Alcohol Avoidance Research Articles

Unintentional drowning fatalities in Sweden between 2002 and 2021

BackgroundDespite declining over the past three decades, unintentional drownings still account for an estimated 236 000 annual deaths worldwide. Susceptibility persists amongst demographic groups and is influenced by sex, age, and socio-economic status, emphasizing the need for targeted interventions. Due to rapidly evolving population dynamics, particularly within Europe, there is a further responsibility to understand the impact of ethnicity on the risks of drowning to guide prevention.MethodsWe conducted a national population-based retrospective study using data from the Swedish National Board of Forensic Medicine and Statistics Sweden for the years 2002 to 2021. The analysis includes variables such as age, sex, presence of alcohol and narcotics as well as activity undertaken at the time of drowning and type of water body. Furthermore, we considered ethnicity to identify subpopulations at greater risks.ResultsResults revealed a plateau in unintentional drowning rates in Sweden since 2012, despite an overall decrease from 2002 to 2021. Findings confirm the trend that males are overrepresented within drowning statistics across all age groups, and that individuals aged > 50 constitute over half of all unintentional drownings. Men aged between 40-69 years boating, and individuals of non-Swedish origin, particularly those < 20 years of age, face a notably greater risk of drowning, underscoring the need for subpopulation-targeted prevention strategies.ConclusionThe ten-year plateau in unintentional drowning signals the need for an official national prevention strategy with annual evaluations. Suggestions also include improved parental supervision of children, further avoidance of alcohol while swimming and boating, as well as targeted swimming lessons and water competency training for individuals of non-Swedish origin.

Evidence for preventing EVRB in cirrhotic patients: A systematic review.

Systematic strategies for preventing and treating esophagogastric variceal rebleeding (EVRB) are currently inadequate. This systematic review aimed to update this critical gap by searching contemporary studies from major guideline websites, databases, and professional associations focused on EVRB prevention in cirrhosis patients. Key findings highlight evaluation methods, risk management, preventive measures, health education, and follow-up strategies. Notably, a hepatic venous pressure gradient exceeding 18 mmHg is identified as a reliable predictor of gastroesophageal varices (GOV) rebleeding. Effective management of primary diseases is crucial, with methods including antiviral and anti-fibrotic therapies, alcohol avoidance, vaccination, and careful medication management. The combination of nonselective β-blockers (NSBBs) and endoscopic variceal ligation (EVL) is established as the gold standard for secondary EVRB prevention. For patients experiencing recurrent bleeding despite NSBBs and EVL, transjugular intrahepatic portosystemic shunt (TIPS) therapy is recommended. Surgical options, such as surgical shunt and devascularization, are advised for those unsuitable for endoscopic therapy or TIPS, particularly in Child-Pugh A and B patients unresponsive to treatment. Additionally, traditional Chinese medicine options, such as Fufang Biejia Ruangan Tablets, Fuzheng Huayu Capsules, and Anluo Huaxian Pills, have shown promise in improving hepatic fibrosis and GOV in cirrhotic patients. This review offers a comprehensive overview of current prevention and treatment strategies for EVRB, providing valuable insights for clinicians and healthcare professionals.

Adulthood dietary and lifestyle patterns and risk of breast cancer: Global Cancer Update Programme (CUP Global) systematic literature review

BackgroundAn increasing number of studies in recent years investigate various dietary and lifestyle patterns and associated breast cancer (BC) risk. ObjectivesThis study aimed to comprehensively synthesize and grade the evidence on dietary and lifestyle patterns and BC risk. MethodsDatabases were systematically searched up to 31 March, 2022, for evidence from RCTs and prospective cohort studies on adherence to a dietary pattern alone or in combination with lifestyle behaviors and incidence of or mortality from primary BC in adult females. Findings in all, premenopausal, and postmenopausal females were descriptively synthesized instead of meta-analyzed due to patterns heterogeneity. An independent Global Cancer Update Programme Expert Panel graded the strength of the evidence. ResultsA total of 84 publications were included. Results for patterns reflecting both a healthy diet and lifestyle were more consistent than for patterns that included diet only. There was strong-probable evidence that a priori World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and American Cancer Society (ACS) dietary and lifestyle scores may reduce BC risk in all and postmenopausal females, whereas in premenopausal females, less evidence was found contributing to limited-suggestive grade. There was also a limited-suggestive evidence that adherence to the Healthy Lifestyle Index and other diet and lifestyle scores may reduce BC risk in postmenopausal females; a posteriori Western/meat/alcohol dietary patterns may increase BC risk in postmenopausal females; and prudent/vegetarian/Mediterranean dietary patterns may reduce BC risk in all females. For the remaining patterns, evidence was graded as limited-no conclusions. ConclusionsAdvice to adopt combined aspects of a healthy diet and lifestyle according to WCRF/AICR and ACS scores, encouraging a healthy weight, physical activity, alcohol and smoking avoidance, and a healthy diet rich in fruits, vegetables, (whole)grains and cereals and discouraging red and processed meat, can be proposed to females to lower BC risk.This review was registered at PROSPERO as ID CRD42021270129 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021270129) on 28 August, 2021, and further updated on 4 May, 2022, in order to extend the search period.

