sacramento, CA, United States of America
| | - C. Bradley Hare
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, United States of America
| | - Jaime Dumoit Smith
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Esti Iturralde
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - James Dilley
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
| | - Michael J. Silverberg
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Derek D. Satre
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States of America
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
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6
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Arcadepani FB, Fidalgo TM. Substance use among older adults: a review of the literature. J Addict Dis 2023; 41:289-299. [PMID: 36377720 DOI: 10.1080/10550887.2022.2109923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To explore studies that have examined the effectiveness of possible interventions to reduce the substance use among older adults. METHODS From the search, 295 abstracts were identified and 200 were excluded. Ninety-five remaining articles were reviewed, and 90 were excluded after full text review. Nine articles were included after reviewing bibliographic references on the topic. A total of 14 articles, which all met the inclusion criteria, were considered in the review. RESULTS All 14 studies found that pharmacological and non-pharmacological interventions can reduce substance use (alcohol, cocaine, nicotine and benzodiazepines) among older adults (mean age 45 years or older). CONCLUSIONS There are promising possibly pharmacological and non-pharmacological interventions that can be used to reduce substance use among older adults. In addition, other studies are needed to expand the therapeutic arsenal in this population.
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Affiliation(s)
- Felipe B Arcadepani
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Thiago M Fidalgo
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
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Paun O, Loukissa D. Substance Use Disorders in Older Adults. J Psychosoc Nurs Ment Health Serv 2023; 61:15-19. [PMID: 37389940 DOI: 10.3928/02793695-20230607-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Although substance misuse (primarily alcohol and prescribed benzodiazepines and opioids) among Americans aged ≥60 years is becoming an escalating health concern, substance use disorder (SUD) is often underestimated and/or undiagnosed, preventing older adults from receiving needed treatment. Chronic medical conditions, mental health issues, and psychosocial stressors increase older adults' risks for developing SUD. Racial/ethnic minority groups (e.g., American Indian, Alaska Native) experiencing health care inequities and limited resources are more vulnerable to developing SUD. It is recommended that SUD screening be included in annual check-ups using tools adapted to older adults. Clinicians should consider older adults' comorbidities to differentiate symptoms of substance use from neurocognitive disorders, depression, anxiety, and metabolic disorders. To ensure successful outcomes, interventions must be tailored to the specific needs of older adults. Building on the current federal government administration's support, SUD practice guidelines should be updated with older adults in mind. [Journal of Psychosocial Nursing and Mental Health Services, 61(7), 15-19.].
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Martin S, Oltra A, Del Monte J. Psychiatric and non-psychiatric population vulnerabilities in time of a crisis: the unsuspected aggression factor. BMC Psychiatry 2023; 23:386. [PMID: 37264352 DOI: 10.1186/s12888-023-04843-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/04/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis. METHODS We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations. RESULTS Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group. CONCLUSION New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.
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Affiliation(s)
- Sylvia Martin
- Center for Research and Bioethics, Uppsala University, Husargatan 3, BMC, entrance A11, 75224, Uppsala, Sweden.
- Psycho.Tcce, Clinical psychology Private practice, Montpellier, France.
| | - Anna Oltra
- Clinical psychology Private practice, Toulouse, France
| | - Jonathan Del Monte
- Psychosocial Laboratory, Aix-Marseille University, Aix Marseille, France
- Clinical Psychology Department, Nîmes University, Nîmes, France
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Sumetsky N, Frankeberger J, Coulter RWS, Burke JG, Friedman MR, Mair C. Mental Health and Alcohol Use during and before the Early Phases of the COVID-19 Pandemic. Behav Med 2023; 49:195-203. [PMID: 35000570 PMCID: PMC9289939 DOI: 10.1080/08964289.2021.2015278] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022]
Abstract
The early phases of the coronavirus 19 disease (COVID-19) pandemic were associated with changes in psychological well-being and alcohol use. However, it is unclear whether these changes are artifacts of psychological well-being and alcohol use prior to the pandemic across different sociodemographic groups. We received surveys from 247 adult residents of Allegheny County, Pennsylvania (United States), with an oversampling of sexual- and gender-minority individuals. Responses included measures of psychological well-being, substance use, and sociodemographic characteristics. Unadjusted mean depression scores, anxiety scores, and number of drinking days increased for all age and income groups during COVID-19, while average number of drinks per drinking day and days intoxicated differentially increased or decreased by age and income groups. Using Bayesian seemingly unrelated regression, we assessed depression and anxiety symptoms and alcohol use during the early stages of the pandemic and one month before COVID-19 was first identified in Allegheny County concurrently. Those in the youngest (18-24) group drank on more days during (but not before) the pandemic than those in the 25-44 age group. Compared to cisgender women, gender-minority adults had higher depression scores during the early stages of the pandemic. Employed adults had lower anxiety scores during (but not before) the pandemic than adults who were unemployed. Those with past-year annual incomes above $80,000 had fewer drinks on average drinking occasions than those in the $40,000 or below group before (but not during) the pandemic. Patterns of psychological distress and alcohol use associated with the COVID-19 pandemic differ by subgroup compared to patterns prior to the pandemic. Interventions addressing worsening mental health outcomes and shifting alcohol use patterns must be sensitive to the needs of vulnerable groups, such as younger adults and those experiencing poverty or unemployment.
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Affiliation(s)
- Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
| | - Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
| | - Robert W. S. Coulter
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
- Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health
| | - Jessica G. Burke
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
| | - M. Reuel Friedman
- Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health
- Center for Social Dynamics and Community Health, University of Pittsburgh Graduate School of Public Health
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Racial and Ethnic Disparities in Mental Health and Mental Health Care During The COVID-19 Pandemic. J Racial Ethn Health Disparities 2023; 10:961-976. [PMID: 35318615 PMCID: PMC8939391 DOI: 10.1007/s40615-022-01284-9] [Citation(s) in RCA: 93] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 12/28/2022]
Abstract
During the pandemic, the overall mental health of the US population declined. Given higher rates of COVID-19 infections and deaths experienced by communities of color along with greater exposure to pandemic-related stressors (e.g., unemployment, food insecurity), we expect that the decline in mental health during the pandemic was more pronounced among Black, Hispanic, and Asian adults, with these groups also having less access to mental health services. We examine two nationally representative US surveys: the 2019 National Household Interview Survey (NHIS; N = 30,368) and the 2020-2021 Household Pulse Survey (HPS; N = 1,677,238). We find mental health of Black, Hispanic, and Asian respondents worsened relative to White respondents during the pandemic, with significant increases in depression and anxiety among racialized minorities compared to Whites. There is also evidence of especially high mental health burden for Black adults around the murder of George Floyd by police and for Asian adults around the murder of six Asian women in Atlanta. White respondents are most likely to receive professional mental health care before and during the pandemic, and Black, Hispanic, and Asian respondents demonstrate higher levels of unmet mental health care needs during the pandemic than White respondents. Our results indicate that within the current environment, White adults are at a large and systemic advantage buffering them from unexpected crises-like the COVID-19 pandemic. Without targeted interventions, the long-term social consequences of the pandemic and other co-occurring events (e.g., death of Black and Hispanic people by police) will likely include widening mental health disparities between racial/ethnic groups.
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[Impact of COVID-19 lockdown on the prescription of benzodiazepines]. Aten Primaria 2023; 55:102552. [PMID: 36599201 PMCID: PMC9726689 DOI: 10.1016/j.aprim.2022.102552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To evaluate the effect of COVID-19 lockdown on the prescription of benzodiazepines by gender, age and district health departments. DESIGN Longitudinal observational study. LOCATION Primary care. Asturias (Spain) health district V. PARTICIPANTS People over 15 years of age with filled benzodiazepine prescriptions in between 2017 and 2020. MAIN MEASUREMENTS Benzodiazepine DHD (defined daily dose per 1000 habitants) mean difference between the period defined as pre-lockdown and lockdown. Additionally, the difference was adjusted for gender, sex and district health department and also with the interaction among them. RESULTS DHD mean pre-lockdown was 131.3 and 139.5 in the lockdown; this difference was significant in the global analysis (95% CI: 4.1-12.1). There was an increase in the DHD mean in the 60-74 age group (95% CI: 2.28-21.42), in the group over 90 years old (95% CI: 21.31-40.63) and in women (95% CI: 3.51-14.59). Finally, a decrease in the DHD mean of V11 (95% CI: -29 to -0.66) and V14 (95% CI: -54.28 to -25.04) district health departments was observed. CONCLUSIONS Certain subgroups show a change in the pattern of benzodiazepine prescription without being able to relate this to the lockdown. We believe that there could be some inertia in the prescription of psychiatric medication according to the biopsychosocial characteristics of the patients; it is important to detect this in order to avoid the medicalization of psychological disorders.
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Coffee Consumption during the COVID Pandemic in a Portuguese Sample: An Online Exploratory Study. Foods 2023; 12:foods12020421. [PMID: 36673513 PMCID: PMC9858285 DOI: 10.3390/foods12020421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Coffee is one of the most consumed beverages worldwide and is part of the Portuguese lifestyles. This study aims to describe coffee consumption during the COVID-19 pandemic, the change in consumption, the relation between work and familiar pressure during the COVID-19 pandemic and coffee consumption, and the reasons for this consumption pattern. METHODS This is a cross-sectional study conducted by an online questionnaire (n = 463) between March and June 2020. During the data collection phase, information about coffee consumption and socio-demographic characteristics were gathered. RESULTS All respondents were and are coffee consumers. The coffee average intake before the COVID-19 pandemic was 2.40 ± 0.84 cups of coffee per day, and the average consumption during the COVID-19 confinement was 2.68 ± 0.88 cups. Consumption increased during the COVID-19 pandemic, but a correlation between the consumption changes and the familiar or work pressure was not found. The general reasons for the increase in the coffee consumption were "social/cultural" (27%), "the search for energy "boost"" (22.9%), "to feel awake" (22.7%), "to deal with stress" (22.7%) and "the taste" (21.8%). CONCLUSIONS The results suggest the ever-increasing popularity of coffee consumption. Respondents also highlighted that some situations make them more prone to consume coffee consumption, such as when they face stress and the need to control tiredness. The COVID pandemic depleted a change in behaviors.
