Harmful Alcohol Research Articles

How can agent-based modelling provide new insights into the impact of minimum unit pricing in Scotland?

In recent years we have gained insight into the impact of minimum unit pricing (MUP)-a legal floor price below which a given volume of alcohol cannot be sold-on population-level reductions in alcohol sales, consumption and harm. However, several questions remain unanswered including how individual-level purchasing changes impact the local economy (e.g., balance between on-licence and off-licence outlets), lead to long-term population-level trends (e.g., youth drinking) and social harms (e.g., violence). Agent-based modelling captures heterogeneity, emergence, feedback loops and adaptive and dynamic features, which provides an opportunity to understand the nuanced effects of MUP. Agent-based models (ABM) simulate heterogeneous agents (e.g., individuals, organisations) often situated in space and time that interact with other agents and/or with their environment, allowing us to identify the mechanisms underlying social phenomena. ABMs are particularly useful for theory development, and testing and simulating the impacts of policies and interventions. We illustrate how ABMs could be applied to generate novel insights and provide best estimates of social network effects, and changes in purchasing behaviour and social harms, due to the implementation of MUP. ABMs like other modelling approaches can simulate alternative implementations of MUP (e.g., policy intensity [£0.50, £0.60] or spatial scales [local, national]) but can also provide an understanding of the potential impact of MUP on different population groups (e.g., alcohol exposure of young people who are not yet drinking). Using ABMs to understand the impact of MUP would provide new insights to complement those from traditional epidemiological and other modelling methods.

Reducing alcohol harms whilst minimising impact on hospitality businesses: ‘Sweetspot’ policy options

BackgroundDuring COVID-19, hospitality businesses (e.g. bars, restaurants) were closed/restricted whilst off-sales of alcohol increased, with health consequences. Post-covid, governments face lobbying to support such businesses, but many health services remain under pressure. We appraised ‘sweetspot’ policy options: those with potential to benefit public services and health, whilst avoiding or minimising negative impact on the hospitality sector. MethodsWe conducted rapid non-systematic evidence reviews using index papers, citation searches and team knowledge to summarise the literature relating to four possible ‘sweetspot’ policy areas: pricing interventions (9 systematic reviews (SR); 14 papers/reports); regulation of online sales (1 SR; 1 paper); place-shaping (2 SRs; 18 papers/reports); and violence reduction initiatives (9 SRs; 24 papers/reports); and led two expert workshops (n = 11). ResultsInterventions that raise the price of cheaper shop-bought alcohol appear promising as ‘sweetspot’ policies; any impact on hospitality is likely small and potentially positive. Restrictions on online sales such as speed or timing of delivery may reduce harm and diversion of consumption from on-trade to home settings. Place-shaping is not well-supported by evidence and experts were sceptical. Reduced late-night trading hours likely reduce violence; evidence of impact on hospitality is scant. Other violence reduction initiatives may modestly reduce harms whilst supporting hospitality, but require resources to deliver multiple measures simultaneously in partnership. ConclusionsAvailable evidence and expert views point to regulation of pricing and online sales as having greatest potential as ‘sweetspot’ alcohol policies, reducing alcohol harm whilst minimising negative impact on hospitality businesses.

Prevalence and correlates of alcohol and drug harms to others: Findings from the 2020 U.S. National Alcohol Survey.

Measure prevalence and overlap of secondhand harms from other people's use of alcohol, cannabis, opioid, or other drugs and examine sociodemographic and other correlates of these secondhand harms. This cross-sectional analysis used data from 7,799 respondents (51.6% female; 12.9% Black, 15.6% Hispanic/Latiné; mean age: 47.6) in the 2020 U.S. National Alcohol Survey. Secondhand harms included family/marriage difficulties, traffic accidents, vandalism, physical harm, and financial difficulties. Weighted prevalence estimates provided nationally representative estimates of these harms. Logistic regression assessed associations between individual characteristics and secondhand harms. Lifetime prevalence of secondhand harms from alcohol, cannabis, opioid, or other drugs was 34.2%, 5.5%, 7.6%, and 8.3%, respectively. There was substantial overlap among lifetime harms: almost 30% of those reporting secondhand alcohol harms also reported secondhand drug harms. Significant correlates of secondhand substance harms included female sex (alcohol, other drug); white (alcohol, opioid), American Indian/Alaska Native (opioid), and Black (cannabis) race/ethnicity; and separated/divorced/widowed marital status (opioid). Those reporting family history of alcohol problems had significantly higher odds of reporting secondhand harms across substance types. Individuals who reported frequent cannabis use had higher odds of reporting secondhand alcohol and opioid harms compared to those with no cannabis use, (aOR=1.55; aOR=2.38), but lower odds of reporting secondhand cannabis harms (aOR=0.51). Although less prevalent than secondhand alcohol harms, 14% of participants reported secondhand harms from someone else's drug use and frequently experienced secondhand harms attributed to multiple substances. Population-focused interventions are needed to reduce the total burden of alcohol and drug use.

