scholarly journals Self-reported alcohol topography, past alcohol use history, and current alcohol cravings

2021 ◽  
Author(s):  
Jonathan K. Noel
Keyword(s):  
Alcohol Use ◽  
Online Survey ◽  
Latent Class ◽  
Disease Status ◽  
Drinking Motives ◽  
Long Term Effects ◽  
Alcohol Cravings ◽  
Class Assignment ◽  
Current Alcohol

Introduction: Drinking topography is the idea that how a person drinks, in addition to how much they drink, can influence the immediate and long-term effects of alcohol consumption. Measures are often crude, and there has been little effort to associate such measures with disease status. Methods: To address these gaps, an online survey was completed by 734 U.S. participants. They described how they usually drank using a series of 20 words (e.g., chug, nip, nurse, shots). A latent class analysis was performed to identify clusters of descriptors. Past alcohol use history, as measured by the Alcohol Use Disorders Identification Test (AUDIT), and current alcohol cravings, as measured by the Desires for Alcohol Questionnaire (DAQ), were then regression on class assignment. The analysis was adjusted for age, sex, race, ethnicity, marital status, income, and education level. Results: Three LCA classes were accepted, with the class characterized by the words shot, swig, gulp, chug, and guzzle having significantly higher AUDIT (b[95% CI] = 1.22 [0.98, 1.46], p < 0.001) and DAQ (b[95% CI] = 12.9 [10.5, 15.3], p < 0.001) scores relative to the class characterized by sample, sip, and nurse. The third class predominantly used drink and sip, and was not significantly different from the sample class (p's = 0.290-0.471). Conclusions: Measuring drinking topography offers a unique way to identify individuals at risk of an alcohol use disorder or those who may be resistant to treatment. It may also be useful in determining drinking motives. However, additional research is needed.

scholarly journals “If I knew I could get that every hour instead of alcohol, I would take the cannabis”: need and feasibility of cannabis substitution implementation in Canadian managed alcohol programs

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Bernie Pauly ◽  
Meaghan Brown ◽  
Clifton Chow ◽  
Ashley Wettlaufer ◽  
Brittany Graham ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Harm Reduction ◽  
Partial Substitution ◽  
Organizational Leaders ◽  
Willingness To Participate ◽  
Alcohol Cravings ◽  
Alcohol Harm Reduction ◽  
Alcohol Programs ◽  
Robust Evidence

Abstract Background While there is robust evidence for strategies to reduce harms of illicit drug use, less attention has been paid to alcohol harm reduction for people experiencing severe alcohol use disorder (AUD), homelessness, and street-based illicit drinking. Managed Alcohol Programs (MAPs) provide safer and regulated sources of alcohol and other supports within a harm reduction framework. To reduce the impacts of heavy long-term alcohol use among MAP participants, cannabis substitution has been identified as a potential therapeutic tool. Methods To determine the feasibility of cannabis substitution, we conducted a pre-implementation mixed-methods study utilizing structured surveys and open-ended interviews. Data were collected from MAP organizational leaders (n = 7), program participants (n = 19), staff and managers (n = 17) across 6 MAPs in Canada. We used the Consolidated Framework for Implementation Research (CFIR) to inform and organize our analysis. Results Five themes describing feasibility of CSP implementation in MAPs were identified. The first theme describes the characteristics of potential CSP participants. Among MAP participants, 63% (n = 12) were already substituting cannabis for alcohol, most often on a weekly basis (n = 8, 42.1%), for alcohol cravings (n = 15, 78.9%,) and withdrawal (n = 10, 52.6%). Most MAP participants expressed willingness to participate in a CSP (n = 16, 84.2%). The second theme describes the characteristics of a feasible and preferred CSP model according to participants and staff. Participants preferred staff administration of dry, smoked cannabis, followed by edibles and capsules with replacement of some doses of alcohol through a partial substitution model. Themes three and four highlight organizational and contextual factors related to feasibility of implementing CSPs. MAP participants requested peer, social, and counselling supports. Staff requested education resources and enhanced clinical staffing. Critically, program staff and leaders identified that sustainable funding and inexpensive, legal, and reliable sourcing of cannabis are needed to support CSP implementation. Conclusion Cannabis substitution was considered feasible by all three groups and in some MAPs residents are already using cannabis. Partial substitution of cannabis for doses of alcohol was preferred. All three groups identified a need for additional supports for implementation including peer support, staff education, and counselling. Sourcing and funding cannabis were identified as primary challenges to successful CSP implementation in MAPs.