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Yang TC, Shoff C, Shaw BA, Strully K. Neighborhood characteristics and opioid use disorder among older Medicare beneficiaries: An examination of the role of the COVID-19 pandemic. Health Place 2023; 79:102941. [PMID: 36442317 DOI: 10.1016/j.healthplace.2022.102941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/28/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022]
Abstract
This study investigates how the associations between residential characteristics and the risk of opioid user disorder (OUD) among older Medicare beneficiaries (age≥65) are altered by the COVID-19 pandemic. Applying matching techniques and multilevel modeling to the Medicare fee-for-service claims data, this study finds that county-level social isolation, concentrated disadvantage, and residential stability are significantly associated with OUD among older adults (N = 1,080,350) and that those living in counties with low levels of social isolation and residential stability experienced a heightened risk of OUD during the pandemic. The results suggest that the COVID-19 pandemic has aggravated the impacts of residential features on OUD.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Sociology, University at Albany, State University of New York, Albany, NY, USA; Department of Epidemiology, University of Texas Medical Branch, Galveston, TX, USA.
| | | | - Benjamin A Shaw
- Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Kate Strully
- Department of Sociology, University at Albany, State University of New York, Albany, NY, USA
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14
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Kabadayi Sahin E, Usul E. Prehospital Emergency Service Use for Substance-Related Issues before and during COVID-19. Emerg Med Int 2023; 2023:8886832. [PMID: 37101767 PMCID: PMC10125766 DOI: 10.1155/2023/8886832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/06/2023] [Accepted: 04/02/2023] [Indexed: 04/28/2023] Open
Abstract
Objective The COVID-19 pandemic disrupted the healthcare system and disproportionally affected individuals with substance use. This study aimed to evaluate the prehospital emergency medical service (EMS) use for substance-related health issues during the COVID-19 pandemic period and compare the changes with the pre-COVID-19 period. Methods The prehospital EMS calls due to substance-related problems in overall Turkiye were analyzed retrospectively. The applications were categorized into the pre-COVID-19 period (May 11, 2019, to March 11, 2020) and the COVID-19 period (March 11, 2020, to January 4, 2021). These two periods were compared to if there were any changes in sociodemographic features of the applicants, the reason for EMS calls, and the dispatch results of the calls. Results There were 6,191 calls in the pre-COVID-19 period and 4,758 calls in the COVID-19 period. According to the age groups, the number of applications of 18 years and under decreased, while the application of people 65 years and over increased during the COVID-19 period (p < 0.001). Considering the reasons for the EMS application, there was an increase in the calls due to suicide and transfers during the COVID-19 period. Besides, the EMS applications for court-ordered treatment decreased in the COVID-19 period (p < 0.001). There was no statistically significant difference in terms of dispatch results (p = 0.081). Conclusions This study shows that the elderly group is at higher risk for substance-related medical problems. Suicide is an important risk among individuals with substance use. The increase in demand for ambulance transfer services can place a significant burden on prehospital emergency care. There is a need for measures to provide emergency and transport services, especially for the elderly and suicide attempts during any future case of emergency.
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Affiliation(s)
- Esra Kabadayi Sahin
- Department of Psychiatry, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Eren Usul
- Department of Emergency Medicine, Ankara Etlik City Hospital, Ankara, Turkey
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Meshberg-Cohen S, Farook M, Gross G, Levina V, DeViva J. Treatment utilization and modality preference among veterans receiving outpatient substance use disorder treatment during a pandemic. Am J Addict 2023; 32:32-39. [PMID: 36286598 DOI: 10.1111/ajad.13347] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/23/2022] [Accepted: 09/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study examines substance use disorder (SUD) treatment utilization patterns in response to a pandemic. METHOD Retrospective electronic medical record data were collected during three time periods (N = 390): "Pre-COVID-19" (12/02/2019-03/14/2020), "COVID-19" (03/15/2020-06/30/2020), and COVID-19 "Re-entry" (7/01/2020-10/01/2020). Number of visits in each time period, SUD diagnosis, treatment modality (video, telephone, none), demographic, and clinical variables were examined. One-way analyses of variance (ANOVA) and chi-square analyses tested the relationships between treatment modality, demographics, clinical variables, and psychiatric emergency room (PER) visits. Binary logistic regressions examined the effect of treatment modality on PER use during COVID-19 and Re-entry, controlling for alcohol, opioid, and cocaine use disorders, age, and past-year (pre-COVID-19) PER use. RESULTS Treatment modality was associated with SUD (alcohol, cocaine, opioids), age, and PER visits. Veterans who primarily attended telephone appointments were more likely to require PER services compared to those attending video appointments. In the full model, alcohol use disorder (AUD), past-year PER visits, and treatment modality (telephone visits) continued to be significantly associated with COVID-19 PER use, while past-year PER visits correlated with Re-entry PER use. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE During COVID-19, veterans whose main treatment modality was telephone were more likely to require PER services than veterans who were seen by video, even after controlling for age, AUD, opioid use disorder, and past-year PER visits. This study is the first to have examined SUD treatment modality utilization patterns in response to COVID-19. Findings suggest that treatment modality during the initial phase of COVID-19 correlated with PER presentation.
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Affiliation(s)
- Sarah Meshberg-Cohen
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Minnah Farook
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Georgina Gross
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Victoria Levina
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jason DeViva
- Psychology Service/Department of Psychiatry, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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16
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Angerville B, Moinas M, Martinetti MP, Naassila M, Dervaux A. Changes in Alcohol Consumption among Users of an Internet Drug Forum during a COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14585. [PMID: 36361469 PMCID: PMC9654161 DOI: 10.3390/ijerph192114585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The aim of the present study was to assess the frequency and clinical correlates of users of an Internet drug forum who changed their alcohol use during the March-May 2020 COVID-19 lockdown in France. METHODS An anonymous Internet-based cross-sectional survey during the COVID-19 lockdown was used via messages on a French Internet drug forum. Participants reported any increase in their alcohol consumption during the lockdown. Alcohol craving and depressive/anxiety symptoms were assessed using the Obsessive and Compulsive Drinking scale (OCDS) and Hospital Anxiety and Depression scale (HADS). RESULTS Of 1310 respondents, 974 (79% of 1270) participants reported alcohol use before lockdown. During the lockdown, 405 participants (41.6%; IC95 (38.5-44.7)) reported an increase. Odds of an increase in alcohol consumption was higher for those with HADS scores higher than 7 (aOR: 2.19; p = 0.00002), OCDS scores greater than 7 (aOR: 3.50; p < 0.001), and daily psychostimulant use (aOR: 1.85; p = 0.002). CONCLUSIONS Users of an Internet drug forum who reported high levels of depressive symptoms, high levels of alcohol craving, and the use of psychostimulants were more likely to increase alcohol consumption during a COVID-19 lockdown.
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Affiliation(s)
- Bernard Angerville
- Établissement Public de Santé Mentale Barthélémy Durand, 91150 Etampes, France
- Groupe de Recherche sur l’Alcool & les Pharmacodépendances (GRAP) INSERM U1247, Université de Picardie Jules Verne, 80054 Amiens, France
| | - Marc Moinas
- Service de Soins de Suite et de Réadaptation en Addictologie, Centre Hospitalier Intercommunal Montdidier Roye, 80700 Roye, France
| | | | - Mickael Naassila
- Groupe de Recherche sur l’Alcool & les Pharmacodépendances (GRAP) INSERM U1247, Université de Picardie Jules Verne, 80054 Amiens, France
| | - Alain Dervaux
- Établissement Public de Santé Mentale Barthélémy Durand, 91150 Etampes, France
- Groupe de Recherche sur l’Alcool & les Pharmacodépendances (GRAP) INSERM U1247, Université de Picardie Jules Verne, 80054 Amiens, France
- UFR de Médecine, Université Paris-Saclay, 94270 Kremlin-Bicêtre, France
- Laboratoire de Recherche PSYCOMADD, Centre Hospitalier Paul Brousse, 94800 Villejuif, France
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17
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Crawley MR, Chapman AJ, Koestner A, Pounders S, Krech L, Lypka M, Fisk C, Iskander G. Fall Risk Identification Throughout the Continuum of Care for Elderly Trauma Patients: An Injury Prevention Initiative. Injury 2022; 53:3715-3722. [PMID: 36075779 DOI: 10.1016/j.injury.2022.08.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 08/06/2022] [Accepted: 08/29/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Falls are the second leading cause of trauma-related deaths worldwide. Identifying fall risk patients and initiating interventions reduces injuries and mortality, particularly in the elderly. The primary aim of this retrospective study was to identify missed opportunities for fall risk identification and intervention for geriatric trauma patients. PATIENTS AND METHODS In this retrospective observational cohort study, the trauma registry was queried to identify geriatric patients admitted for a fall over 36 months. The electronic medical record (EMR) was reviewed to evaluate patients' fall risk in the 12 months prior to the index fall admission. The EMR was also queried for repeat falls within 12 months after discharge, and to determine if fall prevention education was provided at discharge. RESULTS 597 patients met inclusion criteria; 68.3% were female. 64.7% were at risk for falling in the year before admission. 2% had documented fall prevention education at discharge. 32% of patients fell again within a year of discharge and 19.4% were readmitted for a repeat fall. Patients at high risk for falls (on the Hester-Davis scale) were significantly more likely to be readmitted (p = 0.005) and expire within six months (p = 0.033) than moderate risk patients. Mortality at 12 months post-admission for all patients was 19.4%. CONCLUSION This large study demonstrated that geriatric trauma patients admitted for a fall were already at risk for falling in the 12 months prior to admission. This is a novel finding that presents a substantial prevention opportunity for healthcare systems. Education and implementation of proven techniques to prevent falls as soon as at-risk patients are identified has the potential to change the course for a patient who may not only fall, but also fall again. This proactive approach could significantly impact the fall epidemic in our elderly population.