Quantifying alcohol's harm to others: a research and policy proposal.

Just under 2.5million people die annually due to alcohol use. This global estimate, however, excludes most of the health burden borne by others than the alcohol user. Alcohol's harm to others includes a multitude of conditions, such as trauma from traffic crashes, fetal disorders due to prenatal exposure to alcohol, as well as interpersonal and intimate partner violence. While alcohol's causal role in these conditions is well-established, alcohol's harm to others' contribution to the overall health burden of alcohol remains unknown. This knowledge gap leads to a situation in which alcohol policy and prevention strategies largely focus on the reduction of alcohol's detrimental health harms on the alcohol users, neglecting affected others and population groups most vulnerable to these harms, including women and children. In this article, we seek to elucidate why estimates for alcohol's harm to others are lacking and offer guidance for future research. We also argue that a full assessment of the alcohol health burden that includes the harm caused by others' alcohol use would enhance the visibility and public awareness of such harms, and advancing the evaluation of policy interventions to mitigate them.

Applying behavioral economics to understand changes in alcohol outcomes during the transition to adulthood: Longitudinal relations and differences by sex and race.

Population drinking trends show clear developmental periodicity, with steep increases in harmful alcohol use from ages 18 to 22 followed by a gradual decline across the 20s, albeit with persistent problematic use in a subgroup of individuals. Cross-sectional studies implicate behavioral economic indicators of alcohol overvaluation (high alcohol demand) and lack of alternative substance-free reinforcers (high proportionate alcohol-related reinforcement) as potential predictors of change during this developmental window, but longitudinal evidence is sparse. Using a sample of emerging adults (N = 497, Mage = 22.61 years, 62% female, 48.69% White, 40.44% Black), this study examined prospective, bidirectional relations between both past-week heavy drinking days (HDD) and alcohol problems and proportionate alcohol-related reinforcement (reinforcement ratio), alcohol demand intensity (consumption at zero price), alcohol demand Omax (maximum expenditure), and change in demand elasticity (rate of change in consumption across escalating price) over five assessments (every 4 months) using random intercept cross-lagged panel models. Alcohol problems and HDD decreased across assessments. Significant between-person effects indicated that each behavioral economic variable was associated with increased drinking risk. Change in reinforcement ratio was positively associated with decreases in alcohol problems. Multigroup invariance modeling revealed distinct risk pathways in that change in demand intensity and Omax predicted change in alcohol problems for male participants and change in intensity predicted change in alcohol problems for non-White participants. The study provides consistent support for proportionate alcohol-related reinforcement and mixed support for demand as within-person predictors of reductions in drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Heavy drinkers' expectations and experiences when discussing alcohol use during a general practice visit in Australia: A qualitative study.

Our understanding of community members' expectations and experiences of discussing alcohol use in general practice settings is limited, particularly for people with heavy alcohol use. Qualitative interviews were conducted with people with heavy alcohol use to explore their experiences of discussing alcohol use with their general practitioner (GP). Interviews were audio-recorded and transcribed, and data were analysed using an inductive thematic approach. Three themes were identified: (1) patient perceptions of alcohol discussions in primary care; (2) the importance of the doctor-patient relationship; and (3) consequences of unmet health needs and expectations. Patients expect their GPs to initiate conversations about alcohol use. Positive interactions are characterised by GPs' caring, non-judgemental and collaborative approach, whereas negative interactions focus on a perceived lack of knowledge or ability to manage excessive alcohol use. Alcohol harm reduction efforts should include strategies for bolstering the therapeutic relationship between GPs and their patients.

