“Deaths of Despair” among College Students Amidst COVID-19 Pandemic: A Call for Action

As COVID-19 pandemic gains foothold worldwide, all spheres of life, including daily activities, education, economic, social sectors experienced significant downturns. While COVID-19 affects all population subgroups, college students are particularly vulnerable given their transition to the emerging adulthood surrounded by a broad possibility of future. According to a mounting evidence, college students bear a disproportionate burden of psychosocial morbidities, which can be explained by the uncertainties surrounding the course of the pandemic and the sudden transition to online education. Moreover, many businesses scaled down their recruitment efforts leaving limited employment for students and more competition in the graduate labor market. COVID-19 pandemic has set up a “perfect storm” for students to initiate or relapse of maladaptive behaviors to alleviate their negative feelings. This is where “Deaths of Despair” comes into play. This chapter aims to reflect on the factors contributing to “Deaths of Despair” among college students in the wake of COVID-19 pandemic. Author of this chapter would like to advocate for developing tailored interventions to promote the post-traumatic growth among college students

Assessing the Health and Financial Burden of Neonatal Abstinence Syndrome Among All Payer Inpatient Pediatric Discharges in Nevada

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to drug-dependent mothers. NAS poses a significant health and fiscal challenge nationally, with its incidence increasing by a factor of six (1.20 to 6.7 per 1,000 hospital births/year) along with the concomitant rise in health care cost from 2000-2016. Besides national data, it is critical to quantify NAS at the state-level to identify the target areas for prevention. Given the higher opioid prescribing rates among pregnant women in Nevada, it is critical to assess the health and financial magnitude of NAS in the state. The objectives of this cross-sectional study were to describe the burden of NAS in Nevada from 2016 to 2018, including incidence, hospital utilization trends and cost, and differences across demographic and clinical characteristics between newborns with and without a NAS diagnosis. This study utilized hospital administrative data from the Center for Health Information Analysis. The units of observation were in-patient pediatric discharges with a diagnostic code of NAS following maternal drug abuse. Statistical analyses included estimation of crude incidence rates per 1,000 hospital births, bootstrapped significance testing for independent-samples t-tests and chi-square tests, and multilevel logistic regression modelling. Results demonstrated an increase in overall NAS incidence of 8 per 1,000 hospital births, with disproportionate effects in certain demographic groups. The incidence of NAS was the highest among white newborns (12 per 1,000 hospital births) and those who were Medicaid insured (13.2 per 1,000 hospital births). NAS infants were more likely to experience other clinical conditions, longer hospital stays (mean length of stay 17 days), incur higher health care costs, and undergo intense medical procedures. NAS has taken a heavy toll on Nevada’s health care system with over 75% of the total cost attributed to state Medicaid programs. These findings support the need for targeted interventions in clinical and public health settings aimed at prevention and burden reduction of NAS in Nevada

The National Diabetes Prevention Program an intervention for Diabetes Risk Reduction

Diabetes mellitus is among the most frequently occurring chronic conditions, affecting 28 million adults in the Nation. The Nevada diabetes prevalence rate is approaching the National average, with 1 out of 4 diabetic patients experiencing serious clinical complications. Diabetes is typically preceded by a preventable condition classified as prediabetes, in which the blood sugar level exceeds the normal level, yet not enough to be classified as Type 2 diabetes. Prediabetes increases the risk of developing diabetes within 10 years, if not effectively managed. In an attempt to help reduce this risk, the CDC recently introduced an evidence-based intervention, the National Diabetes Prevention Program (NDPP) that aims to delay the onset of diabetes mellitus in people having prediabetes or those predisposed to having diabetes mellitus. The purpose of this current study is to assess the effect of the NDPP upon the change in weight and physical activity status of participants. A total of 66 subjects were recruited from the employees of Wyndham vacation resort, United Healthcare, and center of the Dignity Health organization, following the selection criteria provided by the CDC. This study assessed the secondary data obtained from the Women’s Center of Dignity Health. The study utilized multiple logistic and linear regression, pearson’s correlation, and one way ANOVA for assessing the association, and group differences among the variables used. The results of the logistic regression indicated that the odds of achieving the desired weight loss goal is 24% more likely for each additional session attended in the intervention. Moreover, the linear regression model suggested that number of sessions significantly predict the physical activity minutes achieved and percentage of weight loss. It was also determined that for every increase in session, there will be an increase in physical activity minutes of 8.3 minutes and decrease in weight by 0.3 % from the baseline.The findings of this study may suggest an effective intervention for regulating the modifiable risk factors for lowering the risk of diabetes mellitus. In addition, this study may propose an avenue of prospective research for ascertaining sustainability of behavior change and performing outcome evaluation of the program among future intervention participants

A Theory-Based Analysis of COVID-19 Vaccine Hesitancy Among African Americans in the United States: A Recent Evidence

