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Open Access Publications from the University of California

Scholarly Works (177 results)

  • Article
  • Peer Reviewed
UC San Francisco Previously Published Works (2013)

Background

APOE e4 genotype is known to be a risk factor for Alzheimer's disease and atherosclerosis. Recently, published evidence has shown that APOE e4 genotype may also be associated with the cessation of cigarette smoking.

Objectives

The aim of this retrospective analysis was to explore whether any past smoking outcomes differed based on APOE e4 genotype in a large national dataset.

Methods

Data were extracted from the National Alzheimer's Coordinating Center's longitudinal Uniform Data Set study. We limited this retrospective baseline analysis to the normal cognition (n = 2995) and mild cognitive impairment (n = 1627) groups that had APOE genotype and smoking data. Because this was an exploratory retrospective analysis, we conducted descriptive analyses on all variables based on APOE e4 genotype. We controlled for demographic, clinical, medication and neurocognitive data in the analyses.

Results

In both the normal cognition group and the mild cognitive impairment group, e4 carriers and e4 non-carriers did not significantly differ on total years smoked, age when last smoked and the average # of packs/day smoked during the years they smoked. In both groups, e4 carriers and e4 non-carriers differed on various neurocognitive measures.

Conclusion

These data do not support the recently published evidence of the association between APOE e4 genotype and smoking outcomes.

Scientific significance

Larger prospective clinical trials are needed to further explore the relationship between APOE genotype and smoking outcomes.
    Cover page: APOE e4 genotype and cigarette smoking in adults with normal cognition and mild cognitive impairment: a retrospective baseline analysis of a national dataset
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2008)

    OBJECTIVE: This study examined the level, changes and predictors of alcohol consumption and binge drinking over a 7-year period among young adults (18-25 years) who met the criteria for problem drinking. METHOD: Interviews with 270 18 to 25 years old problem and dependent drinkers from representative public and private substance use treatment programs and the general population were conducted after 1, 3, 5, and 7 years. Measures included demographic characteristics, severity measures, and both formal and informal influences on drinking. RESULTS: Overall alcohol consumption declined over time but leveled off around 24 years of age. Being male, not attending AA over time, as well as more baseline dependence symptoms and greater ASI alcohol and legal severity were associated with greater consumption and binge drinking. In addition, greater levels of binge drinking were associated with less education, earlier age of first use, and a larger social network of heavy drinkers. In conclusion, more attention should be paid to heavy drinking among young adults and to the factors that influence their drinking patterns.

      Cover page: Alcohol in emerging adulthood: 7-year study of problem and dependent drinkers.
      • Thesis
      • Peer Reviewed
      UC San Francisco Electronic Theses and Dissertations (2020)

      Brief Statement of the Problem: Effectively treating cognitive impairment as part of a comprehensive treatment plan for adults with cocaine use disorder (CUD) could potentially improve important clinical outcomes, such as abstinence, quality of life, and treatment completion. Because existing models of cognitive rehabilitation have yielded small to medium effect sizes in improving cognition in CUD, newer models of cognitive rehabilitation are needed to improve cognition more effectively in CUD.

      Description of the Methods and Procedures Used to Gather Data: This dissertation describes a pilot 12-week, randomized, parallel group outpatient study of treatment-seeking adults with CUD (age 18-65) who were mild-to-moderately cognitively impaired and dissatisfied with their quality of life. Participants were randomized to a “Cog-Rehab” arm (drug counseling + occupational therapy-based cognitive rehabilitation), or to a “Control” arm (drug counseling + psychoeducation/computer exercises).

      Condensed Summary of the Findings: Study participants had a mean age of 57.5 years (SD 5.8), 30 (96.8%) were male, 19 (61.3%) were Black, 12 (38.7%) were White, 6 (19.4%) were Latino, 15 (48.4%) were single, and had a mean education of 12.8 years (SD 1.4). Some significant between-group effect sizes were found for certain neurocognitive measures (favoring Cog-Rehab arm: attentional bias 1.0 attention 0.7, visual memory 0.8, executive function 1.0) and one functional assessment (favoring Cog-Rehab arm: Drug User Quality of Life Score 0.8). This study was feasible, acceptable, and provides preliminary evidence for efficacy based on effect sizes. MET-R performance was significantly associated only with the overall impulsivity neurocognitive domain (adjusted coefficient 0.8, 95% CI 0.2 to 1.3) on a neurocognitive battery. The MET-R may be uniquely measuring the domain of impulsivity that is not captured by traditional neurocognitive testing.

