Tourniquet does not affect intraoperative kinematics during total knee arthroplasty: Results of a prospective study using a robotic assistance system.

PURPOSE: Tourniquet use during total knee arthroplasty (TKA) remains controversial. There are limited data demonstrating the effect of tourniquet use on flexion and extension gaps. The use of a tourniquet can theoretically affect the kinematics of the knee joint, specifically the extension and flexion gaps and the laxity, by mechanically compressing the soft tissues including the muscles above the knee joint. Therefore, this study was designed to prospectively evaluate changes in flexion and extension gaps with and without the use of a tourniquet. METHODS: The following prospective study included 50 consecutive patients who underwent TKA using a surgical robot. The inclusion criteria were advanced osteoarthritis (OA) and varus-alignment or valgus-alignment <3° (hip-knee-ankle angle, standing long-leg X-ray), and the exclusion criteria were BMI >35 kg/m2 and mechanical axis in >3° valgus. A CR-TKA was performed, and the medial and lateral gaps (in mm) throughout the full range of motion in 10° increments were recorded. The procedure was conducted both with and without an applied tourniquet (350 mmHg). RESULTS: No significant differences were observed in the medial joint space. By contrast, the lateral gap showed significant differences in 10-20° of flexion (with a tourniquet 1.9 mm vs. without a tourniquet 2.1 mm, p = 0.018), 20-30° (1.6 vs. 1.8 mm, p = 0.02), 100-110° (0.9 vs. 1.1 mm, p = 0.021), and 110-120° (0.8 vs. 1 mm, p = 0.038). Thus, at the above degrees of flexion on the lateral side, there was a decrease in the mean of 0.2 mm with the use of a tourniquet. CONCLUSION: Although the use of a tourniquet showed a detectable change in the lateral gap in four 10° segments of flexion, clinical relevance with an average difference of 0.2 mm is not achieved. Thus, the use of a tourniquet in TKA can still be advocated based on the presented data. LEVEL OF EVIDENCE: Level I.

Behavioral Parent Training via Telehealth for Autistic Children: Further Exploration of Feasibility During the COVID-19 Pandemic.

Objectives: Many autistic children exhibit challenging and disruptive behaviors that can present challenges for both children and their families by interfering with acquisition of adaptive skills and affecting family and peer relationships. Behavioral parent training (BPT) is an evidence-based approach to reducing autistic children's disruptive behavior, but many families face a number of barriers to accessing BPT, such as availability of BPT in their community, and transportation and scheduling challenges. Therefore, we sought to explore the feasibility and promise of effectiveness of adapting an established BPT program to a telehealth format during the COVID-19 pandemic. Methods: A feasibility trial of BPT via telehealth was conducted with fourteen parents of autistic children. Results: Parents and clinicians were able to implement BPT via telehealth with a high degree of fidelity, and parents rated both BPT and the telehealth format favorably. The program also showed promise of effectiveness in reducing autistic children's disruptive behavior, improving their adaptive skills, as well as reducing parents' stress, and improving parents' sense of parenting competence. Conclusions: The findings replicate and extend findings from previous studies, further demonstrating the promise of telehealth as a viable alternative format for delivering BPT. We also explore implications for future research, including the opportunity for more thorough evaluation of the effectiveness of BPT via telehealth.

Development and field test of the Salutogenic Wellness Promotion Scale - short form (SWPS-SF) in U.S. college students.

Survey research is important for understanding health and improving practice among health professions. However, survey research can have drawbacks, such as overuse and excessively lengthy questionnaires that burden respondents. These issues lead to poor response rates and incomplete questionnaires. Low and incomplete response rates result in missing data and reduced sample size, damaging the value, usability and generalizability of the information collected. To address issues related to response rates and improve health research, shorter surveys are recommended because they impose less of a burden on respondents and are useful with larger populations. Health-related surveys also often focus on the factors leading to ill health without dedicating equal attention to factors supporting positive health. This study developed and tested a short form (SF) of the validated Salutogenic Wellness Promotion Scale (SWPS), which measures causes of health (rather than causes of disease), using responses from 2052 college students. The participants answered questions about their demographics and completed the SWPS and a perceived health assessment. Statistical tests demonstrated the SWPS-SF had significant relationships with the full SWPS, health status, and Grade Point Average (GPA). Statistical tests were also used to establish cutoff scores that had a high true positive and low false negative rate. These cutoff scores demonstrated a relationship of higher performance and better health. These promising results suggest this short test can provide valid information without burdening the respondents. Authors recommend additional tests be completed to validate the SWPS-SF.