African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch’s t test, and Pearson’s correlation tests were utilized for the analyses. Hierarchical regression modelling was performed to determine the increment in variation accounted for through addition of predictors over a set of models. Nearly 48% of unvaccinated Blacks reported being vaccine-hesitant. The vaccine-hesitant group was relatively younger (40.5 years ± 15.8 vs. 46.2 years ± 17.4, p \u3c 0.001), were Republicans (22.1% vs. 10.0%, p \u3c 0.001), lived in the North-East region (26.0% vs. 11.4%, p \u3c 0.001) and had religious affiliations other than Christianity (21.2% vs. 13.6%, p = 0.04). The mean scores of perceived advantages ((9.01 ± 3.10 vs. 7.07 ± 3.60, p \u3c 0.001) and behavioral confidence (8.84 ± 3.76 vs. 5.67 ± 4.09, p \u3c 0.001) were higher among vaccine non-hesitant group as opposed to the hesitant ones. In a final regression model, all MTM constructs) predicted nearly 65% of variance in initiating COVID-19 vaccination behavior among the vaccine-hesitant group (adjusted R2 = 0.649, F = 32.944, p \u3c 0.001). With each unit increment in MTM constructs (e.g., participatory dialogue and behavior confidence), the initiation of COVID-19 vaccination among vaccine-hesitant Blacks increased by 0.106 and 0.166 units, respectively. Based on the findings of this study a m-health educational intervention to promote COVID-19 vaccine uptake behavior among Blacks is proposed

Trends in Scientific Output on the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community Research: A Bibliometric Analysis of the Literature

Introduction: Lesbian, Gay, Bisexual, and Transgender (LGBT) represent a diverse group with special needs due to the unusual developmental experiences and social inequalities. This paper aims to explore and outline a future research direction in LGBT issues through tracing our historical understanding of this population from an aspect of scientific research. Methods: LGBT-related peer-reviewed documents were retrieved from the PubMed database and the study period was set from the inception to 2021. Python-based methods were then performed to analyze the publication metadata and extract the most prominent research topics based on the abstract contents. Key points covered in the study were the development and trend of scientific effort and research themes in the LGBT topic, identified through the Bigram model and Latent Dirichlet Allocation algorithm. Results: A total of 21,221 publication records were retrieved from the PubMed database. Literature analyses demonstrated that scientific research in LGBT had grown gradually but began to gain momentum since 2010, evidencing increased attention to this demographic in the last decade. Regarding the region-wise scientific effort in LGBT, the United States (U.S.) was the most productive country (with \u3e 45% of the total publications), followed by the United Kingdom (UK), Canada, Australia, and the Netherlands. Furthermore, Peru and Thailand, besides the U.S., Australia, and Canada, were the top countries that had relatively allocated more of their scientific efforts to LGBT research based on the calculated activity indices. Topics attracting the most attention in LGBT research over time were “male sexuality and risk , followed by sexual development , health care service , social experience , and intervention strategies . Discussion: This study provided a broad view of the developmental trends in LGBT research from invisibility to attention through a bibliometric lens and could serve as a data-based guideline for policymakers and social scientists. Take-home message: As shown by this bibliometric analysis, scientific research in Lesbian, Gay, Bisexual, and Transgender (LBGT) had grown gradually but began to gain momentum since 2010, evidencing increased attention to this demographic in the last decade

The Role of Vitamin E in Slowing Down Mild Cognitive Impairment: A Narrative Review

With the aging population, dementia emerges as a public health concern. In 2012, the Health and Retirement Study found that 8.8% of adults over 65 years suffered from dementia. The etiopathogenesis and treatment of dementia are not well understood. Antioxidant properties of Vitamin E and its major elements tocopherols and tocotrienols have been reported to be effective in slowing down the progression of dementia from its initial stage of Mild cognitive impairment (MCI). Therefore, the current review aims to explore the role of vitamin E on MCI. A literature search using the key words “Vitamin E, tocopherols, tocotrienols, and mild cognitive impairment” was conducted in MEDLINE (PubMed), CINAHL, and Google Scholar. The inclusion criteria were: (1) articles published in the past ten years; (2) published in English language; (3) published in peer-reviewed journals; and (4) descriptive and epidemiological or evaluation studies. Articles published prior to 2010, focused on other forms of dementia than MCI, grey literature and non-peer-reviewed articles were excluded. A total of 22 studies were included in the narrative synthesis. The results were equivocal. Eleven studies showed some level of the neuroprotective effect of Vitamin E, tocopherols and tocotrienols on the progression of MCI. The mixed results of this review suggest further exploration of the possible protective effects of Vitamin E on the development of dementia. Future studies can be conducted to decipher antioxidant properties of vitamin E and its association with slowing down the cognitive decline