Active Shooter Protocols: Perceptions, Preparedness, and Anxiety

2021 ◽  
Vol 26 (2) ◽  
pp. 91-100
Author(s):  
Veronica Worthington ◽  
Matthew Hayes ◽  
Melissa Reeves
Keyword(s):  
High School ◽  
Online Survey ◽  
Real Life ◽  
Unintended Consequences ◽  
Hierarchical Regression ◽  
Training Methods ◽  
Active Shooter ◽  
Long Term Effects ◽  
Perceived Knowledge

The national concern about active shootings has pushed schools to implement intense drills without considering unintended consequences. Studies have found that, although training had the potential to increase preparedness, it also increased anxiety. These findings apply to short-term effects, but there is a lack of empirical research on long-term effects of active shooter drills. The present study investigated whether active shooter training completed in high school impacts current levels of anxiety and preparedness of undergraduates. Collegiate participants (N = 364) completed an online survey and answered questions about their perceived knowledge of protocols, protocol actions, and training methods from high school followed by the same set of questions, this time referring to their current university. Participants then completed an anxiety measure (Spielberger, 1983) and a preparedness measure. Two hierarchical regression analyses were conducted to predict anxiety and preparedness. This study expanded findings on the effects of active shooter training by demonstrating long-term effects for high school training. Evacuation protocols (β = −.13, p = .03; β = .16, p = .007) and perceived knowledge (β = −.16, p = .004; β = .14, p = .01) positively impacted anxiety and preparedness, respectively, of university students. Experiences at the university level had an additional, larger impact on student anxiety, ΔR2 = .11, F(8, 347) = 5.88, p < .001, and preparedness, ΔR2> = .26, F(8, 347) = 17.32, p < .001, which seems to overshadow the effects from high school. This may be problematic because the perceived knowledge that leads to higher feelings of preparedness may not translate into appropriate actions in a real-life situation, potentially risking lives.

High Response Rates To Crizotinib In Advanced, Chemoresistant ALK+ Lymphoma Patients

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 368-368 ◽  
Author(s):  
Sara Redaelli ◽  
Francesca Farina ◽  
Alessandra Stasia ◽  
Monica Ceccon ◽  
Luca Mologni ◽  
...  
Keyword(s):  
Tyrosine Kinases ◽  
Catalytic Domain ◽  
B Cell Lymphoma ◽  
Disease Status ◽  
Response To Therapy ◽  
Chromosome 2 ◽  
Long Term Effects

