Reference periods in retrospective behavioral self-report: A qualitative investigation

Reduction in the use of green spaces during the COVID-19 pandemic and its impact on mental health

Our study examined the use of green spaces before and during the pandemic in a large cohort of Italian twins and evaluated its impact on measures of mental health (depressive, anxiety, stress symptoms). Twins were analysed as individuals and as pairs. A twin design approach was applied to minimize confounding by genetic and shared environmental factors. Questionnaires from 2,473 twins enrolled in the Italian Twin Registry were screened. Reduced green space use was associated with significantly higher levels of depression, anxiety and distress. Being a woman, residing in urban areas, and having a high perceived risk of the outbreak resulted in a higher likelihood to modify green space use, with a negative impact on mental health.

The Behavior of Self-Monitoring of Blood Glucose and Glycemic Control in Taiwanese Population

Self-monitoring of blood glucose (SMBG) is common in patients with diabetes. The aim of this study was to explore how frequency/behavior of SMBG affect glucose control in patients with type 2 diabetes. This cross-sectional study was conducted at a regional teaching hospital in Taiwan. All participants completed a structured questionnaire about the frequency and behavior of SMBG, and hemoglobulin A1C (A1C) data were recorded from medical records. A total of 382 diabetes outpatients participated in the study. In the patients using insulin injections, A1C was better in patients with SMBG ≥ 28 times than in those with SMBG < 28 times per month (7.82 ± 1.86% vs. 8.33 ± 1.31%, p = 0.025). In the patients not using insulin, A1C was better in patients with SMBG > 14 times than those with SMBG ≤ 14 times per month (7.08 ± 0.23% vs. 7.55 ± 0.08%, p = 0.038). The patients who more frequently reviewed the causes of hypoglycemia and hyperglycemia had a better A1C level (p for linear trend <0.001). Our study suggested that SMBG ≥ 28 and >14 times could improve glycemic control for insulin-requiring and non-insulin-requiring type 2 diabetes patients, respectively. Further exploration of the cause of hyperglycemia or hypoglycemia shown by SMBG could also improve blood glucose control.

Urban green space use during a time of stress: A case study during the COVID-19 pandemic in Brisbane, Australia

Spending time in nature is one potential way to cope with the negative physical and psychological health impacts from major stressful life events. In 2020, a large fraction of the global population was impacted by restrictions to contain the spread of the COVID-19 outbreak, a period characterised by marked health risks and behavioural changes. Here we explore whether people responded to this stressor by spending more time in nature and investigate the reasons for any changes.We surveyed 1,002 people in Brisbane, Australia in 2020, to measure the change in use of green space during the restrictions period and benefits people associated with visiting them.About 36% of participants increased their urban green space use, but 26% reduced it, indicating a great deal of flux. Furthermore, 45% of the previous non-users of urban green space began using it for the first time during the restrictions period. Older people were less likely to increase their green space use and those with a backyard were more likely to increase their use of green spaces.Participants' change in use occurred regardless of the amount of green space available in close proximity to their households. In addition, we did not find a relationship between nature-relatedness and change in use.People's reasons for green space use shifted during the pandemic-related restrictions period, with many emphasising improvement of personal well-being rather than consolidating community capital. Most participants indicated an increase in the importance of the psychological and physical benefits obtained from urban green spaces.We conclude that increased urban green space use during moments of stress such as the COVID-19 pandemic has the potential to ameliorate some of the negative effects of the stressor, but that the capacity and desire to spend more time in green space varies markedly across society. Sufficient urban green space provision for all sections of society will maximise the opportunity to employ a nature-based coping mechanism during times of personal or community stress.

Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST

BACKGROUND

There is a need for screening and brief assessment instruments to identify primary care patients with substance use problems. This study's aim was to examine the performance of a two-step screening and brief assessment instrument, the TAPS Tool, compared to the WHO ASSIST.

METHODS

Two thousand adult primary care patients recruited from five primary care clinics in four Eastern US states completed the TAPS Tool followed by the ASSIST. The ability of the TAPS Tool to identify moderate- and high-risk use scores on the ASSIST was examined using sensitivity and specificity analyses.

RESULTS

The interviewer and self-administered computer tablet versions of the TAPS Tool generated similar results. The interviewer-administered version (at cut-off of 2), had acceptable sensitivity and specificity for high-risk tobacco (0.90 and 0.77) and alcohol (0.87 and 0.80) use. For illicit drugs, sensitivities were >0.82 and specificities >0.92. The TAPS (at a cut-off of 1) had good sensitivity and specificity for moderate-risk tobacco use (0.83 and 0.97) and alcohol (0.83 and 0.74). Among illicit drugs, sensitivity was acceptable for moderate-risk of marijuana (0.71), while it was low for all other illicit drugs and non-medical use of prescription medications. Specificities were 0.97 or higher for all illicit drugs and prescription medications.

CONCLUSIONS

The TAPS Tool identified adult primary care patients with high-risk ASSIST scores for all substances as well moderate-risk users of tobacco, alcohol, and marijuana, although it did not perform well in identifying patients with moderate-risk use of other drugs or non-medical use of prescription medications. The advantages of the TAPS Tool over the ASSIST are its more limited number of items and focus solely on substance use in the past 3months.

Design of the NIDA clinical trials network validation study of tobacco, alcohol, prescription medications, and substance use/misuse (TAPS) tool

BACKGROUND

Substance use and its associated use disorders are under-detected and under-treated in primary care. There is a need for a clinically useful brief screening and assessment instrument to identify primary care patients with substance use, sub-threshold substance use disorder (SUD), and SUD to facilitate brief intervention and treatment.

METHODS

We describe the design of the recently completed National Drug Abuse Treatment Clinical Trials Network's tobacco, alcohol, prescription medications, and substance use/misuse screen and brief assessment tool validation study. Study aims included to: develop a 2-stage screening and brief assessment tool (TAPS Tool) to detect substance use, problem use, and SUD among adult primary care patients; examine the validity of both the screen component and the TAPS Tool by comparing them to reference standard screening and assessment measures of no use, problem use, and SUD; and determine the feasibility and acceptability of the self-administration and interviewer-administration of the tool. The design included a pilot testing phase (n=30) and the main study of 2000 adult primary care participants who were randomly assigned in counter-balanced order to have the interviewer-administration or the self-administration of the TAPS Tool followed by the other administration format. Participants' views of feasibility, acceptability and preference for format of self-administration versus interviewer-administration of the TAPS Tool were assessed. Criterion measures of use and DSM-5 SUDs were administered.

DISCUSSION

The TAPS Tool study builds on prior work to develop a 2-stage clinical tool for facilitating the adoption of screening, brief assessment and treatment for SUDs in primary care.