Alcoholism and marital consent.

Commentary on Salvatore et al. (2017): Dyadic research can clarify non-shared environmental influences on alcohol use disorder and divorce.

Objective: To determine factors associated with non-adherence of existing alcohol regulations and policies on alcohol sale in Thika municipality Kiambu County. Design: A descriptive cross-sectional study. Setting: Thika Municipality, Kiambu County, Kenya Subjects: Eighty nine (89) participants were enrolled in the study. Ten (10) Key Informant Interviews were conducted among the security personnel, health officers, managers and supervisors. Results: Out of the 89 outlet operators enrolled in the study, (70.8%) among the respondents were not aware of the alcohol control act. Association between marital status and non adherence of the act was significant (p=0.003). There was low knowledge of 5.6%, who were aware of when the alcohol act was implemented, majority who totaled to 70.8% were not aware on when the alcohol control policy came into existence. Majority of the respondent 62.9% reported not to adhere to the alcohol control act of 2010; also the study showed that 57.3% of the responded were not aware of measures to control illicit brew. From the In-depth interviews most of the respondents interviewed confirmed that many of the operators were not aware of the act and it was difficult to implement thus subjecting the consumers into alcohol abuse. They also confirmed that with lack of employment, many women engaged into the alcohol operations which also contributed to the breakdown of their families given the mode of operations. Conclusion: This study concludes that there is failure in enforcement and adherence of the 2010 alcohol regulations. The study recommends the review of the alcohol control act of 2010 to ensure tough measures and penalties are adapted to anyone who fails to adhere to the act. Also there is need for awareness to be initiated to ensure members are informed and adhere to the policy. Setting up of an independent unit that will be mandated to enforcement and adherence of the 2010 alcoholic act.

To observe the relationship between alcohol dependence and new detected hypertension in adult residents of Xuzhou city. Participants were sampled by stratified multi-stage randomly cluster sampling method from February 2013 to June 2013 among permanent residents aged 18 and more in Xuzhou city. The alcohol dependence was defined with Michigan Alcoholism Screening Test (MAST). Other information was obtained by questionnaire. Spearman correlation analysis and multivariate logistic regression analysis were performed to identify the relationship between alcohol dependence and new detected hypertension. The alcohol dependence rate was 11.56% on the whole cohort (n=36 157), and 22.02%(3 854/17 501) for male and 1.74%(324/18 656) for female(P<0.01). The new detected hypertension rate was 9.46%(3 422/36 157) in the whole cohort. The new detected hypertension rate increased in proportion with the severity of alcohol dependence (P<0.01). Spearman correlation analysis showed that alcohol dependence was positively correlated with systemic blood pressure(r=0.071, P<0.01) and diastolic blood pressure (r=0.077, P<0.01). After adjusting for gender, age, marital status, body mass index, smoking status, physical activity level, educational level, income level and region, multivariate logistic regression analysis showed that alcohol dependence was an independent risk factor for hypertension (low alcohol dependence: OR=1.44, 95%CI 1.14-1.81, P<0.01; light alcohol dependence: OR=1.35, 95%CI 1.11-1.64, P<0.01; medium alcohol dependence: OR=1.83, 95%CI 1.40-2.41, P<0.01). The alcohol dependence is an independent risk factor for new detected hypertension in adult residents of Xuzhou city. Intensive hypertension prevention and treatment strategies should be performed on this population based on our results.

