Impact of Emotional Competencies on Current E-Cigarette Use Within a Young Adult Sample

Significance: Maladaptive emotional states are important drivers of tobacco use, but the mediating factors are poorly understood, particularly for e-cigarette use. Given that e-cigarette use has increased in prevalence and popularity, research examining motivating factors to engage in use is necessary. Methods: Survey data were collected from youth (18-25) attending a four-year university (N = 216, M-age = 20.41, 36.6% African American). Respondents answered questions about emotion dysregulation (Difficulties in Emotion Regulation Scale; DERS), positive/negative urgency (Urgency, Premeditation, Perseverance, Sensation Seeking, and Positive Urgency Scale; UPPS-P), affect (Positive and Negative Affect Scale, PANAS), distress tolerance (Distress Tolerance Scale, DTS); negative affect reduction outcome expectancies (NAROE) and current use. A path analysis was used to examine the direct effects of affect, the 3 emotional competencies (emotion dysregulation, positive and negative urgency, and distress tolerance), and NAROE on current use, as well as the mediational effects of NAROE. Results: Path analyses displayed a positive direct effect of negative urgency (β = .209; p=.017) on negative affect reduction outcome expectancies and direct effects of negative affect (β = -.170; p=.032), positive urgency (β = -.180; p=.013), and negative affect reduction outcome expectancies (β = .257; p=.007) on current use. Negative affect reduction outcome expectancies mediated the relationship between negative urgency and current use (β =.052, p=.008) and positive urgency and current use (β =.037, p=.038) Conclusion: Emotion competencies, specifically the ability to control one’s impulses during highly emotional periods may play a role in e-cigarette initiation and maintenance. Emotional competencies may be helpful in implementing preventative and cessation programs.https://digitalcommons.odu.edu/gradposters2020_sciences/1002/thumbnail.jp

Cigarette smoking and drug use among a nationally representative sample of HIV-positive individuals

Background and Objectives: Among HIV-positive populations, the prevalence of cigarette smoking remains disproportionately high and is associated with significant morbidity and mortality. Little is known about this topic among HIV-positive persons in the general population. Methods: Data came from the 2005 to 2011 National Survey on Drug Use and Health (NSDUH) public use data files. Unadjusted and adjusted multinomial logistic regression analyses explored the associations between socio-demographic, drug and alcohol use, and drug and/or alcohol treatment characteristics with smoking status among HIV-positive individuals (n = 349). Results: More than 40% of the sample was current smokers. In adjusted analyses, females (aRRR = .11, 95% CI = .03–.41) and participants who had never been married (aRRR = .19, 95% CI = .05–.58), were more likely to be former smokers than never smokers. Females (aRRR = .37, 95% CI = .14–.96) and individuals older than age 35 (aRRR = .37, 95% CI = .16–.89) were less likely to be current smokers than never smokers. Conversely, previously married persons (aRRR = 5.72, 95% CI = 1.40–23.31), participants reporting binge drinking (aRRR = 5.96, 95% CI = 2.27–15.64), and lifetime drug or alcohol treatment (aRRR = 5.12, 95% CI = 2.09–12.55) were more likely to be current smokers than never smokers. Conclusions: Findings help confirm the high prevalence of smoking among HIV-positive persons suggesting the need for integrated substance use and smoking cessation treatment among HIV-positives. Scientific Significance: The present findings have implications for the development and implementation of targeted smoking cessation programs for HIV-positive smokers

Patterns of youth tobacco and polytobacco usage: The shift to alternative tobacco products