Exploration of the Relationship Between Concussions and Depression Symptoms, Anxiety Symptoms, and Hazardous Drinking Among a Sample of College Students.

Objective: In clinical and athlete populations, research has found that experiencing a concussion (or traumatic brain injury) is correlated with experiencing other psychiatric conditions, including depression and alcohol problems. However, less is known about concussion comorbidity in other population segments. The purpose of this study is to examine the relationships between concussions and depression symptoms, anxiety symptoms, and hazardous drinking among a large sample of college students (N = 1776) enrolled in a mandatory health course. Methods: This study used an online health survey to examine concussion frequency (informal and formal diagnoses), sports-related concussions, depression symptoms, anxiety symptoms, and hazardous drinking in the sample. Bivariate and multivariate analyses were conducted to examine comorbid relationships between concussion frequency and the dependent variables of interest (anxiety symptoms, depression symptoms, and hazardous drinking). Results: We found that 691 (39.1%) participants indicated having at least one concussion. Analyses indicated that concussion frequency scores of both formal or informal diagnoses were significantly associated with scores of depression symptoms, anxiety symptoms, and hazardous drinking. When examining concussion frequency scores of only formal diagnoses, only hazardous drinking evidenced a statistically significant relationship. In addition, participants who had a sports concussion had significantly higher concussion frequency scores and hazardous drinking scores than those who have had a concussion that was not sport-related. Conclusions: The comorbid concussion relationships found in this study are consistent with those observed in clinical and athlete populations. It is important for college health professionals to be aware that concussion comorbidity is not limited to the athlete population and can impact the entire student body.

Examining the relationship between poor sleep health and risky driving behaviors among college students.

Objective: Risky driving behaviors, such as texting while driving, are common among young adults and increase risk of traffic accidents and injuries. We examine the relationship between poor sleep and risky driving behaviors among college students as potential targets for traffic injury prevention.Methods: Data for this study were obtained from a cross-sectional survey administered to a college student sample in the United States Midwest (n = 1,305). Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI). Risky driving behaviors were measured, including sending texts/emails; reading texts/emails while driving; talking on the phone while driving; falling asleep while driving; and driving under the influence. Risky driving behavior was defined as a response of "just once," "rarely," "sometimes," "fairly often" or "regularly" (reference = "never"). Logistic regression was used to examine the relationship between sleep and risky driving, after adjusting for confounders.Results: Among participants, 75% reported sending texts/emails while driving, 82% reported reading texts/emails while driving, and 84% reported phone talking while driving; 20% reported falling asleep while driving; 8% reported driving under the influence; and 62% reported 3 or more risky behaviors. Compared to those reporting no sleep disturbance, those with sleep disturbance "once or twice a week" were more likely to report sending a text/email while driving (aOR: 2.9, 95%CI:1.7-4.9), reading a text/email while driving (aOR:3.1,95%CI:1.5-5.5), talking on the phone while driving (aOR:1.9, 95%CI:1.0-3.4), and falling asleep while driving (aOR:3.4,95%CI:1.5-7.4). Compared to those reporting no daytime dysfunction, those reporting issues "once or twice a week" were more likely to report talking on the phone while driving (aOR:1.7, 95%CI:1.1-2.7) and falling asleep while driving (aOR:3.6,95%CI:2.3-5.6).Conclusions: Future research may consider designing behavioral interventions that aim to improve sleep, reduce drowsy driving among young adults.

Applying the Socio-Ecological Model to barriers to implementation of ACL injury prevention programs: A systematic review.

