Telephone-based cognitive behavioural therapy for patients with postoperative bariatric surgery to manage COVID-19 pandemic-related mental health issues and distress (TELE-BARICARE): a protocol for a randomised controlled trial.

INTRODUCTION: Bariatric surgery is currently the most effective treatment for obesity, and is performed yearly in over 8000 patients in Canada. Over 50% of those who live with obesity also have a history of mental health disorder. The COVID-19 pandemic has made it difficult for people living with obesity to manage their weight even after undergoing bariatric surgery, which combined with pandemic-related increases in mental health distress, has the potential to adversely impact obesity outcomes such as weight loss and quality of life. Reviews of virtual mental health interventions during COVID-19 have not identified any interventions that specifically address psychological distress or disordered eating in patients with obesity, including those who have had bariatric surgery. METHODS AND ANALYSIS: A randomised controlled trial will be conducted with 140 patients across four Ontario Bariatric Centres of Excellence to examine the efficacy of a telephone-based cognitive behavioural therapy intervention versus a control intervention (online COVID-19 self-help resources) in postoperative bariatric patients experiencing disordered eating and/or psychological distress. Patients will be randomised 1:1 to either group. Changes in the Binge Eating Scale and the Patient Health Questionnaire 9-Item Scale will be examined between groups across time (primary outcomes). Qualitative exit interviews will be conducted, and data will be used to inform future adaptations of the intervention to meet patients' diverse needs during and post-pandemic. ETHICS AND DISSEMINATION: This study has received ethics approvals from the following: Clinical Trials Ontario (3957) and the University Health Network Research Ethics Committee (22-5145), the Board of Record. All participants will provide written informed consent prior to enrolling in the study. Results will be made available to patients with bariatric surgery, the funders, the supporting organisations and other researchers via publication in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER: NCT05258578.

Perception of risk and behaviors associated with driving under the effects of alcohol and marijuana on university students of Venezuela / Percepção de riscos e comportamentos associados à condução sob os efeitos do álcool e da maconha em estudantes universitários da Venezuela / Percepción de riesgo y comportamientos asociados a la conduccion bajo los efectos del alcohol y marihuana en estudiantes universitarios de Venezuela

ABSTRACT Objective: to evaluate the relationship between risk perception and the behaviors associated with driving under the influence of drugs. Method: quantitative cross-sectional study. The sample is composed by university students (n=383, average age 21.2 years). To evaluate the behaviors, items from Ontario Student Drug Use and Health were adapted, and two other instruments were used to measure alcohol and marijuana consumption. Results: it indicates a low risk perception when driving under the influence of drugs. There are no differences between the risk perception of being stopped by the police or being penalized for driving under effects of alcohol and/or marijuana among the students whose report the behavior called driving-under-influence and those without such behavior. However, there were differences between the perception of the risk of involvement in a vehicle accident and the behaviors called driving-under-influence, showing that those who report driving under the influence of alcohol and/or marijuana perceive a lower risk of accidents due to the effects of alcohol X2 (1, N=292)=7,999, p=.005 and of both substances X2 (1, N=35)=6.386, p=.012. Likewise, a lower perception of the risk of accidents was found among the subjects who board a vehicle driven by someone who uses marijuana X2 (1, N=67)=15,087, p=.000 and those who do not report being a passenger of a driver under influence; as well as when under the simultaneous effect of alcohol and marijuana X2 (1, N=366)=8,849, p=.003. Conclusion: it is concluded that the development of preventive programs in the university environment, as well as public policies that include the component of education and compliance with legal regulations, is important.

