Gender and Direction of Effect of Alcohol Problems and Internalizing Symptoms in a Longitudinal Sample of College Students

Background: Alcohol problems and internalizing symptoms are consistently found to be associated but how they relate to each other is unclear. Objective: The present study aimed to address limitations in the literature of comorbidity of alcohol problems and internalizing symptoms by investigating the direction of effect between the phenotypes and possible gender differences in college students. Method: We utilized data from a large longitudinal study of college students from the United States (N = 2607). Three waves of questionnaire-based data were collected over the first two years of college (in 2011–2013). Cross-lagged models were applied to examine the possible direction of effect of internalizing symptoms and alcohol problems. Possible effects of gender were investigated using multigroup modeling. Results: There were significant correlations between alcohol problems and internalizing symptoms. A direction of effect was found between alcohol problems and internalizing symptoms but differed between genders. A unidirectional relationship varying with age was identified for males where alcohol problems initially predicted internalizing symptoms followed by internalizing symptoms predicting alcohol problems. For females, a unidirectional relationship existed wherein alcohol problems predicted internalizing symptoms. Conclusions/Importance: We conclude that the relationship between alcohol problems and internalizing symptoms is complex and differ between genders. In males, both phenotypes are predictive of each other, while in females the relationship is driven by alcohol problems. Importantly, our study examines a population-based sample, revealing that the observed relationships between alcohol problems and internalizing symptoms are not limited to individuals with clinically diagnosed mental health or substance use problems.     

Handwashing: Clean Hands Save Lives

Abstract

Handwashing is one of the most important ways to prevent the spread of illness. The five steps that need to be completed every time handwashing occurs are: wet, lather, scrub, rinse, dry. Using these tips will improve the likelihood of fighting germs and reducing the spread of illness. The Centers for Disease Control has launched a new campaign titled “Life is Better with Clean Hands” as an initiative to spread the word about the importance of handwashing, and can be found at <http://cdc.gov/handwashing>. Through this campaign and other publications, the CDC hopes to see a reduction in spread of illness.     

Systemic lupus erythematosus associated with ANCA-associated vasculitis: an overlapping syndrome?

Systemic lupus erythematosus (SLE) and small-sized vessel vasculitis are usually two distinguishable autoimmune diseases. However, a vasculitis may be found in the course SLE but rarely corresponds to an ANCA-associated vasculitis (AAV). We report four cases of de novo SLE associated with AAV, our aim being to discuss the clinical significance of this association. We included four patients fulfilling the criteria for both SLE and AAV and followed in two different university hospitals between 1996 and 2009. In light of a 20-year literature review (25 described clinical cases), we discussed the etiopathogeny of such an association. All patients presented a severe renal involvement (creatininemia ranging from 120 to 370?μmol/l) and thrombopenia (ranging from 45,000 to 137,000 platelets/mm³). The other main clinical symptoms were arthritis (n?=?3), serositis (n?=?2) and intra-alveolar hemorrhage (n?=?2). An inflammatory syndrome was noticed at diagnosis in all cases. ANCAs were MPO-ANCAs in all cases. Two out of these four patients were also diagnosed with antiphospholipid syndrome. The frequency of this association seems not fortuitous. Although the etiopathogenic mechanisms of such an association remain to be more precisely described, several clinical, histological and immunological features support the hypothesis of the existence of a SLE-AAV overlapping syndrome. Moreover, clinicians must be aware of such an overlapping syndrome, notably because its initial presentation can be very severe.     

Perspectives of Physician Parents in the NICU

Sixty-four physician parents of infants cared for in the neonatal intensive care unit (NICU) were mailed a survey inquiring about privacy, emotional state, and communication. Fifty-seven (89%) physician parents responded. Forty-six (81%) infants were preterm. Responses were not associated with illness severity or hospital length of stay. Most respondents believed their infant received good care and achieved a good outcome, but suggestions to enhance communication were common, and their consideration may improve NICU care. Most physician parents believed their experience made them more empathetic and compassionate. Further investigation into the reasons for this may help to enhance future medical education.     

A Typology and Analysis of Drug Resistance Strategies of Rural Native Hawaiian Youth

This study examines the drug resistance strategies described by Native Hawaiian youth residing in rural communities. Sixty-four youth from 7 middle and intermediate schools on the Island of Hawai‘i participated in a series of gender-specific focus groups. Youth responded to 15 drug-related problem situations developed and validated from prior research. A total of 509 responses reflecting primary or secondary drug resistance strategies were identified by the youth, which were qualitatively collapsed into 16 different categories. Primary drug resistance strategies were those that participants listed as a single response, or the first part of a two-part response, while secondary drug resistance strategies were those that were used in tandem with primary drug resistance strategies. Over half of the responses reflecting primary drug resistance strategies fell into three different categories (“refuse,” “explain,” or “angry refusal”), whereas over half of the responses reflecting secondary drug resistance strategies represented one category (“explain”). Significant gender differences were found in the frequency of using different strategies as well as variations in the frequency of using different strategies based on the type of drug offerer (family versus friends/peers). Implications for prevention practice are discussed.