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Affiliation(s)
- Meaghan R Crawley
- Spectrum Health Butterworth Hospital, Trauma Services, 100 Michigan St. NE, Grand Rapids, MI 49503, USA
| | - Alistair J Chapman
- Spectrum Health Butterworth Hospital, Acute Care Surgery, 100 Michigan St. NE, Grand Rapids, MI 49503, USA; Spectrum Health Trauma Research Institute, Acute Care Surgery, 100 Michigan St. NE, Grand Rapids, MI 49503, USA
| | - Amy Koestner
- Spectrum Health Butterworth Hospital, Trauma Services, 100 Michigan St. NE, Grand Rapids, MI 49503, USA
| | - Steffen Pounders
- Spectrum Health Trauma Research Institute, Acute Care Surgery, 100 Michigan St. NE, Grand Rapids, MI 49503, USA
| | - Laura Krech
- Spectrum Health Trauma Research Institute, Acute Care Surgery, 100 Michigan St. NE, Grand Rapids, MI 49503, USA.
| | - Matthew Lypka
- Spectrum Health Office of Research and Education, Biostatistics Core, 15 Michigan St. NE, Grand Rapids, MI 49503, USA
| | - Chelsea Fisk
- Spectrum Health Trauma Research Institute, Acute Care Surgery, 100 Michigan St. NE, Grand Rapids, MI 49503, USA
| | - Gaby Iskander
- Spectrum Health Butterworth Hospital, Acute Care Surgery, 100 Michigan St. NE, Grand Rapids, MI 49503, USA
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18
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Addressing the Crises in Treating Substance Use Disorders in Later-life: Tele-medication Assisted Treatment (TELE-MAT) for an Older Adult Population. Am J Geriatr Psychiatry 2022; 30:1064-1066. [PMID: 35760702 PMCID: PMC9232273 DOI: 10.1016/j.jagp.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 01/25/2023]
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19
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Desai A, Grossberg G. Substance Use Disorders in Postacute and Long-Term Care Settings. Psychiatr Clin North Am 2022; 45:467-482. [PMID: 36055733 DOI: 10.1016/j.psc.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Substance use disorders (SUDs) have not been rigorously studied in postacute and long-term care (PALTC) populations. SUDs are among the fastest growing disorders in the community dwelling older population. Untreated SUDs often lead to overdose deaths, emergency department visits, and hospitalizations due to SUD-related adverse effects, especially exacerbation of comorbid physical and mental health conditions. Primary care providers (PCPs) working in PALTC settings can and should play a key role in its prevention and treatment. This clinical review identifies several practical strategies that PCPs can incorporate in their daily practice to improve lives of PALTC population having SUD.
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Affiliation(s)
- Abhilash Desai
- Division of Geriatric Psychiatry, Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO 63104, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, UW Boise Psychiatry Residency, BVAMC Wellness Center B. 116, 500 W. Fort street, Boise, ID 83702, USA.
| | - George Grossberg
- Division of Geriatric Psychiatry, Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO 63104, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, UW Boise Psychiatry Residency, BVAMC Wellness Center B. 116, 500 W. Fort street, Boise, ID 83702, USA
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20
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Hussain J, Ling L, Alonzo RT, Rodrigues R, Nicholson K, Stranges S, Anderson KK. Associations between sleep patterns, smoking, and alcohol use among older adults in Canada: Insights from the Canadian Longitudinal Study on Aging (CLSA). Addict Behav 2022; 132:107345. [PMID: 35526407 DOI: 10.1016/j.addbeh.2022.107345] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/12/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
Poor sleep is associated with chronic health conditions among older adults. As substance use rates increase in this population, age-related physiological and cognitive declines may exacerbate its detrimental consequences, including sleep problems. We analyzed cross-sectional associations between sleep patterns, smoking, and alcohol use using baseline data from 30,097 community-dwelling Canadian adults aged 45-85 years from the Canadian Longitudinal Study on Aging. Insomnia symptoms (difficulties falling/staying asleep), sleep duration (short:<6h; long:>8h), and sleep satisfaction(dissatisfied/neutral/satisfied) were measured. Smoking and alcohol-use frequency (past 12 months), average daily amount (past 30 days), and binge drinking (past 12 months) were self-reported, and associations were examined using modified Poisson regression. Approximately 23% of participants had insomnia symptoms, and 26% reported sleep dissatisfaction. 91% of participants were current non-smokers, whereas 7% reported smoking daily. Over 50% drank ≤ 2 drinks daily, and 3% reported binge drinking. There was a higher adjusted prevalence of insomnia among daily smokers (PR = 1.10, 95% CI = 1.00-1.21) and binge drinkers (PR = 1.21, 95% CI = 1.02-1.43). Odds of short sleep duration were lower among regular drinkers (COR = 0.71, 95% CI = 0.56-0.90) and higher among daily smokers (COR = 1.19, 95% CI = 1.01-1.40). Heavy and frequent smoking and alcohol use are associated with both insomnia symptoms and sleep dissatisfaction, but not consistently with sleep duration. Further longitudinal investigation of this relationship in aging populations is needed in clinical and public health settings to infer the extent of causality and design effective public health interventions in this vulnerable population.
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Affiliation(s)
- Junayd Hussain
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Linda Ling
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rea T Alonzo
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Kathryn Nicholson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, Western University, London, Ontario, Canada.
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21
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Walker L, Cordero MI, McChesney G, Gee I, Grogan S. Associations Between Covid-19-Related Threat, Stress, and Smoking in UK Adults Aged Under- and Over-30. Tob Use Insights 2022; 15:1179173X221121229. [PMID: 35991488 PMCID: PMC9389033 DOI: 10.1177/1179173x221121229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 11/15/2022] Open
Abstract
It has been suggested that smoking and age are associated with higher vulnerability to Covid-19. While threat of Covid-19 may reduce or stop smoking, increased stress due to lockdown could increase smoking behaviour. This study aimed to investigate changes in smoking behaviour in relation to age, Covid-19-related threat and subjective perceived stress during the UK lockdown. A cross-sectional study was performed. Online adverts were used to recruit UK residents who smoked combustible tobacco any time from January 2020. A questionnaire measured demographic information, smoking behaviour pre- and during-lockdown, perceived subjective stress (PSS), and Covid-19 related threat. Data were collected from a total of 145 participants (58% women, 39% men, 3% non-binary; mean age: 26 years, SD = 7.7), during UK lockdown between 22nd May and 22nd June 2020. Independent of stress and Covid-19-related threat, smoking was reduced in those aged less than 30 years. In participants aged 30 and above, increases in smoking behaviour were associated with higher PSS. The results highlight the relevance of the different stages of life on the relationship between stress, threat, and smoking behaviour. Greater emphasis should be placed on stress reduction for adult smokers aged 30 and above to enable smoking cessation.
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Affiliation(s)
- Lucy Walker
- Department of Psychology, Manchester Metropolitan
University, Manchester, UK
| | - Maria I. Cordero
- Department of Psychology, Manchester Metropolitan
University, Manchester, UK
| | - Gillian McChesney
- Department of Psychology, Manchester Metropolitan
University, Manchester, UK
| | - Ivan Gee
- Public Health Institute, Liverpool John Moores
University, Liverpool, UK
| | - Sarah Grogan
- Department of Psychology, Manchester Metropolitan
University, Manchester, UK
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22
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Norberto MJ, Rodríguez-Santos L, Montanero J, Cáceres MC. Concordance in psychopharmacological treatment before and after first mental health consultation. Arch Psychiatr Nurs 2022; 39:66-72. [PMID: 35688546 DOI: 10.1016/j.apnu.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/08/2022] [Accepted: 03/19/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyse concordance between treatment prescribed before and after the first mental health consultation. We understand concordance in two different senses: first, as a similar amount of equivalent doses and drug type; second, as a similar treatment for each patient. METHOD This is an analytical, descriptive, retrospective study on psychopharmacological treatment before and after first mental health consultation of 1236 patients. Drugs were classified into four groups and the equivalent dose respect to reference medication was considered in each group in order to make a comparison between primary and mental health. RESULTS Moderate concordance was found in prescribed treatments before and after first mental health consultation (except antidepressants). The average number of benzodiazepines decreased, as did average doses prescribed at mental health consultation respect to previously prescribed treatment; average doses of antidepressants, however, increased. From the patient's perspective, dose increase was more frequent than decrease. Nevertheless, a high percentage of polymedicated patients were found, although this percentage decreased after the first mental health consultation. CONCLUSION There exists a moderate concordance between the pharmacological treatment prescribed before and after the first mental health consultation. However, the use of benzodiazepines diminished significantly after the first consultation, mainly due to a decrease in the percentage of polymedicated patients.
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Affiliation(s)
- M J Norberto
- Unit of Psychiatry, Servicio Extremeño de Salud, Badajoz, Spain.
| | - L Rodríguez-Santos
- Area de Psiquiatría, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, Badajoz, Spain.
| | - J Montanero
- Departamento de Matemáticas, Universidad de Extremadura, Badajoz, Spain.
| | - M C Cáceres
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, Badajoz, Spain.
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23
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Frankeberger J, Sumetsky N, Friedman MR, Burke JG, Coulter RWS, Mair C. Changes in activity locations during the COVID-19 pandemic and associations with depression, anxiety, loneliness, and alcohol use. WELLBEING, SPACE AND SOCIETY 2022; 3:100092. [PMID: 35860439 PMCID: PMC9281410 DOI: 10.1016/j.wss.2022.100092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/29/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Restrictions and guidelines to limit the spread of COVID-19 caused considerable and rapid changes to individuals' daily routines. This study examines how activity locations changed during the COVID-19 pandemic and associated social distancing restrictions, and whether these changes were associated with depression, anxiety, loneliness, and alcohol use. METHODS A web-based survey was conducted early in the COVID-19 pandemic (May-June 2020) in Allegheny County (Pittsburgh), Pennsylvania. Participants (n = 265) reported visits to activity locations in the last 30 days and retrospectively for February 2020 (pre-pandemic). A principal components analysis was conducted to assess change in utilization of activity locations. Component scores of changes to activity locations were compared by sociodemographics. Poisson and zero-inflated negative binomial models were used to examine the relationship between component scores and pandemic depression symptoms, anxiety symptoms, loneliness, and drinking days. RESULTS Five distinct principal components of activity location changes were identified. The first component, characterizing broad reductions in activity locations during the early phases of the pandemic, was associated with increased depression and loneliness. CONCLUSIONS Results indicate non-uniform shifts in routine activities during the pandemic and highlight the importance of understanding how changes to the social environment affect individuals' psychological wellbeing and alcohol use.