P140 PREVALENCE OF HYPERTENSION IN A RURAL COMMUNITY IN THE FEDERAL CAPITAL TERRITORY ABUJA (GBESSA) NORTH CENTRAL NIGERIA

Background: High Blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan Africa. This has been attributed to acculturation of the populace who are rapidly adopting modern lifestyle changes. Aim This study aimed to describe the prevalence and identify risk factors for hypertension in rural community in the Federal capital territory in Nigeria. Methods A cross sectional survey of 491 households with 1,739 adults aged 18 years and above was carried out. Information about health and lifestyle was obtained from structured questionnaire interviews, followed by assessment of blood pressure (BP) and anthropometry. Results: There were 18.1% (95% confidence interval (CI), 16.0-20.6% participants with hypertension (defined as a systolic BP-140, diastolic BP-90mmHg or on antihypertensives medication). This prevalence of Hypertension was found to rise with age. Between the sexes males recorded a higher prevalence of 19.6% compared to 17.4%: females but this was not statistically ×2 P-value =0.34. Single and widowed subjects recorded high prevalence of 32.2% and 30.0% of Hypertension while students had low rate of 5.6%. The prevalence of Hypertension was 20.5% among farmers.Whereas, obesity (measured by WHR), alcohol intake, cigarette smoking, and family history of hypertension had no valid statistical evidence, chewing tobacco/ snuff, previously diagnosed diabetes mellitus or family history of diabetes showed statistically significant differences. Conclusion: This findings underscore the need for public health campaign at community levels to prevent increasing blood pressure and it's sequelae. This will involve campaigns to maintain the age- long tradition of exercise, avoidance of smoking, alcohol and weight maintenance.

A case study of impaired consciousness caused by alcohol consumption in apediatric patient taking high-dose cefixime.

A variety of drugs have been known to induce disulfiram-like reactions in individuals exposed to ethanol, including certain cephalosporin antibiotics with methylthiotetrazole (MTT) substituents or methylthiodioxotriazine (MTDT) rings. Among cephalosporins, cefixime is known to cause fewer disulfiram-like reactions. This case report, the first involving a pediatric patient, presents the scenario of a 14-year-old female who exhibited drowsiness, loss of consciousness, and cold extremities within an hour after ingesting 9 cefixime capsules. Upon admission, drug intoxication was considered, prompting immediate gastric lavage and toxicology tests, which revealed the presence of both cefixime and alcohol. Subsequent monitoring of vital signs, rehydration, and symptomatic treatments aimed at facilitating toxic excretion were administered during hospitalization. Following initial assessment by a clinical pharmacist, drug intoxication was deemed improbable, though an atypical disulfiram-like reaction or alcohol intoxication could not be ruled out. Further evaluation, coupled with the child's cefixime overdose, suggested an atypical disulfiram-like reaction. This case underscores the potential for disulfiram reactions even with cephalosporins lacking MTT substituents or MTDT rings. Notably, it is the first report of an atypical disulfiram-like reaction triggered by alcohol consumption following cefixime overdose, emphasizing the importance of caution in cefixime usage and avoidance of alcohol or alcohol-containing substances.

