Adrienne Keller

Tobacco, alcohol and other drug use among college students.

Smoking, binge drinking, and illicit drug use remain common among college students. The purpose of this study was to characterize college students who smoke, and to determine the relationship between smoking behavior and alcohol and illicit drug use. Cigarette smoking, alcohol use and illicit drug use practices were surveyed at ten public colleges in Virginia. A total of 3,374 undergraduate respondents from eight schools (those with response rates > 20%) were analyzed. The one-year smoking prevalence was 23.5%. Smokers were significantly more likely to be white, female, and to have lower life satisfaction and grade point averages than nonsmokers. Students classified themselves as regular or occasional smokers. Smoking was significantly associated with binge drinking in the last two weeks and with marijuana, cocaine, and LSD use in the past year. Except for binge drinking, the associations were stronger for regular than for occasional smokers. Cigarette smoking, even occasional use, identifies a subgroup of college students who are at increased risk of binge drinking and illicit drug use. This information may be useful in developing targeted drug prevention programs.

Reliability and Construct Validity of the Changes in Sexual Functioning Questionnaire Short-Form (CSFQ-14)

The Changes in Sexual Functioning Questionnaire (CSFQ) is a 36-item clinical and research instrument identifying five scales of sexual functioning. This study documents the internal consistency and factor structure of a 14-item version of the CSFQ (CSFQ-14), which yields scores for three scales corresponding to the phases of the sexual response cycle (i.e., desire, arousal, and orgasm) as well as the five scales of the original CSFQ. Factor analysis confirms the construct validity of the CSFQ-14 as a global measure of sexual dysfunction. The CSFQ-14 and the individual scales exhibit strong internal reliability.

Salivary cortisol, dehydroepiandrosterone, and testosterone interrelationships in healthy young males: A pilot study with implications for studies of aggressive behavior

The present small pilot study was designed to demonstrate the feasibility and relevance of using salivary assessments of biological markers to model a complex biological substrate of aggressive behavior. Five college-aged males completed the State-Trait Anger Expression Inventory on enrollment and provided saliva samples at 2000, 0200 and 0800 h during one mid-week 24-h period for three consecutive weeks. Saliva samples were assayed for cortisol (C), dehydroepiandrosterone (DHEA), and testosterone (T). All three biological measures showed stable circadian rhythms for each individual across the weeks of the study. Circadian variations indicate the importance, for C in particular, of including collection at 0200 h. Examination of the relationship among C, DHEA and T and the scales of the State-Trait Anger Expression Inventory provides preliminary evidence of an acceptable methodology to study complex interrelationships based on both levels and circadian variations of all three biological measures. This study demonstrates the feasibility of using salivary collection and assays to assess the level and stability of circadian variation in biological markers, and the necessity of formulating complex models to investigate the relationship between biology and behavior.

College Health Surveillance Network: Epidemiology and Health Care Utilization of College Students at US 4-Year Universities

Abstract Objective: This description of the College Health Surveillance Network (CHSN) includes methodology, demography, epidemiology, and health care utilization. Participants: Twenty-three universities representing approximately 730,000 enrolled students contributed data from January 1, 2011, through May 31, 2014. Methods: Participating schools uploaded de-identified electronic health records from student health services monthly. Results: During this study, just over 800,000 individuals used the health centers, comprising 4.17 million patient encounters. Sixty percent of visits included primary care, 13% mental health, 9% vaccination, and 31% other miscellaneous services. The 5 most common specific diagnostic categories (with annual rates per 100 enrolled students) were preventive (16); respiratory (12); skin, hair, and nails; infectious non–sexually transmitted infection (5 each); and mental health (4). Utilization and epidemiologic trends are identified among subpopulations of students. Conclusions: CHSN data establish trends in utilization and epidemiologic patterns by college students and the importance of primary and behavioral health care services on campuses.

Exploratory study of premenstrual symptoms and serotonin variability

SummaryPremenstrual symptoms can pose significant problems for a large number of women; this small exploratory study was designed to investigate biological markers that may provide etiological clues. Using an algorithm based on daily symptom charting for two months, 15 participants were assigned to one of three study groups: non-symptomatic (n = 9), probable PMS (n = 3) and probable PMDD (n = 3). During two overnight admissions, one prior to and one following the onset of menses, participants had blood drawn to assess the level of available serotonin via one of its metabolites, 5-HIAA. The three groups exhibited potentially significant differences in several biological markers. This study‘s results are consistent with a hypothesis implicating serotonin in the generation of premenstrual symptomology.

Causes of Mortality Among American College Students: A Pilot Study

This pilot study from self-selected institutions of higher education provides an estimate of the causes and rates of mortality among college students between the ages of 18 and 24 years old. One hundred fifty-seven 4-year colleges participated in an online survey of student deaths during one academic year. A total of 254 deaths were reported. The mortality rates (per 100,000) were as follows: total accidental injuries, 10.80; suicide, 6.17; cancer, 1.94; and homicide, 0.53. Within the accident and injury category, alcohol-related vehicular deaths (per 100,000) were 3.37 and alcohol-related nontraffic injuries were 1.49. Men had significantly higher rates of suicide (10.46) than women (2.34). Suggestions for future research and implications of these findings are discussed.