Abstract In hematological disorders ALK expression is present in >50% of Anaplastic Large Cell Lymphomas (ALCL) as a result of a t(2;5)(p23;q35) translocation that causes the ALK gene on chromosome 2 to fuse with the NPM gene on chromosome 5. ALK + ALCL respond to cytotoxic drugs, but relapses occur and bear a poor prognosis(Stein, Foss et al. Blood 96 3681-95 2000; Ferreri, Govi et al. Crit Rev Oncol Hematol 83 293-302 2012). ALK-positive large B-cell lymphoma (ALK+ LBCL) is a rare lymphoma with a most frequent t(2;17)(p23;q23) translocation responsible for Clathrin-ALK fusion protein(Swerdlow, Campo et al. 2 2008). Crizotinib is the first ALK inhibitor which entered clinical practice: it is an orally bioavailable small-molecule inhibitor active on the ALK and MET receptor tyrosine kinases. While the activity of crizotinib in ALK+ lung cancer is documented (Kwak, Bang et al. N Engl J Med 363 1693-703 2010)no report on long term effects of crizotinib in ALK+ lymphomas exists; impressive short-term therapeutic activity was reported in two patients (Gambacorti-Passerini, Messa et al. N Engl J Med 364 775-6 2011), but no long-term data are available. In the present study, crizotinib was administered (250 mg BID) as monotherapy to 11 ALK+ lymphoma patients, diagnosed with ALK+ Non-Hodgkin lymphoma (NHL) by immunohistochemistry and FISH. Nine patients had a ALCL histology while the remaining 2 were DLBCL Patients had a refractory or relapsed disease after at least one prior chemotherapy regimen and measurable disease. All had involvement at multiple sites (nodal and extranodal) as well as B symptoms and an ECOG performance score of 1-4. Response to therapy was assessed according to RECIST criteria (Therasse, Arbuck et al. J Natl Cancer Inst 92 205-16 2000) The Overall Response Rate (ORR) was 10/11 (91%, 95% CI: 60-99%) and included 9 CR (82%, 95% CI: 51-96%) and 1 PR. Evidence of response by PET/CAT scan was present as early as 12 days. B symptoms disappeared promptly and LDH levels normalized within 30 days after the start of crizotinib. Disease status at the latest follow-up (June 2013) is as follows: 4 patients are in CR under continuous crizotinib treatment; they also test negative by RT-PCR for NPM/ALK (Mussolin, Damm-Welk et al. Leukemia 27 416-22 2012). Three patients (2 with LBCL and 1 with ALCL) died due to disease progression; 1 patient obtained CR, relapsed after 2 months of treatment and is now in CR on continued brentuximab treatment (month 29); 1 patient obtained CR on crizotinib and after 2 months stopped treatment, received an alloBMT and is still in CR; 2 patients treated for relapses post alloBMT obtained CR and are still in CR but they stopped crizotinib after 8-10 months. The two patients with ALK+ LBCL died within 3 months; in those with ALCL the CR rate was 9/9 (100%, 95% CI, 74-100%) with a median duration of 10 months (range 2-37). The 3 years PFS and OS rates are 62% (95% CI, 35-85%) and 73% (95% CI, 40-93%) respectively, with a plateau in the curve after the initial 6 months. In two relapsed patients the kinase domain of NPM-ALK could be amplified from peripheral blood samples obtained at the time of relapse (month 5 and 2). Deep sequencing of these products revealed the presence of different mutations: Q1064R at high prevalence (95%,) in patient (pt) #2 and I1171N (33%) plus M1328I (14%) in pt #6. All these mutations were not present in samples obtained before crizotinib treatment. I1171N was already discovered in an in-vitro screening (Ceccon, Mologni et al. Mol Cancer Res 11 122-32 2012): it commands an intermediate level of resistance to crizotinib (RI: 5.8) which however is cross resistant with other anti-ALK TKI such as AP26113 and NVP-TAE684. The other two mutations were not previously described: they present a RI to crizotinib of 2.4 (M1328I) and 8.5 (Q1064R). Since these residues do not form direct contacts with crizotinib, they probably interact with different structures within the catalytic domain such as the hydrophobic R-spine (I1171N) (Ceccon, Mologni et al. Mol Cancer Res 11 122-32 2012), the activation loop (M1328I), or yet unidentified regions (Q1064R). In conclusion, these positive results extend our initial observation on two patients (Gambacorti-Passerini, Messa et al. N Engl J Med 364 775-6 2011) and provide long-term follow up data. Crizotinib exerted a potent antitumor activity in advanced ALK+ lymphoma and produced durable responses in this population of heavily pre-treated patients, with a benign safety profile. Disclosures: Gambacorti-Passerini: Pfizer: Consultancy, Research Funding; BMS: Consultancy.

scholarly journals COVID-19 vs. stakeholder engagement: the impact of coronavirus containment measures on stakeholder involvement in European energy research projects

2021 ◽  
Vol 1 ◽  
pp. 57
Author(s):  
Diana Süsser ◽  
Andrzej Ceglarz ◽  
Vassilis Stavrakas ◽  
Johan Lilliestam
Keyword(s):  
Stakeholder Engagement ◽  
Online Survey ◽  
Stakeholder Involvement ◽  
Future Research ◽  
Research Projects ◽  
Long Term Effects ◽  
Energy Research ◽  
Containment Measures ◽  
The Impact

The coronavirus (COVID-19) pandemic has affected societies and economies around the world, and the scientific community is no exception. Whereas the importance of stakeholder engagement in research has grown quickly the consequences of the pandemic on this has so far not been empirically studied. In this paper, we investigate the effects of the COVID-19 crisis on European energy research, in particular the stakeholder work, during the first wave of the coronavirus in spring and summer 2020. We pose the research questions: (i) How much of a problem are the coronavirus containment measures for stakeholder engagement? (ii) How have researchers coped with the situation, and (iii) How do they evaluate alternative stakeholder activities implemented? We conducted an online survey among European energy research projects with stakeholder engagement between June and August 2020. We found that only one of six engagement activities could be implemented as planned, whereas almost half were cancelled or delayed. The most common coping strategies were changing involvement formats – mainly to webinars or online workshops – or postponement. Whereas respondents are largely satisfied with one-to-one and unidirectional online formats, such as webinars, online interviews, and online surveys, they see interactive group activities as less suitable for online engagement. Most respondents plan to continue using online formats to complement, but not to replace, physical meetings in future research. All long-term effects remain to be seen, but given the postponement of many stakeholder involvement activities, many projects may face problems at later stages of their realisation. These findings suggest that the pandemic may have catalysed a rapid introduction of specific online formats in academic stakeholder interaction processes.

