Оценивание эффектов возрастных когорт в потреблении аддиктивных благ

Fillmore & Weafer (2004) present some very interesting and potentially important results suggesting that men are more susceptible than women to both the disinhibiting and stimulating effects of a moderate dose of alcohol. Research suggests that men are more susceptible than women to the disinhibiting effects of alcohol on aggression (Giancola & Zeichner 1995; Giancola et al. 2002), and, it has been well documented that men drink more and have more alcohol-related problems than women (Williams et al. 1989; Finn & Hall 2004). The present results suggest a potential mechanism that might contribute to these important gender differences. Alcohol may compromise inhibitory control of certain processes in men more than women, resulting in a tendency for men to consume more drinks on a single occasion than women, and a tendency for men to be more aggressive than women when intoxicated. Although the gender differences observed by Fillmore and Weafer make sense given the known gender differences in excessive alcohol use and alcohol-related problems, a number of questions need to be systematically addressed to establish the reliability of these effects. The first word of caution stems from the small sample size used in this study. Larger sample sizes are necessary to ensure that the observed gender differences are not just an oddity of the small sample. Furthermore, if these are true gender differences then it is important to assess whether they are reliable across time, dose level, blood alcohol concentration limb location, risk-status, and context. In fact, systematic study of the reliability and correlates of gender differences in the disinhibiting effects of alcohol would be helpful in uncovering the mechanisms responsible for this effect, if it is a true effect, and their relevance for broader gender differences in alcohol consumption and problems. If the differences are observed only at specific dosage levels or in specific contexts, then this might clarify some of the mechanisms underlying this effect. The authors discuss this issue to some degree when noting that gender differences in the disinhibiting effects of alcohol have not been observed on some inhibitory control tasks, such as the the stop-signal task (Mulvihill, Skilling & Vogel-Sprott 1997). We also have not observed gender differences in the disinhibiting effect of alcohol on a different go/no-go task that uses monetary incentives and punishments to activate or inhibit behavior (Finn et al. 1999). Gender differences also might vary in relation to risk status. For instance, while moderate drinking women appear to have significantly fewer alcohol problems than moderate drinking men, heavy drinking women appear to have equal or more alcohol-related problems than heavy-drinking men (Wilsnack, Wilsnack & Klassen 1984), suggesting that heavy drinking women may be more disinhibited than heavy-drinking men. Finally, the authors offer an interesting speculation that the gender differences in alcohol's stimulating effects may contribute to the observed differences in alcohol's disinhibiting effect. This is intuitively appealing speculation, but the authors can directly test this speculation by assessing whether alcohol-induced decreases in response inhibition are correlated with alcohol-induced increases in subjective stimulation. In summary, the gender differences in alcohol's disinhibiting effect observed by Fillmore and Weafer are potentially important and may have relevance for gender differences in alcohol consumption and problems. However, it is important to systematically study these effects in larger samples that vary in risk status while using different tasks, doses, and contexts. Such work will be very valuable to our understanding of broader gender differences in alcohol use and abuse and the mechanisms contributing to these differences.

Are there gender differences in levels of heavy, binge and problem drinking? Evidence from three generations in the west of Scotland

It is well known that cigarette smoking and the use of other addictive goods is harmful to health. Still, some people smoke cigarettes and drink alcohol in their daily lives. The consumption of addictive goods seems, therefore, to be the antithesis of rational behavior. In this article, however, it is demonstrated that a rational individual, in the sense that he or she maximizes his or her well-being while anticipating the future consequences of his or her choices, may in fact choose to consume addictive goods. Specifically, the two-good extension of the rational addiction model is demonstrated and related to relevant policy questions. For instance, should one encourage the use of smokeless tobacco in smoking cessation programs? According to the empirical results, the answer is no. Further, should one discourage smoking by increasing the tax on cigarettes? Again, the answer is no.

Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population

Reliable internet connectivity is crucial for family participation in pediatric digital health care, including telehealth. Lack of internet connectivity is a barrier to pediatric telehealth access. While surveys commonly inquire about metrics, such as internet plan or device ownership, fewer measures exist for the reliability of internet connectivity when needed. There is limited knowledge of the national prevalence of reliable internet connectivity among households with children and how reports of reliable internet connectivity are associated with use of internet plans and devices. We examined the prevalence of reliable internet connectivity among households with children and its association with digital technology access and sociodemographic factors. We performed a secondary data analysis of a US national cross-sectional survey examining parents' health-seeking decisions for children younger than 18 years old. The respondent panel was hosted by the National Opinion Research Center (NORC) AmeriSpeak. This analysis focused on survey items on reliable internet connectivity, digital technology access (internet plan type and device ownership type), and sociodemographic characteristics (education, employment, geographic region, race and ethnicity, and disability) of parent respondents and their children. The dependent variable was a binary indicator of household reliable internet connectivity. Respondents were categorized as having unreliable internet connectivity if they self-reported internet worry or unreliable internet experience. Unadjusted Rao-Scott chi-square tests and adjusted multivariable logistic regressions with sampling weights were applied. The final survey sample (N=1158) comprised 753 (55%) females, 614 (57%) non-Hispanic White, and 948 (81%) metropolitan respondents. There were 125 (12%) parents who reported internet worry, 152 (13%) parents who reported unreliable internet experience, and 76 (7%) parents who reported both. Combining these measures, we identified 201 (19%) parents with unreliable internet connectivity, defined as reporting either internet worry or unreliable internet experience. In contrast, 957 (81%) parents reported reliable internet connectivity in the household. In adjusted analysis, reliable internet connectivity was significantly associated with owning both nonmobile and mobile internet plans combined (86% reliable internet connectivity) versus nonmobile internet plan-only (67%; P=.001); postgraduate (94%) versus high school education (75%; P<.001); employment (84%) versus unemployment (76%; P=<.01); racial and ethnic marginalized status (77%) versus nonmarginalized (85%; P=<.01); and disability (70%) versus without disability (85%; P<.001), but not with device ownership, geographic region, race and ethnicity as separate groups, or parent sex. One-fifth of families with children experienced unreliable internet connectivity, highlighting an important dimension of the digital health divide that appears distinct from internet plan use or device ownership alone. Future research is needed to derive consensus on measuring reliable internet connectivity as a separate metric, including specifying the definition, survey questions, response options, and time frame of unreliability experience. Since reliable internet connectivity is needed for the growing field of digital health care, it is a critical issue for equitable pediatric health care access and delivery.

Alcohol consumption has demonstrated substantial temporal trends, with some evidence suggesting strong birth cohort effects. The identification of at-risk birth cohorts can inform the interpretation of alcohol trends across age, time, and demographic characteristics such as gender. The present literature review has 2 objectives. First, we conduct a cross-national review of the literature on birth cohort differences in alcohol consumption, disorder, and mortality. Second, we determine the consistency of evidence for birth cohort effects on gender differences. A search was conducted and key data on population characteristics, presence and direction of cohort effects, and interactions with gender compiled. Thirty-one articles were included. Evidence suggests that younger birth cohorts in North America, especially those born after World War II, are more likely than older cohorts to engage in heavy episodic drinking and develop alcohol disorders, but this cohort effect is not found in Australia and western Europe. Cross-nationally, substantial evidence indicates that women in younger cohorts are at especially high risk for heavy episodic drinking and alcohol disorders. Younger birth cohorts in North America and Europe are engaging in more episodic and problem drinking. The gender gap in alcohol problems is narrowing in many countries, suggesting shifting social norms surrounding gender and alcohol consumption. These trends suggest that public health efforts to specifically target heavy drinking in women are necessary.

Evaluation of sexual behaviors is essential to better understand the epidemiology of sexually transmitted infections and their sequelae. The National Health and Nutrition Examination Surveys (NHANES) is an ongoing probability sample survey of the US population. Using NHANES sexual behavior data from 1999 to 2012, we performed the following: (1) trend analyses among adults aged 25 to 59 years by 10-year birth cohorts and (2) descriptive analyses among participants aged 14 to 24 years. Sex was defined as vaginal, anal, or oral sex. Among adults aged 25 to 59 years, median age at sexual initiation decreased between the 1940-1949 and 1980-1989 cohorts from 17.9 to 16.2 among females (P trend < 0.001) and from 17.1 to 16.1 among males (P trend < 0.001). Median lifetime partners increased between the 1940-1949 and 1970-1979 cohorts, from 2.6 to 5.3 among females (P trend < 0.001) and from 6.7 to 8.8 among males (P trend < 0.001). The percentage of females reporting ever having a same-sex partner increased from 5.2% to 9.3% between the 1940-1949 and 1970-1979 cohorts (P trend < 0.001). Among participants aged 14 to 24 years, the percentage having had sex increased with age, from 12.5% among females and 13.1% among males at age 14 years to more than 75% at age 19 years for both sexes. Among sexually experienced 14- to 19-year-olds, 45.2% of females and 55.0% of males had at least 3 lifetime partners; 39.4% of females and 48.6% of males had at least 2 partners in the past year. The proportion of females aged 20 to 24 years who reported ever having a same-sex partner was 14.9%. The proportion of participants aged 14-19 or 20-24 years reporting ever having sex did not differ by survey year from 1999 to 2012 for either males or females. Sexual behaviors changed with successive birth cohorts, with more pronounced changes among females. A substantial proportion of adolescents are sexually active and have multiple partners. These data reinforce existing recommendations for sexual health education and sexually transmitted infection prevention targeting adolescents before sexual debut.