Background: Despite significant declines in youth cigarette smoking, overall tobacco usage remains over 20% as non-cigarette tobacco product usage is increasingly common and polytobacco use (using 1+ tobacco product) remains steady. Objectives: The present study was designed to identify patterns of youth tobacco use and examine associations with sociodemographic characteristics and tobacco dependence. Methods: The current analysis uses Latent Class Analysis (LCA) to examine the 6,958 tobacco users (n = 2,738 female) in the National Youth Tobacco Survey (2012 and 2013). We used as indicators past month use of tobacco products (cigarettes, cigars, smokeless tobacco, e-cigarettes, hookah, snus, pipes, bidis, and kreteks) and regressed resulting classes on sociodemographic characteristics and tobacco dependence. Results: Nine classes emerged: cigarette smokers (33.4% of sample, also included small probabilities for use of cigars and e-cigarettes), cigar smokers (16.8%, nearly exclusive), smokeless tobacco users (12.3%, also included small probabilities for cigarettes, cigars, snus), hookah smokers (11.8%), tobacco smokers/chewers (10.7%, variety of primarily traditional tobacco products), tobacco/hookah smokers (7.2%), tobacco/snus/e-cig users (3.3%), e-cigarette users (2.9%,), and polytobacco users (1.7%, high probabilities for all products). Compared to cigarette smokers, tobacco/hookah smokers and hookah smokers were more likely to report Hispanic ethnicity. Polytobacco users were more likely to report dependence (AOR:2.77, 95% CI:[1.49–5.18]), whereas e-cigarette users were less likely (AOR:0.49, 95% CI:[0.24–0.97]).Conclusion: Findings are consistent with other research demonstrating shifts in adolescent tobacco product usage towards non-cigarette tobacco products. Continuous monitoring of these patterns is needed to help predict if this shift will ultimately result in improved public health

Current status and best practices of shared governance in US pharmacy programs

© 2020, American Association of Colleges of Pharmacy. All rights reserved. Objective. To characterize shared governance in US schools and colleges of pharmacy and recom-mend best practices to promote faculty engagement and satisfaction. Findings. The literature review revealed only one study on governance in a pharmacy school and some data from an AACP Faculty Survey. Of the 926 faculty members who responded to the survey, the majority were satisfied or very satisfied with faculty governance (64%) and the level of input into faculty governance (63%) at their school. Faculty members in administrative positions and those at public institutions were more satisfied with governance. The forum resulted in the development of five themes: establish a clear vision of governance in all areas; ensure that faculty members are aware of their roles and responsibilities within the governance structure; ensure faculty members are able to join committees of interest; recognize and reward faculty contributions to governance; and involve all full-time faculty members in governance, regardless of their tenure status. Summary. Establishing shared governance within a school or college of pharmacy impacts overall faculty satisfaction and potentially faculty retention

The impact of adolescent exposure to medical marijuana laws on high school completion, college enrollment and college degree completion

Background: There is concern that medical marijuana laws (MMLs) could negatively affect adolescents. To better understand these policies, we assess how adolescent exposure to MMLs is related to educational attainment. Methods: Data from the 2000 Census and 2001-2014 American Community Surveys were restricted to individuals who were of high school age (14-18) between 1990 and 2012 (n = 5,483,715). MML exposure was coded as: (i) a dichotomous any MML indicator, and (ii) number of years of high school age exposure. We used logistic regression to model whether MMLs affected: (a) completing high school by age 19; (b) beginning college, irrespective of completion; and (c) obtaining any degree after beginning college. A similar dataset based on the Youth Risk Behavior Survey (YRBS) was also constructed for confirmatory analyses assessing marijuana use. Results: MMLs were associated with a 0.40 percentage point increase in the probability of not earning a high school diploma or GED after completing the 12th grade (from 3.99% to 4.39%). High school MML exposure was also associated with a 1.84 and 0.85 percentage point increase in the probability of college non-enrollment and degree non-completion, respectively (from 31.12% to 32.96% and 45.30% to 46.15%, respectively). Years of MML exposure exhibited a consistent dose response relationship for all outcomes. MMLs were also associated with 0.85 percentage point increase in daily marijuana use among 12th graders (up from 1.26%). Conclusions: Medical marijuana law exposure between age 14 to 18 likely has a delayed effect on use and education that persists over time. (C) 2016 Elsevier Ireland Ltd. All rights reserved