BACKGROUND: Preventing anterior cruciate ligament (ACL) injuries is important to avoid long-term adverse health consequences. Identifying barriers to implementation of these prevention programs is crucial to reducing the incidence of these injuries. Our purpose was to identify barriers of implementation for ACL injury prevention programs and suggest mechanisms for reducing the barriers through application of a Socio-Ecological Model (SEM). METHODS: Studies investigating ACL prevention program effectiveness were searched in Medline via PubMed and the Cochrane Library, and a subsequent review of the references of the identified articles, yielded 15 articles total. Inclusion criteria encompassed prospective controlled trials, published in English, with ACL injuries as the primary outcome. Studies were independently appraised by 2 reviewers for methodological quality using the PEDro scale. Barriers to implementation were identified when reported in at least 2 separate studies. A SEM was used to suggest ways to reduce the identified barriers. RESULTS: Five barriers were identified: motivation, time requirements, skill requirements for program facilitators, compliance, and cost. The SEM suggested ways to minimize the barriers at all levels of the model from the individual through policy levels. CONCLUSION: Identification of barriers to program implementation and suggesting how to reduce them through the SEM is a critical first step toward enabling ACL prevention programs to be more effective and ultimately reducing the incidence of these injuries.

Patterns of Daily Fantasy Sport Play: Tackling the Issues.

Daily fantasy sports (DFS), a rapidly growing industry, allows players to create fantasy teams of real-life players and potentially win cash prizes, derived from entry fees. Some stakeholders have expressed concern that DFS's accelerated nature and other features might promote excessive play and related harm. We conducted the first descriptive summary of actual DFS play using records from a cohort of subscribers to a dominant operator, DraftKings. Participants (N = 10,385) initially entered paid National Football League (NFL) contests. Across all participants, players entered a median of two contests per entry day and typically submitted a single entry for each contest they entered. Players paid a median of $87 in entry fees throughout the 2014 NFL season and experienced an overall median net loss of $30.7. However, we identified heavily involved sub-groups of players based on number of contests entered, total entry fees, and net loss. These top 1% groups were less likely to restrict themselves to NFL games, exhibited greater time involvement, but also won a greater percentage of the contests they entered than typical players. Our observations of typical and heavily involved players tend to mirror those generated in previous Internet sports gambling research.

Pregaming: A Field-Based Investigation of Alcohol Quantities Consumed Prior to Visiting a Bar and Restaurant District.

BACKGROUND: Investigations examining the association between pregaming, or the consumption of alcohol prior to attending a social gathering or drinking establishment, and blood alcohol concentrations have primarily relied on estimations (i.e., Widmark equation), rather than objective biologic samples, such as breath alcohol concentration (BrAC). OBJECTIVES: The current study assessed: (1) pregaming, using quantity-based measures, among a sample of college and non-college affiliated bar patrons, (2) associations between pregaming intensity/status and participant intoxication (BrAC), and (3) whether participants who pregamed were more likely to identify as a hazardous drinker. METHODS: 548 bar patrons provided data on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and a single pregaming item assessing quantity of alcohol consumed prior to visiting a bar/restaurant district in 2015. BrAC samples were collected post interview. We used hierarchical linear regression models, respectively, to assess whether pregaming significantly impacted BrAC and whether presence of hazardous drinking predicted pregaming behavior. RESULTS: After controlling for sex, race/ethnicity, age, student status, and Greek affiliation, the linear regression model explained 32.3% (R2 = .323) of the variance of BrAC levels (F(12) = 21.162, p < .001), with 4.30% of the variance explained solely by pregaming (ß = 0.014; p < .001). The linear regression model to assess if harzardous drinking behavior (AUDIT-C) significantly predicted pregaming explained 31.2% (R2 = .312) of the variance of pregaming behavior (F(18) = 13.276, p < .001), with 4.2% of the variance explained solely by AUDIT-C scores (ß = 0.280; p < .001). CONCLUSION: Findings further highlight pregaming as a harmful risk behavior linked to elevated levels of hazardous drinking and intoxication.