How to descript a clinical case correctly: For inquiry scientists and demanding doctors

The article presents step by step international CARE guidelines (CAse REport), which regulate the structure of the description of a clinical case and include a checklist of 13 points. This form of presentation of the material does not create any difficulties in understanding, does not require a long period of time to prepare a publication for the author, demonstrating a unique personalized experience and informing the medical community about interesting clinical manifestations, diagnostic or therapeutic approaches within a particular nosology, as well as describing rare or newly reported side effects of drugs or features of their prescription. Below as an example presented a clinical observation of a young man with diabetes mellitus of complex origin, which was diagnosed after the initial diagnosis of type 2 diabetes mellitus, which was later supplemented with recurrent pancreatitis, pancreatic cyst development and alcohol abuse with underlying severe hypertriglyceridemia (up to 67 mmol/l). Given the limited choice of glucose-lowering therapy, inability to prescribe metformin, glucagon-like peptide-1 agonists, infeasibility to use dipeptidyl peptidase 4 inhibitors and gliflozins (history of episodes of balanoposthitis), after a detailed discussion with the patient, a decision was made to prescribe a combination insulin drug – biphasic Lispro (RinLis Mix 25, Geropharm, Russia), which, together with fundamental lifestyle changes, strong alcohol avoidance, and regular medical follow-ups, allowed him to achieve glycemic targets and reduce plasma triglyceride levels, which once again supported the versatility of insulin as hypoglycemic agent, easiness to use and comprehensive glycemic control, if pre-mixed ultra-fast-acting insulin analogue and its protaminized analogue are prescribed. The prescription of insulin premix in this case is also justified in terms of clinical guidelines, as the man led a regular lifestyle, had low physical activity, an HbA1c level greater than 1.5% of the target value, as well as fasting and postprandial hyperglycemia.

“And I Believe in Signs”: Soviet Secularity and Islamic Tradition in Kyrgyzstan

AbstractIn Central Asia, the Soviet state had destroyed most Islamic institutions by the late 1930s, which gradually alienated millions of Soviet Muslims from the basics of Islamic theology and key Islamic practices of virtue cultivation, including the five daily prayers (namaz), Islamic ethics of dressing (like covering certain parts of the body), and certain lifestyle prescriptions (such as the avoidance of alcohol, gambling, and premarital sex). As a result, mainstream Islam in Central Asia came to revolve around the main Islamic life-cycle rites (i.e., male circumcision, the marriage ceremony, and funeral prayer) and occasional practices of uttering blessings, reciting short Qur’anic verses for the souls of the deceased, and visiting shrines, among others. Although more than thirty years have passed since the fall of the USSR, this non-observant form of Islam remains widespread in the region. Inquiring into the conceptual and affective aspects of Soviet forced secularization in Central Asia, I make two interrelated interventions into secularism studies and the anthropology of Islam. First, I theorize Soviet secularism through attending to the modern state’s aspiration to transcend and transform the particularities of lived traditions, which reveals significant overlaps between communist and liberal modes of statecraft and subject formation. Second, reflecting on a non-observant form of Islam in contemporary Kyrgyzstan, I ask: what remains of a tradition of virtue ethics when its modes of abstract reasoning and virtue cultivation have all but vanished?

Asian flush gene variant increases mild cognitive impairment risk: a cross-sectional study of the Yoshinogari Brain MRI Checkup Cohort.

The East Asian-specific genetic diversity, the rs671 variant of aldehyde dehydrogenase 2, causes the "Asian flush" phenomenon following alcohol consumption, resulting in an alcohol avoidance phenotype. The variant is suggested as a risk factor for Alzheimer's disease; however, its association with mild cognitive impairment (MCI), an effective target for secondary prevention of dementia, remains unclear. This cross-sectional study examined 430 individuals aged 60-80 years (251 women) without overt cognitive impairment in Yoshinogari, Japan. The effect of the rs671 variant on MCI, defined by scores <26 or <25 on the Japanese version of the Montreal Cognitive Assessment, was evaluated using multivariate logistic regression. The models included APOEε4, sex, age, education, history of habitual drinking, Brinkman index, hypertension, diabetes, and subclinical magnetic resonance imaging findings and consistently estimated the risk of the rs671 variant. Subsequently, stratified analyses by history of habitual drinking were performed based on an interactive effect between rs671 and alcohol consumption, and the rs671 variant significantly influenced MCI in participants who did not drink habitually, with odds ratios ranging from 1.9 to 2.1 before and after adjusting for covariates, suggesting an association independent of hippocampal atrophy and small vessel dysfunction. Conversely, no such association with the rs671 variant was observed in participants with a history of habitual alcohol use. Instead, hippocampal atrophy and silent infarcts were associated with MCI. This is the first study to demonstrate an association between the rs671 variant and MCI morbidity. The findings highlight the need for race-specific preventive strategies and suggest potential unrecognized mechanisms in dementia development.

