Decrease In Alcohol Consumption Research Articles

Elevation of Transient Receptor Potential Vanilloid 1 Function in the Lateral Habenula Mediates Aversive Behaviors in Alcohol-withdrawn Rats.

Chronic alcohol use and withdrawal leads to increased pain perception, anxiety, and depression. These aberrant behaviors are accompanied by increased excitatory glutamatergic transmission to, and activity of, the lateral habenula neurons.Vanilloid type 1, or TRPV1, channels are expressed in the habenula and they facilitate glutamatergic transmission. Whether TRPV1 channel plays a role in habenula hyperactivity is not clear. Glutamatergic transmission in the lateral habenula was inhibited by TRPV1 channel antagonists. In vivo, local administration of TRPV1 antagonists into the lateral habenula attenuated hyperalgesia, anxiety, and relapse-like drinking in rats who chronically consumed alcohol.The data suggest that enhanced TRPV1 channel function during withdrawal may contribute to aberrant behavior that promotes relapse alcohol consumption. Recent rat studies indicate that alcohol withdrawal can trigger a negative emotional state including anxiety- and depression-like behaviors and hyperalgesia, as well as elevated glutamatergic transmission and activity in lateral habenula neurons. TRPV1, a vanilloid receptor expressed in the habenula, is involved in pain, alcohol dependence, and glutamatergic transmission. The authors therefore hypothesized that TRPV1 contributes to the changes in both the behavioral phenotypes and the habenula activity in alcohol-withdrawn rats. Adult male Long-Evans rats (n = 110 and 280 for electrophysiology and behaviors, respectively), randomly assigned into the alcohol and water (Naïve) groups, were trained to consume either alcohol or water-only using an intermittent-access procedure. Slice electrophysiology was used to measure spontaneous excitatory postsynaptic currents and firing of lateral habenula neurons. The primary outcome was the change in alcohol-related behaviors and lateral habenula activity induced by pharmacologic manipulation of TRPV1 activity. The basal frequency of spontaneous excitatory postsynaptic currents and firing of lateral habenula neurons in alcohol-withdrawn rats was significantly increased. The TRPV1 antagonist capsazepine (10 µM) induced a stronger inhibition on spontaneous excitatory postsynaptic currents (mean ± SD; by 26.1 ± 27.9% [n = 11] vs. 6.7 ± 18.6% [n = 17], P = 0.027) and firing (by 23.4 ± 17.6% [n = 9] vs. 11.9 ± 16.3% [n = 12], P = 0.025) in Withdrawn rats than Naive rats. By contrast, the TRPV1 agonist capsaicin (3 μM) produced a weaker potentiation in Withdrawn than Naïve rats (spontaneous excitatory postsynaptic currents: by 203.6 ± 124.7% [n = 20] vs. 415.2 ± 424.3% [n = 15], P < 0.001; firing: 38.1 ± 14.7% [n = 11] vs. 73.9 ± 41.9% [n = 11], P < 0.001). Conversely, capsaicin's actions in Naïve but not in Withdrawn rats were significantly attenuated by the pretreatment of TRPV1 endogenous agonist N-Oleoyldopamine. In Withdrawn rats, intra-habenula infusion of TRPV1 antagonists attenuated hyperalgesia and anxiety-like behaviors, decreased alcohol consumption upon resuming drinking, and elicited a conditioned place preference. Enhanced TRPV1 function may contribute to increased glutamatergic transmission and activity of lateral habenula neurons, resulting in the aberrant behaviors during ethanol withdrawal.

Declining alcohol consumption among adolescents and schools in Stockholm, 2010-2016.

Aims:The principle aim of this study was to investigate changes in alcohol consumption among adolescents in Stockholm from 2010 to 2016. A further aim was to investigate whether there are divergent or similar trends in alcohol consumption among elementary schools in Stockholm from 2010 to 2016 and, if there are diverging trends, to examine how the differences might be explained.Methods:Data were analysed using multilevel mixed effects linear regression, in which individual students represented one level and schools the second level.Data:Student-level data were derived from the Stockholm School Survey for the years 2010, 2012, 2014 and 2016 (n = 15481). School-level data (n = 132) were derived from registries of the Swedish National Agency for Education.Results:The results showed that there was an almost 45% decline in total alcohol consumption among ninth-grade students in Stockholm between 2010 and 2016. The decline was similar among all analysed consumption groups. Two factors were found to statistically explain some of the general decline: more restrictive parental attitudes towards alcohol and, more importantly, decreasing alcohol consumption among the students’ peers. The downward trends among schools between 2010 and 2016 were universal but not identical, but when parental attitudes towards alcohol and peers’ alcohol behaviour were controlled for, the diverging school trends in alcohol consumption were considerably more equal.Conclusions:School constitutes a social context for the student of which both parents and peers are important parts, and the diverging changes may be due to the norms and behaviours, influenced by parents and peers, characterising these schools.

Epidemiology of low-energy lower extremity fracture in Chinese populations aged 50 years and above.

