Alarming patterns of moderate and high-risk alcohol use among transgender women in Goiás, Central Brazil

BackgroundScant studies have examined alcohol consumption among transgender women in Latin America. This cross-sectional study estimated the prevalence and associated factors of risky alcohol use among transgender women in Goiás, a state located in the center of Brazil.MethodsParticipants were 440 transgender women (median age = 35 years, interquartile range = 9) recruited through respondent-driven sampling. All participants were interviewed about sociodemographic characteristics, violence, and risk behavior. Alcohol use was assessed using the alcohol use disorders identification test (AUDIT). An AUDIT score greater than or equal to eight was considered as risky alcohol consumption. Logistic regression analysis was used to examine predictors of risky alcohol use, and p-values <0.05 were considered significant.ResultsThe majority were young, single, sex workers. Most transgender women had used alcohol in the previous year (85.7%), and more than half (56.6%) reported binge drinking and risky alcohol consumption (60.2%). There was a high overlap between sexual behavior, drugs, and alcohol use. Using alcohol during sex (adjusted odds ratio [aOR]: 2.9; 95% confidence interval [CI]: 1.7–4.8), cocaine/crack use (aOR: 2.3; 95% CI: 1.5–3.7) and having a drug user as a sexual partner (aOR: 2.9; 95% CI: 1.5–5.9) were independently associated with risky alcohol consumption.ConclusionAlcohol consumption was highly prevalent, and drugs seem to play an important role in risky alcohol consumption among transgender women Goiás. These findings support stakeholders to promote intervention strategies to reduce this pattern of alcohol consumption and reduce the burden of substance use disorders among transgender women

Change in marijuana use and its associated factors among persons living with HIV (PLWH) during the COVID-19 pandemic: Findings from a prospective cohort

Emerging literature shows increased drug use during the COVID-19 pandemic. However, limited research has examined the change in marijuana use among persons living with HIV (PLWH). This study aimed to investigate how marijuana use changed in a cohort of PLWH during the first year of the pandemic and identify factors associated with the change

Improving depression and perceived social support enhances overall quality of life among myocardial infarction survivors: necessity for integrating mental health care into cardiac rehabilitation programs

Abstract Background Depression and low perceived social support (PSS) have been found to deleteriously affect quality of life (QoL) among myocardial infarction (MI) survivors. The complex relationship between these variables has not been assessed. We wanted to assess first the prevalence of depression among MI survivors and whether depression mediates the effect of PSS on QoL and, second, whether the physical and social domains of QoL mediated the effect of depression and PSS on the emotional domain. This cross-sectional study was done among MI survivors using Cardiac Depression Scale, MacNew Quality of Life After Myocardial Infarction Questionnaire and Multidimensional Scale of Perceived Social Support to assess for depression, QoL and PSS respectively. Results A total of 103 MI survivors were included in the study, and the mean age was 59.66 (± 10.42) years. Depression was found in 21.36% of the participants. The indirect effect of PSS on QoL with depression as a mediator was significant (b = 0.15, p < 0.001, 95% CI = 0.12, 0.18). The direct effect of PSS on QoL controlling for depression was also significant (b = 0.05, p < 0.001, 95% CI = 0.02, 0.07). Depression as a mediator in the relationship explained 75.3% of the effect of PSS on QoL. PSS and depression did not have a significant direct effect on emotional QoL, but it became significant when the physical and social domains were included in the model. The total indirect effects of PSS and depression on emotional QoL were b = 0.16, p < 0.001, 95% CI = 0.05, 0.17 and b = − 0.05, p < 0.001, 95% CI = − 0.06, − 0.03, respectively. Conclusion Depression and poor PSS impair physical and social domains, which impairs the emotional domain of QoL; as such, overall QoL is undermined. As limited physical and social activity because of depression and poor PSS may increase the risk of further cardiovascular events, a holistic approach which includes mental health care is warranted

Towards Rapid Development of Conversational Virtual Humans using Web3D Technologies