        Cover page: Cognitive Rehabilitation for Cocaine Use Disorder
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2013)
        Major depressive disorder (MDD) is often chronic and characterized by relapse and recurrence despite successful treatments to induce remission. Mindfulness-based cognitive therapy (MBCT) was developed as a means of preventing relapse for individuals in remission using cognitive interventions. In addition, MBCT has preliminarily been found to be useful in treating active depression. This current investigation is unique in evaluating the long-term outcome of individuals with active depression who achieved remission with MBCT. 18 participants who achieved remission after an 8-week MBCT group were seen for evaluation at a mean follow-up interval of 48.7 months (SD=10.2) after completing treatment. The current study shows that in these participants, the gains achieved after the initial treatment including remission of depression, decreased rumination, decreased anxiety, and increased mindfulness continued for up to 58.9 months of follow-up. The data suggests that all levels of depression from less recurrent and mild to more recurrent and severe were responsive to MBCT. The average number of minutes per week of continued practice in our cohort was 210, but the number of minutes of practice did not correlate with depression outcomes. MBCT's effects may be more related to regularity of practice than specific quantity. This study provides a preliminary exploration of MBCT's long-term effects, which can aid in future research with a typically chronic illness.
          Cover page: Preliminary Long-Term Follow-up of Mindfulness-Based Cognitive Therapy-Induced Remission of Depression
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2015)
          The rate of cigarette smoking is greater among persons with mental health and/or substance abuse problems. There are few population-based datasets with which to study tobacco mortality in these vulnerable groups. The Oregon Health Authority identified pers
            • Article
            • Peer Reviewed
            UC San Francisco Previously Published Works (2014)
            A parallel-process latent growth curve model was used to model alcohol and marijuana use (vs. nonuse). Participation in team sports and gender were considered to be time-invariant covariates. The sample consisted of 8,179 youth from the National Survey of Parents and Youth. Data were collected over four yearly rounds. Analysis revealed that being part of a competitive sports team was related to a lower probability of marijuana initiation, but to increased rates of alcohol use over time. Males had significantly higher levels of marijuana initiation and decreases in rates of alcohol use over time; females had significantly greater rate of increase in alcohol use over time. Analysis suggests that youth involved in sports are less likely to use marijuana over time. This information may help to uncover other predictors of use over time and to inform policy making as well design as effective prevention.
              Cover page: Participation in Team Sports and Alcohol and Marijuana Use Initiation Trajectories
              • Article
              • Peer Reviewed
              UC San Francisco Previously Published Works (2015)

              Introduction

              In an ethnically-diverse, uninsured psychiatric sample with co-occurring drug/alcohol addiction, we evaluated the feasibility and reproducibility of a tobacco treatment intervention. The intervention previously demonstrated efficacy in insured psychiatric and nonpsychiatric samples with 20.0%-25.0% abstinence at 18 months.

              Methods

              Daily smokers, recruited in 2009-2010 from psychiatric units at an urban public hospital, were randomized to usual care (on-unit nicotine replacement plus quit advice) or intervention, which added a Transtheoretical-model tailored, computer-assisted intervention, stage-matched manual, brief counseling, and 10-week post-hospitalization nicotine replacement.

              Results

              The sample (N = 100, 69% recruitment rate, age M = 40) was 56% racial/ethnic minority, 65% male, 79% unemployed, and 48% unstably housed, diagnosed with unipolar (54%) and bipolar (14%) depression and psychotic disorders (46%); 77% reported past-month illicit drug use. Prior to hospitalization, participants averaged 19 (SD = 11) cigarettes/day for 23 (SD = 13) years; 80% smoked within 30 minutes of awakening; 25% were preparing to quit. Encouraging and comparable to effects in the general population, 7-day point prevalence abstinence for intervention versus control was 12.5% versus 7.3% at 3 months, 17.5% versus 8.5% at 6 months, and 26.2% versus 16.7% at 12 months. Retention exceeded 80% over 12 months. The odds of abstinence increased over time, predicted by higher self-efficacy, greater perceived social status, and diagnosis of psychotic disorder compared to unipolar depression.