Brief intervention for chronic liver disease patients with alcohol use disorder in a hepatology outpatient unit: Effects and limitations.

It is not uncommon to encounter outpatients in the hepatology department with harmful alcohol habits. When treating such chronic liver disease (CLD) patients, an adequate intervention method for harm reduction of alcohol use, such as brief intervention (BI) or BI and nalmefene, should be considered. This study aimed to elucidate the clinical effectiveness of BI for CLD patients affected by harmful alcohol use. From June 2021 to 2023, 123 Japanese CLD outpatients (hepatitis B virus:hepatitis C virus:alcoholic liver disease:others=32:18:42:31) with an Alcohol Use Disorders Identification Test (AUDIT) score of ≥8 at the initial interview and a repeat interview with AUDIT 9months later were enrolled. Clinical features related to patient behavior following the initial AUDIT interview were retrospectively evaluated, and compared between patients without and with BI treatment. For the non-BI and BI groups, baseline AUDIT score (median 10 [interquartile range (IQR) 9-13] vs. 12 [IQR 10-17], p=0.016) and relative change in AUDIT score (median 0 [IQR -3 to 2] vs. -3 [IQR -7 to 0], p<0.01) showed significant differences, whereas there was no significant difference between the groups for AUDIT score at the time of the second interview (p=0.156). Following BI, significant improvements were observed for items 1, 2, 3, 4, 5, 8, and 10 of AUDIT (each p<0.05). Patients with an alcohol use disorder as well as those with alcohol dependency who received BI showed a significant decline in AUDIT score, although the score of the follow-up AUDIT indicated continued alcohol use disorder. In addition to BI, medication with nalmefene should be considered, based on individual factors.

Co-design of digital public health substance use resources: A collaboration between young people and experts.

Substance use and mental illness remain critical issues for young Australians, however, engagement with evidence-based health resources is challenging among this age group. This study aimed to develop engaging, useful digital health resources, underpinned by neuroscience principles, to build awareness of the harms of electronic cigarettes (e-cigarettes) and concurrent alcohol and antidepressant use. A mixed-methods approach was adopted to co-design two evidence-based videos resources. The resources were co-designed with the Matilda Centre's Youth Advisory Board Centre's Youth Advisory Board through a series focus groups and individual feedback reviews. Young people residing in New South Wales were then invited to complete a survey to evaluate the usefulness, relatability and impact on perceived harms associated with each substance pre- and post-viewing resources. A total of 100 participants completed the survey (mean age = 21.5 years, SD = 2.77, 42% Female, 2% Non-binary). The animated videos were well received, with the large majority (91% and 87% respectively) of participants rating them 'excellent' or 'very good'. After viewing the videos, there was a significant increase in the perception of harm associated with e-cigarette use, monthly (t(99) = 2.76, p = .003), weekly (t(99) = 4.82, p < .001) and daily (t(99) = 4.92, p < .001), and consuming alcohol whilst taking antidepressants both weekly (t(100) = 2.93, p = .004) and daily (t(100) = 3.13, p = .002). This study describes a successful co-design process demonstrating how meaningful involvement of young people, alongside traditional research methods, can produce substance use prevention resources that are useful, engaging and increase knowledge of harms among young people. SO WHAT?: To achieve meaningful public health impact researchers, experts and digital creators can work together to co-create substance use educational materials that are engaging, well-liked, while imparting important health knowledge.

Experiences of Alcohol Use and Harm among Travellers, Roma, and Gypsies: A Participatory Qualitative Study