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Affiliation(s)
- Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - M Reuel Friedman
- Center for LGBT Health Research, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
- Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Jessica G Burke
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Robert W S Coulter
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
- Center for LGBT Health Research, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
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Seddon J, Trevena P, Wadd S, Elliott L, Dutton M, McCann M, Willmott S. Addressing the needs of older adults receiving alcohol treatment during the COVID-19 pandemic: a qualitative study. Aging Ment Health 2022; 26:919-924. [PMID: 33928805 DOI: 10.1080/13607863.2021.1910794] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The COVID-19 global pandemic resulted in major changes to the provision of alcohol treatment in the UK, these changes coincided with increases in the use of alcohol. This study sought to understand the impact of the pandemic on older adults in alcohol treatment, and to explore how changes in the provision of alcohol treatment were experienced. METHOD Semi-structured interviews were completed with older adults (aged 55+) in alcohol treatment, as well as alcohol practitioners providing support to older adults. Data were analysed using thematic analysis. Alcohol use was assessed using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C). RESULTS Thirty older adults in alcohol treatment and fifteen alcohol practitioners were recruited. The COVID-19 pandemic was found to result in both increases and decreases in alcohol use; changes in alcohol use depended on a number of factors, such as living arrangements, family support, physical and mental health. Many alcohol treatment services moved to a model of remote support during the pandemic. However, face-to-face service provision was considered to be essential by both older adults in alcohol treatment and alcohol practitioners. Engagement with online support was low, with older adults facing barriers in using online technology. CONCLUSION The study highlights the importance of face-to-face treatment and intervention for older adults in alcohol treatment. Addiction services may see increased demand for treatment as a result of the pandemic; it is important that services consider the needs of older adults, many of whom may be marginalised by a remote model of service provision.
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Affiliation(s)
- Jennifer Seddon
- Substance Misuse & Ageing Research Team, Institute of Applied Social Research, The University of Bedfordshire, Luton, UK
| | - Paulina Trevena
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sarah Wadd
- Substance Misuse & Ageing Research Team, Institute of Applied Social Research, The University of Bedfordshire, Luton, UK
| | - Lawrie Elliott
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maureen Dutton
- Substance Misuse & Ageing Research Team, Institute of Applied Social Research, The University of Bedfordshire, Luton, UK
| | - Michelle McCann
- Substance Misuse & Ageing Research Team, Institute of Applied Social Research, The University of Bedfordshire, Luton, UK
| | - Sarah Willmott
- Substance Misuse & Ageing Research Team, Institute of Applied Social Research, The University of Bedfordshire, Luton, UK
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25
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Emmer De Albuquerque Green C, Scharf T, Kessler EM. Responding to Covid-19: an analysis of position statements of gerontological societies worldwide. Eur J Ageing 2022; 19:1229-1241. [PMID: 36692750 PMCID: PMC9014281 DOI: 10.1007/s10433-022-00700-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 01/26/2023] Open
Abstract
The Covid-19 pandemic, with its adverse implications for older adults, has generated unprecedented public interest in issues around age and ageing globally. We systematically investigated the responses of national gerontological and geriatric societies (NGGS) to emerging challenges during the first wave of the pandemic. Framed within traditional research topics in gerontology, the aim was to identify the spectrum of focal points and positions directed towards governments, policy makers, researchers and society. A comprehensive, two-phased data collection strategy generated N = 22 position statements of NGGS affiliated to the International Association of Gerontology and Geriatrics. Using Ayalon et al. (J Gerontol Ser B, 2020. https://doi.org/10.1093/geronb/gbaa066 ) thematic categorisation of gerontological research, we applied quantitative and qualitative content analysis to analyse "calls for action" within the statements. The content of NGGS' position statements show a high level of agreement on the salient topics during the first wave of the pandemic and reveal shared values such as equality, diversity and inclusion of older adults and the discipline of gerontology to be an applied one with relevance to policy and practice. The results can support future interdisciplinary research in gerontology post Covid-19 based on a vision to contribute to a society of all ages.
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Affiliation(s)
| | - Thomas Scharf
- Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eva-Marie Kessler
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
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Reilly ED, Chamberlin ES, Duarte BA, Harris JI, Shirk SD, Kelly MM. The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study. Front Psychol 2022; 13:812247. [PMID: 35478735 PMCID: PMC9035845 DOI: 10.3389/fpsyg.2022.812247] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.
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Affiliation(s)
- Erin D. Reilly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
- *Correspondence: Erin D. Reilly,
| | - Elizabeth S. Chamberlin
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
| | | | - J. Irene Harris
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Steven D. Shirk
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Megan M. Kelly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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Jaworski BK, Taylor K, Ramsey KM, Heinz AJ, Steinmetz S, Owen JE, Tsai J, Pietrzak RH. Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel. JMIR Ment Health 2022; 9:e36217. [PMID: 35245204 PMCID: PMC8985691 DOI: 10.2196/36217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although the COVID-19 pandemic has not led to a uniform increase of mental health concerns among older adults, there is evidence to suggest that some older veterans did experience an exacerbation of preexisting mental health conditions, and that mental health difficulties were associated with a lack of social support and increasing numbers of pandemic-related stressors. Mobile mental health apps are scalable, may be a helpful resource for managing stress during the pandemic and beyond, and could potentially provide services that are not accessible due to the pandemic. However, overall comfort with mobile devices and factors influencing the uptake and usage of mobile apps during the pandemic among older veterans are not well known. COVID Coach is a free, evidence-informed mobile app designed for pandemic-related stress. Public usage data have been evaluated; however, the uptake and usage of the app among older veterans have not been explored. OBJECTIVE The purpose of this study was to characterize smartphone ownership rates among US veterans, identify veteran characteristics associated with downloading and use of COVID Coach, and characterize key content usage within the app. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative, prospective cohort of 3078 US military veterans before and 1 year into the pandemic. The NHRVS sample was drawn from KnowledgePanel, a research panel of more than 50,000 households maintained by Ipsos, Inc. The median time to complete the survey was nearly 32 minutes. The research version of COVID Coach was offered to all veterans who completed the peripandemic follow-up assessment on a mobile device (n=814; weighted 34.2% of total sample). App usage data from all respondents who downloaded the app (n=34; weighted 3.3% of the mobile completers sample) were collected between November 14, 2020, and November 7, 2021. RESULTS We found that most US veterans (81.5%) own smartphones, and that veterans with higher education, greater number of adverse childhood experiences, higher extraversion, and greater severity of pandemic-related posttraumatic stress disorder symptoms were more likely to download COVID Coach. Although uptake and usage of COVID Coach were relatively low (3.3% of eligible participants, n=34), 50% of the participants returned to the app for more than 1 day of use. The interactive tools for managing stress were used most frequently. CONCLUSIONS The COVID-19 pandemic has increased the need for and creation of digital mental health tools. However, these resources may require tailoring for older veteran populations. Future research is needed to better understand how to optimize digital mental health tools such as apps to ensure uptake and usage among older adults, particularly those who have experienced traumas across the lifespan.
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Affiliation(s)
- Beth K Jaworski
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Katherine Taylor
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Kelly M Ramsey
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Adrienne J Heinz
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Sarah Steinmetz
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Jason E Owen
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Jack Tsai
- National Center on Homelessness Among Veterans, US Department of Veterans Affairs, Tampa, FL, United States.,School of Public Health, San Antonio Campus, University of Texas Health Science Center at Houston, San Antonio, TX, United States
| | - Robert H Pietrzak
- National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, US Department of Veterans Affairs, New Haven, CT, United States.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
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Branquinho C, Paiva T, Guedes F, Gaspar T, Tomé G, Gaspar de Matos M. Health risk behaviors before and during COVID-19 and gender differences. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1102-1110. [PMID: 34517436 PMCID: PMC8657327 DOI: 10.1002/jcop.22705] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/28/2021] [Accepted: 08/30/2021] [Indexed: 05/06/2023]
Abstract
Changes in routines and habits, fear of contamination from the coronavirus disease 2019 (COVID-19) virus, and economic crisis have resulted in significant impacts upon individuals' lives, health, and risk behaviors. The present study aims to analyze health risk behaviors and gender differences of Portuguese adults before and during the COVID-19 pandemic. A quantitative analysis using SPSS v. 26 software presents the evaluation of 5746 responses (M = 48.5 years, SD = 14.3), of which 67.7% were female. t Test was used to study differences in means before and during the pandemic and analysis of variance test to analyze gender differences. In the comparative study before and during the pandemic showed a decrease in the number of meals per day, physical activity and perception of sleep quality; an increase in tobacco use, beer consumption, and media use (TV, mobile phone, social networks, and online games). Gender differences study demonstrated that the number of meals per day suffered a decrease from pre to pandemic in women, while increasing in men, becoming prominent in the second moment under study. Both genders had an increase in consumption behaviors and substance use, but women revealed a decrease in the consumption of wine during the pandemic, while men revealed more consumption behaviors in the variables under study. The use of media also changed, with men showing a higher level in TV hours per day, social networks and online games before the pandemic and in TV hours per day and games/online during the pandemic. Women stand out in the use of mobile phone per day during the pandemic. Daily physical activity decreased during the pandemic, as did sleep quality. Males revealed a higher practice of physical activity at both periods, as well as sleep quality. Based on the results presented, it is expected that considerations and actions in the scope of public health policies and health prevention and promotion, will be rethought and adapted to the specificities of each gender.
