Differences by gender at twelve months in a brief intervention trial among Mexican-origin young adults in the emergency department.

In this study, we investigate the role of gender in prevalence and consequences of binge drinking and brief intervention outcomes among Mexican-origin young adults aged 18-30 years at the U.S.-Mexico border. We conducted a secondary analysis, stratified by gender, from a randomized controlled trial of a brief motivational intervention in a hospital emergency department. Intervention effects for males included reductions in drinking frequency, binge drinking, and alcohol-related consequences. For females the intervention was associated with reduction in drinking frequency and binge drinking but did not have a significant effect on alcohol-related consequences. Results suggest a new direction for tailoring interventions to gender.

Brief Intervention in the Emergency Department Among Mexican-Origin Young Adults at the US-Mexico Border: Outcomes of a Randomized Controlled Clinical Trial Using Promotores.

AIMS: A randomized controlled trial of brief intervention (BI), for drinking and related problems, using peer health promotion advocates (promotores), was conducted among at-risk and alcohol-dependent Mexican-origin young adult emergency department (ED) patients, aged 18-30. METHODS: Six hundred and ninety-eight patients were randomized to: screened only (n = 78), assessed (n = 310) and intervention (n = 310). Primary outcomes were at-risk drinking and Rapid Alcohol Problems Screen (RAPS4) scores. Secondary outcomes were drinking days per week, drinks per drinking day, maximum drinks in a day and negative consequences of drinking. RESULTS: At 3- and 12-month follow-up the intervention condition showed significantly lower values or trends on all outcome variables compared to the assessed condition, with the exception of the RAPS4 score; e.g. at-risk drinking days dropped from 2.9 to 1.7 at 3 months for the assessed condition and from 3.2 to 1.2 for the intervention condition. Using random effects modeling controlling for demographics and baseline values, the intervention condition showed significantly greater improvement in all consumption measures at 12 months, but not in the RAPS4 or negative consequences of drinking. Improvements in outcomes were significantly more evident for non-injured patients, those reporting drinking prior to the event, and those lower on risk taking disposition. CONCLUSIONS: At 12-month follow-up this study demonstrated significantly improved drinking outcomes for Mexican-origin young adults in the ED who received a BI delivered by promotores compared to those who did not. TRIAL REGISTER: ClinicalTrials.gov. CLINICAL TRIAL REGISTRATION NUMBER: NCT02056535.

A qualitative exploration of perceived gender differences in methamphetamine use among women who use methamphetamine on the Mexico-U.S. border.

The purpose of this study is to extend the research on contextual factors that influence the initiation and continued use of methamphetamine (meth) by women on the U.S.-Mexico border. At present, a minimal body of literature exists that explores meth use on the Mexico-U.S. border. A purposeful sample of 20 women who were active meth users aged ≥18 years was recruited by trained outreach workers from a variety of meth-user networks in Ciudad Juárez, Mexico, the city bordering El Paso, Texas. Respondents participated in in-depth, semi-structured interviews including questions on users' perceived familial, social, and environmental influences of meth use. Gender-based themes emerged from the analysis: (1) patterns of meth use; (2) places where drugs were used; (3) effects of relationship networks on meth use; (4) differential access to drugs; (5) trading sex for drugs; (6) perceived class differences; and (7) long-term drug use and its consequences. Respondents reported a preference for using meth as powder or pills as opposed to smoking or injecting the drug. They reported being introduced to meth by men they trust and relying on men for drug acquisition in spaces less accessible and more dangerous to women. They described how the drug changed their lifestyle and their behavior towards family members and friends, including instances of physical and psychological violence. Interventions for women on the Mexico-U.S. border should be developed based on users' social networks to target social processes to prevent initiation and to bring active meth users into treatment.

Smoking Is Associated with Increased Risk of Binge Drinking in a Young Adult Hispanic Population at the US-Mexico Border.

BACKGROUND: This study examines factors related to general health and health behavior, including smoking, that may be associated with binge drinking, drinking "at risk," and potential for alcohol use disorder among young adults of Mexican ancestry. METHODS: A total of 2191 young adult emergency department (ED) patients (18-30 years) of Mexican ancestry in a public hospital proximate to the US-Mexico border completed health surveys while they were waiting to be treated, including questions on general health, drinking, smoking, and drug use. RESULTS: Thirty-seven percent of the study participants reported binge drinking, 38% were "at-risk" alcohol users (above National Institute on Alcohol Abuse and Alcoholism guidelines), and 22% were Rapid Alcohol Problem Screen (RAPS) positive (indicating potential for alcohol use disorder). Smoking was reported by 31%, marijuana use by 16%, and other drug use by 9%. Multiple variable models revealed that smoking was the strongest factor associated with binge drinking. Those who smoked were 3.1 (P < .0001) times more likely to binge drink. Other factors independently associated with binge drinking were age 22-25 years (odds ratio [OR] = 1.5, P = .003), male gender (OR = 1.5, P = .0001), and ED visit for injury (OR = 1.4, P = .007). CONCLUSIONS: There is a strong association of smoking and binge drinking. Study findings suggest that brief interventions designed to reduce preventable health risks for young Hispanics should include discussion of both binge drinking and smoking behaviors.

Landscape structure shapes the diversity of tree seedlings at multiple spatial scales in a fragmented tropical rainforest.