Alcohol is widely used in many cultures as part of everyday life and for special occasions. It is a leading cause of preventable death in the UK, with higher rates among socioeconomically disadvantaged people. Gypsies and Travellers are ethnic and cultural minorities who experience extreme social disadvantage but there is a lack of knowledge about their alcohol use. The study aim was to explore experiences of alcohol use and harm in these distinct groups. Taking a participatory research approach, peer researchers conducted semistructured interviews (n = 26) to explore experiences of alcohol use and harm within the following four Gypsy/Traveller communities: Irish Travellers, Boaters, Gypsies, and Slovakian Roma. Vignettes were used as a basis for interview questions. Data were analysed thematically following the framework model. Alcohol consumption was found to be fundamental to celebration in all groups and integrated within social norms. Among Gypsies, Irish Travellers and Roma, drinking was associated with masculinity and despite an increase in alcohol use among women, female drinking remains highly socially regulated. Gypsies and Irish Travellers reported being illegally excluded from public drinking venues, while Slovakian Roma experienced less discrimination towards their ethnic group in the UK. Knowledge of the risks of alcohol dependence was high in all groups, but there was little awareness of the health impact of regular heavy drinking. Shame was a barrier to help-seeking for Gypsy, Roma, and Irish Traveller men and women, while Boaters’ nomadism reduced access to both primary care and alcohol treatment services. These distinct ethnic and cultural groups are aware of the health and social risks of alcohol use but experience barriers to accessing healthcare. Each community has different needs in relation to prevention of alcohol dependence, highlighting the need for targeted health promotion to accompany national strategies to reduce alcohol harm.

Psychologically Traumatic Birth: Associations with Increased Drinking and Delayed Risk of Alcohol Harm in Mothers

Abstract Background Experience of trauma is a risk factor for increased alcohol use. Childbirth can be psychologically traumatic but there is minimal research investigating whether psychological birth trauma (PBT) is a risk factor for increased maternal drinking or what factors are associated with alcohol use in mothers who have and who have not experienced PBT. Method An online observational survey of mothers with (n = 291) and without (n = 230) experience of PBT. Participants self-reported alcohol use and completed measures of alcohol harm, drinking motives, trauma (general and birth related) and mental health. Free text options were included to complement quantitative data. Results Irrespective of PBT status, stronger endorsement of negative reinforcement drinking motives (e.g. coping) predicted higher alcohol use and hazardous drinking. However, children’s age influenced this relationship. In mothers with a history of PBT, negative reinforcement drinking motives predicted weekly alcohol use and alcohol harm as their children grew older. In mothers without PBT, positive reinforcement drinking motives predicted greater weekly alcohol use as children grew older, but negative drinking motives predicted reduced drinking. Multiple aspects of the parental role influenced drinking (e.g. coping-based motives) and non-drinking (e.g. child well-being motives) behaviour. Changes in motives from pre-motherhood to motherhood focused around a shift from positive to negative reinforcement drinking motives. Mothers with PBT reported mental health symptoms as both a reason to drink and not to drink alcohol. Conclusion This study provides novel evidence on maternal alcohol use, and how PBT may influence drinking behaviour in mothers. Importantly, PBT may be a type of trauma which is associated with a delayed risk for maladaptive alcohol use and risk of alcohol harm. This evidence can facilitate more research aimed at understanding this important public health issue and can inform alcohol interventions tailored to the needs of mothers which consider the long-lasting impact of birth experience.

A systematic review to determine the effect of strategies to sustain chronic disease prevention interventions in clinical and community settings: study protocol

BackgroundThe primary purpose of this review is to synthesise the effect of strategies aiming to sustain the implementation of evidenced-based interventions (EBIs) targeting key health behaviours associated with chronic disease (i.e. physical inactivity, poor diet, harmful alcohol use, and tobacco smoking) in clinical and community settings. The field of implementation science is bereft of an evidence base of effective sustainment strategies, and as such, this review will provide important evidence to advance the field of sustainability research.MethodsThis systematic review protocol is reported in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) checklist. Methods will follow Cochrane gold-standard review methodology. The search will be undertaken across multiple databases, adapting filters previously developed by the research team, data screening and extraction will be performed in duplicate, strategies will be coded using an adapted sustainability-explicit taxonomy, and evidence will be synthesised using appropriate methods (i.e. meta-analytic following Cochrane or non-meta-analytic following SWiM guidelines). We will include any randomised controlled study that targets any staff or volunteers delivering interventions in clinical or community settings. Studies which report on any objective or subjective measure of the sustainment of a health prevention policy, practice, or programme within any of the eligible settings will be included. Article screening, data extraction, risk of bias, and quality assessment will be performed independently by two review authors. Risk of bias will be assessed using Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2). A random-effect meta-analysis will be conducted to estimate the pooled effect of sustainment strategies separately by setting (i.e. clinical and community). Sub-group analyses will be undertaken to explore possible causes of statistical heterogeneity and may include the following: time period, single or multi-strategy, type of setting, and type of intervention. Differences between sub-groups will be statistically compared.Discussion/conclusionThis will be the first systematic review to determine the effect of strategies designed to support sustainment on sustaining the implementation of EBIs in clinical and community settings. The findings of this review will directly inform the design of future sustainability-focused implementation trials. Further, these findings will inform the development of a sustainability practice guide for public health practitioners.Systematic review registrationPROSPERO CRD42022352333.

