Correlates of Smoking Status among Women Experiencing Intimate Partner Violence: Substance Use, Posttraumatic Stress, and Coping [post-print]

Background and Objectives Smoking prevalence among women who experience intimate partner violence (IPV) is two to three times higher than the prevalence among women nationally. Yet, research on cigarette smoking among this population of women is scarce. Methods This study examined differences between daily smokers and non-smokers among a sample of 186 IPV-victimized women. Comparing these groups may identify key factors that could inform future research, and ultimately, smoking cessation interventions to improve women\u27s health. Results Results showed that smokers and non-smokers differed in terms of alcohol and drug use problem severity, posttraumatic stress symptom severity, psychological and physical IPV victimization severity, and severity of use of psychological and physical IPV. Smokers fared worse on all domains where differences emerged. Findings of a logistic regression demonstrated that alcohol problem severity was related to daily smoking status; post hoc analysis revealed that the effect of alcohol problem severity was moderated by the level of Posttraumatic stress disorder (PTSD) avoidance symptom severity. Discussion and Conclusions Findings suggest a sub-population of women experiencing IPV who smoke and incur additional risk for psychiatric symptom severity and maladaptive behaviors. This study suggests the need to examine factors such as IPV and its negative sequelae to inform smoking cessation research for women. Scientific Significance This study contributes to the scarce literature examining the intersections of PTSD, alcohol and drug use, and smoking. Examining these factors in the context of IPV, which is a highly prevalent problem, is critical to informing future treatment development investigations. (Am J Addict 2015;24:546–553

Social processes : a curriculum approach to local and community history : Julian, North Carolina : a case study

Although enrollments in traditional history courses have declined in recent years, interest in local and community history has never been higher. As a result, a number of local and community histories have been published, and various strategies have been developed for use in the social studies classroom which frequently include the writing of family histories, studying the artifacts and remains of the community, the use of architectural history, and the collection of oral histories. It is the contention of this study, however, that the use of social processes provides the best framework for the investigation of local and community history

Protocol for a case-control prospective study to investigate the impact of Hepatic Encephalopathy on Nutritional Intake and Sarcopenia status in patients with end-stage LIVer disease:HENS-LIV study

INTRODUCTION: Hepatic encephalopathy (HE) is a debilitating symptom of end-stage liver disease (ESLD), but there remains a paucity of evidence regarding its impact on nutritional status, nutritional intake, compliance with nutritional support and resultant muscle health and function. Malnutrition and sarcopenia are associated with increased morbidity and mortality in patients with ESLD. The aim of the current case–control study is to prospectively investigate the impact of HE on nutritional intake and sarcopenia status in patients with ESLD. METHODS AND ANALYSIS: Patients with ESLD, with HE (n=10) and without HE (n=10) will be recruited at the outpatient liver unit, University Hospital Birmingham, UK. All patients will undergo clinical assessment at baseline and again at 6–8 weeks (in-line with their routine clinical follow-up), to assess the impact of HE on reported nutritional intake, nutritional status and sarcopenia/physical functional status. Standard medical, dietetic and home-based exercise physiotherapy care will continue for all participants as determined by their clinical team. Two methods of assessing nutritional intake will include the 24-hour food recall and 3-day food diaries. Assessment of sarcopenia status will be undertaken using anthropometry (mid-arm muscle circumference (MAMC)) and ultrasound imaging of the quadriceps muscle group. Markers of physical function (hand grip strength; chair rise time), frailty (Liver Frailty Index (LFI)), physical activity (accelerometery) and exercise capacity (Duke Activity Status Index (DASI)) will be assessed at both clinic visits. ETHICS AND DISSEMINATION: The study is approved by Wales Research Ethics Committee 2 and Health Research Authority (REC reference: 21/WA/0216). Recruitment into the study commenced November 2021. The findings will be disseminated through peer-reviewed publications and international presentations. TRIAL REGISTRATION NUMBER: RRK7156

Development and validation of the DIabetes Severity SCOre (DISSCO) in 139 626 individuals with type 2 diabetes: a retrospective cohort study

OBJECTIVE: Clinically applicable diabetes severity measures are lacking, with no previous studies comparing their predictive value with glycated hemoglobin (HbA1c). We developed and validated a type 2 diabetes severity score (the DIabetes Severity SCOre, DISSCO) and evaluated its association with risks of hospitalization and mortality, assessing its additional risk information to sociodemographic factors and HbA1c. RESEARCH DESIGN AND METHODS: We used UK primary and secondary care data for 139 626 individuals with type 2 diabetes between 2007 and 2017, aged ≥35 years, and registered in general practices in England. The study cohort was randomly divided into a training cohort (n=111 748, 80%) to develop the severity tool and a validation cohort (n=27 878). We developed baseline and longitudinal severity scores using 34 diabetes-related domains. Cox regression models (adjusted for age, gender, ethnicity, deprivation, and HbA1c) were used for primary (all-cause mortality) and secondary (hospitalization due to any cause, diabetes, hypoglycemia, or cardiovascular disease or procedures) outcomes. Likelihood ratio (LR) tests were fitted to assess the significance of adding DISSCO to the sociodemographics and HbA1c models. RESULTS: A total of 139 626 patients registered in 400 general practices, aged 63±12 years were included, 45% of whom were women, 83% were White, and 18% were from deprived areas. The mean baseline severity score was 1.3±2.0. Overall, 27 362 (20%) people died and 99 951 (72%) had ≥1 hospitalization. In the training cohort, a one-unit increase in baseline DISSCO was associated with higher hazard of mortality (HR: 1.14, 95% CI 1.13 to 1.15, area under the receiver operating characteristics curve (AUROC)=0.76) and cardiovascular hospitalization (HR: 1.45, 95% CI 1.43 to 1.46, AUROC=0.73). The LR tests showed that adding DISSCO to sociodemographic variables significantly improved the predictive value of survival models, outperforming the added value of HbA1c for all outcomes. Findings were consistent in the validation cohort. CONCLUSIONS: Higher levels of DISSCO are associated with higher risks for hospital admissions and mortality. The new severity score had higher predictive value than the proxy used in clinical practice, HbA1c. This reproducible algorithm can help practitioners stratify clinical care of patients with type 2 diabetes