FRI101 Marked Reduction In Severe Resistant Hypertriglyceridemia On PCSK9 Inhibitor

Abstract Disclosure: S. Kaul: None. A. Gupta: None. Introduction: PCKS9 inhibitors, such as evolocumab, have been shown to lower triglyceride levels by approximately 10-20% (1). However, there have not been any reports of PCSK9 inhibitors lowering triglyceride levels by more than 100%. Clinical Case: A 35-year-old white man presented with hypertriglyceridemia for more than eight years. Past medical history was significant for recurrent pancreatitis and diabetes mellitus type 2 with recent HbA1c of 7.6% (normal range &amp;lt;5.7%) on metformin 1 gram BID and insulin glargine 15 units daily. He had multiple hospitalizations for pancreatitis requiring insulin drip. His triglycerides remained elevated on fenofibrate, atorvastatin, and icosapent ethyl despite alcohol avoidance and changes in diet with progressive elevation to 5000 mg/dL (normal range 0-150 mg/dL) requiring four sessions of plasmapheresis and hospitalization requiring intravenous insulin drip. His family history also included hypertriglyceridemia in his mother. He was started on evolocumab 140 mg subcutaneously every 2 weeks and noted to have drastic improvement of triglycerides down to a normal level of 138 mg/dL. On recent labs, his triglyceride level was noted to be 921 mg/dL with HbA1c at 8.0%. He did admit non-compliance to diet but did not require any more hospitalizations for pancreatitis since starting evolocumab. Conclusions: This is the first reported case of an unexplored potential of evolocumab in patients with severe hypertriglyceridemia. Reference: (1) Warden BA, Fazio S, Shapiro MD. The PCSK9 revolution: Current status, controversies, and future directions. Trends Cardiovasc Med. 2020;30(3):179-185. doi:10.1016/j.tcm.2019.05.007 Presentation: Friday, June 16, 2023

Dietary therapy for patients with chronic pancreatitis in Japan: a cross-sectional online survey of physicians and registered dietitians.

This study was aimed towards understanding the current status of dietary therapy for patients with pancreatic exocrine insufficiency (PEI) in Japan and its alignment with Japanese recommendations for high-fat intake and concomitant high-potency pancreatic enzyme replacement therapy (PERT) by surveying treating physicians and registered dietitians. The 19-item physicians' online questionnaire collected data about the number of patients with PEI treated, methods used to assess PEI and nutritional status in patients with PEI, as well as provision of dietary guidance and details of treatment with PERT. The 10-item registered dietitians' online questionnaire captured data about the provision of dietary guidance, including setting (inpatient or outpatient) and details of nutritional guidance provided to patients. Overall, 35 physicians and 23 dietitians completed the respective questionnaires. The primary cause of PEI in patients treated by physicians during the previous month was chronic pancreatitis (80.5%). Of 30 (86%) physicians who reported implementing dietary guidance for patients with PEI, less than half (43%) followed national guidelines and most (83%) implemented a low-fat diet. The use of PERT in recently treated patients with PEI was low. Amongst 11 (48%) dietitians who reported providing dietary guidance to patients with chronic pancreatitis and PEI, 7 (64%) recommended restricting fat intake in patients with uncompensated chronic pancreatitis. Dietitians overall were more likely to provide guidance about alcohol avoidance (91%) than smoking cessation (48%) to appropriate patients. This survey suggests that additional educational efforts are required to align the management practices of physicians and registered dietitians with evidence-based clinical practice guidelines for Japanese patients with chronic pancreatitis and PEI.