Burden of Mental Disorders and Suicide Attributable to Childhood Maltreatment

The proportion of mental disorders and burden causally attributable to childhood maltreatment is unknown. To determine the contribution of child maltreatment to mental health conditions in Australia, accounting for genetic and environmental confounding. This meta-analysis involved an epidemiological assessment accounting for genetic and environmental confounding between maltreatment and mental health and 3 cross-sectional national surveys: the Australian Child Maltreatment Study (ACMS) 2023, National Study of Mental Health and Well-being 2020-2022, and Australian Burden of Disease Study 2023. Causal estimates were derived on the association between childhood maltreatment and mental health conditions from a meta-analysis of quasi-experimental studies. This was combined with the prevalence of maltreatment from the ACMS to calculate the population attributable fraction (PAF). The PAF was applied to the number and burden of mental health conditions in Australia, sourced from 2 population-based, nationally representative surveys of Australians aged 16 to 85 years, to generate the number and associated burden of mental disorders attributable to child maltreatment. Physical abuse, sexual abuse, emotional abuse, or neglect prior to age 18 years. Proportion and number of cases, years of life lost, years lived with disability, and disability-adjusted life-years of mental health conditions (anxiety, depression, harmful alcohol and drug use, self-harm, and suicide attempt) attributable to childhood maltreatment. Meta-analytic estimates were generated from 34 studies and 54 646 participants and applied to prevalence estimates of childhood maltreatment generated from 8503 Australians. Childhood maltreatment accounted for a substantial proportion of mental health conditions, ranging from 21% (95% CI, 13%-28%) for depression to 41% (95% CI, 27%-54%) of suicide attempts. More than 1.8 million cases of depressive, anxiety, and substance use disorders could be prevented if childhood maltreatment was eradicated. Maltreatment accounted for 66 143 years of life lost (95% CI, 43 313-87 314), primarily through suicide, and 184 636 disability-adjusted life-years (95% CI, 109 321-252 887). This study provides the first estimates of the causal contribution of child maltreatment to mental health in Australia. Results highlight the urgency of preventing child maltreatment to reduce the population prevalence and burden of mental disorders.

Liver Fibrosis Assessed Via Noninvasive Tests Is Associated With Incident Heart Failure in a General Population Cohort

The aim of this study was to determine whether liver fibrosis is associated with heart failure in a general population cohort, and if genetic polymorphisms (PNPLA3 rs738409; TM6SF2 rs58542926), linked to increased risk of liver fibrosis and decreased risk of coronary artery disease, modify this association. Using UK Biobank data, we prospectively examined the relationship between noninvasive fibrosis markers (nonalcoholic fatty liver disease [NAFLD] fibrosis score [NFS], Fibrosis-4 [FIB-4] and aspartate transaminase [AST] to platelet ratio index [APRI]) and incident hospitalization/death from heart failure (n= 413,860). Cox-regression estimated hazard ratios (HRs) for incident heart failure. Effects of PNPLA3 and TM6SF2 on the association between liver fibrosis and heart failure were estimated by stratifying for genotype and testing for an interaction between genotype and liver fibrosis using a likelihood ratio test. A total of 12,527 incident cases of heart failure occurred over a median of 10.7 years. Liver fibrosis was associated with an increased risk of hospitalization or death from heart failure (multivariable adjusted high-risk NFS score HR, 1.59; 95% confidence interval [CI],1.47-1.76; P < .0001; FIB-4 HR, 1.69; 95% CI, 1.55-1.84; P < .0001; APRI HR, 1.85; 95% CI, 1.56-2.19; P < .0001; combined fibrosis scores HR, 1.90; 95% CI, 1.44-2.49; P < .0001). These associations persisted for people with metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with alcohol consumption (Met-ALD), and harmful alcohol consumption. PNPLA3 rs738409 GG and TM6SF2 rs58542926 TT did not attenuate the positive association between fibrosis markers and heart failure. For PNPLA3, a statistically significant interaction was found between PNPLA3 rs738409, FIB-4, APRI score, and heart failure. In the general population, serum markers of liver fibrosis are associated with increased hospitalization/death from heart failure. Genetic polymorphisms associated with liver fibrosis were not positively associated with elevated heart failure risk.