The maintenance of seedling diversity of animal-dispersed tree species is fundamental for the structure and function of forest patches in fragmented tropical rainforests. Nonetheless, the effects of landscape structure at different spatial scales on α- and ß-diversity of tree seedling communities are recently explored. Using a multi-scale approach, we assessed the relative effect of landscape composition and configuration on α- and ß-diversity of animal-dispersed seedlings within 16 forest patches in the Lacandona rainforest, Mexico. We assessed these effects at 13 spatial scales (from 300 to 1500 m radius, at 100 m intervals) for three metrics of effective number of species considering α- and ß-diversity. We found that α-diversity was largely affected by landscape composition and ß-diversity by landscape configuration. On the one hand, the amount of secondary forest influenced α-diversity. Additionally, species richness increased in landscapes with highly aggregated forest patches. On the other hand, ß-diversity was affected positively by forest fragmentation and negatively by the edge contrast of forest patches with the surrounding matrix. Our findings indicate that landscape configuration is a strong driver of seedling diversity in highly deforested rainforests. Promoting forest patches and secondary forests through payment for ecosystem services' programs, favoring matrix quality within land-sharing schemes of smallholder agriculture and secondary forest management, and identifying restoration opportunities for assisted or unassisted natural regeneration are urgently needed for conservation of seedling diversity in human-modified tropical landscapes.

Preparing Mexican-Origin Community Health Advocates (Promotores) to Conduct SBIRT for Problem Drinking in the Emergency Room.

Community Health Advocates (CHAs), known as Promotores in Spanish-speaking communities, are an important resource for the mobilization, empowerment, and the delivery of health education messages in Hispanic/Latino communities. This article focuses on understanding cultural, didactic, and logistical aspects of preparing CHAs to become competent to perform a brief intervention and referral to treatment (SBIRT) in the emergency room (ER). The CHAs training emphasizes making connections with Mexican-origin young adults aged 18-30, and capitalizing on a teachable moment to effect change in alcohol consumption and negative outcomes associated with alcohol use. We outline a CHA recruitment, content/methods training, and the analysis of advantages and challenges presented by the delivery of an intervention by CHAs.

Readiness to Change and to Accept Help and Drinking Outcomes in Young Adults of Mexican Origin.

OBJECTIVE: The purpose of this study was to assess whether readiness to change drinking (RCD) and readiness to accept help (RAH) improve short- and longer term drinking outcomes. METHOD: Data from a randomized controlled trial of screening and brief intervention (SBI) conducted in a U.S. emergency department at the U.S.-Mexico border are reported. A total of 620 at-risk and dependent Mexican-origin drinkers (56% male), ages 18-30, received either an assessment only or intervention (SBI). Drinking outcomes included drinking days per week, average and maximum drinks per drinking day, heavy drinking (5+ drinks) days per week, and negative consequences. Random effects longitudinal models predicted baseline, 3-month, and 12-month drinking outcomes from baseline RCD and RAH. Models tested if (a) outcomes were significantly reduced at follow-ups and (b) differential reduction occurred by RCD, RAH, and post-intervention changes in readiness among those receiving SBI. RESULTS: For both study groups, outcomes improved from baseline to each follow-up across RCD and RAH status. RCD was not associated with differential improvement in outcomes for either group. In the SBI group, those RAH reported larger reductions at 3 months in average and maximum quantity than those not RAH but did not differ from those not RAH at 12-month outcomes. Among the SBI group, changing from not ready to ready (RTC or RAH) post-intervention was not associated with greater reductions in drinking compared with remaining not ready or ready post-intervention. CONCLUSIONS: Baseline RCD is not associated with drinking outcomes. Baseline RAH may facilitate greater reductions in drinking for those receiving SBI and should be further examined as a possible mediator of SBI effects for young adults of Mexican origin.

Effects of ENSO and temporal rainfall variation on the dynamics of successional communities in old-field succession of a tropical dry forest.

The effects of temporal variation of rainfall on secondary succession of tropical dry ecosystems are poorly understood. We studied effects of inter-seasonal and inter-year rainfall variation on the dynamics of regenerative successional communities of a tropical dry forest in Mexico. We emphasized the effects caused by the severe El Niño Southern Oscillation (ENSO) occurred in 2005. We established permanent plots in sites representing a chronosequence of Pasture (abandoned pastures, 0-1 years fallow age), Early (3-5), Intermediate (8-12), and Old-Growth Forest categories (n = 3 per category). In total, 8210 shrubs and trees 10 to 100-cm height were identified, measured, and monitored over four years. Rates of plant recruitment, growth and mortality, and gain and loss of species were quantified per season (dry vs. rainy), year, and successional category, considering whole communities and separating seedlings from sprouts and shrubs from trees. Community rates changed with rainfall variation without almost any effect of successional stage. Mortality and species loss rates peaked during the ENSO year and the following year; however, after two rainy years mortality peaked in the rainy season. Such changes could result from the severe drought in the ENSO year, and of the outbreak of biotic agents during the following rainy years. Growth, recruitment and species gain rates were higher in the rainy season but they were significantly reduced after the ENSO year. Seedlings exhibited higher recruitment and mortality rate than sprouts, and shrubs showed higher recruitment than trees. ENSO strongly impacted both the dynamics and trajectory of succession, creating transient fluctuations in the abundance and species richness of the communities. Overall, there was a net decline in plant and species density in most successional stages along the years. Therefore, strong drought events have critical consequences for regeneration dynamics, delaying the successional process and modifying the resilience of these systems.