Sensor Network Based Smart Helmet for Bike Riders for Accident Prevention

Road accidents are increasing day by day because riders do not use helmet and due to alcohol consumption. A huge amount in today's world people die in traffic accidents. Accidents can occur when using a smart helmet detected. The Project Goal is to design smart helmet in case of an accident alcohol avoidance and alcohol detection. The IR sensor checks if the person is wearing it helmet or not. The gas sensor recognizes the alcohol substance in the rider breath. If the person doesn’t have a helmet and if they are consuming alcohol, a bike won't start. If there are no signs of alcohol and a helmet is worn, then only the bike starts. The moment the rider met with an accident, the sensor recognizes the condition of the motorcycle and reports the accident. Then The GPS in the bike sends the location of the accident site to the main server nearby hospitals.

Effect of Jinlida granule on glycolipid metabolism, oxidative stress, and inflammatory factors in type 2 diabetes mellitus patients with non alcoholic fatty liver disease

Purpose: To investigate the effect of Jinlida granule on glycolipid metabolism, oxidative stress, and inflammatory factors in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD). Methods: A total of 132 T2DM patients with NAFLD were equally and randomly divided into study and control groups. Patients in the control group were treated with non-drug therapy including routine diet control, exercise, alcohol avoidance, and drug therapy (using blood glucose and lipid lowering drugs). The study group was treated with Jinlida granule in addition to other measures used in the control group. Blood glucose, blood lipid, and liver function parameters were compared after treatment. Nesfatin-1, oxidative stress, inflammatory factors, liver fat content, and degree of fibrosis were assessed. The efficacy and potential mechanism of Jinlida granule in the patients were assessed. Results: Blood glucose, lipid, and liver function parameters in the study group were lower than in the control group following treatment. Nesfatin-1, GSH-Px, and adiponectin levels were higher, while MDA, TNF-α, liver fat, LSM and CAP levels were lower than in the control group (p &lt; 0.05). The response rate of the study group was 96.97 %, which was higher than the 87.88 % in the control group (p &lt; 0.05). The incidence of adverse drug reactions in the two groups during treatment was comparable (p &gt; 0.05). Conclusion: Jinlida granule exerts positive effect on T2DM patients with NAFLD. Thus, Jinlida granule has potentials for application as an adjuvant in the treatment of T2DM with NAFLD.

Restricting diet for perceived health benefit: A mixed-methods exploration of peripartum food taboos in rural Cambodia.

Food taboos encompass food restrictions practiced by a group that go beyond individual preferences. During pregnancy and lactation, food taboos may contribute to inadequate nutrition and poor maternal and infant health. Restriction of specific fish, meat, fruits and vegetables is common among peripartum women in many Southeast Asian countries, but data from Cambodia are lacking. In this mixed-methods study, 335 Cambodian mothers were asked open-ended questions regarding dietary behaviours during pregnancy and up to 24 weeks postpartum. Descriptive statistics and content analysis were used to characterize food taboos and multiple logistic regression analyses were conducted to identify predictors of this practice. Participants were 18-44 years of age, all of Khmer ethnicity and 31% were primiparous. Sixty-six per cent of women followed food taboos during the first 2 weeks postpartum, whereas ~20% of women restricted foods during other peripartum periods. Pregnancy taboos were often beneficial, including avoidance of sugar-sweetened beverages, coffee and alcohol. Conversely, postpartum avoidances typically included nutrient-dense foods such as fish, raw vegetables and chicken. Food taboos were generally followed to support maternal and child health. No significant predictors of food taboos during pregnancy were identified. Postpartum, each additional live birth a woman had reduced her odds of following food taboos by 24% (odds ratio [95% confidence interval]: 0.76 [0.61-0.95]). Specific food taboo practices and rationales varied greatly between women, suggesting that food taboos are shaped less by a strict belief system within the Khmer culture and more by individual or household understandings of food and health during pregnancy and postpartum.

Psychosocial interventions for patients with alcohol use disorder: A systematic review

Purpose: The aims of this study were to identify the psychosocial interventions for patients with alcohol use disorder and to assess the effects of those interventions. Methods: A systematic literature search was conducted using PubMed, the Cochrane Library, Embase, CINAHL, PsycINFO, KoreaMed, KMBASE, RISS, KISS, Science ON, and DBpia to identify studies reported in English or Korean from 2012 to 2021. Results: From the 4,051 studies extracted, 14 studies were selected for review. The majority of the psychosocial interventions were focused on cognitive therapy or cognitive-behavior therapy. Most of the studies reported that the interventions made positive effects on alcohol consumptions. In addition, the psychosocial interventions for patients with alcohol use disorder were effective on coping, support, alcohol avoidance behavior, and hostility bias. Most of the studies reporting positive effects of psychosocial intervention programs applied computers, mobile phones, or similar electronic devices. Conclusion: The findings of this systematic review suggest that the use of computers or mobile devices in psychosocial intervention programs will be effective. It can be said that this systematic review reflects the current trends involving the development of information and communication technology. This systematic review can provide basic data for establishing evidence and suggesting future directions for psychosocial interventions for patients with alcohol use disorder.