Physical and Mental Disabilities Among the Gender-Diverse Population Using the Behavioral Risk Factor Surveillance System, Brfss (2017–2019): A Propensity-Matched Analysis

This propensity-matched analysis utilized the publicly available Behavioral Risk Factor Surveillance System (2017–2019) data to compare the burden of disabilities among transgender/non-binary (TGNB) and cisgender groups. The groups were matched (1:1 ratio) on demographic variables using Nearest Neighborhood Matching. Categorical variables were compared among groups using a Chi-square analysis to test differences in the proportions. Multivariate logistic regression analysis was fit to predict the likelihood of the physical and mental disabilities among the TGNB group compared with the cisgender group while controlling for healthcare access factors, income, and employment. Survey weights were included in the model to account for the complex survey design. In a weighted sample of 664,103 respondents, only 2827 (0.4%) self-identified as TGNB. In the matched sample, a higher proportion of the TGNB group belonged to the low-income group (39.5% vs. 29.8%, p \u3c 0.001), were unable to work (12.5% vs. 8.6%, p \u3c 0.001), and delayed care due to cost barriers (19.0% vs. 12.4%, p \u3c 0.001). Compared with the cisgender group, the odds of having difficulty making decisions were 1.94 times higher (95% CI: 1.67–2.27) and odds of difficulty walking were 1.38 times higher (95% CI: 1.19, 1.59) among the TGNB group. Additionally, the TGNB group had 59.8% higher adjusted odds ratio (aOR) (aOR 1.598, 95% Confidence interval (CI): 1.256, 2.034) of experiencing difficulty dressing and 83.3% higher odds (aOR 1.833, 95% CI: 1.533, 2.191) in having difficulty doing things alone. The findings of this study advocate for developing policies and interventions to deliver culturally competent care to the TGNB population with disabilities

Knowledge or Awareness of Non-communicable Diseases and their Associated Risk Factors among University Students in Fiji: A Cross-sectional Study

Introduction: Chronic diseases (aka Non-communicable diseases, NCDs) contribute to the global burden of morbidity and mortality, with a significant share of premature deaths among low-and middle-income countries (LMICs), including Fiji. The early exposure to the risk factors of NCDs affects the entire life course; knowledge or awareness of adolescents towards NCDs and associated risk factors is critical for health promotion. This study aims to investigate the knowledge or awareness level of chronic conditions and their risk factors among Fijian students. Methods: In this cross-sectional study, a sample of 338 university students was recruited using the paper as well as web-based pre-tested survey through a convenience sampling technique. Differences in knowledge or awareness by gender, study year and program were analyzed using Chi-square/Fisher exact test. Results: Our research showed a higher proportion of females had knowledge or awareness about the increasing prevalence of NCDs in Fiji and associated risk factors as opposed to males. Among different programs, students enrolled in physical education were more likely to be aware about the global death toll attributed to NCDs compared to those enrolled in science majors. As expected, the awareness levels were higher among second- and third-year students than freshers. The most prominent information sources of NCDs reported by the students were teachers. Discussion: These findings highlight the need of developing school-based health awareness and promotion programs. Take-home message: The findings of this study will serve as the baseline data to develop new programs and to evaluate existing programs (if any), as limited data are available related to the implementation of NCDs prevention efforts in Fiji Islands

Assessing the Testability of the Multi-Theory Model (MTM) in Predicting Vaping Quitting Behavior among Young Adults in the United States: A Cross-Sectional Survey.

Purpose: Given the increased exposure to e-cigarettes and nicotine among young adults, difficulty in quitting vaping is likely, which supports the need for effective behavioral interventions. Therefore, this cross-sectional study aims to assess the testability of the contemporary multi-theory model of health behavior change in predicting the vaping quitting behavior among young adults in the United States. Methods: A nationally representative sample of 619 young adults engaged in vaping behavior and aged 18–24 years was recruited to complete a 49-item web-based survey. A structural equation model was used to test relationships between MTM constructs. Hierarchical multiple regression was utilized to predict the variance in the initiation and sustenance of vaping quitting behavior by predictor variables, such as demographic characteristics, history of behaviors, and MTM constructs. Results: Of 619 respondents, over 75% were White and nearly 70% had educational attainment equal to high school or some college. In total, 62% of respondents were using nicotine, followed by 33.3% were using cannabis. About 80% of the respondents reported being engaged in drinking alcohol, and nearly 45% were engaged in cigarette smoking. The predictive effect of all MTM constructs on vaping quitting initiation (adjusted R2 = 0.417, F (23, 595) = 20.215, p \u3c 0.001) and sustenance (adjusted R2 = 0.366, F (23, 595) = 16.533, p \u3c 0.001) was statistically significant. Conclusions: The findings of this study point to the usability and applicability of MTM in operationalizing and developing vaping quitting behavior interventions targeting young adults