Opportunities for Adding Undernutrition and Frailty Screening Measures in US National Surveys

Differences in cancer rates among adults born between 1920 and 1990 in the USA: an analysis of population-based cancer registry data

Prescription use and misuse of opioids are linked to greater sleep disturbance. However, there are limited data on the prevalence of sedative-hypnotic medication use among persons who use opioids. Therefore, this study examined whether past-year sedative-hypnotic use among persons who used/misused opioids was higher than among individuals who did not use opioids. Data were acquired from the US National Survey on Drug Use and Health for 2015-2018. Use of a sedative benzodiazepine (temazepam, flurazepam, triazolam) or a Z-drug (eszopiclone, zaleplon, zolpidem) was examined in relation to use/misuse of an opioid within the past year. Logistic regression models estimated the associations between opioids and sedative-hypnotics using inverse probability of treatment weighting. A secondary machine learning analysis tested 6 binary classifiers to predict sedative-hypnotic use based on opioid use/misuse and other covariates. Of 171,766 respondents, 24% used a prescription opioid whereas 3.6% misused an opioid in the past year. Among those who used a prescription opioid, 1.9% received a sedative benzodiazepine and 9% received a Z-drug during the same time frame. Use of an opioid was associated with greater odds of sedative benzodiazepine use (odds ratio, 4.4; 95% confidence interval, 3.61-5.4) and Z-drug use (odds ratio, 3.8; 95% confidence interval, 3.51-4.09), and stronger associations were noted for misuse of an opioid. Machine learning models accurately classified sedative-hypnotic medication use for > 70% of respondents based on opioid use/misuse. Sedative-hypnotic use is common among persons who use opioids, which is of concern given the elevated mortality risk with concurrent use of these substances. Tubbs AS, Ghani SB, Naps M, Grandner MA, Stein MD, Chakravorty S. Past-year use or misuse of an opiod is associated with use of a sedative-hypnotic medication: a US National Survey on Drug Use and Health (NSDUH) study. J Clin Sleep Med. 2022;18(3):809-816.

Research relevance. Consumption of addictive goods and its impact on the human capital is widely discussed in contemporary research literature, not only on the micro- and macro- but also on the meso-level. At the present stage of the ongoing transformations we are prompted to reassess current approaches to this problem and to re-evaluate its public significance; moreover, practical application of available research outcomes should also be reconsidered. In Russia, consumption of addictive goods is subject to significant regional variations determined by socio-economic and other factors. Research aim. The study is aimed at investigating the impact of consumption of addictive goods (alcohol) on the quality of Russian consumers' human capital and at building a system of indicators to estimate this impact. Data and methods. The study uses the methods of comparative analysis, expert estimation, ranking, and economic-statistical analysis, it also proposes a spatial approach to problems associated with regional variations in human capital of consumers of addictive goods. The study relies on the Russian and international research evidence; the data of the Federal State Statistics Service and its regional offices; expert estimates and the authors' own calculations. Results. The study demonstrates the connection between consumption of addictive goods and consumers' human capital. It also describes a system of statistical indicators that can be used for estimating the impact of alcohol consumption on human capital and the criteria such indicators should meet. Based on the proposed indicator set, the study analyzes and compares the trends in human capital deterioration on the regional and national levels. As a result of cross-regional analysis, regions with the highest and lowest figures of human capital deterioration are identified. Conclusions. As their addiction progresses, alcohol consumers face an increasing devaluation of their human capital. This parameter varies significantly across Russian regions due to a range of climatic, regional, and socio-economic factors, which should be taken into account when devising and implementing regional alcohol policies. The existing system of statistical observations uses a limited set of indicators that needs to be expanded to allow for a more comprehensive cross-regional analysis.

