Background/Objectives Prescription sleep medication use is most prevalent among women and older adults. Morning drowsiness and impaired coordination are side-effects of sleep medications that may affect driving safety. The association between current use of zolpidem-containing medications and motor vehicle collisions (MVCs) was evaluated among very old drivers. Patients/Methods Participants were current drivers aged ≥70 years residing in north-central Alabama, spoke English, had a valid driver's license, and drove within the past 3 months (n=2,000). Current zolpidem use was determined by pill-bottle review. Participant's 5-year MVC history was determined from Alabama Department of Public Safety accident reports. The 5-year MVC and at-fault MVC rate ratios (RR) were estimated comparing zolpidem users with nonusers in the overall sample and a-priori defined age and sex subgroups. Results The unadjusted RR (95%CI) of MVCs comparing zolpidem users with nonusers was attenuated after adjustment (1.46 [1.02-2.08] and 1.38 [0.97-1.98], respectively). Among women, the unadjusted and adjusted RRs (95%CI) were 1.65 (1.03-2.66) and 1.61 (1.00-2.60), respectively. The unadjusted and adjusted RRs (95%CI) among those aged ≥80 years were 2.24 (1.19-4.57) and 2.35 (1.20-4.61), respectively. There were no statistically significant associations among men or participants <80 years old. Similar patterns were present for at-fault MVCs. Conclusion Current zolpidem users, specifically women and individuals aged ≥80 years, had higher MVC rates than nonusers. Practitioners should consider behavioral treatment before initiating low doses of zolpidem and escalating it as needed to achieve restorative sleep in females and individuals aged ≥80 years to reduce the risk of zolpidem-associated MVCs.

Objectives: Sugar-sweetened beverages and dental caries are prevalent among children. Measurement choices could explain their inconsistent relationships. This study evaluated associations between detailed baseline non-water beverage consumption (NWBC) behaviors and longitudinal early childhood caries (ECC) experiences in young, high-caries risk children. Methods: Researchers followed poor, rural, African Americans, recruited at 8-18 months old from Uniontown, Alabama, through convenience sampling, annually for 5 years (N = 66). Baseline questionnaires obtained demographics, oral hygiene, and daily dietary histories, including beverage types, frequencies, and NWBC behaviors of intake speed (intermittent/rapid), container (bottles/ non-bottles), and bedtime beverages (yes/no). Dentists conducted examinations annually to determine decayed, missing, filled (carious) surfaces (dmfs) scores, producing increments (dmfs finaldmfs initial). Age-adjusted logistic regressions estimated odds ratios (OR) and 95% confidence intervals (95% CI) for ECC (carious: incidence >0 versus caries-free: incidence = 0) with NWBC behavior then NWBC frequency, individually and conditional on NWBC behaviors, exposures.

Background: As human papillomavirus positive (HPV+) oral cavity and pharynx cancer (OCPC) incidence increases significantly, our objective was to determine if selected sociodemographic and clinical factors were associated with HPV+ OCPCs overall and by oropharyngeal and non-oropharyngeal sites. Methods: Surveillance, Epidemiology and End Results Program data were used in this study. Specifically, univariate and logistic regression models were used to examine the relationships between HPV+ and HPV- OCPC cases and age, sex, race, ethnicity, marital status, factors of neighborhood socioeconomic status (i.e., nSES/Yost Index) and rurality/urbanity, first malignancy status, histology, reporting source, stage at diagnosis, and OCPC anatomic site. The same approach was used to identify risk factors for HPV positivity for oropharyngeal and non-oropharyngeal OCPCs separately. Results: In all OCPCs, cases that were male, &lt;80 years old, lived in the four highest nSES categories, diagnosed with a non-“gum and other mouth” OCPC (ref=hypopharynx), not locally staged at diagnosis, and a first malignancy had higher odds of being HPV+. Cases that were American Indian/Alaska Native and Asian or Pacific Islander (ref=White), Spanish-Hispanic-Latino ethnicity, non-married/partnered, and not reported by a hospital/clinic had lower odds of being HPV+. Associations were maintained in oropharyngeal OCPCs and only age and race remained significant for non-oropharyngeal OCPCs. Conclusions: Sociodemographic and clinical differences in HPV+ and HPV- OCPC, overall and for (non)oropharyngeal, cases exist. Impact: Identification of OCPC and (non)oropharyngeal risk factors for HPV positivity may assist in discovering high-risk groups that should receive enhanced public health efforts to reduce the United States OCPC burden.

Objectives Field‐traditional decayed, missing, filled surfaces (dmfs) increments require complete follow‐up, only using initial and final visits. Repeated dmfs scores complicate sophisticated statistical models, limiting their utility. Elsewhere, area under the curve (AUC) uses all repeated measures to summarize data. This study applied AUC methodology to caries data, creating average AUCs for dmfs trajectories (dmfsaAUC) and comparing increments and dmfsaAUC values. Methods Longitudinal data were obtained from high‐caries risk (i.e. poor, rural, African American community in Perry County, Alabama) infants, 8 to 18 months at baseline. Baseline and five annual visual oral examinations provided dmfs scores. Differences in baseline and final dmfs scores constituted increments. The trapezoidal rule was applied to dmfs trajectories to calculate AUC values which were adjusted for varying follow‐up times, producing dmfsaAUC values. Participants sharing incremental or dmfsaAUC values had their trajectories and second caries measurements compared. Within‐participant increment and dmfsaAUC differences were evaluated (paired t test, α = 0.05). Comparative analyses required complete follow‐up. Results The dmfsaAUC provided forty‐eight additional person‐years, increasing the potential sample size by 20% (N = 85). Sixty‐six children, 5.7 to 6.3 year‐olds at study’s end, contributed 121 331 person‐days to five‐year increment and dmfsaAUC calculations. Trajectories and dmfsaAUC values varied for participants with equivalent increments; comparable trajectories and different increments resulted from participants with similar dmfsaAUC values. Within‐participant disease amounts were similar. Conclusions When desired, dmfsaAUC can replace increments as a more data‐inclusive summary of longitudinal caries burden, incorporating intermediate visits, incomplete follow‐up and time.