Determinants of depressive and alcohol use disorders among female sex workers in Ethiopia: evidence from a national bio-behavioral survey, 2020

BackgroundFemale sex workers (FSWs) face an elevated risk of developing mental health disorders and alcohol use disorders (AUD), which in turn increase their vulnerability to HIV and other sexually transmitted infections (STIs) and other negative outcomes. To effectively address both of these health issues, it is crucial to understand the shared key determinants underlying these illnesses, which is a substantial knowledge gap in Ethiopia and elsewhere in the world. Therefore, this study aimed to identify the common key determinants of depression and AUD among FSWs in Ethiopia using a bivariate multivariable ordinal logistic model.MethodsWe analyzed cross-sectional biobehavioral data collected in 2020 from 16 cities and major towns in Ethiopia using the respondent-driven sampling (RDS) technique, which involved a total of 6,085 FSWs. FSWs who had lived at the study sites for at least a month before the study period were deemed eligible for recruitment. Major depressive disorder (DD) and AUD were screened using the Patient Health Questionnaire (PHQ9) and alcohol use disorder identification test (AUDIT), respectively. We used descriptive statistics to summarize study population characteristics and bivariate multivariable ordinal logistic regression (BMOLR) to identify common determinants of DD and AUD combined and their nonnormal correlation.ResultsAmong 6085 FSWs screened for DD and AUD, 13.5% and 4.0% have met the criteria for moderate and severe depressive disorder, respectively, and 20.3% and 34.7% have met the AUDIT criteria for harmful or hazardous behavior and alcohol dependence, respectively. FSW with experience of inconsistent condom use, condom failure, violence, mobility, use of any drugs, non-paying partners, abortion, and selling sex for more than five years were associated with an increase in the severity of both disorders. A high average income from selling sex and the number of paying partners reduced the severity of depression and increased the level of alcohol dependence. Being HIV positive and ever having anal sex were associated only with an increase in depression.ConclusionMajor DD and AUD are prevalent among FSWs in Ethiopia. The findings revealed that common key determinants, which exacerbated the severity of both disorders, were also risk factors for HIV and other STIs. Consequently, integrated STI strategies are essential in the screening, referral, and treatment of depression and AUD. Intervention packages should encompass determinants of depression and AUD, including condom utilization, drug use, mobility between towns, abortion, violence, and counseling services. Additionally, strategies to ensure economic security should be incorporated.

Evaluation of harmful drinking among professional drivers by direct ethanol biomarkers and its relation with psychological distress

Objective This study aimed to evaluate the alcohol consumption among professional truck and bus drivers using direct ethanol biomarkers, and to explore its relationship with anxiety, depression, and stress. Methods The assessment of potential harmful drinking was conducted through the measurement of direct biomarkers: phosphatidylethanol (PEth), ethyl glucuronide (EtG), and ethyl sulfate (EtS), using dried blood spots (DBS). Additionally, self-reported data from the Alcohol Use Disorders Identification Test (AUDIT-C) were used. Emotional states, including depression, anxiety, and stress, were evaluated using the Depression, Anxiety, and Stress Scale (DASS-21). Results A total of 97 drivers participated in the study, with the majority being male (96%) and identified as truck drivers (75.3%). Among them, 43.3% reported working more than 10 h daily. The majority of volunteers exhibited normal levels of stress (81.4%), anxiety (83%), and depression (86.6%). According to the AUDIT-C assessment, 30.9% were categorized as having a moderate risk, while 11.3% were deemed to be at high risk for harmful alcohol consumption behavior. Ethyl glucuronide (EtG) and ethyl sulfate (EtS) levels, indicating recent ethanol consumption, were detected in 14.4% of the drivers. In contrast, the long half-life metabolite PEth (16:0-18:1) was present in 88.7% of the volunteers. A moderate correlation (rs = 0.45, p < .01) was observed between PEth levels and AUDIT-C scores. The Receiver Operating Characteristic (ROC) curve, utilizing a PEth threshold of ≥ 59.0 ng ml−1, displayed 78% sensitivity and 73% specificity in effectively distinguishing high risk for alcohol intake. Notably, no significant associations were found between alcohol consumption and levels of stress, depression, and anxiety. Conclusions The study findings indicate a noteworthy proportion of drivers engaging in regular alcohol consumption alongside a demanding workload. Notably, PEth measurements highlighted an underreporting within the AUDIT-C self-reports. These results lend robust support for the utilization of biomarkers in assessing alcohol consumption patterns among drivers.