A person-centered approach to understanding negative reinforcement drinking among first year college students [post-print]

The current study used a person-centered approach (i.e. latent profile analysis) to identify distinct types of college student drinkers based on the predictions of motivational, social learning, and stress and coping theories of maladaptive drinking. A large sample (N = 844; 53% female) of first-year undergraduates from two institutions, public and private, who reported consuming one or more drinks in the last three months completed measures of depressive and anxiety symptoms, positive alcohol-outcome expectancies, negative life events, social support, drinking motives, drinking level and drinking-related problems. Latent profile analysis revealed a small subgroup of individuals (n = 81, 9%) who conformed to the anticipated high-risk profile; specifically, this group demonstrated high levels of negative affect, coping motives, drinks per week, and drinking-related problems. However, additional groups emerged that showed patterns inconsistent with the proposed vulnerability profile (e.g., high negative affect, positive expectancies, and negative life events, but relatively low drinking levels). Findings from our person-centered approach showing the presence of groups both consistent and inconsistent with the predictions of motivational, social learning, and stress and coping theories highlight the need to identify and target certain college students for prevention and intervention of negative affect-related drinking

A Methodological Review of the Articles Publishes in Georgia Educational Researcher from 2003-2010

Methodological reviews, reviews that concentrate on research methods rather than research outcomes, have been used in a variety of fields to improve research practice, inform debate, and identify islands of practice. In this article, we report on the results of a methodological review of all of the articles published in Georgia Educational Researcher from 2003-2010. We examined the methodological characteristics, authorial characteristics, and methodological quality of those articles using quantitative content analysis. The major findings were that (a) the proportions of the type and traditions of articles published in Georgia Educational Researcher were similar to the proportions in education research articles in general, (b) case study research and correlational research were most prominent, (c) a few universities accounted for most of the articles published, (d) male and female authors’ articles were published in equitable proportions, and (e) there were no statistically significant differences in methodological quality between genders, university affiliations, types of research, or years of publication. We end with a few suggestions for improving the quality of qualitative research articles in the Georgia Educational Researcher

The comorbidity burden of type 2 diabetes mellitus: patterns, clusters and predictions from a large English primary care cohort

Background: Presence of additional chronic conditions has significant impact on the treatment and management of type-2 diabetes (T2DM). Little is known about the patterns of comorbidities in this population. The aims of this study are to quantify comorbidity patterns in people with T2DM, to estimate the prevalence of six chronic conditions in 2027 and to identify clusters of similar conditions. Methods: We used the Clinical Practice Research Datalink (CPRD) linked with the Index of Multiple Deprivation (IMD) data to identify patients diagnosed with T2DM between 2007 and 2017. 102,394 people met the study inclusion criteria. We calculated the crude and age-standardised prevalence of 18 chronic conditions present at and after the T2DM diagnosis. We analysed longitudinally the 6 most common conditions and forecasted their prevalence in 2027 using linear regression. We used agglomerative hierarchical clustering to identify comorbidity clusters. These analyses were repeated on subgroups stratified by gender and deprivation. Results: More people living in the most deprived areas had ≥1 comorbidities present at the time of diagnosis (72% of females; 64% of males) compared to the most affluent areas (67% of females; 59% of males). Depression prevalence increased in all strata, and was more common in the most deprived areas. Depression was predicted to affect 33% of females and 15% of males diagnosed with T2DM in 2027. Moderate clustering tendencies were observed, with concordant conditions grouped together and some variations between groups of different demographics. Conclusions: Comorbidities are common in this population and high between-patient variability in comorbidity patterns emphasises the need for patient-centred healthcare. Mental health is a growing concern and there is a need for interventions that target both physical and mental health in this population

Distinguishing emotional distress from mental disorder: A qualitative exploration of the Four-Dimensional Symptom Questionnaire (4DSQ).

BACKGROUND: Primary care clinicians see people experiencing the full range of mental health problems. Determining when symptoms reflect disorder is complex. The Four-Dimensional Symptom Questionnaire (4DSQ) uniquely distinguishes general distress from depressive and anxiety disorders. It may support diagnostic conversations and targeting of treatment. AIM: We aimed to explore peoples' experiences of completing the 4DSQ and their perceptions of their resulting score profile across distress, depression, anxiety and physical symptoms. DESIGN AND SETTING: A qualitative study conducted in the UK with people recruited from primary care and community settings. METHOD: Participants completed the 4DSQ then took part in semi-structured telephone interviews. They were interviewed about their experience of completing the 4DSQ, their perceptions of their scores across four dimensions, and the perceived utility if used with a clinician. Interviews were transcribed verbatim and data were analysed thematically. RESULTS: Twenty-four interviews were conducted. Most participants found the 4DSQ easy to complete and reported that scores across the four dimensions aligned well with their symptom experience. Distinct scores for distress, depression and anxiety appeared to support improved self-understanding. Some valued the opportunity to discuss their scores and provide relevant context. Many felt the use of the 4DSQ with clinicians would be helpful and likely to support treatment decisions, although some were concerned about time-limited consultations. CONCLUSION: Distinguishing general distress from depressive and anxiety disorders aligned well with people's experience of symptoms. Use of the 4DSQ as part of mental health consultations may support targeting of treatment and personalisation of care