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Affiliation(s)
- Cátia Branquinho
- Aventura Social Project, Faculty of Human MotricityUniversity of LisbonLisbonPortugal
- Department of Education, Social Sciences and Humanities, Faculty of Human KineticsUniversity of LisbonLisbonPortugal
- ISAMB Research Center, Faculty of MedicineUniversity of LisbonLisbonPortugal
| | - Teresa Paiva
- CENC—Centre for Electroencephalography and Clinical NeurophysiologyLisbonPortugal
| | - Fábio Guedes
- Aventura Social Project, Faculty of Human MotricityUniversity of LisbonLisbonPortugal
- Department of Education, Social Sciences and Humanities, Faculty of Human KineticsUniversity of LisbonLisbonPortugal
- ISAMB Research Center, Faculty of MedicineUniversity of LisbonLisbonPortugal
| | - Tânia Gaspar
- Aventura Social Project, Faculty of Human MotricityUniversity of LisbonLisbonPortugal
- ISAMB Research Center, Faculty of MedicineUniversity of LisbonLisbonPortugal
- Faculty of Social Sciences and HumanitiesLusíada University of LisbonLisbonPortugal
| | - Gina Tomé
- Aventura Social Project, Faculty of Human MotricityUniversity of LisbonLisbonPortugal
- Department of Education, Social Sciences and Humanities, Faculty of Human KineticsUniversity of LisbonLisbonPortugal
- ISAMB Research Center, Faculty of MedicineUniversity of LisbonLisbonPortugal
| | - Margarida Gaspar de Matos
- Aventura Social Project, Faculty of Human MotricityUniversity of LisbonLisbonPortugal
- Department of Education, Social Sciences and Humanities, Faculty of Human KineticsUniversity of LisbonLisbonPortugal
- ISAMB Research Center, Faculty of MedicineUniversity of LisbonLisbonPortugal
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Peprah P, Arthur-Holmes F, Agyemang-Duah W, Frimpong SO, Gyimah AA, Kovor F. The correlates of substance use among older adults in Ghana during the COVID-19 pandemic. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.31592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Prince Peprah
- Center for Primary Health care and Equity, University of New South Wales, Sydney, Australia; Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | | | | | | | | | - Faustina Kovor
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Nordeck CD, Riehm KE, Smail EJ, Holingue C, Kane JC, Johnson RM, Veldhuis CB, Kalb LG, Stuart EA, Kreuter F, Thrul J. Changes in drinking days among United States adults during the COVID-19 pandemic. Addiction 2022; 117:331-340. [PMID: 34159674 PMCID: PMC8441933 DOI: 10.1111/add.15622] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/30/2020] [Accepted: 06/09/2021] [Indexed: 12/11/2022]
Abstract
AIMS To examine changes in drinking behavior among United States (US) adults between March 10 and July 21, 2020, a critical period during the COVID-19 pandemic. DESIGN Longitudinal, internet-based panel survey. SETTING The Understanding America Study (UAS), a nationally representative panel of US adults age 18 or older. PARTICIPANTS A total of 4298 US adults who reported alcohol use. MEASUREMENTS Changes in number of reported drinking days from March 11, 2020 through July 21, 2020 in the overall sample and stratified by sex, age, race/ethnicity, household structure, poverty status, and census region. FINDINGS Compared with March 11, the number of drinking days per week was significantly higher on April 1 by an average of 0.36 days (95% CI = 0.30, 0.43), on May 1 by an average of 0.55 days (95% CI = 0.47, 0.63), on June 1 by an average of 0.41 days (95% CI = 0.33, 0.49), and on July 1 by an average of 0.39 days (95% CI = 0.31, 0.48). Males, White participants, and older adults reported sustained increases in drinking days, whereas female participants and individuals living under the federal poverty line had attenuated drinking days in the latter part of the study period. CONCLUSIONS Between March and mid-July 2020, adults in the United States reported increases in the number of drinking days, with sustained increases observed among males, White participants, and older adults.
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Affiliation(s)
- Courtney D. Nordeck
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
| | - Kira E. Riehm
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
| | - Emily J. Smail
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
| | - Calliope Holingue
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
- Department of Neuropsychology, Kennedy Krieger InstituteJohns Hopkins UniversityBaltimoreMDUSA
| | - Jeremy C. Kane
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Renee M. Johnson
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
| | | | - Luther G. Kalb
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
- Department of Neuropsychology, Kennedy Krieger InstituteJohns Hopkins UniversityBaltimoreMDUSA
| | - Elizabeth A. Stuart
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
| | - Frauke Kreuter
- Joint Program in Survey MethodologyUniversity of MarylandMDUSA
- Department of StatisticsLudwig Maximilian University of MunichMunichGermany
- Statistical Methods GroupInstitute for Employment ResearchNurembergGermany
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraVICAustralia
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Curtis AF, Schmiedeler A, Musich M, Connell M, Miller MB, McCrae CS. COVID-19-Related Anxiety and Cognition in Middle-Aged and Older Adults: Examining Sex as a Moderator. Psychol Rep 2022; 126:1260-1283. [PMID: 35099322 PMCID: PMC8810388 DOI: 10.1177/00332941211064820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aging populations experience disproportionate risk for cognitive decline, which may be exacerbated by coronavirus (COVID-19) illness, particularly among women. This study tested sex as a moderator of associations between COVID-19 state anxiety and cognition in middle-aged/older adults. Adults aged 50+ (N = 275; 151 men/124 women) completed the Coronavirus Anxiety Scale and Cognitive Failures Questionnaire online from remote locations in July/August 2020. A subset of participants (n = 62) completed an objective cognitive task (Stroop). Multiple regressions determined whether sex moderated associations between COVID-19 anxiety and cognitive outcomes. Sex was a significant moderator, such that for women (not men), greater COVID-19 anxiety was associated with more memory failures and blunders (subjective measures) and worse processing speed (objective measure). COVID-19 state anxiety is linked to everyday cognition and processing speed in women, but not men. Consistency across subjective and objective measures promotes the need for sex-specific understanding of the pandemic’s behavioral and cognitive effects in mid-to-late life.
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Affiliation(s)
- Ashley F. Curtis
- Department of Psychiatry, University of Missouri, Columbia, MO, USA; Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Anthony Schmiedeler
- Department of Psychiatry, University of Missouri, Columbia, MO, USA; Department of Educational, School, and Counseling Psychology, University of Missouri, Columbia, MO, USA
| | - Madison Musich
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Maggie Connell
- Department of Psychiatry, University of Missouri, Columbia, MO, USA
| | - Mary Beth Miller
- Department of Psychiatry, University of Missouri, Columbia, MO, USA
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Jaffe AE, Graupensperger S, Blayney JA, Duckworth JC, Stappenbeck CA. The Role of Perceived Social Norms in College Student Vaccine Hesitancy: Implications for COVID-19 Prevention Strategies. Vaccine 2022; 40:1888-1895. [PMID: 35190209 PMCID: PMC8789646 DOI: 10.1016/j.vaccine.2022.01.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 12/16/2022]
Abstract
Among US adults, the highest rates of hesitancy to receive the COVID-19 vaccine are among young adults aged 18 to 25. Vaccine hesitancy is particularly concerning among young adults in college, where social interactions on densely populated campuses can lead to substantial community spread. Given that many colleges have opted not to mandate vaccines, identification of modifiable predictors of vaccine hesitancy – such as perceived social norms – is key to informing interventions to promote vaccine uptake. To address this need, we examined predictors of and explicit reasons for vaccine hesitancy among 989 students aged 18 to 25 recruited from four geographically diverse US universities in the spring of 2021. At the time of the survey, 57.3% had been vaccinated, 13.7% intended to be vaccinated as soon as possible, and 29.0% were vaccine hesitant. Common reasons for hesitancy were wanting to see how it affected others first (75.2%), not believing it was necessary (30.0%), and other reasons (17.4%), which were examined via content analysis and revealed prominent safety concerns. Despite these varied explicit reasons, logistic regressions revealed that, when controlling for demographics and pandemic-related experiences, perceived descriptive and injunctive social norms for vaccine uptake were each significant predictors of vaccine hesitancy (ORs = 0.35 and 0.78, respectively). When both norms were entered into the same model, only perceived descriptive norms uniquely predicted vaccine hesitancy (OR = 0.37; 95% CI: 0.29 – 0.46). Findings suggest perceived social norms are strongly associated with vaccine-related behavior among young adult college students. Correcting normative misperceptions may be a promising approach to increase vaccine uptake and slow the spread of COVID-19 among young adults.
