The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with antiretroviral therapy. Unhealthy behaviours, particularly substance-use behaviours, are utilized by many HIV-positive individuals to manage neuropathic symptoms. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of unhealthy behaviours to self-manage peripheral neuropathy in HIV disease. Sociodemographic and disease-related correlates and unhealthy behaviours were examined in a convenience sample of 1,217 respondents who were recruited from data collection sites in several US cities, Puerto Rico, Colombia, and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified a variety of unhealthy self-care behaviours including injection drug use, oral drug use, smoking cigarettes and alcohol ingestion. Specific unhealthy behaviours that participants reported to alleviate peripheral neuropathy included use of marijuana (n=67), smoking cigarettes (n=139), drinking alcohol (n=81) and street drugs (n=30). A subset of those individuals (n=160), who identified high levels of neuropathy (greater than five on a scale of 1-10), indicated significantly higher use of amphetamines and injection drug use in addition to alcohol use and cigarette smoking. For participants from Norway, substance use (using alcohol: 56%) was one of the most frequent self-management strategies. Implications for clinical practice include assessment and education of persons with HIV for self-care management of the complex symptom of peripheral neuropathy.
Parkinson’s disease (PD) is inversely associated with smoking. Whether this association is due to a causal relationship or to confounding by a covariate of smoking is still debated.The Institute for Health Metrics and Evaluation (IHME) released refreshed data on October 15, 2020. This study included that recently released data. The study included populations of the United States and ten U.S. states from 2004 to 2018. The ten U.S. states included the five states with the highest PD incidence rates in 2019 (Maine, Vermont, Kansas, Alaska, Missouri) and the five states with the lowest PD incidence rates in 2019 (Arkansas, Mississippi, South Dakota, Nebraska, Delaware). The study used scatter plots to explore the association between PD incidence and smoking and the association between PD incidence and a covariate of smoking, lower endoscopy utilization.For PD verses smoking, the results indicate that there is an inverse correlation for the United States, but there is no association for the ten states. The coefficient of determination (R2) for the United States was 0.714 and ranged from a low of 0.004 for South Dakota to 0.613 for Mississippi. The average R 2 for the ten states was 0.357.For PD verses lower endoscopy, the results indicate that the best model fit to the data is a polynomial. When the fitting curve examined in the regression analysis was a 3rd order (cubic) polynomial, there was a positive correlation between PD and lower endoscopy for the United States and for all ten states. The R2 for the US was 0.971 and ranged from a low of 0.709 for Alaska to 0.970 for Kansas. The average R2 for the ten states was 0.878.The results suggest that the inverse association between PD incidence and smoking is confounded by a positive association between PD and lower endoscopy utilization. Further investigation of a possible relationship between PD incidence and lower endoscopy utilization is warranted and may provide a means for reducing PD incidence.
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