Examination of associations between risky driving behaviors and hazardous drinking among a sample of college students.

OBJECTIVE: Hazardous drinking is associated with other risky behaviors and negative health-related outcomes. This study examined covariation between hazardous drinking scores and the following risky driving behaviors: Falling asleep while driving, texting (receiving and sending) while driving, and driving after consuming alcohol. METHODS: The participants in this study were a sample of undergraduate students (N = 1,298) who were enrolled in an introductory health course at a large Southeastern university in spring 2016 and completed an online health survey that assessed hazardous drinking, falling asleep while driving, texting while driving, and driving after consuming alcohol. We conducted a series of 2-step regression analyses to examine covariation between hazardous drinking scores (using the Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]) and the risky driving behaviors of interest. RESULTS: We found that the majority of participants did not drink and drive (91.8%), nor did they fall asleep while driving (80.4%); however, the majority did read a text while driving (81.7%) and sent a text while driving (75.3%). In the full multivariable model, hazardous drinking score was positively associated with drinking and driving (step 2 odds ratio [OR] = 1.28, 95% confidence interval [CI], 1.18, 1.38) and sending a text message while driving (step 2 b = 0.19, P = .01). Hazardous drinking score was also positively associated with reading a text while driving (step 1 b = 0.14, P < .001) and falling asleep while driving (step 1 b = 0.02, P = .02) in the model only controlling for demographic characteristics. The analyses also indicated covariability between the following risky driving behaviors: (1) drinking and driving/reading a text message while driving, (2) drinking and driving/falling asleep and driving, (3) reading a text while driving/sending a text while driving, and (4) sending a text while driving/sleeping and driving. CONCLUSION: The findings of this study indicate a need for interventions discouraging both hazardous drinking and risky driving behaviors in college student populations; recommendations to reduce risky driving and hazardous drinking are discussed.

Examining Differences in Breath Alcohol Concentration (BrAC) Levels and Hazardous Drinking by Smoking Status Among a Sample of College Student Bar Patrons.

While the association between current smoking and alcohol consumption is well known, the relationship between social smoking and alcohol consumption is less understood. The purpose of this study was to examine the association between smoking status and two alcohol consumption measures in a sample of college student bar patrons. The data used in this study was collected in fall 2015. Study participants (N = 415) were college student bar patrons who agreed to complete an interview that assessed smoking status (i.e., regular smoker, social smoker, non-smoker) and two alcohol consumption measures: (1) breath alcohol concentration (BrAC) levels (using a handheld breathalyzer device) and (2) hazardous drinking scores (using the AUDIT-C scale). We conducted one-way ANOVAs with Bonferroni correction to examine differences in BrAC levels and hazardous drinking scores by smoking status. Among sample participants, 25.3% were regular smokers, 14.7% were social smokers, and 60.0% were non-smokers. Smokers had significantly higher BrAC levels than social smokers and non-smokers. Regular smokers also had significantly higher hazardous drinking scores than social smokers and non-smokers. The BrAC levels and hazardous drinking scores of social smokers and non-smokers were not significantly different. The drinking habits of social smokers reflected those of non-smokers and being a regular smoker was associated with higher drinking levels than the rest of the sample. Because of the association found between alcohol consumption and regular smoking, combining efforts to reduce these behaviors in college students might be advantageous.

Concussion History, Hazardous Drinking, and BrAC Levels Among a Sample of Bar Patrons, 2015.

