Using the Behavioral Risk Factor Surveillance System to Determine the Association of Alcohol Use and Depressive Disorders in Texas, 2019-2021

Background: Alcohol is a commonly consumed substance and has been widely studied to negatively affect mental health. Alcohol misuse and depression often coexist as comorbid conditions. The presence of one can exacerbate the other, creating a cyclic pattern that may be challenging to break. Understanding the relationship between alcohol usage and depression may guide researchers and healthcare professionals towards prevention efforts and treatment strategies to increase the chances of achieving long-term wellness and improved mental wellbeing in our community. Objective: To examine the association of alcohol use and depressive disorders in a randomly sampled adult population in Texas. Methods: The Behavioral Risk Factor Surveillance System is the largest national telephone-based survey system in the United States. The system contains de-identified public data of randomly sampled individuals. From 2019 to 2021, cross-sectional data were collected and analyzed using multivariate logistic regression models from 13,568 participants in Texas. P-values \u3c .05 were statistically significant. Analysis was performed to determine the relationship between alcohol use and other variables and self-reported diagnoses of depressive disorders: major depressive disorder, dysthymia, or minor depression. These variables include demographic information and factors related to social determinants of health. Results: From 2019-2021, 13,568 participants’ responses were analyzed using multivariate logistic regression. Compared to those who reported drinking no alcoholic beverages per week, participants who drank more than 1 alcoholic beverage per week had increased odds of reporting being diagnosed with a depressive disorder; however, the association was not significant: up to 7 drinks (OR 1.33, p-value 0.55), up to 14 drinks (OR 1.32, p-value 0.58), 14 or more drinks (OR 1.38, p-value 0.54). There were significantly increased odds for those who reported drinking 5+ drinks for men or 4+ drinks for women on an occasion 5 times or more, in the past 30 days, to report being diagnosed with a depressive disorder (OR 1.53, p-value 0.01). Relative to white, non-Hispanics and those underweight (BMI \u3c 18.5), other racial groups and those with normal and overweight BMIs (BMI 18.5 – 29.9) had significantly decreased odds of reporting a depressive disorder. Age groups less than 65 (18-24: OR 2.99, p-value \u3c .0001; 25-44: OR 2.25, p-value \u3c.0001, 45-64: OR 1.73, p-value .0003) and participants out of work for over a year (OR 2.83, p-value \u3c .0001) or unable to work (OR 8.61, p-value .0001) had the highest odds of reporting a form of depression. Conclusions: These findings substantiate the need for greater efforts to aid those under the age of 65, specifically with seeking employment and initiatives to decrease heavy alcohol use (defined as 5+ drinks for men or 4+ drinks for women) to decrease the prevalence of depressive disorders in Texas

The Future of Old Age Income Security

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The role of wisdom in organisational leadership

This thesis begins with a review of the literature on wisdom models, theories of wise leadership, and existing wisdom measures. It continues with a review of how the concept of wisdom may add value to existing leadership models, highlighting the need to empirically identify the characteristics of wise leaders and develop a wise leadership measure. A nomological framework for wise leadership is then presented. Based on a review of the wisdom and leadership paradigms, a mixed-methods research design is described for three studies to define the characteristics of wise leadership in organisations; identify specific leadership challenges that might require wise responses; and to develop the wise leadership measure comprising of vignettes. The first study involves critical incident interviews with 26 nominated wise leaders and 23 of their nominators, which led to the identification of nine wise leadership dimensions which include Strong Ethical Code, Strong Judgement, Optimising Positive Outcomes, Managing Uncertainty, Strong Legacy, Leading with Purpose, Humanity, Humility, and Self-Awareness. The second study includes critical incident interviews with 20 leaders about organisational challenges associated with the nine dimensions, to elucidate the wise leadership measure. The third study includes the design of 45 vignettes based on organisational challenges that measure the nine wise leadership dimensions. The measure is then administered to 250 organisational leaders to establish its construct validity, leading to the selection of 18 vignettes forming the final wise leadership measure. Theoretical, methodological and practical implications of this research are then discussed with recommendations for future research

Inequality in Singapore: Requirements for Enhancing the Quality of Public Debate

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Regulating Microfinance: A Suggested Framework

Economic and political weekly45115-1

Social Protection in ASEAN : Challenges and Initiatives for Post 2015 Vision

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Utilization of Flow Concept for Digital Service Requirements Prioritization

We argue that the concept of flow can be useful in investigating how requirements for digital services can be analyzed. We apply Novak et al\u27s (2000) framework to analyze how flow can be utilized for requirements prioritization for digital services. Our findings indicate that the flow can be very useful for requirements development. Furthermore, the findings show that the flow can be potentially used for understanding experiential- and task-oriented user activities. Therefore, we conclude that the flow should be considered as a service requirements prioritization metric not only for digital services dominated by hedonic utility needs by users, but with all digital services. This calls for further research in service requirements method development and on how flow impacts user experience

Long-Term Survival after Stage IIIB Gallbladder Adenocarcinoma

Patients with gallbladder adenocarcinomas are rare but present with low five-year survival rates. However, there are patients that survive long after their diagnosis with late-stage gallbladder cancer. The objective of this clinical case report is to highlight factors which may have contributed to this patient’s current 15-year survival to provide further insight on the prognosis of aggressive gallbladder adenocarcinomas. A 43-year-old woman presented to the clinic with back pain. She had an ultrasound which showed dilated bile ducts and a filling defect with endoscopic retrograde cholangiopancreatography. A gall bladder mass was found and biopsied. Biopsy concluded the mass to be a stage IIIB gallbladder adenocarcinoma (T2N1M0R0) in 2007. Subsequently, she had a cholecystectomy with the resection of segments 4 and 5 of the liver, a resection of the extrahepatic bile ducts and received adjuvant chemotherapy. Literature cites after a cholecystectomy, lymphadenectomy, and resection of adjacent affected organs, 5-year-survival can still be as low as 5% for gallbladder adenocarcinomas. A few cases of gallbladder adenocarcinomas attribute long-term survival to a multidisciplinary treatment of resection, chemotherapy, and concurrent radiotherapy and low serum levels of CA 19-9 for those with nodal involvement. A study of 40 patients with T3 gallbladder adenocarcinomas showed favorable survival with low serum carcinoembryonic antigen and negative resection margins. This case highlights the factors of long-term survival in patients with gallbladder adenocarcinoma that may provide value in prescribing an appropriate treatment and assessing the prognosis of these potentially fatal cancers

Fairness and Sustainability of Pension Arrangements in Singapore: An Assessment

Malaysian Journal of Economic Studies502175-19