Objective To investigate environmental factors of the relapse of alcohol dependence. Methods One hundred and seventeen in-patients with alcohol dependence were assessed with a home-designed questionnaire, Family Environment Scale Chinese Version (FES-CV), Clinic Institute Alcohol Withdrawal Syndrome Scale Chinese Version(CIWA-Ar) and the Scale of Personality Change Post-Traumatic Brain Injury(SPCPTBI). One hundred and five patients reassessed with alcohol dependence syndrome diagnostic criteria 1 year after hospitalization.t-test, chi-square and logistic regression were used for analysis. Results 57 of 105 were relapse and 48 of them were not relapse. The results showed that relapse group had a higher divorce or separated or remarried rate(21/36) than the no-relapse one (7/41) ( chi-square = 6.60, P=0.010); a less number of years of education(5.2±1.8 vs 7.2±1.7, t=5.64, P=0.000); a bigger daily drinking((512 ±186)ml vs (396 ±109)ml, t=3.93, P=0.000); a higher drinking frequency in relapse group((2.6±0.9) vs (1.8±0.6)times, t=5.38, P=0.000); a higher rates in personality change(47/57 vs 15/48), brain damages (27/57 vs 13/48) and mood disorders (35/57 vs 17/48), They also showed that relapse group had more problems on intimate degree (5.66±1.40 vs 6.20±1.20) , emotional expression (4.59±1.54 vs 5.41±1.26, independence(3.61±1.29 vs 4.64±1.49), organization(4.26±1.56 vs 5.22±1.18), and self-controlling(4.21±1.43 vs 5.12±1.12), the differences were significant (P<0.05); a higher contradiction score(4.35±1.73 vs 3.64±1.22, t=2.42, P=0.017). Logistic regression analysis showed that the number of daily drinking , intelligent damaged, emotional problems, and dependence were the risk factors for the alcoholic relapse(OR=7.44, 3.99, 3.92, 2.96); Self-controlling was the protective factors for the alcoholic relapse (OR=0.19). Conclusion Problem marital status, less education , and heavy drinking , and the number of drinking times, personality change, intellectual impairment and mood change, and poor family environment were the risk factors for the relapse of alcohol dependence. Key words: Alcohol dependence; Abstinence; Relapse rate; Risk factor

This cross-sectional study used data from 483 young adult marital dyads to evaluate conflict-with-partner and support-from-partner as moderators of alcohol use on 2 outcomes: alcohol problems and marital satisfaction. A path analytic modeling approach was used to test stress-exacerbating and stress-buffering hypotheses, and to accommodate the interdependent nature of the dyadic data. This cross-sectional sample was selected from an adolescent-to-young adult longitudinal study in which spouses were recruited into the study during a later young adult assessment when the sample was, on average, 32.5years old. Individual interviews using computerized technology were conducted with participants. Findings for the outcome of alcohol problems indicated stress exacerbation in that higher conflict by each partner in interaction with higher alcohol use was associated with more alcohol problems for wives. Husbands' and wives' alcohol problems were lower when higher partner support buffered the association between alcohol use and alcohol problems. For the outcome of marital satisfaction, higher support-from-partner buffered the association between alcohol use and marital satisfaction. Finally, the combination of alcohol use and conflict-with-partner had more adverse implications for women's alcohol problems relative to men's alcohol problems. These findings highlight that interactions between interpersonal dimensions of romantic relationships and alcohol use by both partners contribute to our understanding of their associations with alcohol problems and marital satisfaction within the marital relationship. Furthermore, there was some sex specificity in that some interactions were more prominently associated with alcohol problems for wives than husbands.

Alcohol addiction in patients with comorbidity of borderline personality disorder and Bipolar disorder

Background: Alcohol consumption has been steadily increasing in developing countries including India since 1980s. Recently among various strata of society there is increasing social acceptance of alcohol intake. In India, no reliable data about the extent of the public health problems due to alcoholism and various socio-demographic factors responsible are available. Aim: To study the Socio-demographic factors among people with Alcohol Dependence Syndrome (ADS) undergoing treatment at large tertiary Hospital of Maharashtra Methodology: A cross-sectional hospital based descriptive study was carried out for duration of 6 months and all the admitted patients with ADS were taken into the study. A total of 75 people with ADS consented to be part of the study and were included in the study. Data was collected by means of personal interview method with the help of pre-tested questionnaire. Results: 30.6% of persons with ADS were of age group 35-39 years, while 29% were of 30-34 Years. 86.6% had family income of <20,000/- while 12 % had between 20,000-30,000/- and only 1.3% had family income above 30,000/-. As per education status is considered 34.6% had primary education, 36% secondary education, 17.3% had higher secondary and 11.9% had undergone graduation.82.6% belong to rural areas. 28 % had upto 3 siblings, 29% had 4-5 siblings and 42% had more than 6 siblings.15.6 % had history of alcohol intake in their family. 30 % say that they started drinking when away from family. 57.3% said that they started drinking at t he age of 20-24 years while 25% told that they started at 25-29 years. The main reasons for starting alcohol were to be social (66.6%), to relieve stress (30.6%) and to improve work (2.6%). 76 % said that they usually drink outside i.e., hotels while 24% drink at home. Conclusions: This study clearly shows the effects of family history, age of onset, loneliness, socialism, low income, education and effect of family size on the severity of alcoholism. Intensive educational programs for school children and ca mpaign for general public through most common mass-media technology would be most effective.