BACKGROUND: Alcohol consumption and experiencing a concussion are positively correlated. Concussion history has not been examined previously in any alcohol field study (i.e., conducted in a natural setting). OBJECTIVE: To better understand the relationship between concussion history and alcohol consumption. METHODS: We conducted two anonymous field studies among a 2015 sample of bar patrons (N = 544; 62.5% males) in a college town to assess concussion history and two alcohol consumption measures: (1) breath alcohol concentration (BrAC) levels and (2) hazardous drinking scores (based on the AUDIT-C). Next, we conducted a logistic regression analysis to predict concussion history using the two alcohol consumption measures and other potential covariates (i.e., age, gender, race, college student status). RESULTS: Among participants in our sample, the average BrAC level was.070 (SD =.053) and the average hazardous drinking score was 4.7 (SD = 2.5). Less than half of participants indicated that they had experienced a concussion in their lifetime (235; 43.2%). The logistic regression model indicated that hazardous drinking scores were significantly, positively associated with having experienced a concussion, whereas other covariates (i.e., BrAC, age, gender, race, college student status) did not significantly predict concussion history. Conclusions/Importance: Hazardous drinkers were more likely to have experienced a concussion. Therefore, the relationship found in this sample, between hazardous drinking behavior and concussion history, points to hazardous drinking as a possible risk factor for having had a concussion in the past.

Exploring the Relationship Between the Misuse of Stimulant Medications and Academic Dishonesty Among a Sample of College Students.

The misuse of prescription stimulant medications (MPS) and academic dishonesty (AD) are both problematic behaviors among college students. Although both behaviors are linked to a student's desire to succeed academically, little research has been conducted to examine the relationship between these behaviors. The purpose of this study was to determine if students who engaged in past-year MPS committed acts of AD more frequently than those who do not engage in MPS. We collected our data from a sample of undergraduates (n = 974) between the ages of 18 and 25 enrolled at one of three universities in the US who completed an online questionnaire to assess AD and MPS. Results indicated that 18.2 % of the sample engaged in MPS in the past year and 65 % committed one or more acts of AD during the past year. An increased frequency of AD increased the odds of reporting MPS when controlling for known covariates (e.g., gender, stimulant prescription status, and energy drink consumption). In addition, higher rates of MPS were identified in students affiliated with a Greek organization, those with a current stimulant prescription, those who consume energy drinks, and those who misuse other prescriptions. Concerning specific AD-types, misusers reported copying off someone else's homework, having someone copy of their homework, and using the internet to commit acts of dishonesty more frequently than those who do not engage in MPS. This study adds to the MPS college student literature by highlighting the relationship between MPS and AD.

Identification of Vape Shops in Two North Carolina Counties: An Approach for States without Retailer Licensing.

Stores that sell electronic nicotine delivery systems (ENDS) as their primary product are a new phenomenon and often termed "vape shops". While vape shops are now regulated by state and federal agencies, not all states maintain lists of vape shops in operation. Standard ways of identifying tobacco retailers through off-premise alcohol permits and business listing services may not identify vape shops. We used four online business listing services (i.e., Google Maps, ReferenceUSA, YellowPages.com, Yelp) to identify vape shops in two counties in North Carolina (NC). In one county, we also assessed four vaping web sites. We drove primary and secondary roads to physically validate the identified stores and attempt to identify stores not listed online. To assess the accuracy of the online searches, we calculated sensitivity and positive predictive values (PPVs). This research was conducted in spring and summer 2016 and identified 28 vape shops online. We confirmed 16 vape shops (seven in Pitt County, NC, USA, and nine in Durham County, NC, USA). Online searches ranged in sensitivity, 62.5%-81.3%, and PPVs ranged from 73.3% to 92.3%. Because of the range of sensitivity found among the business listing services, state policymakers should consider uniform licensing requirements for vape and tobacco retailers to more easily track retailers and ensure compliance with regulations.

Perceptions of breath alcohol concentration (BrAC) levels among a sample of bar patrons with BrAC values of 0.08% or higher.