scholarly journals Writing Well: The Long-Term Effect on Empathy, Observation, and Physician Writing Through a Residency Writers' Workshop

2017 ◽  
Vol 9 (3) ◽  
pp. 357-360 ◽  
Author(s):  
Megan Lemay ◽  
John Encandela ◽  
Lisa Sanders ◽  
Anna Reisman
Keyword(s):  
Narrative Analysis ◽  
Online Survey ◽  
Medical Training ◽  
Long Term Effects ◽  
Written Responses ◽  
Long Term Effect ◽  
Writing Revision ◽  
Guided Writing ◽  
Writers Workshop

ABSTRACT Background Writing narratives during medical training can provide a way to derive meaning from challenging experiences, enhance reflection, and combat burnout. The Yale Internal Medicine Residency Writers' Workshop, an annual 2-day intensive workshop followed by faculty-guided writing revision and publication, has been training resident physicians in the craft of writing since 2003. Objective The study aimed to assess the long-term effects of a craft-focused writers' workshop for residents on empathy, observation skills, and future writing. Methods A survey of closed and open-ended questions was sent to former workshop participants (2003–2013), who rated and described the workshop's influence on their observation skills, empathy, improvement in writing, and continued informal and formal writing. A total of 89 of 130 participants (68%) completed the online survey. We identified key themes in written responses and collected quantitative ratings on a 5-point Likert scale of self-reported influence on these factors. Simple statistics and narrative analysis were used to derive results. Results Most participants agreed or strongly agreed that the workshop influenced their ability for careful observation (72 of 85, 85%); ability to be empathic with patients or colleagues (51 of 77, 66%); quality of writing (69 of 77, 90%); and continued formal or informal writing (52 of 77 [68%] and 41 of 77 [53%], respectively). Participants felt the workshop improved their attention to detail, provided a deeper understanding of others' experiences, and improved their writing. Conclusions Participants in a residency writers' workshop experienced lasting effects on observation, empathy, and writing skills.

The Influence of Running Away on the Risk of Female Sexual Assault in the Subsequent Year

2011 ◽  
Vol 26 (6) ◽  
pp. 816-829 ◽  
Author(s):  
Lisa E. Thrane ◽  
Kevin A. Yoder ◽  
Xiaojin Chen
Keyword(s):  
Sexual Assault ◽  
Alcohol Use ◽  
Romantic Relationship ◽  
Poor Mental Health ◽  
Long Term Effects ◽  
Childhood Neglect ◽  
Running Away ◽  
Sexual Onset ◽  
History Of

This study explores the sexual risk trajectories of female youths and sheds light on the long-term effects of running away. It evaluates whether running away increases the risk of sexual assault in the following year, which is after runaways return home. The sample consists of 5,387 heterosexual females between the ages of 11 and 18 years from the Longitudinal Study of Adolescent Health. Nearly one quarter (23%) of runaways report a previous sexual assault in contrast to 5% of nonrunaways. In a logistic regression model, childhood neglect increases the risk of sexual assault between Waves 1 and 2 by nearly two times. Poor mental health is statistically significant. Alcohol use doubles the odds of sexual assault. The risk of sexual assault is approximately three-fold for girls with a history of sexual onset and sexual touching in a romantic relationship. Running away increases the risk by nearly two and a half times. There is evidence that alcohol use and sexual onset partially mediates the relationship between running away and sexual assault.

scholarly journals Multidimensional Profiles of Religiosity: Do They Matter for Gen-Xers’ Psychological and Familial Well-Being?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 347-347
Author(s):  
Kent Jason Cheng ◽  
Woosang Hwang ◽  
Jeung Hyun Kim ◽  
Merril Silverstein ◽  
Maria Brown
Keyword(s):  
Young Adult ◽  
Generation X ◽  
Latent Class ◽  
Well Being ◽  
Religious Attendance ◽  
Long Term Effects ◽  
Aging Parents ◽  
Religious Ideology ◽  
Gen X