Background: Alcohol related liver diseases are common in most countries across the world. A variety of factors have been identified at the individual and community level affecting the patterns and amount of alcohol consumption. This study was done to determine such factors among patients with alcohol related liver disease. Aim : To study the socio-economic and cultural factors among patients with alcoholic liver disease at a tertiary care center in Southern India. Materials & methods: This observational questionnaire based study was done among patients with alcoholic liver disease, who were on regular follow up at a tertiary hospital in Mangaluru, Southern India. After a written informed consent, patients fulfilling the selection criteria were selected to the study. They were interviewed based on a preformatted proforma. The collected data were analyzed for mean, standard deviation and chi square test using SPSS-21. Results: The subjects (n=100) studied were Kannada, Malayalam, Konkani and Tulu speaking in the age group between 18 to 60 years. In this study 43% subjects were in the age group 35-44 years and 39% of them were married. Among these 96% consumed mixed diet and only 9% did daily physical activity. The educational background found was; middle school (29%), diploma holders (26%), high school (19%), college graduates (16%), primary school (6%) and illiterates (4%). Based on occupation status, 6% were professionals, 29% farmers/shop owners, 6% skilled worker, 29% unskilled worker and 13% unemployed. We found 22% to be binge drinkers and 78% to consume alcohol daily; 15% requiring an eye-opener. Conclusion: As seen in similar studies, the alcohol is a predominant problem in the uneducated, low earning, and stressed individuals in a society. The alcohol related health issues are global and dependent on multiple social and cultural factors. Improving the public awareness on alcohol related health issues is the key to minimize its burden in the society.

Using the AUDIT-K (Korean versions of alcohol use disorders identification test), it was able to select a large number of potential danger drinkers who routinely live. There were no statistically significant differences in age, religion, marital status, occupation, family history of alcohol drinking, age at onset of alcohol use, smoking, and BMI (body mass index). However, only education and drinking periods were statistically significant. These results are consistent with the previous study, which suggests that alcohol consumption is higher among men who are educated. The level of education also suggests that there is a need to look at the differences depending on what you learned and how. Alcohol consumption by education also shows different results. Also, drinking at a young age will lead to a longer drinking period, which is consistent with previous studies on the age at onset of drinking. In this study, drinking period was the most important factor of alcohol use disorder and it is considered that measures and education of national government system which can delay drinking age as much as possible is needed as a method to shorten drinking period.

Background: Alcohol dependence syndrome (ADS) and mood disorders, such as bipolar disorder and depression, are psychiatric disorders punctuated by many relapses and remissions. Patients suffering from these disorders impose a considerable burden on their caregivers. The burden includes multiple responsibilities such as financial costs and physical care of the patient while compromising on their freedom. Due to their nature of relapses and chronicity, they also harm the caregiver’s mental health. Hence, our attempt to study and compare the caregiver burden imposed by mood disorders and ADS. Aims and Objectives: To study the burden between caregivers of patients with mood disorders and ADS and to identify a significant association, if any, between sociodemographic characteristics and caregiver burden. Methods: It is a cross-sectional hospital-based study. Sixty patients, along with their primary caregivers attending the psychiatry outpatient department at a teaching hospital, were included in the study. Detailed evaluation was done on patients and caregivers using a semi-structured pro forma. The Burden Assessment Schedule is a standardized tool that was used to assess the caregiver burden. Those with severe burden were then screened for psychiatric disorders using the Mini-International Neuropsychiatric Interview. Results: The burden was similar in caregivers of mood disorders and ADS patients. Only 17% of caregivers were found to have a clinically diagnosable psychiatric illness. Marital relation was more affected by alcohol dependence than mood disorder. Furthermore, caregivers of patients with ADS were more likely to develop psychiatric illnesses. A more significant burden was seen with increased duration of illness, though not significantly. Conclusion: The mean total burden score being similar in both groups implies that the degree of burden experienced is the same. Most caregivers reported symptoms of anxiety and depression, though not clinically significant.

