Prospective Associations between Childhood Exposure to Living with Adult Alcohol Misuse and Major Depressive Disorder in Adulthood: The Role of Child Maltreatment.

BACKGROUND: Many children grow up with adult alcohol misuse in the home. A clearer understanding of this exposure's long-term mental health consequences and the role of associated child maltreatment experiences and potential protective factors could guide relevant intervention strategies. OBJECTIVE: To prospectively evaluate the association between living with adult alcohol misuse during childhood and major depressive disorder (MDD) during adulthood; whether child maltreatment explains the association; and whether sex, school bonding, or neighborhood bonding moderate the association.Participants and setting: This study used longitudinal data from 783 individuals followed from childhood to age 39. METHODS: At grade 9, participants were asked whether they lived with adults who misused alcohol. Diagnostic assessments of MDD were conducted across three time-points during participants' thirties and participants were categorized as having met diagnostic criteria 0, 1, or 2 or more times. RESULTS: Ordinal logistic regressions found that children living with adult alcohol misuse showed greater chronicity of adult MDD (OR = 1.63; 95% CI: 1.05, 2.52). There was a 49% reduction in the odds ratio and the association was no longer statistically significant when child maltreatment was included in the model (OR = 1.32; 95% CI: 0.84, 2.07). No statistically significant moderation of associations was observed. CONCLUSIONS: Children exposed to adult alcohol misuse, and maltreatment often associated with this misuse, may be at risk for mental health challenges well into adulthood. Interventions that address childhood exposure to adult alcohol misuse and associated maltreatment may be important to mitigate long-term mental health challenges to exposed children.

Association of concussion with high school academic standing: sex, school grade and race as stratifiers.

INTRODUCTION: The purpose was to examine the association between concussion history and academic standing among high school students, and whether the association varies by sex, school grade and race/ethnicity. METHODS: Data from the 2019 Youth Risk Behaviour Survey were used for our cross-sectional study. Exposure was self-reported history of concussions in the past 12 months. Outcome was self-reported academic standing in the past 12 months. Poisson regression was used to analyse the exposure-outcome association, and whether there were differences by our stratifying variables. RESULTS: Having a history of concussion in the past 12 months was significantly associated with a higher risk of poor academic standing during the same period, and the association varied by race/ethnicity. DISCUSSION: Youth with a history of concussion may be at risk for poorer academic standing, indicating to the importance of prevention. Future studies are needed to examine the interaction of race/ethnicity on the presented association.

Association Between Consumption of Sugar-Sweetened Beverages and 100% Fruit Juice With Poor Mental Health Among US Adults in 11 US States and the District of Columbia.

INTRODUCTION: Excess sugar consumption is linked to several mental health conditions. Sugar-sweetened beverages (SSBs) and 100% fruit juice contain similar amounts of sugar per serving, yet prior studies examining sugary beverages and mental health are limited to SSBs. Of those, few have assessed potential modifiers such as sex. METHODS: We examined the association between daily consumption of fruit juice and SSBs with poor mental health by using data from the 2017 Behavioral Risk Factor Surveillance System. We used Poisson regression models with clustered-robust standard errors to measure the association between SSB and fruit juice consumption (none, >0 to <1, and ≥1 times per day) and experiencing 14 or more days of poor mental health in the past month, adjusting for sociodemographic characteristics. We used an F test of joint significance to assess effect modification by sex for SSB and fruit juice analyses. RESULTS: Consuming SSBs 1 or more times per day versus consuming none was associated with a 26% greater prevalence of poor mental health (95% CI, 1.11-1.43). Associations for consuming >0 to <1 times per day compared with consuming none were not significant. We found no evidence of an association between fruit juice consumption and mental health, nor evidence of effect modification by sex in the SSB and fruit juice analyses. CONCLUSION: Consuming SSBs 1 or more times per day was significantly associated with poor mental health whereas 100% fruit juice consumption was not. Future studies should examine alternative cut-points of fruit juice by using prospective designs.

Effective Use of Interpreter Services for Diverse Patients in a Safety-Net Hospital: Provider Perceptions of Barriers and Solutions.

INTRODUCTION: Culturally and linguistically diverse (CALD) patients should but do not routinely receive professional interpretation. The authors examined provider perceptions of barriers and solutions to interpreter services (IS) in a safety-net hospital to inform quality improvement (QI). METHODS: A 13-item survey was distributed to 750 clinicians representing 10 services across professional roles, including social workers. Closed- and open-ended questions addressed accessing IS, IS value, and care for CALD patients. Respondents ranked eight barriers to routine IS use and provided ideas for improvement. Descriptive statistics characterized survey results in aggregate and by professional role and care team. Quantitative and qualitative results were triangulated for agreement between survey domains and coded free-text response themes. RESULTS: A total of 221 responses were analyzed (29.5% response rate). Cost was the lowest-ranked barrier across roles. Leading barriers were efficiency pressures and cumbersome access. Free-text responses agreed with these findings. CALD patients were perceived to have higher complication risk by 87.5% of social workers but by 56.8% of other roles. Recommendations to increase IS varied by team: streamlined access process (46.2% emergency, 37.8% inpatient respondents), expanded in-person interpretation (55.6% inpatient, 45.8% perioperative respondents), and better equipment (44.4% outpatient, 35.9% emergency, 25.0% perioperative respondents). CONCLUSION: Provider experiences vary by care team and interpretation modality. Interpretation services are cumbersome to access and compete with efficiency pressures, leading to shortcuts that fail to provide adequate language access. Three initial QI efforts resulted: increased video interpretation equipment, a new language access committee, and a new language access leadership role.