Breath alcohol concentration (BrAC) is a commonly used measure of alcohol intoxication. Because of the potential negative consequences of excessive alcohol consumption, it is important to examine how accurately intoxicated individuals can estimate their BrAC values, especially individuals over the legal BrAC driving threshold (i.e., 0.08%). To better understand perceptions of BrAC values among intoxicated individuals, this field study examined actual BrAC values and BrAC range estimates (0.08% and above, 0.02-0.07%, less than 0.02%) among a sample of bar patrons (N = 454) with BrAC levels at 0.08% or higher. Bivariate and multivariate analyses were conducted to examine the relationship between actual BrAC values and perceived BrAC levels. We also examined whether the following demographic and drinking variables were associated with underestimating BrAC in this sample: gender, age, race, college student status, plans to get home, and hazardous drinking. Results indicated that the majority (60.4%) of participants underestimated their BrAC (i.e., less than 0.08%) and lower BrAC values correlated with underestimating BrAC ranges (p < .001, 95% CI[0.2, 0.6]). Further, females (p = .001, 95% CI[1.3, 3.3]) and participants under 21 (p = .039, 95% CI = 1.0, 2.6) were significantly more likely to estimate their BrAC to be less than 0.08%, which is concerning given that young (less than 21) intoxicated females are a group at high risk for sexual assault on college campuses. (PsycINFO Database Record

Alcohol use, risky sexual behavior, and condom possession among bar patrons.

PURPOSE: The current study seeks to: 1) assess the relationship between alcohol consumption and intentions to engage in unprotected sex in an uncontrolled environment, and 2) to identify if covariates (race, age, sex, breath alcohol content (BrAC), intentions to engage in sex, hazardous drinking rates) are significant predictors of condom possession during time of uncontrolled alcohol consumption. METHODS: Data were collected from 917 bar patrons to assess alcohol use using the Alcohol Use Disorders Identification Test (AUDIT-C), BrAC levels, intentions to engage in risky sex, and condom possession. Correlational analysis and hierarchical binary logistic regression was conducted using SPSS. RESULTS: Correlational analyses indicated a negative relationship between AUDIT-C scores (r=-0.115, p=0.001), BrAC (r=-0.08, p=0.015), and intentions to use a condom. Over 70% of participants intended to use a condom if they engaged in sex; however, only 28.4% had a condom to use. The regression analysis indicated the predictive model (χ(2)=114.5, df=8, p<0.001) was statistically significant, and correctly classified 72.9% of those in possession of a condom. CONCLUSIONS: Alcohol consumption was associated with intentions to have unprotected sex; however, intentions to engage in protected sex and condom possession were higher for males and those with higher BrAC levels.

Hazardous drinking and weight-conscious drinking behaviors in a sample of college students and college student athletes.

BACKGROUND: "Weight-conscious drinking" refers to behaviors to restrict calories in conjunction with consuming alcohol and is associated with numerous negative consequences. This behavior has been observed in the college student population but has not been examined among college student athletes. METHODS: This cross-sectional study assessed drinking, hazardous drinking levels (Alcohol Use Disorders Identification Test-Consumption [AUDIT-C] sum score), and weight-conscious drinking behaviors (for weight loss purposes and for intoxication purposes) using a paper-and-pencil survey that was completed by students at a large, private university in the Southwest United States. The sample for this study included college student nonathletes (n = 482; 212 males and 270 females) who completed the survey in 1 of 34 classes and college student athletes (n = 201; 79 males and 122 females) who completed the survey during practice. These analyses examined whether hazardous drinking level and other personal covariates (gender, race, and athlete status) predicted the 2 weight-conscious drinking behaviors of interest. RESULTS: Among the subsample of students who drank, the same proportion of participants indicated weight-conscious drinking behavior for weight loss and weight-conscious drinking behavior for intoxication (both 24.9%; n = 122). In the multivariate analyses, students with higher hazardous drinking scores and females were significantly more likely to report engaging in both weight-conscious drinking behaviors. In those analyses, neither weight-conscious drinking behavior varied by athlete status. CONCLUSIONS: In this sample of college students, hazardous drinking most predicted weight-conscious drinking behavior and superseded gender and athlete status. In response, college health professionals should consider evidenced-based approaches to address hazardous drinking.

Alcohol-related injuries, hazardous drinking, and BrAC levels among a sample of bar patrons.