Factors associated with lower disease-specific and generic health-related quality of life in Rome IV irritable bowel syndrome.

Little is known about associations with reduced quality of life in irritable bowel syndrome (IBS) or impact of IBS on quality of life compared with other chronic conditions. We collected demographic, gastrointestinal and psychological symptoms, healthcare usage, direct healthcare costs, impact on work and activities of daily living data from 752 individuals with Rome IV-defined IBS. We used the irritable bowel syndrome quality of life (IBS-QOL) and the EQ-5D-5L questionnaires to examine characteristics associated with lower quality of life. The mean IBS-QOL among all 752 individuals with Rome IV IBS was 48.4 (SD 22.3) and the mean EQ-5D score was 0.570 (SD 0.283), the latter being comparable to people with stroke, leg ulcers or chronic obstructive pulmonary disease. Lower levels of both disease-specific and generic quality of life were associated with severe IBS symptom scores, abnormal anxiety or depression scores, and higher somatoform symptom-reporting and gastrointestinal symptom-specific anxiety scores (p < 0.001 for all analyses). Those with lower quality of life had significantly higher healthcare usage and direct healthcare costs and more impairment in work and activities of daily living (p < 0.01 for all analyses). Avoidance of alcohol, lower educational level, abnormal anxiety, depression or somatoform symptom-reporting scores, and impairment in social leisure activities, home management or maintaining close relationships were all independently associated with lower quality of life. IBS has a substantial impact on the quality of life of those affected, and worse than observed in some severe chronic organic conditions.

The Role of Diet and Lifestyle in Women with Breast Cancer: A Review of the Literature

One in eight women worldwide will develop breast cancer in their lifetime. Obesity, physical activity, and dietary composition are known to influence the prognosis of breast cancer. There have been significant concerns regarding the toxicity of existing pharmaco- and chemotherapies, and additional complementary dietary and lifestyle interventions are suggested for breast cancer prevention. This review aims to highlight current information regarding the association between dietary patterns and lifestyle with BC, including risk and prognosis. In addition, this article discusses dietary intake, physical activity, and other habits as lifestyle modification strategy targets. The incidence of breast cancer is increasing at an alarming rate worldwide, making it the most prevalent malignancy in women. A significant relationship exists between obesity, physical inactivity, a sedentary lifestyle, dietary patterns, and breast cancer risk. Unhealthy lifestyle habits, such as smoking, alcohol consumption, and tobacco use, also contribute to this increased risk. Obese women who have a high risk of breast cancer had better metabolic and inflammatory profiles when they engaged in lifestyle activities and diet interventions that were tailored to their needs. Physical activity was linked with a reduction in cancer incidence and mortality risk. A decrease in an individual’s consumption of red meat, animal fat, and sugary foods, as well as their increased consumption of fiber, fruits, and vegetables, were associated with a reduced risk of breast cancer. Other modifiable risk factors, such as smoking cessation and the avoidance of alcohol and tobacco, contributed to breast cancer survival. A healthy lifestyle that includes exercise and dietary modifications may serve as adjuvants to expedite breast cancer prevention interventions and optimize the health of cancer survivors.

Early intervention using written exposure therapy for PTSD and AUD symptoms following sexual assault: Description of design and methodology

