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This study examined opioid and analgesic misuse, and associated reasons for misuse, among participants without cancer in the United States. We extracted data from three distinct waves of the National Survey on Drug Use and Health (NSDUH, 2017–2019). Using weighted multivariable logistic regression models, we examined the associations between misuse and its reasons. Among individuals without cancer who misused pain relievers, the top three reasons for misuse were to relieve physical pain (62.6%), to get high (29.2%), or to relax (28.9%). For compound analgesics, the top three reasons for misuse were similar: relieving physical pain (67.9%), getting high (22.1%), and relaxation (25.6%). Compared to participants who misused opioids, respondents using compound analgesics and other pain relievers had lowers odds of using pain relievers for getting high (all p <.05). Understanding the underlying reasons for opioid and analgesic misuse can inform development of public health policy and help in determining best practices for prescription and monitoring programs. [ABSTRACT FROM AUTHOR]

There is limited research exploring the changing clinical practices among healthcare providers (HPs) care for patients with Emergency Department (ED)-initiated Medication for Opioid Use Disorder (MOUD). This scoping review followed the methodological framework of Arksey and O'Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus for related studies from inception through October 12, 2022. Following the application of inclusion and exclusion criteria, 16 studies were included. Subsequently, they were charted and analyzed thematically based on ecological systems theory. The main determinants in the four ecological systems were generated as follows: (1) microsystem: willingness and attitude, professional competence, readiness, and preference; (2) mesosystem: ED clinical practices, departmental factors; (3) exosystem: multidisciplinary approaches, discharge planning, and (4) macrosystem: stigma, health insurance, policy. The findings have implications for HPs and researchers, as insufficient adoption, implementation, and retention of MOUD in the ED affect clinical practices. Across the four ecological systems, ED-initiated MOUD is shaped by multifaceted determinants. The microsystem underscores pivotal patient-HP trust dynamics, while the mesosystem emphasizes interdepartmental synergies. Exosystemically, resource allocation and standardized training remain paramount. The macrosystem reveals profound effects of stigma, insurance disparities, and evolving policies on treatment access and efficacy. Addressing these interconnected barriers is crucial for optimizing patient outcomes in the context of MOUD. [ABSTRACT FROM AUTHOR]

Background: Taiwan has a substantial number of veterans, but knowledge regarding their emergency department (ED) visits during the coronavirus disease 2019 (COVID-19) pandemic remains limited. This study examined the characteristics of veterans' ED visits during Taiwan's COVID-19 epidemic. Methods: This was a cross-sectional study conducted at the ED of a large veteran medical center located in Taipei, Taiwan, from May 2018 to October 2021. We analyzed the numbers and features of visits in summer and autumn according to the first wave of the COVID-19 epidemic in Taiwan in 2021. Results: Medical institutions were positively associated with veteran status. Emergency department complaints of trauma (adjusted odds ratio [AOR] = 1.15, 95% CI: 1.06-1.25; summer P < .01) and chest pain/tightness (AOR = 1.65, 95% CI: 1.45-1.87; summer P < .01; AOR = 1.4, 95% CI: 1.26-1.55; P < .01) were associated with increased odds of being a veteran. Triage levels above 2 were positively associated with veteran status in the autumn model (AOR = 1.14, 95% CI: 1.07-1.22; P < .01). Patients hospitalized after ED visits were associated with reduced odds of veteran status (P < .01). Those who spent a long time in the ED were more likely to be veterans than those who spent a shorter time in the ED (P < .01). Veterans were less likely to visit the ED regardless of the time frame of the study period (P < .01), except during the COVID-19 outbreak in the autumn (2019-2020). Conclusions: The distinctions in ED visits highlighted the individuality of veterans' medical needs. Our findings suggest that the veteran medical system can add to the focus on improving senior-friendly care, fall prevention, quality of life of institutionalized veterans, access for homeless veterans, and care for ambulatory care–sensitive conditions. [ABSTRACT FROM AUTHOR]

AbstractThis study examined the relationship of playing mahjong with smoking and alcohol consumption behaviors among Chinese older adults. We used a large and nationally representative dataset, the 8th wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Older adults who were 65 years old or above were included in the final analysis sample (n = 10,954). Multivariable logistic regressions were used to examine the associations of playing mahjong with current and former smoking/alcohol consumption status. Additionally, we used negative binomial and multiple linear regressions to investigate the number of cigarettes smoked per day and the amount of alcohol consumed per day. Compared with older adults who did not play mahjong, those who played mahjong at least once per month were more likely to report both current and prior smoking/alcohol consumption habits (all p < 0.05). The sub-analysis revealed that older adults who played mahjong at least once per week tended to smoke more cigarettes per day (all p < 0.05) than those who did not play mahjong at all. When public health practitioners advocate for the health benefits of playing mahjong, they should also consider its associations with smoking/alcohol consumption behaviors among Chinese older adults. [ABSTRACT FROM AUTHOR]