Early Liver Transplant for Alcohol-associated Liver Disease Has Excellent Survival but Higher Rates of Harmful Alcohol Use

Background and AimsEarly liver transplantation for alcohol-associated liver disease (ALD) has increased worldwide. Short-term outcomes have been favorable, but data on longer-term outcomes are lacking. MethodsSingle-center retrospective study of primary LT recipients between 2010-2020, with follow-up through July 1, 2022. Survival analysis was performed using log rank, Cox models, and Kaplan-Meier method. Cox models were created to identify variables associated with mortality, logistic regression to identify variables associated with post-LT alcohol use. ResultsOf 708 patients who underwent LT, 110 (15.5%) had ALD and abstinence <6 months prior to LT (ELT), 234 (33.1%) had ALD and alcohol abstinence >6 months (SLT), and 364 (51.4%) had non-ALD diagnoses. Median follow-up was 4.6 years (IQR 2.6, 7.3). ELT recipients were younger (p=0.001) with median abstinence pre-LT of 61.5 days. On adjusted Cox model, post-LT survival was similar in ELT and SLT (HR 1.31, p=0.30) and superior to non-ALD (HR 1.68, p=0.04). Alcohol use (40.9% vs 21.8%, p<0.001) and harmful alcohol use (31.2% vs 16.0%, p=0.002) were more common in ELT recipients. Harmful alcohol use was associated with post-LT mortality on univariate (HR 1.69, p=0.03), but not multivariable regression (HR 1.54, p=0.10). Recurrence of decompensated ALD trended toward more common in ELT (9.1% vs 4.4%, p=0.09). Greater than 6 months pre-LT abstinence was associated with a decreased risk of harmful alcohol use (OR 0.42, p=0.001), but not in a multivariable model (OR 0.71, p=0.33). ConclusionsPatients who undergo ELT for ALD have similar or better survival than other diagnoses in the first 10-years after LT despite a higher incidence of post-LT alcohol use.

Making decisions one drink at a time and the "just one drink" effect: A fuzzy-trace theory model of harmful drinking.

Understanding the decision factors that drive harmful alcohol use among young adults is of practical and theoretical importance. We apply fuzzy-trace theory (FTT) to investigate a potential danger that may arise from the arguably correct notion that a single drink carries no meaningful risk. Decisions that are mentally represented as one drink at a time could contribute to excessive drinking. College students (N = 351) made a series of decisions to take or decline eight hypothetical drinks presented one at a time. Outcome measures included each decision, recent alcohol consumption (weekly drinks, peak blood alcohol content, and binges), and alcohol-related harms (scores on the Brief Young Adult Alcohol Consequences Questionnaire and Alcohol Use Disorders Identification Test). Linear regression models predicted each outcome from sex, perceived risk of a single drink, perceived risk of heavy drinking, perceived consequences of drinking, and general health-related risk sensitivity. Consistent with FTT, decisions to have a first drink and up to four additional drinks in short succession were each associated with lower perceived risk of one drink-a "just-one drink" effect-independent of perceived risks of heavy drinking, perceived consequences of drinking, and general risk sensitivity. Similarly, all measures of recent alcohol consumption and consequent harms were associated with perceived risk of one drink. Participants reporting "zero risk" of a single drink had worse outcomes on all measures than those reporting at least "low risk." Results are consistent with the theoretically informed premise that consumption decisions are typically made one drink at a time rather than by deciding the total number of drinks to be consumed in a sitting. When decisions about alcohol use proceed one drink at a time, a perception of zero risk in a single drink may contribute to heavy drinking.