In a Costa Rican study comparing fertility levels of women living in consensual unions with those living in legal unions no relationship was observed between fertility and the type of union. This finding differed from the findings obtained in a number of previous investigations conducted in several Caribbean and Latin American countries. In these investigations consensual unions were observed to have a depressing effect on fertility. These studies were conducted among population groups which tended to be characterized by a shortage of males. Perhaps the shortage of males was responsible for both the large number of consensual unions as well as the reduced fertility levels. The data used in the present analysis was derived from interviews conducted with 295 couples living in consensual unions and 985 couples living in legal unions. More than 3/4 of the respondents were white a little less than 1/4 were Indian and only a few were black. Information was collected on a number of socioeconomic and psychological variables as well as on family planning knowledge and attitudes. Women in consensual and legal unions were similar in terms of the number of live births and conceptions they had experienced. They did differ however on a number of other variables which were indicative of social class differences. Women in consensual unions exhibited traits generally associated with lower class status. In order to determine whether social class differences were masking a depressing effect of consensual unions on fertility fertility levels between the 2 union groups were compared while controlling for social class differences. Even when social class was controlled no significant difference was observed in the fertility levels of the 2 groups. Tables provide data on: 1) % distribution of respondents on 27 selected variables by type of union; and 2) the results of the correlation analysis.

Marital distress is progressively becoming a severe social problem. Under sorne social circumstaoces, crime aod delinquency is greater for children of unhappy or brokeo heme,, alcoholism is more frequent among the sepaxated, and marital distress precedes about halfof the first admissions to mental hospitals. Recently, nurnerous behavior analysts have conducted research on the effects of behavioral technology on marital distress. The most reliable results point out that procedures such as behavioral contracting, training couples on verbal aoci nonverbal interactioo, target behaviors defioitioo, problem analysis and ne¬gotiating skills, among others, are successful it, alleviating marital distress. These procedures also show supetiority when they are compared with others derived from psychodynarnic conceptions. The research methodology of many of these behavioral studies, ho-wever, shows sorne severe limitations. The malo weaknesses include: lack of reliable dependentmeasures, lack of validity of independent procedures, incompetent experimental designs and personal research biases. Sorne methodological procedures are suggested to improve the quality of further studies and a summary table abstracts the status of this research aiea.

Objective To investigate and analyze the humane care quality and behavior of clinical nurses in informed consent, and provide theoretical basis about how to implement humane care in clinical nursing practice. Methods Using Nurse Humanities Care Quality Table which developed by Liu Yuxi, and Nurse Informed Consent Humanistic Behavior Self-rating Scale witch designed by self, To investigate 110 clinical nurses who picked out by hierarchical random sampling. Results In the humanistic care quality assessment, the score of the ability was the lowest in nurses′ humanistic care quality, the average score (23.06±1.72) accounted for 65.88% of the total score (35). the score of knowledge dimension was positively correlated with age and working years (r=0.339, 0.294, both P<0.01). the score of perceived dimension was positively correlated with age (r=0.250, P<0.01). In the humanistic care behavior assessment of informed consent, the score of the communication and emergency ability dimension were the lowest. The average score (21.65±1.93) accounted for 86.60% of the total score (25). The marital status of the clinic nurses was negatively correlated with respect and care (r=-0.305, P<0.01). The humanistic knowledge was positively correlated with support and communication and emergency response (r=0.422, 0.371, both P <0.01), the concept was positively correlated with respect and care, support and security (r=0.640, 0.587, both P<0.01). Conclusions The quality of nurses′ humanistic care is significantly related to the humanistic care behavior in informed consent. It should improve the quality of nurses′ humanistic care for cultivating humanistic care behavior in nursing practice. Key words: Informed consent; Humanistic care quality; Related analysis

The potentially conflicting observations that members of female-headed households in Latin America tend to be especially poorly off but that one does not need to live in a female-headed household to face utter poverty can be reconciled in part by considering household structure in terms of female headship and marital status. We illustrate this point using a microfile of the 1985 Colombia census of housing and population, focussing on mothers aged 15-59. While headship effects the material well-being of single, separated/divorced, and widowed mothers, mothers in a consensual union tend to be badly off materially even when they do not head their own household. Considering mothers outside consensual unions, formally married non-head mothers tend to be materially better off than non-married head mothers but not as well off as non-married non-head mothers. A country-wide analysis is refined by examining subregions, the idea being to investigate the issue in areas with potentially different marriage structures.