BACKGROUND: Alcohol-related injuries are a serious public health issue and research has found that alcohol consumption is positively correlated with injury risk. OBJECTIVE: To better understand the association between alcohol consumption and injury risk. METHODS: We conducted four anonymous cross-sectional field studies among a sample of bar patrons (N = 917) to assess breath alcohol concentration (BrAC) levels, hazardous drinking levels (based on AUDIT-C score), and past year alcohol-related injuries in Fall 2014. Next, we conducted two logistic regression analyses to predict alcohol-related injuries: one model used hazardous drinking level as a predictor variable and the other model used BrAC. RESULTS: Among participants in our sample, the average BrAC% was .076 (SD =.055) and the average hazardous drinking score (based on the AUDIT-C) was 5.0 (SD = 2.6). The majority of participants indicated that they had not experienced an alcohol-related injury in the past year (859; 93.7%). Our regression analyses found that each incremental increase in a participants' hazardous drinking score increased the odds of experiencing a self-reported alcohol-related injury by 1.4 times and as BrAC increased one unit of change (percentage), the odds of a past-year alcohol related injury increased twofold (OR = 2.2). Other covariates (ie, age, gender, race, college student status) did not significantly predict alcohol-related injuries in either model. DISCUSSION AND CONCLUSIONS: High-risk drinking behaviors, including higher BrAC levels, greatly influenced experiencing an alcohol-related injury. SCIENTIFIC SIGNIFICANCE: This is the first examination of BrAC levels and alcohol-related injuries in a primarily college student sample.

Game On: Past Year Gambling, Gambling-Related Problems, and Fantasy Sports Gambling Among College Athletes and Non-athletes.

College students experience higher rates of gambling-related problems than most other population segments, including the general population. Although Division I (D1) athletes often have more at stake than the average student if and when they gamble (e.g., the potential to lose their athletic eligibility), relatively few studies have assessed the gambling behavior of this population and none have specifically assessed fantasy sports gambling. We conducted a study to examine gambling behavior (past-year gambling, gambling-related problems, and fantasy sport gambling) among a sample (N = 692) of college students at a private religiously affiliated university in the Southwest US. The sample for our study was unique in that approximately 30 % of the participants were D1 athletes. We compared the gambling behavior among three groups based on the athlete status: D1 athletes, club/intramural/recreational (CIR) athletes, and non-athletes (NAs). Compared to females in our sample, males observed higher rates of past year gambling, fantasy sports participation, fantasy sports gambling, and gambling-related problems. Among males, we found that CIR athletes observed the highest rates of past year gambling and fantasy sports participation and D1 athletes observed higher rates than NAs. We did not find differences in fantasy sport gambling and past year gambling-related problems based on athlete status in males or females.

Powdered alcohol: Awareness and likelihood of use among a sample of college students.

BACKGROUND AND OBJECTIVES: In March 2015, the Alcohol and Tobacco Tax and Trade Bureau approved the sale of Palcohol, the first powdered alcohol product to be marketed and sold in the U.S. Powdered alcohol is freeze-dried, and one individual-serving size packet added to 6 ounces of liquid is equivalent to a standard drink. This study assessed awareness of powered alcohol and likelihood to use and/or misuse powdered alcohol among college students. METHODS: Surveys were administered to a convenience sample of 1,841 undergraduate students. RESULTS: Only 16.4% of respondents had heard of powdered alcohol. After being provided a brief description of powdered alcohol, 23% indicated that they would use the product if available, and of those, 62.1% also indicated likelihood of misusing the product (eg, snorting it, mixing it with alcohol). Caucasian students (OR = 1.5) and hazardous drinkers (based on AUDIT-C scores; OR = 4.7) were significantly more likely to indicate likelihood of use. Hazardous drinkers were also six times more likely to indicate likelihood to misuse the product. DISCUSSION AND CONCLUSIONS: These findings can inform upstream prevention efforts in states debating bans on powdered alcohol. In states where powdered alcohol will soon be available, alcohol education initiatives should be updated to include information on the potential risks of use and be targeted to those populations most likely to misuse. SCIENTIFIC SIGNIFICANCE: This is the first peer-reviewed study to assess the awareness of and likelihood to use and/or misuse powdered alcohol, a potentially emerging form of alcohol.