China is a country with a large alcohol user population, but it also faces other public health challenges like the growth of older adult population and shift in dietary behaviors in the past few decades. We examined the associations of alcohol consumption and dietary behaviors with severe cognitive impairment among Chinese older men and women. We used panel data from three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to examine this topic of interest. Older adults who answered three survey waves were analyzed (age ≥ 65), with a total of 7,950 observations (n = 7,950). In the panel logistic regression models, only former alcohol use was positively associated with severe cognitive impairment among older men (p <.05), but not in older women. Neither current light nor heavy alcohol consumption was associated with cognitive impairment. Older men and women who did not consume or rarely consume fruits and vegetables were more likely to develop severe cognitive impairment (all p <.01). Public health practitioners can use the empirical results from this research to identify what patterns of alcohol use and dietary behaviors can help prevent cognitive impairment among older adults. [ABSTRACT FROM AUTHOR]

Objective: Explore the relevant evidence about stress‐related cognitive appraisal and coping strategies among registered nurses in the emergency department (EDRNs) coping with the COVID‐19 pandemic. Methods: This scoping review followed the methodological framework of Arksey and O'Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus electronic databases for related studies from inception through February 2, 2022. This review further conducted study selection based on the PRISMA flow diagram and applied Lazarus and Folkman's Psychological Stress and Coping Theory to systematically organize, summarize, and report the findings. Findings: Sixteen studies were included for synthesis. Most of the studies showed that the majority of EDRNs were overwhelmed by the COVID‐19 pandemic. Depression, triaging distress, physical exhaustion, and intention to leave ED nursing were cited as major threats to their wellness. Additionally, comprehensive training, a modified triage system, a safe workplace, psychological support, promotion of resilience, and accepting responsibility may help EDRNs cope with pandemic‐related challenges effectively. Conclusion: The long‐lasting pandemic has affected the physical and mental health of EDRNs because they have increased their effort to respond to the outbreak with dynamically adjusted strategies. Future research should address a modified triage system, prolonged psychological issues, emergency healthcare quality, and solutions facing EDRNs during the COVID‐19 or related future pandemics. Clinical Relevance: EDRNs have experienced physical and psychological challenges during the pandemic. The ED administrators need to take action to ensure EDRNs' safety in the workplace, an up‐to‐date triage system, and mental health of frontline nurses to provide high‐quality emergency care for combating COVID‐19. [ABSTRACT FROM AUTHOR]

China has faced challenges related to the rapid growth of its ageing population, and sleep is one of the public health challenges to this demographic group. This study examines the socio-demographic and behavioural factors associated with status change of sleeping patterns among Chinese older adults, using longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Socio-demographic factors were selected from the 2012 wave of the CLHLS to examine the sleep status change in the 2014 wave. Multivariable logistic and multinomial regressions were used to study older adults' changes of sleep quality and daily sleep duration. Older adults, 65 years old or above, were selected as study participants. A higher level of education was negatively associated with poor sleep quality and longer sleep duration (>8 hours). Increasing age was positively associated with both shorter and longer sleep duration. Being female was negatively associated with longer sleep duration. However, exercise status, smoking behaviour and alcohol use all were neither positively nor negatively associated with status change of sleeping patterns. Participants' education, age and gender might be important factors associated with sleep status change. However, the effects of behavioural factors should be studied further. Policy implications and further research directions are discussed based on empirical results. [ABSTRACT FROM AUTHOR]

Medical marijuana legalization (MML) has become more prevalent in the United States. This study examined the association between medical marijuana legalization and sources of obtaining marijuana among adults in the United States. Adult participants (age ≥ 18) from the 2018 wave of the National Survey on Drug Use and Health (NSDUH) were analyzed (n = 42,669, weighted N = 247,247,786). We used two multinomial regression models to estimate the association. The first model controlled for sociodemographic variables, and the second model additionally included an interaction effect of participants' race with MML. In the first model, participants residing in states with MML were positively associated with reporting lifetime marijuana use (but did not use in the past 12 months), buying marijuana, receiving marijuana for free or sharing with others, and growing marijuana on their own (all p <.01). With the interaction of participants' race, nonwhites residing in states with MML were negatively associated with reporting lifetime marijuana use and receiving marijuana for free or sharing marijuana with others (all p <.05). Policy makers should be aware of the sources of obtaining marijuana in the states with legalization of medical marijuana. [ABSTRACT FROM AUTHOR]