Objective To explore the influence factors of unqualified alanine aminotransferase (ALT) of voluntary blood donors in Chengdu. Methods From June 1, 2012 to June 1, 2013, a total of 16 424 voluntary blood donors from a street blood collection point of Chengdu Blood Center were selected as subjects by random sampling method. Among them, there were 8 860 male and 7 564 female donors, aged from 18 to 55 years. Blood samples for ALT primary screening were detected by dry chemical method, and blood samples for ALT laboratory re-examination were detected by rate method. The ALT value > 40 U/L was determined to be unqualified for ALT blood screening or laboratory re-examination of blood donors. The information management system of Tangshan Qiao 5.0 was used to collect the data of blood donors including gender, age, height, weight, marital status, nationality, occupation, educational level and the seasons of blood donation. The ALT unqualified rates of blood donors with different demographic characteristics (gender, age, marital status, nationality, occupation and education level), seasons of blood donation and body mass index (BMI) were calculated respectively. Chi-square test was used to compare the ALT unqualified rates of blood donors with different demographic characteristics, seasons of blood donation and BMI. Multivariate unconditional logistic regression analysis was used to further study the independent influence factors of ALT disqualification in voluntary blood donors. The procedures followed in this study were in accordance with the requirements of the World Medical Association Declaration of Helsinki revised in 2013. And the Informed Consent of Blood Donors were signed with all blood donors before blood donation. Results ① Among the 16 424 voluntary donors in this study, and the unqualified rate of ALT was 14.4% (2 363/16 424). Among them, a number of 2 256 donors failed in ALT primary screening, accounting for 95.5% (2 256/2 363); and 107 donors failed in ALT laboratory re-examination, accounting for 4.5% (107/2 363). ② The results of univariate analysis for the influence factors of ALT disqualification in 16 424 voluntary blood donors in this study showed that there were significant differences in ALT unqualified rates among donors of different gender, age, marital status, occupation, education level, seasons of blood donation and BMI, respectively (χ2=872.65, 627.76, 575.94, 641.88, 150.64, 50.71, 2 152.05; P<0.001). ③ The results of multivariate unconditional logistic regression analysis showed that male (OR=3.52, 95%CI: 3.13-3.96, P<0.001), age of 26-35 years (OR=1.25, 95%CI: 1.07-1.46, P<0.001), 18.5 kg/m2 ≤ BMI<25.0 kg/m2 (OR=2.34, 95%CI: 1.24-4.45, P=0.010), 25.0 kg/m2≤BMI<28.0 kg/m2 (OR=7.51, 95%CI: 3.98-14.29, P<0.001) and BMI≥28.0 kg/m2 (OR=19.48, 95%CI: 10.13-37.45, P<0.001); married (OR=1.27, 95%CI: 1.09-1.47, P<0.001); blood donation in summer (OR=1.50, 95%CI: 1.26-1.79, P<0.001), blood donation in autumn (OR=1.79, 95%CI: 1.51-2.13, P<0.001), blood donation in winter (OR=1.27, 95%CI: 1.02-1.47, P<0.001) were the independent risk factors for ALT disqualification in blood donors. Student donor was the independent protective factor for ALT disqualification of blood donors (OR=0.31, 95%CI: 0.25-0.37, P<0.001). Conclusions The ALT unqualified rate of blood donors in Chengdu is at a high level. Independent risk factors for ALT disqualification in blood donors included age of 26-35 years, BMI≥18.5 kg/m2, married, and blood donation in summer, autumn and winter. In view of these independent risk factors, corresponding measures should be taken to reduce the ALT unqualified rate of voluntary blood donors in Chengdu. Key words: Blood donors; Alanine transaminase; Population structure; Influence factors; Unqualified rate