Research relevance. Consumption of addictive goods and its impact on the human capital is widely discussed in contemporary research literature, not only on the micro- and macro- but also on the meso-level. At the present stage of the ongoing transformations we are prompted to reassess current approaches to this problem and to re-evaluate its public significance; moreover, practical application of available research outcomes should also be reconsidered. In Russia, consumption of addictive goods is subject to significant regional variations determined by socio-economic and other factors. Research aim. The study is aimed at investigating the impact of consumption of addictive goods (alcohol) on the quality of Russian consumers' human capital and at building a system of indicators to estimate this impact. Data and methods. The study uses the methods of comparative analysis, expert estimation, ranking, and economic-statistical analysis, it also proposes a spatial approach to problems associated with regional variations in human capital of consumers of addictive goods. The study relies on the Russian and international research evidence; the data of the Federal State Statistics Service and its regional offices; expert estimates and the authors' own calculations. Results. The study demonstrates the connection between consumption of addictive goods and consumers' human capital. It also describes a system of statistical indicators that can be used for estimating the impact of alcohol consumption on human capital and the criteria such indicators should meet. Based on the proposed indicator set, the study analyzes and compares the trends in human capital deterioration on the regional and national levels. As a result of cross-regional analysis, regions with the highest and lowest figures of human capital deterioration are identified. Conclusions. As their addiction progresses, alcohol consumers face an increasing devaluation of their human capital. This parameter varies significantly across Russian regions due to a range of climatic, regional, and socio-economic factors, which should be taken into account when devising and implementing regional alcohol policies. The existing system of statistical observations uses a limited set of indicators that needs to be expanded to allow for a more comprehensive cross-regional analysis.

Objective To investigate the relation between alcohol consumption and heart disease by using differences in county level alcohol sales laws as a natural experiment.Design Observational cohort study using differences in...

Stroke is the third leading cause of death in the United States.1 2 3 4 A decline in the age-adjusted death rate for nonwhite women began in 1924, for nonwhite men in 1930, and for whites by 1918.5 The rate of decline accelerated in the 1970s, probably because of improved hypertension control, but slowed in the 1980s for reasons that remain unclear.6 Recently published statistics suggest that the long-term decline in stroke mortality rates in the United States may have ceased. There is unmistakable evidence for a marked slowdown in the decline in stroke mortality.6 The age-adjusted US stroke mortality rate increased between 1992 and 1993; a recent report documented another rise in the preliminary rate for 1995 (percent change from 1994 to 1995, +0.8).7 Age-adjusted rates per 100 000 for 1991 to 1995 were 26.8, 26.2, 26.5, 26.5, and 26.7, respectively (Table 1⇓). It is important to view these increases in proper perspective while in no way diminishing the serious impact of the slowdown in the decline of stroke mortality in the United States since 1978.6 To this end, we tested the hypotheses (1) that the rate of decline of age-adjusted mortality rates in 1987 to 1994, the period since the previous report,6 has returned to that seen in the 1960s before the widespread availability of antihypertensive therapy, and (2) that this occurred in each sex/race group. In 1987 to 1994, the mean annual absolute and percent decline in age-adjusted death rates for stroke was less than observed in 1979 to 1986 for each sex/race group (Table 2⇓).6 It was comparable to that observed in the 1960s, before the rapid decline of the 1970s that was commonly attributed to marked improvements in hypertension detection and treatment.2 This …

Background:Excessive alcohol use stands as a serious threat to individual and community well-being, having been linked to a wide array of physical, social, mental, and economic harms. Alcohol consumption differs by gender, a trend seen both globally and in Moshi, Tanzania, a region with especially high rates of intake and few resources for alcohol-related care. To develop effective gender-appropriate treatment interventions, differences in drinking behaviors between men and women must be better understood. Our study aims to identify and explore gender-based discrepancies in alcohol consumption among Kilimanjaro Christian Medical Center (KCMC) patients.Methods:A systematic random sampling of adult patients presenting to KCMC’s Emergency Department (ED) or Reproductive Health Center (RHC) was conducted from October 2020 until May 2021. Patients answered demographic and alcohol use-related questions and completed brief surveys including the Alcohol Use Disorder Identification Test (AUDIT). Through purposeful sampling, 19 subjects also participated in in-depth interviews (IDIs) focused on identifying gender differences in alcohol use.Results:During the 8-month data collection timeline, 655 patients were enrolled. Men and women patients at KCMC’s ED and RHC were found to have significant differences in their alcohol use behaviors including lower rates of consumption among women, (average [SD] AUDIT scores were 6.76 [8.16] among ED men, 3.07 [4.76] among ED women, and 1.86 [3.46] among RHC women), greater social restrictions around women’s drinking, and more secretive alcohol use behaviors for where and when women would drink. For men, excess drinking was normalized within Moshi, tied to men’s social interactions with other men, and generally motivated by stress, social pressure, and despair over lack of opportunity.Conclusion:Significant gender differences in drinking behaviors were found, primarily influenced by sociocultural norms. These dissimilarities in alcohol use suggest that future alcohol-related programs should incorporate gender in their conceptualization and implementation.