              Conclusions

              Findings indicate uninsured smokers with serious mental illness can engage in tobacco treatment research with quit rates comparable to the general population. A larger investigation is warranted. Inclusion of diverse smokers with mental illness in clinical trials is supported and encouraged.
                Cover page: Treating Tobacco Dependence at the Intersection of Diversity, Poverty, and Mental Illness: A Randomized Feasibility and Replication Trial
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2014)

                Objective

                The Food and Drug Administration is considering regulation of menthol cigarettes. While persons with mental distress are known to smoke cigarettes at high rates, little is known about their use of menthol. The authors examined the association of psychological distress and menthol use in a national sample of adult smokers.

                Methods

                Data were from the 2008 and 2009 National Survey on Drug Use and Health. Past month smokers (N=24,157) were categorised for menthol or non-menthol use. Psychological distress was categorised as none/mild, moderate or severe on the Kessler six-item scale.

                Results

                The prevalence of menthol use was higher among individuals with severe psychological distress, women, young adults, African-Americans, Native Hawaiians/Pacific Islanders, persons with fewer years of education and lower income, and the unmarried and uninsured. In a multivariate model controlling for socio-demographic factors, smoking intensity and time to first cigarette, smokers with severe (adjusted OR (AOR) 1.23, 95% CI 1.04 to 1.46, p=0.02) but not moderate (AOR 1.03, 95% CI 0.92 to 1.15, p=0.58) psychological distress were significantly more likely to smoke menthols compared with smokers with none/mild distress.

                Conclusion

                An elevated prevalence of menthol use was found among persons with severe psychological distress, suggesting another group that could potentially benefit from the regulation of menthol cigarettes.
                  Cover page: Menthol use among smokers with psychological distress: findings from the 2008 and 2009 National Survey on Drug Use and Health
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2022)

                  Background

                  Hepatitis B virus birth dose (HepB-BD) vaccination is recommended to reduce mother to infant transmission. We evaluated the HepB-BD status of women who gave birth between 2011 and 2016 (N = 3,583) using the 2015-2016 Myanmar Demographic and Health Survey.

                  Methods

                  Frequency distributions of HepB-BD vaccination across maternal and health system factors, concentration indices, and logistic regression models were used to estimate coverage, inequity, and factors associated with vaccination.

                  Results

                  The majority of participants were younger than 30 years of age, lived in rural areas, and were multiparous. Almost all received antenatal care (ANC), but only 43% received recommended ANC services, and 60% gave birth at home. The overall HepB-BD coverage rate was 26%. Vaccination coverage was higher in urban areas and was inequitably concentrated among children of more educated and wealthier women. HepB-BD coverage was also positively associated with receipt of ANC at non-governmental facilities, and delivery at a facility, skilled provider at birth and Cesarean delivery. After adjusting for sociodemographic and health system factors, receipt of the HepB-BD was positively associated with weekly media exposure, receipt of recommended ANC, and Cesarean delivery, and inversely associated with home delivery.

                  Conclusions

                  Both socioeconomic and health systems factors influenced suboptimal and inequitable vaccination coverage. Improved access to quality ANC and delivery services may increase HepB-BD coverage although targeted approaches to reach home births are likely required to achieve national goals.
                    Cover page: Coverage, inequity and predictors of hepatitis B birth vaccination in Myanmar from 2011–2016: results from a national survey
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2017)

                    Purpose

                    The purpose of the study was to determine from whom and where adolescents obtained tobacco, including cigarettes, e-cigarettes, and hookah.

                    Methods

                    California adolescents (N = 772; 63.19% female; mean age = 16.13 years, SD = 1.61; 26.44% white, 22.12% Asian/Pacific Islander, 36.65% Hispanic, and 14.79% other) were surveyed about their access to different tobacco products.

                    Results

                    Adolescents were significantly more likely to obtain tobacco from friends (54.9%) than family members or direct purchasing (p < .001). Smoke shops were the most common purchase location across products (44.3%), with adolescents significantly more likely to purchase hookah and e-cigarettes from smoke shops than gas stations, liquor stores, or drug stores (p < .02).

                    Conclusions

                    The effective characterization of tobacco access patterns is critical to the development of comprehensive tobacco control. By demonstrating peers and smoke shops as the primary social and retail outlets, this study identifies targets for the optimization of regulation and messaging aimed at reducing adolescents' access to tobacco.
                      Cover page: Access to Tobacco Among California High School Students: The Role of Family Members, Peers, and Retail Venues
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