Cognitive performance profiles by latent classes of drug use

Background and Objectives: The relationship between substance use and cognitive deficits is complex and requires innovative methods to enhance understanding. The present study is the first to use LCA to examine associations of drug use patterns with cognitive performance. Methods: Cocaine/heroin users (N = 552) completed questionnaires, and cognitive measures. LCA identified classes based on past-month drug use and adjusted for probabilities of group membership when examining cognitive performance. Latent indicators were: alcohol (ALC), cigarettes (CIG), marijuana (MJ), crack smoking (CS), nasal heroin (NH), injection cocaine (IC), injection heroin (IH), and injection speedball (IS). Age and education were included as covariates in model creation. Results: Bootstrap likelihood ratio test (BLRT) supported a 5-class model. Prevalent indicators (estimated probability of over 50%) for each class are as follows: “Older Nasal Heroin/Crack Smokers” (ONH/CS, n = 166.9): ALC, CIG, NH, CS; “Older, Less Educated Polysubstance” (OLEP, n = 54.8): ALC, CIG, CS, IH, IC, and IS; “Younger Multi-Injectors” (MI, n = 128.7): ALC, CIG, MJ, IH, IC, and IS; “Less Educated Heroin Injectors” (LEHI, n = 87.4): CIG, IH; and “More Educated Nasal Heroin” users (MENH, n = ALC, CIG, NH. In general, all classes performed worse than established norms and older, less educated classes performed worse, with the exception that MENH demonstrated worse cognitive flexibility than YMI. Discussion and Conclusions: This study demonstrated novel applications of a methodology for examining complicated relationships between polysubstance use and cognitive performance. Scientific Significance: Education and/or nasal heroin use are associated with reduced cognitive flexibility in this sample of inner city drug users

Postoperative Cavity Stereotactic Radiosurgery for Brain Metastases

During the past decade, tumor bed stereotactic radiosurgery (SRS) after surgical resection has been increasingly utilized in the management of brain metastases. SRS has risen as an alternative to adjuvant whole brain radiation therapy (WBRT), which has been shown in several studies to be associated with increased neurotoxicity. Multiple recent articles have shown favorable local control rates compared to those of WBRT. Specifically, improvements in local control can be achieved by adding a 2 mm margin around the resection cavity. Risk factors that have been established as increasing the risk of local recurrence after resection include: subtotal resection, larger treatment volume, lower margin dose, and a long delay between surgery and SRS (>3 weeks). Moreover, consensus among experts in the field have established the importance of (a) fusion of the pre-operative magnetic resonance imaging scan to aid in volume delineation (b) contouring the entire surgical tract and (c) expanding the target to include possible microscopic disease that may extend to meningeal or venous sinus territory. These strategies can minimize the risks of symptomatic radiation-induced injury and leptomeningeal dissemination after postoperative SRS. Emerging data has arisen suggesting that multifraction postoperative SRS, or alternatively, preoperative SRS could provide decreased rates of radiation necrosis and leptomeningeal disease. Future prospective randomized clinical trials comparing outcomes between these techniques are necessary in order to improve outcomes in these patients

Predicting glycated hemoglobin levels in the non-diabetic general population:Development and validation of the DIRECT-DETECT prediction model - a DIRECT study

AIMS/HYPOTHESIS: To develop a prediction model that can predict HbA1c levels after six years in the non-diabetic general population, including previously used readily available predictors. METHODS: Data from 5,762 initially non-diabetic subjects from three population-based cohorts (Hoorn Study, Inter99, KORA S4/F4) were combined to predict HbA1c levels at six year follow-up. Using backward selection, age, BMI, waist circumference, use of anti-hypertensive medication, current smoking and parental history of diabetes remained in sex-specific linear regression models. To minimize overfitting of coefficients, we performed internal validation using bootstrapping techniques. Explained variance, discrimination and calibration were assessed using R2, classification tables (comparing highest/lowest 50% HbA1c levels) and calibration graphs. The model was externally validated in 2,765 non-diabetic subjects of the population-based cohort METSIM. RESULTS: At baseline, mean HbA1c level was 5.6% (38 mmol/mol). After a mean follow-up of six years, mean HbA1c level was 5.7% (39 mmol/mol). Calibration graphs showed that predicted HbA1c levels were somewhat underestimated in the Inter99 cohort and overestimated in the Hoorn and KORA cohorts, indicating that the model's intercept should be adjusted for each cohort to improve predictions. Sensitivity and specificity (95% CI) were 55.7% (53.9, 57.5) and 56.9% (55.1, 58.7) respectively, for women, and 54.6% (52.7, 56.5) and 54.3% (52.4, 56.2) for men. External validation showed similar performance in the METSIM cohort. CONCLUSIONS/INTERPRETATION: In the non-diabetic population, our DIRECT-DETECT prediction model, including readily available predictors, has a relatively low explained variance and moderate discriminative performance, but can help to distinguish between future highest and lowest HbA1c levels. Absolute HbA1c values are cohort-dependent