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Background Each year, alcohol use causes 3.3 million deaths globally and accounts for nearly 30% of injuries treated at Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania. Prior research found significant stigma towards patients reporting alcohol use in general and among healthcare providers for this population. Methods This mixed-methods study aimed to identify sex-based perspectives of stigma among injury patients, family members, and local community advisory board members. Injury patients from the emergency room at KCMC were asked to complete surveys capturing consumption of alcohol, perceived stigma, and consequences of drinking. Patients who completed the survey, their family members, and members of a community advisory board were also recruited to take part in focus groups led by a trained bilingual research nurse. Data were analyzed using multiple linear regression and Wilcoxon rank sum tests with alpha level set at 0.05. Results Results showed that sex was a significant predictor of perceived discrimination (p = 0.037, SE =1.71(0.81)) but not for perceived devaluation (p = 0.667, SE = -0.38(0.89)). Focus groups revealed there were global negative perceptions of the amount of alcohol consumed as well as negative perceptions towards disclosure of alcohol use to healthcare providers. Sex differences in stigma emerged when participants were specifically asked about women and their alcohol consumption. Conclusions The findings of this study suggest there is an underlying sex difference, further stigmatizing women for alcohol use among the injury patient population at KCMC. Tanzanian women suffer from unequal access to healthcare and the stigmatization of alcohol-use likely increases this disparity.

Background: Harmful and hazardous alcohol use and violence are major contributors to global mortality and morbidity, despite being both predictable and preventable. This study seeks to quantify the association between violence-related injury and alcohol use disorders in a referral hospital in Moshi, Tanzania using a prospective trauma registry. Methods: We included all adult trauma patients (>17 years of age) presenting to the Kilimanjaro Christian Medical Center in Moshi, Tanzania in the registry. The trauma registry is an extensive instrument that was translated and back-translated from English to Kiswahili by local research assistants. The registry includes demographic information, patient history, clinical diagnosis and treatment, injury and surgery information, the Patient Health Questionnaire-2 (PHQ2), a behavioural health assessment, the Alcohol Use Disorders Identification Test (AUDIT), and substance use screening. An AUDIT score of ≥8 indicates harmful alcohol use in this setting. Alcohol use in the 6 h prior before injury was determined either from self-report or a blood alcohol concentration above 0. Category of injury (violence or non-violence) was self-reported. Findings: We included data from 500 patients enrolled in the trauma registry between April 17, 2018, and Jan 12, 2019. Of these, 84 patients (16·8%) reported that their injury was due to violence. Patients with violence-related injuries were 2·21 times more likely to have a positive alcohol status than were patients who presented with injuries not related to violence (95% CI 1·36–3·60; p

Background Rotator cuff tears affect millions of individuals each year, often requiring surgical intervention. However, repair failure remains common. We have previously shown that pulsed electromagnetic field (PEMF) therapy improved tendon-to-bone healing in a rat rotator cuff model. The purpose of this study was to determine the influence of both PEMF frequency and exposure time on rotator cuff healing. Methods Two hundred ten Sprague-Dawley rats underwent acute bilateral supraspinatus injury and repair followed by either Physio-Stim PEMF or high-frequency PEMF therapy for 1, 3, or 6 hours daily. Control animals did not receive PEMF therapy. Mechanical and histologic properties were assessed at 4, 8, and 16 weeks. Results Improvements in different mechanical properties at various endpoints were identified for all treatment modalities when compared with untreated animals, regardless of PEMF frequency or duration. Of note, 1 hour of Physio-Stim treatment showed significant improvements in tendon mechanical properties across all time points, including increases in both modulus and stiffness as early as 4 weeks. Collagen organization improved for several of the treatment groups compared with controls. In addition, improvements in type I collagen and fibronectin expression were identified with PEMF treatment. An important finding was that no adverse effects were identified in any mechanical or histologic property. Conclusions Overall, our results suggest that PEMF therapy has a positive effect on rat rotator cuff healing for each electromagnetic fundamental pulse frequency and treatment duration tested in this study.