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Affiliation(s)
- Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United States.
| | - Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jennifer C Duckworth
- Department of Human Development, Washington State University, Pullman, WA, United States
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Eisenbeck N, Carreno DF, Wong PT, Hicks JA, María RRG, Puga JL, Greville J, Testoni I, Biancalani G, López ACC, Villareal S, Enea V, Schulz-Quach C, Jansen J, Sanchez-Ruiz MJ, Yıldırım M, Arslan G, Cruz JFA, Sofia RM, Ferreira MJ, Ashraf F, Wąsowicz G, Shalaby SM, Amer RA, Yousfi H, Chukwuorji JC, Guerra VM, Singh S, Heintzelman S, Hutapea B, Béjaoui B, Dash A, Schlosser KK, Anniko MK, Rossa M, Wongcharee H, Avsec A, Kocjan GZ, Kavčič T, Leontiev DA, Taranenko O, Rasskazova E, Maher E, García-Montes JM. An international study on psychological coping during COVID-19: Towards a meaning-centered coping style. Int J Clin Health Psychol 2022; 22:100256. [PMID: 34429729 PMCID: PMC8355913 DOI: 10.1016/j.ijchp.2021.100256] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/01/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND/OBJECTIVE This study examined the role of different psychological coping mechanisms in mental and physical health during the initial phases of the COVID-19 crisis with an emphasis on meaning-centered coping. METHOD A total of 11,227 people from 30 countries across all continents participated in the study and completed measures of psychological distress (depression, stress, and anxiety), loneliness, well-being, and physical health, together with measures of problem-focused and emotion-focused coping, and a measure called the Meaning-centered Coping Scale (MCCS) that was developed in the present study. Validation analyses of the MCCS were performed in all countries, and data were assessed by multilevel modeling (MLM). RESULTS The MCCS showed a robust one-factor structure in 30 countries with good test-retest, concurrent and divergent validity results. MLM analyses showed mixed results regarding emotion and problem-focused coping strategies. However, the MCCS was the strongest positive predictor of physical and mental health among all coping strategies, independently of demographic characteristics and country-level variables. CONCLUSIONS The findings suggest that the MCCS is a valid measure to assess meaning-centered coping. The results also call for policies promoting effective coping to mitigate collective suffering during the pandemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sandeep Singh
- Guru Jambheshwar University of Science and Technology, India
| | | | | | | | - Arobindu Dash
- IUBAT—International University of Business Agriculture and Technology, Bangladesh
| | | | | | | | | | | | | | | | | | - Olga Taranenko
- National Research University Higher School of Economics, Russia
| | | | - Elizabeth Maher
- New Zealand Acceptance & Commitment Therapy Training Ltd., New Zealand
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Dominguez-Rodriguez A, Herdoiza-Arroyo PE, Martínez Arriaga RJ, Bautista Valerio E, Mateu Mollá J, de la Rosa-Gómez A, Farfallini L, Hernández Jiménez MJ, Esquivel Santoveña EE, Ramírez-Martínez FR, Castellanos Vargas RO, Arzola-Sánchez CA, Arenas-Landgrave P, Martínez-Luna SC. Prevalence of Anxiety Symptoms and Associated Clinical and Sociodemographic Factors in Mexican Adults Seeking Psychological Support for Grief During the COVID-19 Pandemic: A Cross-Sectional Study. Front Psychiatry 2022; 13:749236. [PMID: 35370841 PMCID: PMC8964437 DOI: 10.3389/fpsyt.2022.749236] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/31/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic is one of the greatest challenges in modern history, with more than four million confirmed deaths worldwide. To date, evidence regarding the psychological impact of the COVID-19 pandemic on grievers is scarce for developing countries such as Mexico. This study aimed to assess the levels of anxiety and associated concerns in a sample of Mexican adults bereaved during the COVID-19 outbreak. A cross-sectional study was conducted through the Duelo COVID (COVID Grief) platform, which is a self-guided online treatment. A total of 5,224 participants reported their anxiety, depression, sleep quality, avoidance, and arousal, prolonged grief symptoms, and medication consumption. Independent sample Mann-Whitney U-tests, chi-square tests, and Kruskal-Wallis tests, as well as multinomial logistic regression, were conducted. Results indicated that 90.4% of the participants reported clinical levels of anxiety, depression, and sleep affectations. The people who lost someone during the last 5 months scored higher in normal grief symptoms compared to the people whose loss was 6 months ago or more, and 9.8% of individuals reported the use of prescription medication, with anxiolytics and antidepressants being the most common. Females, younger respondents, unemployed people with a lower educational level, and participants who disclosed a recent suicide attempt were among those who reported medication consumption. Sleep problems were more frequent in older participants.
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Affiliation(s)
| | | | - Reyna Jazmin Martínez Arriaga
- Departamento de Clínicas de Salud Mental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Eduardo Bautista Valerio
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Anabel de la Rosa-Gómez
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luis Farfallini
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
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Palis H, Bélair MA, Hu K, Tu A, Buxton J, Slaunwhite A. Overdose deaths and the COVID-19 pandemic in British Columbia, Canada. Drug Alcohol Rev 2021; 41:912-917. [PMID: 34908203 DOI: 10.1111/dar.13424] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/28/2021] [Accepted: 12/02/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION British Columbia (BC) declared an overdose public health emergency in 2016. Since then, BC has consistently reported the highest overdose death rates of any province in Canada. In the context of the COVID-19 pandemic, overdose deaths in BC reached a record high in 2020. This analysis reports on changes in the profile of people who have died of overdose since BC's declaration of COVID-19 as a public health emergency on 17 March 2020. METHODS Using BC Coroners Service data, Chi-square tests and multivariable logistic regression were conducted to compare demographic, geographic and post-mortem toxicology data between people who died of overdose before (17 March-31 December 2019) and after (17 March-31 December 2020) BC's declaration of COVID-19 as a public health emergency. RESULTS Overdose deaths observed since 17 March 2020 (n = 1516) more than doubled those observed in the same period in 2019 (n = 744). In the adjusted logistic regression model, odds of death in the post compared to pre-COVID-19 period was significantly higher among males compared to females, among all older age groups compared to people aged 30-39, and was lower in public buildings compared to private residences. DISCUSSION AND CONCLUSIONS Alongside a significant increase in overdose deaths since BC's declaration of COVID-19 as a public health emergency, the demographic profile of people who have died of overdose has changed. Ongoing overdose prevention efforts in BC must seek to reach people who remain most isolated, including older adults, who during dual public health emergencies are facing compounded risk of preventable mortality.
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Affiliation(s)
- Heather Palis
- British Columbia Centre for Disease Control, Vancouver, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Kevin Hu
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Andrew Tu
- British Columbia Coroners Service, Burnaby, Canada
| | - Jane Buxton
- British Columbia Centre for Disease Control, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Amanda Slaunwhite
- British Columbia Centre for Disease Control, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
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A Pregnant Mother Infected With Severe Acute Respiratory Syndrome Coronavirus 2 With Substance Dependence: A Case Report. J Addict Nurs 2021; 32:260-262. [PMID: 34855325 DOI: 10.1097/jan.0000000000000437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND In December 2019, the novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China, and now, it has spread all over the world. Pregnant women are a susceptible population, but there is scant information about COVID-19 in this population. Here, we report a case of a mother with substance use disorders who was infected with COVID-19 in her pregnancy. CASE The patient was a 29-year-old, primigravida mother at the 37th gestational week who was referred to our center because of vaginal bleeding and severe uterine contractions. The patient was abusing opioids. With the suspicion of placental abruption, she was admitted for cesarean section. One day after delivery, she developed dyspnea, rhinorrhea, and vomiting. These were thought of as withdrawal signs. Despite methadone administration, these signs persisted. After ruling out deprivation syndrome and possible obstetric causes, a SARS-CoV-2 Polymerase chain reaction (PCR) test was ordered; the result was positive. CONCLUSION In this case, because of the flu-like symptoms of substance withdrawal and postpartum causes of shortness of breath, the medical team's attention was drawn to these causes. SARS-CoV-2 infection should be considered as a differential diagnosis for these patients.
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Mosher Henke R. Knowing Well, Being Well: well-being born of understanding: Shifts in Health Behaviors Amid the COVID-19 Pandemic. Am J Health Promot 2021; 35:1162-1183. [DOI: 10.1177/08901171211055310a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Reynolds CME, Purdy J, Rodriguez L, McAvoy H. Factors associated with changes in consumption among smokers and alcohol drinkers during the COVID-19 'lockdown' period. Eur J Public Health 2021; 31:1084-1089. [PMID: 33839763 PMCID: PMC8083285 DOI: 10.1093/eurpub/ckab050] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The impact of the COVID-19 public health social measures (PHSM) on health behaviours is poorly understood. We aimed to identify factors associated with changes in alcohol and tobacco consumption during the strictest period of PHSM 'lockdown'. METHODS Logistic regression analysis was conducted using secondary data from the Central Statistics Office Social Impact Survey collected during the first lockdown in Ireland (23 April- 1 May 2020). RESULTS Of the 1362 (33.8%) individuals that responded to the survey, 80.6% were current drinkers and 26.0% were smokers. The majority of smokers (60.9%) and drinkers (60.6%) reported no change in consumption. However, 30.5% of smokers and 22.2% of drinkers reported increased consumption. Being concerned about household stress from confinement [adjusted odds ratio (aOR) 1.9, 95% confidence interval (CI) 1.3-2.9, P = 0.002], working from home (aOR 2.1, 95 CI 1.4-3.3, P < 0.001) and urban living (aOR 2.0, 95 CI 1.5-2.9, P < 0.001) were associated with increases in alcohol consumption. Feeling very nervous (aOR 2.2, 95% CI 1.2-4.0, P = 0.009), feeling downhearted/depressed (aOR 2.4, 95% CI 1.3-4.4, P = 0.004), being concerned about someone else's health (aOR 2.0, 95% CI 1.1-3.9, P = 0.031), working from home (aOR 2.3, 95% CI 1.0-5.3, P = 0.046) and increases in alcohol consumption (aOR 3.6, 95% CI 1.7-7.7, P = 0.023) were associated with increases in tobacco consumption. CONCLUSION A mixed picture was evident in terms of changes in consumption among current smokers and drinkers. Increased consumption was more commonly reported than reductions. Increased consumption was associated with psychological distress and socio-economic factors. Policies and services should consider a response to widening inequalities in harmful consumption.
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Affiliation(s)
| | - Joanna Purdy
- Policy Team, Institute of Public
Health, Dublin, Ireland
| | | | - Helen McAvoy
- Policy Team, Institute of Public
Health, Dublin, Ireland
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39
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Satre DD, Meacham MC, Asarnow LD, Fisher WS, Fortuna LR, Iturralde E. Opportunities to Integrate Mobile App-Based Interventions Into Mental Health and Substance Use Disorder Treatment Services in the Wake of COVID-19. Am J Health Promot 2021; 35:1178-1183. [PMID: 34652971 DOI: 10.1177/08901171211055314] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic has heightened concerns about the impact of depression, anxiety, alcohol, and drug use on public health. Mobile apps to address these problems were increasingly popular even before the pandemic, and may help reach people who otherwise have limited treatment access. In this review, we describe pandemic-related substance use and mental health problems, the growing evidence for mobile app efficacy, how health systems can integrate apps into patient care, and future research directions. If equity in access and effective implementation can be addressed, mobile apps are likely to play an important role in mental health and substance use disorder treatment.