Abstract Although researchers have suggested that religiosity is a multidimensional construct, less is known about the long-term effects of religiosity profiles on Generation X (born between 1965 and 1980) adults’ psychological and familial wellbeing over the life courses. Thus, the goal of this study is (1) to identify unobserved profiles of young-adult Gen-Xers’ religiosity based on religious attendance, religious intensity, spirituality, and religious ideology, (2) to investigate demographic factors that predict membership in these religiosity latent classes, and (3) to examine how these profiles of religiosity predict Gen-Xers’ psychological wellbeing (self-esteem, life satisfaction, and depression) and familial wellbeing (martial satisfaction, and affectual and associational solidarity toward their aging parents) in early and middle adulthood. We selected 462 Gen-Xers from the Longitudinal Study of Generation in the 2005 (mean age = 30.25) and the 2016 waves (mean age = 41.25). In terms of data analysis, the three-step latent class analysis was conducted. We identified four religiosity profiles among young-adult Gen-Xers: strongly religious, weakly religious, literalists but not religious, religious but not literalists. Less educated single Gen-Xers were more likely to be in the strongly religious class, and less likely to be in other classes. Gen-Xers in the strongly religious class reported high scores of psychological and familial wellbeing than those in other religiosity classes. Given that the religiosity of the U.S. population has declined substantially over the past few decades, our findings indicate that religiosity is an important resource for Gen-X adults’ psychological and familial wellbeing.

scholarly journals A Pan-Canadian Framework for Cancer Survivorship Research

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 179s-179s ◽  
Author(s):  
R. Urquhart ◽  
J. Kontak ◽  
M. Rothfus ◽  
G. Collier ◽  
E. Green ◽  
...  
Keyword(s):  
Cancer Research ◽  
Cancer Survivorship ◽  
Research Funding ◽  
Online Survey ◽  
Research Priorities ◽  
Long Term Effects ◽  
Framework Development ◽  
The Impact ◽  
National Framework

Background and context: Across all cancer types, two-thirds of Canadians diagnosed with cancer today will survive long-term, reflecting great progress in cancer detection and treatment. Many survivors, however, will experience substantial and long-term impacts of their diagnosis and treatment. Within this context, the Canadian Cancer Research Alliance (CCRA) sought to inform the cancer research funding community on how, and what kinds of research are needed, to enable research that will make a difference to patients as they move from treatment to the posttreatment phase. Aim: To develop and implement a national framework and recommendations to enable coordinated and strategic action among cancer research funders that advances cancer survivorship research in Canada in ways that improve survivors' care and experiences. Strategy/Tactics: Multiple approaches were used to inform framework development: a strategic literature review; an analysis of cancer survivorship research funding from 2005-13; and an online survey and key informant interviews from the broader stakeholder community. An Expert Panel and Patient Advisory Committee were also engaged to provide guidance and feedback. Program/Policy process: Over the course of one year, the project team and a working group of CCRA members met regularly to steer framework development. This involved activities such as developing data collection approaches and tools, reviewing data and emerging findings, and translating findings into priority areas and recommendations. In total, > 200 Canadian and international stakeholders provided input through the survey and interviews. Outcomes: Released March 2017, the Pan-Canadian Framework for Cancer Survivorship Research provides four recommendations for cancer research funders: 1) ensure ongoing and meaningful involvement of cancer survivors; 2) align funding calls with existing needs and potential for impact; 3) create opportunities for the translation of research into practice and policy; and 4) build and maintain infrastructure and expertise to advance research. Specific research priorities were emphasized across three research domains: survivors' experiences and outcomes; late and long-term effects; and models of care. The priorities ranged from investigating the mechanisms of late/long-term effects to conducting intervention research to improve psychosocial outcomes, prevent and ameliorate late effects, and improve integration of follow-up care. What was learned: A broad range of stakeholders came together to develop a national framework to maximize the impact of shared targeted research investment in cancer survivorship research. Survivors' voices were key to agreeing on definitional issues of survivorship, identifying priority research areas, and ultimately lending credibility to the resulting framework. Implementation of the framework is the next step of work for CCRA members. Planning has commenced on identifying an initial priority for joint action.

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