In this paper, we propose a framework for the rapid development of conversational virtual humans (VHs) via the web. Web3D formats, such as WebGL, have enabled the use of interactive VHs on the web. Web-based conversational VHs are found to have great potential in improving population health. However, the development of web-based VHs needs significant time and effort which can lead health experts to avoid VH technology. In this paper, we present a case study to highlight the challenges that lead to significant time and effort in the development of web-based conversational VHs. Based on our findings, we propose a framework that uses Web3D formats and has the potential to address identified challenges in the rapid development of web-based conversational VH systems

Changes in patterns of mortality rates and years of life lost due to firearms in the United States, 1999 to 2016: A joinpoint analysis.

BackgroundFirearm-related death rates and years of potential life lost (YPLL) vary widely between population subgroups and states. However, changes or inflections in temporal trends within subgroups and states are not fully documented. We assessed temporal patterns and inflections in the rates of firearm deaths and %YPLL due to firearms for overall and by sex, age, race/ethnicity, intent, and states in the United States between 1999 and 2016.MethodsWe extracted age-adjusted firearm mortality and YPLL rates per 100,000, and %YPLL from 1999 to 2016 by using the WONDER (Wide-ranging Online Data for Epidemiologic Research) database. We used Joinpoint Regression to assess temporal trends, the inflection points, and annual percentage change (APC) from 1999 to 2016.ResultsNational firearm mortality rates were 10.3 and 11.8 per 100,000 in 1999 and 2016, with two distinct segments; a plateau until 2014 followed by an increase of APC = 7.2% (95% CI 3.1, 11.4). YPLL rates were from 304.7 and 338.2 in 1999 and 2016 with a steady APC increase in %YPLL of 0.65% (95% CI 0.43, 0.87) from 1999 to an inflection point in 2014, followed by a larger APC in %YPLL of 5.1% (95% CI 0.1, 10.4). The upward trend in firearm mortality and YPLL rates starting in 2014 was observed in subgroups of male, non-Hispanic blacks, Hispanic whites and for firearm assaults. The inflection points for firearm mortality and YPLL rates also varied across states.ConclusionsWithin the United States, firearm mortality rates and YPLL remained constant between 1999 and 2014 and has been increasing subsequently. There was, however, an increase in firearm mortality rates in several subgroups and individual states earlier than 2014

Changes in Patterns of Mortality Rates and Years of Life Lost Due to Firearms in the United States, 1999 to 2016: A Joinpoint Analysis

Firearm-related death rates and years of potential life lost (YPLL) vary widely between population subgroups and states. However, changes or inflections in temporal trends within subgroups and states are not fully documented. We assessed temporal patterns and inflections in the rates of firearm deaths and %YPLL due to firearms for overall and by sex, age, race/ethnicity, intent, and states in the United States between 1999 and 2016. We extracted age-adjusted firearm mortality and YPLL rates per 100,000, and %YPLL from 1999 to 2016 by using the WONDER (Wide-ranging Online Data for Epidemiologic Research) database. We used Joinpoint Regression to assess temporal trends, the inflection points, and annual percentage change (APC) from 1999 to 2016. National firearm mortality rates were 10.3 and 11.8 per 100,000 in 1999 and 2016, with two distinct segments; a plateau until 2014 followed by an increase of APC = 7.2% (95% CI 3.1, 11.4). YPLL rates were from 304.7 and 338.2 in 1999 and 2016 with a steady APC increase in %YPLL of 0.65% (95% CI 0.43, 0.87) from 1999 to an inflection point in 2014, followed by a larger APC in %YPLL of 5.1% (95% CI 0.1, 10.4). The upward trend in firearm mortality and YPLL rates starting in 2014 was observed in subgroups of male, non-Hispanic blacks, Hispanic whites and for firearm assaults. The inflection points for firearm mortality and YPLL rates also varied across states. Within the United States, firearm mortality rates and YPLL remained constant between 1999 and 2014 and has been increasing subsequently. There was, however, an increase in firearm mortality rates in several subgroups and individual states earlier than 2014