The Longitudinal Pattern of Alcohol-Related Injury in a College Population: Emergency Department Data Compared to Self-Reported Data

Background: Self-report survey is the most common method of obtaining information from college students on substance use and its consequences. However, the validity and reliability of self-report data, especially in relationship to harmful substance use, is frequently called into question. Objectives: To establish the convergent validity of self-reported alcohol-related injury data and data from a university-affiliated hospital Emergency Department (ED) across a seven year period. (2) To examine the trend lines for relative risk of alcohol-related injury. Methods: Two existing data sets at a major public university are compared: records of 1,253 ED admissions for alcohol-related reasons and 13,518 survey responses. Convergent validity is evaluated with the Pearson correlation coefficients of the two data sets for 2001/2002 through 2007/2008. Longitudinal trends for each data set are evaluated by change in relative risk. Results: Over the seven years, 51% of ED visits for alcohol-related reasons were due to injury, and 14% of survey respondents who drank alcohol reported alcohol-related injury. Both decreased significantly over the years: from 62% to 45% for ED reports and from 24% to 9% for self reports. ED visits for alcohol-related injury and self-reported alcohol-related injury are highly correlated: r = .67, 45% shared variance. Conclusions: The comparison establishes convergent validity for the self-report data and decreased rates of alcohol-related injury. Scientific Significance: These findings support the validity in college populations of self-report data about negative consequences associated with drinking alcohol.

Reported alcohol use and behavior in long-distance runners

Because alcohol may impair sports performance, we hypothesized there would be less drinking in serious recreational runners. We used mailed questionnaires to examine drinking patterns (2-wk quantity/frequency), scores on modified versions of the Michigan Alcoholism Screening Test (brief MAST [BMAST], short MAST [SMAST]), and parental history of problem drinking in 397 men and 144 women runners participating in a 20-mile race, compared with a nonexercising control population of 138 men and 119 women. A subset of 188 pairs (104 men, 84 women) were matched for gender, age, educational level, and marital status. We used chi-square analysis, paired t-test, and ANOVA. Male gender, running, and a family history for problem drinking predicted increased total alcohol consumption. We found that male runners (vs male controls) drank more 14.2 +/- 19.6 vs 5.4 +/- 7.6 drinks.wk-2, P = 0.004) and felt guilty about their drinking (26.6% vs 13.8%, P < 0.01). Men and women runners reported more occasions of drinking than matched controls (2.8 +/- 2.7 vs 2.0 +/- 2.3.wk-2, P = 0.004). Runners with scores on the BMAST (> or = 6) or SMAST (> or = 3) suggestive of a history of problem drinking drank less than controls with a similar score. Contrary to our hypothesis, running is associated with increased alcohol consumption, except in those who report a history of problem alcohol behavior.

Legal Ages for Purchase and Consumption of Alcohol and Heavy Drinking Among College Students in Canada, Europe, and the United States

ABSTRACT Heavy drinking and associated negative consequences remain a serious problem among college students. In a secondary analysis of data from two published study, the authors examine the correlation between minimum legal age to purchase and/or consume alcohol and rates of heavy drinking among college students in 22 countries. The published studies use identical definitions of heavy drinking and similar methodologies. In the study of 20 European countries and the United States, there is a positive correlation between prevalence of heavy drinking and both minimum legal purchase age (r =.34) and minimum legal drinking age (r =.19); in the study of Canada and the United States, there is a perfect positive correlation (r = 1.0). Examination of this evidence does not support the conclusion that a lower minimum legal age for purchase and/or consumption of alcoholic beverages is a protective factor for decreasing heavy drinking among college students.

Evaluation of a Practice-Based Intervention to Improve the Management of Pediatric Asthma

Pediatric asthma remains a significant burden upon patients, families, and the healthcare system. Despite the availability of evidence-based best practice asthma management guidelines for over a decade, published studies suggest that many primary care physicians do not follow them. This article describes the Provider Quality Improvement (PQI) intervention with six diverse community-based practices. A pediatrician and a nurse practitioner conducted the yearlong intervention, which was part of a larger CDC-funded project, using problem-based learning within an academic detailing model. Process and outcome assessments included (1) pre- and post-intervention chart reviews to assess eight indicators of quality care, (2) post-intervention staff questionnaires to assess contact with the intervention team and awareness of practice changes, and (3) individual semi-structured interviews with physician and nurse champions in five of the six practices. The chart review indicated that all six practices met predefined performance improvement criteria for at least four of eight indicators of quality care, with two practices meeting improvement criteria for all eight indicators. The response rate for the staff questionnaires was high (72%) and generally consistent across practices, demonstrating high staff awareness of the intervention team, the practice “asthma champions,” and changes in practice patterns. In the semi-structured interviews, several respondents attributed the intervention’s acceptability and success to the expertise of the PQI team and expressed the belief that sustaining changes would be critically dependent on continued contact with the team. Despite significant limitations, this study demonstrated that interventions that are responsive to individual practice cultures can successfully change practice patterns.