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Affiliation(s)
- Derek D Satre
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.,Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Meredith C Meacham
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lauren D Asarnow
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Weston S Fisher
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Lisa R Fortuna
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Esti Iturralde
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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40
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Aydoğdu M, Aslan R, Can Ö, Altunci YA, Annette Akgür S. Evaluation of substance use in Izmir during the COVID-19 pandemic. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1983045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Melike Aydoğdu
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
| | - Rukiye Aslan
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
| | - Özge Can
- Department of Emergency Faculty of Medicine, Ege University, Bornova, Turkey
| | - Yusuf Ali Altunci
- Department of Emergency Faculty of Medicine, Ege University, Bornova, Turkey
| | - Serap Annette Akgür
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
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41
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Erbas B, Strauch H. [Addicted During Pandemic? - COVID-19 and Addictive Disorders]. DAS GESUNDHEITSWESEN 2021; 84:19-26. [PMID: 34560804 DOI: 10.1055/a-1547-6948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To describe changes in consumer behavior, particularly in Germany, and the population groups affected due to in-creased substance use or are at greater risk of being infected by SARS-CoV-2 and are also in danger of suffering from a more severe course of disease. METHODS The literature search used databases from PubMed and PubPsych, along with expert opinions. RESULTS A slight increase in daily use of alcohol and tobacco was seen, whereas the consumption of illegal drugs decreased in European countries. There was a drop in consumption among occasional users whereas among intensive users, there was an increase in consumption. Adults and children spent more time on media and internet activities during the pandemic. Anxiety, depression and stress could be the reason for the increased behavorial changes. People already suffering from an addiction were not only psychologically burdened but were also at higher risk of a SARS-CoV-2 infection or a severe progression of the disease. CONCLUSION These results suggest possible societal trends which should be validated by larger representative surveys in the near future. Protecting risk groups and utilizing pandemic-adapted prevention measures are necessary.
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Affiliation(s)
- Beate Erbas
- Bayerische Akademie für Sucht- und Gesundheitsfragen, München, Deutschland
| | - Hannah Strauch
- Bay. Zentrum für Prävention und Gesundheitsförderung, LGL, Bad Kissingen, Deutschland
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42
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Kim JE, Lee YL, Chung MA, Yoon HJ, Shin DE, Choi JH, Lee S, Kim HK, Nam EW. Effects of social prescribing pilot project for the elderly in rural area of South Korea during COVID-19 pandemic. Health Sci Rep 2021; 4:e320. [PMID: 34250272 PMCID: PMC8247938 DOI: 10.1002/hsr2.320] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 05/12/2021] [Accepted: 05/20/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Older adults-classified as a high-risk group-are highly likely to experience increased loneliness due to the implementation of various policies designed to prevent the spread of COVID-19. Accordingly, this study aims to examine the effects of a pilot social prescribing project for elderly people in rural area of South Korea during the COVID-19 pandemic. METHODS Using the PRECEDE-PROCEED model, the effectiveness of the pilot project was verified through pre- and post-impact and outcome evaluation. RESULTS According to the results of the impact evaluation, loneliness reduced significantly, while the social participation attitude score increased. Although the average score of self-efficacy increased, it was not statistically significant. Moreover, it was found that self-esteem increased significantly. In the outcome evaluation, depression reduced considerably. CONCLUSION To conclude, the pilot social prescribing project was effective in reducing depression and loneliness for the elderly in rural areas of Korea. It was also confirmed that there is potential to develop a new health promotion project that can improve the self-esteem of the elderly, and expand their social activities. Second, the pilot project was carried out in an integrated manner by utilizing resources in communities with good accessibility. Therefore, it is expected to be used as a new "Integrated community care model" to improve the mental health of the elderly in rural areas. Third, during the COVID-19 pandemic, the elderly tend to experience increasing feelings of depression, isolation, and loneliness due to "social distancing." Therefore, it is expected that social prescribing programs for the elderly in rural areas would become a new alternative for relieve mental disorder of the seniors.
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Affiliation(s)
- Ji Eon Kim
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Yu Lim Lee
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Min Ah Chung
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Hye Jin Yoon
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
| | - Dong Eun Shin
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
| | - Jin Hee Choi
- Mirae Campus LINC+Yonsei UniversityWonjuSouth Korea
| | - Sangheon Lee
- Heungeop‐myeon Sub‐Health CenterWonjuSouth Korea
| | - Hae Kyung Kim
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Heungeop Community LibraryWonjuSouth Korea
| | - Eun Woo Nam
- Healthy City Research Center, Institute of Health and WelfareYonsei UniversityWonjuSouth Korea
- Department of Health AdministrationYonsei University Graduate SchoolWonjuSouth Korea
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Abstract
Purpose of Review The prevalence of alcohol use disorder (AUD) among older adults in the United States is rising, but remains underdiagnosed, underreported, and inadequately managed. This review highlights the medical, social, and cultural factors of AUD in older adults and provides guidelines for its screening, evaluation, and management. Recent Findings The COVID-19 pandemic has created additional challenges and barriers to care, as older adults may have disproportionate worsening of anxiety, depression, and substance use resulting from increased isolation related to physical distancing and shelter-in-place guidelines. Summary All older adults should be routinely screened for AUD with standardized screening tools. If a patient’s screening results are positive, a clinician should conduct a brief assessment, which may be supplemented by laboratory tests. Most older adults at risk for alcohol misuse do not need specialized SUD treatment, but most can benefit from Screening, Brief Intervention, and Referral to Treatment (SBIRT) to prevent substance misuse before it occurs. Medications for the treatment of AUD in older adults include naltrexone, acamprosate, disulfiram, gabapentin and topiramate. Psychosocial treatments, including mutual help groups, are equally important.
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Bergeron CD, Boolani A, Jansen EC, Smith ML. Practical Solutions to Address COVID-19-Related Mental and Physical Health Challenges Among Low-Income Older Adults. Front Public Health 2021; 9:674847. [PMID: 34322471 PMCID: PMC8311292 DOI: 10.3389/fpubh.2021.674847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/11/2021] [Indexed: 12/11/2022] Open
Abstract
Low-income older adults are disproportionately impacted by the COVID-19 pandemic. In this perspective article, we review the context in which low-income older people experience the pandemic and the mental and physical health consequences they have faced to date. Then, we offer practical solutions to help improve low-income older adults' sleep, physical activity, nutrition, and stress that require no or low financial commitment. We argue that governments, communities, and organizations should make greater efforts to promote healthy living for low-income older adults in times of health emergencies to ensure their ability to be universally adopted, regardless of income and resources.
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Affiliation(s)
- Caroline D. Bergeron
- Public Health Agency of Canada, Division of Aging, Seniors and Dementia, Ottawa, ON, Canada
- Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| | - Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, NY, United States
- Department of Biology, Clarkson University, Potsdam, NY, United States
| | - Erica C. Jansen
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, MI, United States
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States
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Abstract
PURPOSE OF REVIEW To understand the effect of COVID-19 pandemic and lockdown on persons with alcohol use disorders. RECENT FINDINGS From a total of 455 titles on COVID-19 and alcohol, 227 abstracts were screened, and 95 articles were reviewed (on November 25th, 2020). The immediate effect was an increase in alcohol related emergencies including alcohol withdrawal, related suicides, and methanol toxicity. Although there are mixed findings with respect to changes in the quantity of drinking, there are reports of binge/heavy drinking during the lockdown as well as relapse postlockdown. Psychological, social, biological, economic and policy-related factors appear to influence the changes in drinking. Although preliminary data suggest no change in alcohol use among persons with comorbid mental illness, findings in this population are presently limited. Among patients with alcohol related liver disease, outcomes appear worse and caution is warranted with the use of medications. Alcohol also appears to increases the risk of COVID-19 infection and complicates its course.Although some nations banned alcohol sales completely during lockdown, others declared it as an essential commodity, resulting in different problems across countries. Alcohol use has added to the burden of the problem particularly among vulnerable groups like the adolescents, elderly, patients with cancer, as well as health professionals. Services for patients with alcohol use disorders have been affected. SUMMARY The COVID-19 pandemic has had considerable impact on alcohol use, with an increase in alcohol related emergencies, changes in alcohol use patterns, increased risk of contracting COVID-19, effect on alcohol policies and sales, and an effect on vulnerable groups. It is essential to understand and respond to the current situation, intervene early, and prevent further repercussions of the pandemic.Video abstract link: https://drive.google.com/file/d/1IJWtIs6e554PryKWhdma4VB--mjSZq1C/view?usp=sharing.
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Affiliation(s)
- Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru
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46
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Impact of COVID-19 on the Mental Health and Distress of Community-Dwelling Older Adults. Geriatr Nurs 2021; 42:998-1005. [PMID: 34256160 PMCID: PMC8566022 DOI: 10.1016/j.gerinurse.2021.06.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 12/01/2022]
Abstract
The purpose of this study was to examine the mental health of community-dwelling older adults as they adapted their everyday health behaviors during the COVID-19 pandemic. In response to a telephone survey, 126 older adults described perceived changes in physical and mental health, and adaptations in their everyday health behaviors. Descriptive statistics, bivariate correlations, and multiple regressions revealed that participants experienced changes in mental and physical health, reduced health service access, lower social engagement, and increased coping behaviors. Greater negative social impact of the pandemic was associated with higher levels of COVID-19 distress. Reduced mental health was significantly related to reductions in health service access, health changes, and fewer adaptive coping behaviors. Adaptive coping behaviors were helpful, just as reduced health access and social contact added risk for mental health problems. Suggestions were provided for alleviating mental health needs by increasing social contact and engaging in adaptive coping behaviors.