RESUMO Objetivo: avaliar a relação entre a percepção de risco e os comportamentos associados à condução sob os efeitos de drogas. Método: estudo quantitativo de corte transversal. A amostra foi com estudantes universitários (n=383, com média de idade de 21,2 anos). Para avaliar os comportamentos foram adaptados os instrumentos Ontario Student Drug Use e Health Survey. Além disso, também foram utilizados outros dois para medir o consumo de álcool e maconha. Resultados: há uma baixa percepção de risco ao dirigir sob os efeitos de drogas. Não há diferenças entre a percepção de risco de ser parado pela polícia nem de ser punido por dirigir sob a influência de álcool e/ou maconha, entre estudantes que relatam comportamentos relacionados à condução sob influência, e aqueles que não têm esses comportamentos. No entanto, foram encontradas diferenças entre a percepção de risco de estar envolvido em um acidente veicular e os comportamentos relacionados com a condução sob influência, mostrando que aqueles que relatam dirigir sob a influência de álcool e/ou maconha, percebem um menor risco de acidentes sob os efeitos do álcool X2 (1, N=292)=7.999, p=0,005, e de ambas as substâncias X2 (1, N=35)=6,386, p=0,012. Da mesma forma, uma menor percepção de risco de acidentes foi encontrada entre os sujeitos que embarcam em um veículo dirigido por alguém que usa maconha X2 (1, N=67)=15.087, p=,000 e aqueles que não relatam ser passageiro de um carro com motorista sob influência; bem como quando eles estão sob o efeito simultâneo de álcool e maconha X2 (1, N=366)=8.849, p=0,003. Conclusão: é importante desenvolver programas preventivos no ambiente universitário, bem como políticas públicas que incluam o componente educacional e o cumprimento das normas legais.

RESUMEN Objetivo: evaluar la relación entre percepción de riesgo y los comportamientos asociados a la conducción bajo los efectos de drogas. Método: estudio cuantitativo de corte transversal. La muestra son estudiantes universitarios (n=383, media de edad 21.2 años). Para evaluar los comportamientos fueron adaptados ítems del Ontario Student Drug Use and Health Survey, además se utilizó otros dos instrumentos, para medir consumo de alcohol y marihuana. Resultados: indican una baja percepción de riesgo al manejar bajo los efectos de drogas, no existen diferencias entre la percepción de riesgo de ser detenido por la policía ni de ser sancionado por conducir bajo los efectos de alcohol y/o marihuana, entre los estudiantes que reportan comportamientos llamado conducir bajo influencia y los que no tienen esos comportamientos. Sin embargo, sí se encontraron diferencias entre la percepción de riesgo de verse involucrado en un accidente de vehículo y los comportamientos llamado conducir bajo influencia, evidenciándose que quienes reportan conducción bajo los efectos de alcohol y/o marihuana, perciben un menor riesgo de accidentes bajo los efectos de alcohol X2(1, N=292)=7.999, p=.005 y de ambas sustancias X2(1, N=35)=6.386, p=.012. Igualmente se encontró una menor percepción de riesgo de accidentes, entre los sujetos que se suben a un vehículo conducido por alguien que usa marihuana X2(1, N=67)=15.087, p=.000 y los que no reportan ser pasajero de un conductor bajo influencia; así como también cuando están bajo el efecto simultáneo de alcohol y marihuana X2(1, N=366)=8.849, p=.003. Conclusión: se concluye que es importante desarrollar programas preventivos en el ámbito universitario, así como políticas públicas que incluyan el componente educativo y el cumplimiento de las normativas legales.

Past year cannabis use and problematic cannabis use among adults by ethnicity in Ontario.

BACKGROUND: Rates of cannabis use differ around the world; in Ontario, the rate of use has been stable since about 2005. Understanding which population groups are at greater risk for problematic cannabis use can help reduce long-term health effects and service expenses. The aim of this study was to explore differences in cannabis use among Canadian adults of different ethnic origins living in Ontario. METHODS: Data are based on telephone interviews with 11,560 respondents and are derived from multiple cycles (2005-2011) of the Centre for Addiction and Mental Health's (CAMH) Monitor survey, an ongoing cross-sectional survey of adults in Ontario, Canada, aged 18 years and older. Data were analyzed using bivariate cross-tabulations and logistic regression. Problematic cannabis use was determined with a score of 8+ on the ASSIST-CIS to identify moderate/high problematic users. RESULTS: Lifetime, past year and problematic cannabis use (in the past 3 months) occurs among all ethnic groups: Canadian, East Asian, South East Asian, South Asian, Caribbean, African, East European, South European, North European, and Central West European. When compared to the Canadian group the odds of past year cannabis use was significantly lower for East Asians and South Asians, but higher for the Caribbean group. Significantly higher odds of problematic cannabis use were found for Caribbeans and Northern Europeans compared to Canadians. CONCLUSIONS: These results of this study provide an important basis for considering the possible impact of the impending legalization of cannabis in Canada among different ethnic groups.