The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common following sexual assault and associated with more severe symptomology and increased likelihood of sexual revictimization. Integrated interventions aimed at reducing PTSD and AUD symptoms following recent sexual assault are needed and should address barriers to care and early treatment termination. The proposed study will test a novel, brief (5 to 7 sessions) intervention that integrates Written Exposure Therapy for PTSD and Cognitive Behavioral Therapy for AUD, and is initiated within the first six weeks post-assault. In Phase 1, qualitative analysis of content gathered during focus groups with treatment providers will be conducted to inform intervention development. In Phase 2, a proof-of-concept pilot study (n = 10) of the intervention, Substance Use Skills Training and Exposure Post-Sexual Assault (STEPS), will be conducted. In Phase 3, a pilot randomized controlled trial (RCT) among 54 recent sexual assault survivors will be implemented using the updated manualized STEPS intervention to evaluate feasibility and preliminary efficacy in reducing PTSD and AUD symptoms. Ecological momentary assessments will be used to assess daily alcohol use, craving, affect, intrusions and avoidance. The effects of STEPS on commonly associated symptoms (e.g., depression, substance use) will be examined. The proposed study has the potential to make a significant public health impact by advancing knowledge on the link between sexual assault and co-occurring PTSD and AUD and informing early intervention efforts for this high-risk population.

Evaluation outcomes of an alcohol and pregnancy campaign targeting multiple audiences.

The aim of this study was to evaluate the effectiveness of a mass media campaign alerting the public to the potential harms of alcohol to unborn babies and to inform future intervention efforts. An online survey was administered to 889 adult Western Australians. The survey assessed demographic characteristics, typical alcohol use, recognition and perceptions of the campaign, and behavioural changes resulting from campaign exposure. A multiple regression analysis was conducted to identify factors associated with perceived campaign effectiveness. Most respondents reported having seen/heard the campaign on at least one form of media (71%). Most considered the campaign to be believable (89%), clear (88%), trustworthy (87%), memorable (82%) and among the best they had seen (78%). As a result of campaign exposure, a large majority reported increased concern about drinking during pregnancy (85%) and most female respondents reported being much less likely to use alcohol during a pregnancy (83%). One-third of female respondents (33%) reported that as a result of being exposed to the campaign they had decided not to consume alcohol while pregnant. Confidence to abstain, awareness of strategies to abstain, lower socioeconomic position, residing in the metropolitan area and recognising the campaign were significantly associated with greater perceived campaign effectiveness. Results indicate the campaign was well received by respondents, increased concern about drinking alcohol during pregnancy and positively influenced women's intentions to refrain from drinking while pregnant. Well-designed campaigns on alcohol avoidance during pregnancy can be considered acceptable and effective by target audiences.

High-Glucose Diet Attenuates the Dopaminergic Neuronal Function in C. elegans, Leading to the Acceleration of the Aging Process.

Parkinson’s disease (PD) is a neurodegenerative disease characterized by the selective degeneration of neurons, primarily in the substantia nigra. Environmental or exogenous factors that cause Parkinson’s disease have not been sufficiently elucidated. Our study aims to investigate the causative effect of a high-glucose diet on Parkinson’s disease-relevant dopaminergic neuronal system in Caenorhabditis elegans. Aging parameters were first observed by measuring the lifespan, body movement, and body sizes with and without the background of high glucose. The toxic effect of a high-glucose diet was further explored by observing the dopaminergic neurons using transgenic Pdat-1::gfp strains, BZ555, under a Zeiss microscope, and the experiments were extended by assessing dopamine-related behavioral analysis including basal slowing response and alcohol avoidance. The aggregation of the α-synucleins was also assessed by observing the NL5901 mutants. Worms fed with 250 mM glucose showed daf-2-independent regulation of aging, displaying a short lifespan (≤15 days), long body size (max. 140%), and slow movement (min. 30%, 10 bends/min). Anterior dopaminergic neurons were rapidly inactivated (70%) by a glucose-rich diet from 12 h of exposure, suggesting specific degeneration in ADE neurons. The dysregulation of neurons led to deteriorations in dopaminergic behaviors including basal slowing response (BSR). A high-glucose diet decreased dopamine synthesis (40 pg/mg vs 15 pg/mg protein) and induced α-synuclein aggregation in the muscles. Results demonstrate the potential of a high-glucose diet as a trigger of dopaminergic neuronal dysregulation conjugating aging acceleration.

Lifestyle for breast cancer risk reduction.

Primary prevention is the most cost-effective long-term strategy for reducing breast cancer occurrence. Lifestyle education centered on the 2018 American Institute for Cancer Research Cancer Prevention Recommendations, offered as a package, should be a core component of routine patient visits. The key components of the recommendations include maintenance of a normal weight; following a low-fat, whole-food, plant-predominant diet rich in whole grains, fruit, and vegetables; regular physical activity; and alcohol avoidance.