The mental health prognosis of offspring born of genocidal rape is influenced by family members, the community and their perceptions toward them.

There is little known about the family and community maltreatment of the offspring born of the genocidal rape and the offspring's self-perceptions and how they influence their recovery from mental health problems. This study aimed to examine how the mental health prognosis of these offspring could be influenced by the family or community perceptions and attitudes toward them and their self-perception and coping strategies. Thirty-two semi-structured qualitative interviews were conducted on 16 dyads of mothers and their offspring who were selected from countrywide. The interviews were audio-recorded and transcribed verbatims that were analysed inductively using thematic analysis within the NVivo 12 software. Participants reported long-term psychological and psychosomatic consequences stemming from being born of genocidal rape. Notably, family and community maltreatment of the offspring and their self-perception exacerbated psychological distress and affected their capacity to recover. The majority of the offspring were using coping strategies such as sole collaboration with peers with the same history, efforts to hide their birth history, social Isolation (silence, untrusting, involvement in media etc), hardworking, reversed roles in the parental relationship, extreme involvement in praying, and harmful alcohol use. Given the documented detrimental effects of individual, family and community attitudes and perceptions on psychological, and psychosomatic symptoms as well as the offspring coping strategies, culturally relevant mental health interventions are required to support the well-being and social reintegration of individuals born of genocidal rape while minimizing stigma and their maladaptive coping strategies.

Alcohol Use and Deaf and Hard of Hearing College Students

&lt;i&gt;Alcohol misuse on college campuses has been shown to be the cause of physical, socio-emotional, and academic harms. Alcohol is also an issue at Gallaudet University but there is a gap in the literature describing this phenomenon. Using the social ecological model, this qualitative case study explored student perceptions and experiences with alcohol use through interviews with 24 deaf and hard of hearing college students at Gallaudet University. The main themes included: something to do, isolation, coping, communication, “playing catch up with life,” belonging, peer pressure, and university dynamics. The results of this study supported the research on alcohol use in the college environment, showing these themes to also be true at Gallaudet University. As a result, researchers recommend for Gallaudet University and other institutions use the education and interventions shown to be effective in the College Alcohol Intervention Matrix with deaf and hard of hearing students. Researchers also identified themes that were divergent from general college students and specific to the experience of being deaf and hard of hearing. This study highlighted the interpersonal level impact and importance of communication with alcohol and related harms. Researchers recommend further research on the spectrum of communication isolation on alcohol use, related harms, and the social-ecological impact of these experiences. In addition, researchers recommend programming and services to specifically address the issues that occur as a result of isolation, coping challenges, desire to belong, susceptibility to peer pressure, and wanting to catch up on life. It is hoped that the insights gained from this study will be used to inform interventions for deaf and hard of hearing college students, to reduce alcohol misuse, and thus to impact positive change.&lt;/i&gt;

Sociodemographic risk factors for the persistence of harmful alcohol use: a pooled analysis of prospective cohort studies.

Previous research suggests several sociodemographic risk factors for the persistence of harmful alcohol use. However, the evidence is limited due to short follow-up times, retrospective reporting and samples comprising onlypeople with alcohol dependence. We pooled data from six prospective cohort studies to systematically evaluate whether the sociodemographic risk factors differ between the incidence and persistence of harmful alcohol use. Data were from six prospective cohort studies from the US, UK and Japan (n = 28,394). We conducted a two-stage meta-analysis to examine the associations of six sociodemographic risk factors (sex, age, presence of a partner, educational attainment, smoking and psychological distress) with the incidence and persistence of harmful alcohol use. Tests of heterogeneity were used to evaluate whether the associations differ between the incident and persistent use. Male sex, younger age, higher education, smoking, and psychological distress were associated with a greater risk of both the incidence and the persistence of harmful alcohol use in mutually adjusted models (ORs = 0.97-1.67). There were no differences in the associations of these risk factors with incident and persistent use, except that the association of psychological distress was greater with incident use compared to persistent use (p for heterogeneity < 0.05). These findings suggest that the incidence and persistence of harmful alcohol use share a similar set of sociodemographic risk factors in the general population.