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This study evaluated factors affecting the completion of blended-eLearning courses for health workers and their effect on stigma. The two courses covered the screening and management of harmful alcohol, tobacco, and other substance consumption in a lower-middle-income country setting. The courses included reading, self-reflection exercises, and skills practice on communication and stigma. The Anti-Stigma Intervention-Stigma Evaluation Survey was modified to measure stigma related to alcohol, tobacco, or other substances. Changes in stigma score pre- and post-training period were assessed using paired t-tests. Of the 123 health workers who registered, 99 completed the pre- and post-training surveys, including 56 who completed the course and 43 who did not. Stigma levels decreased significantly after the training period, especially for those who completed the courses. These findings indicate that blended-eLearning courses can contribute to stigma reduction and are an effective way to deliver continuing education, including in a lower-middle-income country setting. [ABSTRACT FROM AUTHOR]

Alcohol use is the 5th most important risk factor contributing to the global burden of diseases, with stigma and a lack of trained health workers as the main barriers to adequate care. This study assesses the impact of providing blended-eLearning courses teaching the alcohol, smoking, and substance involvement screening test (ASSIST) screening and its linked brief intervention (BI). In public and private facilities, two randomized control trials (RCTs) showed large and similar decreases in alcohol use in those receiving the BI compared to those receiving only the ASSIST feedback. Qualitative findings confirm a meaningful reduction in alcohol consumption; decrease in stigma and significant practice change, suggesting lay health workers and clinicians can learn effective interventions through blended-eLearning; and significantly improve alcohol use care in a low- and middle-income country (LMIC) context. In addition, our study provides insight into why lay health workers feedback led to a similar decrease in alcohol consumption compared to those who also received a BI by clinicians. [ABSTRACT FROM AUTHOR]

Objective: Depression is a highly-prevalent disorder among US adults and despite advancements in treatment options, prevalence rates are increasing. With the emerging recommendations of dietary interventions such as high fish intake come potential risks, for example, exposure to methylmercury (MeHg). Case reports and animal models have suggested a possible association of high doses of MeHg with psychiatric symptoms; the impact of low-dose exposure on depression remains unknown. Methods: In this cross-sectional study, survey-weighted logistic regression models were built to assess the relationship between low-dose MeHg blood levels and depression in a sample of n = 3930 adults from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Results: 9.1% (n = 1335) of the respondents screened positive for depression; all participants had MeHg blood levels below the US Environmental Protection Agency's reference dose. The adjusted multivariate logistic regression model showed no statistically significant association between MeHg blood levels and depression. Conclusion: Low-dose MeHg does not seem to be associated with depression in this study. However, dietary recommendations with regards to fish intake should be made cautiously. Further studies are needed, especially considering predicted increasing environmental pollution of our food webs and the potentially higher vulnerability of subpopulations such as pregnant women. [ABSTRACT FROM AUTHOR]