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Curtis AF, Rodgers M, Miller MB, McCrae CS. Impact of Sex on COVID-19 Media Exposure, Anxiety, Perceived Risk, and Severity in Middle-Aged and Older Adults. J Aging Health 2021; 34:51-59. [PMID: 34114480 DOI: 10.1177/08982643211025383] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To examine associations between COVID-19 media exposure and anxiety/perceived risk/severity and investigate their dependency on sex in middle-aged/older adults. METHODS Adults aged 50+ years completed online surveys: Coronavirus Anxiety Scale, COVID-19 media exposure, COVID-19 media dependency for health information, and COVID-19 perceived risk and severity. Multiple regressions examined independent and interactive (with sex) associations between COVID-19 media exposure/dependency and COVID-19 anxiety/perceived risk and severity. Analyses controlled for age, education, race, total medical conditions, and COVID-19 status. RESULTS Higher COVID-19 media exposure was associated with higher COVID-19 anxiety among men (not women) and higher perceived risk/severity in both sexes. Higher COVID-19 media dependency was associated with higher COVID-19 anxiety and perceived risk/severity in both sexes. CONCLUSION In middle-aged/older adults, the use/dependency of media for COVID-19 information may be linked to negative psychological health and increased COVID-19 perceived risk and severity. Men may be at increased risk of anxiety related to media exposure.
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Affiliation(s)
- Ashley F Curtis
- Department of Psychiatry, 14716University of Missouri, Columbia, MO, USA.,Department of Psychological Sciences, 14716University of Missouri, Columbia, MO, USA
| | - Mikayla Rodgers
- Department of Psychiatry, 14716University of Missouri, Columbia, MO, USA
| | - Mary Beth Miller
- Department of Psychiatry, 14716University of Missouri, Columbia, MO, USA
| | - Christina S McCrae
- Department of Psychiatry, 14716University of Missouri, Columbia, MO, USA
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Young KN, Yeates EO, Grigorian A, Schellenberg M, Owattanapanich N, Barmparas G, Margulies D, Juillard C, Garber K, Cryer H, Tillou A, Burruss S, Penaloza-Villalobos L, Lin A, Figueras RA, Brenner M, Firek C, Costantini T, Santorelli J, Curry T, Wintz D, Biffl WL, Schaffer KB, Duncan TK, Barbaro C, Diaz G, Johnson A, Chinn J, Naaseh A, Leung A, Grabar C, Nahmias J. Drug and alcohol positivity of traumatically injured patients related to COVID-19 stay-at-home orders. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:605-611. [PMID: 34087086 DOI: 10.1080/00952990.2021.1904967] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: COVID-19 related stay-at-home (SAH) orders created many economic and social stressors, possibly increasing the risk of drug/alcohol abuse in the community and trauma population.Objectives: Describe changes in alcohol/drug use in traumatically injured patients after SAH orders in California and evaluate demographic or injury pattern changes in alcohol or drug-positive patients.Methods: A retrospective analysis of 11 trauma centers in Southern California (1/1/2020-6/30/2020) was performed. Blood alcohol concentration, urine toxicology results, demographics, and injury characteristics were collected. Patients were grouped based on injury date - before SAH (PRE-SAH), immediately after SAH (POST-SAH), and a historical comparison (3/19/2019-6/30/2019) (CONTROL) - and compared in separate analyses. Groups were compared using chi-square tests for categorical variables and Mann-Whitney U tests for continuous variables.Results: 20,448 trauma patients (13,634 male, 6,814 female) were identified across three time-periods. The POST-SAH group had higher rates of any drug (26.2% vs. 21.6% and 24.7%, OR = 1.26 and 1.08, p < .001 and p = .035), amphetamine (10.4% vs. 7.5% and 9.3%, OR = 1.43 and 1.14, p < .001 and p = .023), tetrahydrocannabinol (THC) (13.8% vs. 11.0% and 11.4%, OR = 1.30 and 1.25, p < .001 and p < .001), and 3,4-methylenedioxy methamphetamine (MDMA) (0.8% vs. 0.4% and 0.2%, OR = 2.02 and 4.97, p = .003 and p < .001) positivity compared to PRE-SAH and CONTROL groups. Alcohol concentration and positivity were similar between groups (p > .05).Conclusion: This Southern California multicenter study demonstrated increased amphetamine, MDMA, and THC positivity in trauma patients after SAH, but no difference in alcohol positivity or blood concentration. Drug prevention strategies should continue to be adapted within and outside of hospitals during a pandemic.
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Affiliation(s)
- Kirsten N Young
- Department of Surgery, University of California, Irvine, CA, USA
| | - Eric O Yeates
- Department of Surgery, University of California, Irvine, CA, USA
| | - Areg Grigorian
- Department of Surgery, University of California, Irvine, CA, USA.,Department of Surgery, University of Southern California, Los Angeles, CA, USA
| | - Morgan Schellenberg
- Department of Surgery, University of Southern California, Los Angeles, CA, USA
| | | | - Galinos Barmparas
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel Margulies
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Kent Garber
- Department of Surgery, University of California, Los Angeles, CA, USA
| | - Henry Cryer
- Department of Surgery, University of California, Los Angeles, CA, USA
| | - Areti Tillou
- Department of Surgery, University of California, Los Angeles, CA, USA
| | - Sigrid Burruss
- Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | | | - Ann Lin
- Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | | | - Megan Brenner
- Riverside/Riverside University Health System Department of Surgery, University of California, Moreno Valley, CA, USA
| | - Christopher Firek
- Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center (CECORC), Moreno Valley, CA, USA
| | - Todd Costantini
- Department of Surgery, University of California, San Diego, CA, USA
| | | | - Terry Curry
- Department of Surgery, University of California, San Diego, CA, USA
| | - Diane Wintz
- Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA
| | - Walter L Biffl
- Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA
| | - Kathryn B Schaffer
- Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA
| | - Thomas K Duncan
- Department of Surgery, Ventura County Medical Center, Ventura, CA, USA
| | - Casey Barbaro
- Department of Surgery, Ventura County Medical Center, Ventura, CA, USA
| | - Graal Diaz
- Department of Surgery, Ventura County Medical Center, Ventura, CA, USA
| | - Arianne Johnson
- Department of Trauma, Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA
| | - Justine Chinn
- Department of Surgery, University of California, Irvine, CA, USA
| | - Ariana Naaseh
- Department of Surgery, University of California, Irvine, CA, USA
| | - Amanda Leung
- Department of Surgery, University of California, Irvine, CA, USA
| | - Christina Grabar
- Department of Surgery, University of California, Irvine, CA, USA
| | - Jeffry Nahmias
- Department of Surgery, University of California, Irvine, CA, USA
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Graupensperger S, Fleming CB, Jaffe AE, Rhew IC, Patrick ME, Lee CM. Changes in Young Adults' Alcohol and Marijuana Use, Norms, and Motives From Before to During the COVID-19 Pandemic. J Adolesc Health 2021; 68:658-665. [PMID: 33781471 PMCID: PMC8345007 DOI: 10.1016/j.jadohealth.2021.01.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/24/2020] [Accepted: 01/11/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE Alongside the SARS-CoV-2 virus, the COVID-19 pandemic is associated with several secondary health effects. There is concern for increased substance use motivated by coping with stress, anxiety, depression, and boredom-all of which may be elevated during the pandemic. The current study examined intraindividual changes (from pre-COVID to during COVID) in young adults' alcohol and marijuana use, perceptions of peers' use (i.e., norms), and motives for use. METHODS A community sample of young adults (N = 572; Mage= 25.14; 60.8% women) was recruited in Washington State. By using a repeated-measures design, data were collected prior to the COVID-19 pandemic (January 2020) and again during the initial acute phase of the pandemic (April/May of 2020). RESULTS Young adults, on average, increased alcohol use frequency but decreased the amount consumed per drinking occasion. No changes in marijuana use were identified. Young adults (on average) perceived that peers had increased the frequency and total amount of alcohol use and perceived that peers were engaging in heavier marijuana use than prior to COVID-19. For alcohol use motives, there was a significant increase in depression coping motives and significant decreases in social, enhancement, and conformity motives. Boredom motives for marijuana use significantly increased, while celebration motives decreased. CONCLUSIONS Using a prospective design with a sample initially recruited in Washington State, these data indicate that (a) young adults' patterns of alcohol use may have changed, (b) young adults tend to think that peers are engaging in heavier alcohol/marijuana use than before the pandemic, and (c) motives for using alcohol/marijuana may have changed during the pandemic.
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Affiliation(s)
- Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Charles B Fleming
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
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Gaertner B, Fuchs J, Möhler R, Meyer G, Scheidt-Nave C. Older people at the beginning of the COVID-19 pandemic: A scoping review. JOURNAL OF HEALTH MONITORING 2021; 6:2-37. [PMID: 35586562 PMCID: PMC8832372 DOI: 10.25646/7857] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/12/2021] [Indexed: 12/23/2022]
Abstract
This scoping review focuses on evidence gaps regarding the effects on health, social participation and life contexts of older people at the beginning of the COVID-19 pandemic. It is based on a systematic search strategy of the international literature covering a period between December 2019 and June 2020. The review is supplemented by a search of the websites of selected organisations in Germany (cut-off date: 29 June 2020). Search hits were differentiated by types of publication (empirical study, review, discussion paper). The contents were summarised in tabular form according to topic. The publications mainly discussed the high risks of suffering severe courses of COVID-19 faced by older people, specifically those belonging to certain subgroups. In addition, further main topics were the pandemic’s indirect impacts on physical and mental health, physical and cognitive functions and participation in society. Social isolation, loneliness, reduced levels of physical activity and difficulties in maintaining care were discussed as major health risks. Ageism was an issue that was addressed across all of the identified topics. The publications highlighted the need, but also the opportunity, for raising public awareness of the needs of older people in various life contexts. Publications pointed to the urgent need for research into the biological and social causes of older peoples’ high infection risk and how measures could be adapted in a differentiated manner (infection prevention and control measures, social support, medical and nursing care).
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Affiliation(s)
- Beate Gaertner
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ralph Möhler
- Heinrich Heine University Düsseldorf, Institute for Health Services Research and Health Economics.,Bielefeld University, School of Public Health, Department of Health Services Research and Nursing Science
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Science
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