This study aimed to investigate the epidemiology of low-energy lower-extremity fracture in Chinese men and women aged 50 years and above. This study was a part of Chinese National Fracture Survey (CNFS), which used the stratified multistage cluster random sampling method to recruit subjects between January and May 2015. A total of 512187 individuals participated in the CNFS and of them there were 154099 men and women aged 50 years and above included in this study for data analysis. Low-energy fracture was defined as a fracture caused by slip, trip or fall from standing height. Univariate analyses and gender-based multivariate logistic regression models were constructed to identify the independent risk factors. A total of 215 patients had sustained low-energy lower extremity fractures in 2014, indicating the overall incidence was 139.5 (120.9 to 158.2) per 100000 persons, with 127.8 (102.5 to 153.1) and 151.1 (123.8 to 178.5) per 100000 person-year in men and women. Over 80% of fractures occurred at home and on the common road. In men, alcohol consumption (OR, 2.00; 95%CI, 1.29 to 3.08), sleep duration<7h/d (OR, 2.60; 95%CI, 1.68 to 4.03) and history of past fracture (OR, 2.57; 95%CI, 1.33 to 4.95) were identified as significant risk factors associated with low-energy fractures. In women, advanced age (80+ years) (OR, 3.22; 95%CI, 1.80 to 5.75), alcohol consumption(OR, 1.72; 95%CI, 1.00 to 2.98), sleep duration <7h/d (OR, 2.11; 95%CI, 1.40 to 3.18), and history of past fracture (OR, 3.46; 95%CI, 1.97 to 6.09) were identified as significant risk factors and living in western region (OR, 0.60; 95%CI, 0.38 to 0.94) and current weight of 50 to 59.9 kg (OR, 0.17; 95%CI, 0.04 to 0.73) were identified as protective factors for fractures. Accordingly, awareness on the importance of sleep and alcohol consumption on fragility fracture should be improved, and health policies that focus on decreasing alcohol consumption and encouraging individuals to improve their sleep quality and duration should be considered. Maintaining a healthy bodyweight for women should be specifically emphasized to prevent low-energy fractures.

Psychiatric morbidity in violent and nonviolent offenders: A cross-sectional comparative study

Background: Several studies have found that mental illnesses are very commonly seen in the prison population when compared to the normal population and they are a major public health concern. In most of the cases, it is very difficult to differentiate between abnormal personality and criminal behavior and their influence on psychopathology. In the literature, there were many studies done on the entire prison population. However, there were very few studies that compared the characteristics and psychopathology of both violent and nonviolent offenders which are distinct in many ways. Hence, the current study focussed on how the violent differ from the non-violent offenders. Aim: This study aims to study the various sociodemographic factors, crime characteristics, and psychiatric morbidity in violent offenders and nonviolent offenders. Study Design: It is a cross-sectional comparative study conducted at central prison Cherlapalli, Hyderabad. Materials and Methods: Study sample includes 61 violent offenders involved in serious crimes like murder (IPC SEC 302), attempt to murder (IPC SEC 307) and 34 nonviolent offenders (involved in other crimes like theft, check bounce, etc.) The characteristics are analyzed using semi-structured intake pro forma, and psychopathology is analyzed using International Classification of Diseases 10 criteria and MINI scale. Results and Conclusions: In our study, significant differences between the two groups were found in domicile, employment status, marital status, and duration of stay in prison. History of psychiatric illness before and after the crime is most commonly seen in violent offenders when compared to nonviolent offenders. Significant previous incarcerations were high in nonviolent offenders when compared to nonviolent offenders. In both the groups, more than half of the individuals had either alcohol abuse or dependence pattern, and high rates of substance intoxication at the time of the commission of the crime were found in violent offenders. Less than one-fourth of both groups were found to have psychiatric illness apart from alcohol. Hence, more awareness programs and campaigns regarding the influence of alcohol on the crimes can be conducted with the help of police, government, private organizations, and media, especially directed at vulnerable and at-risk population for crime, would indirectly decrease crime rate by decreasing alcohol consumption. There are a lot of studies in Indian literature regarding the psychopathology in the whole of the prison population and also in violent offenders; but, there are very few studies comparing both violent and nonviolent offenders which are a distinct population.

Utilization of the Transtheoretical Model to Determine the Qualitative Impact of a Tribal FASD Prevention Program.

Alcohol consumption during pregnancy can lead to damaging effects on an infant’s health, including fetal alcohol spectrum disorders. Project Changing High-risk alcOhol use and Increasing Contraception Effectiveness Study (CHOICES), a program developed to reduce alcohol-exposed pregnancies through decreased alcohol consumption and increased birth control use, has been implemented with success in a variety of populations. The CHOICES program was structured to align with the transtheoretical model (Stages of Change), a popular public health model. Although studies have described the Stages of Change in the context of a variety of health behaviors, none have addressed the qualitatively distinct characteristics of each stage in the context of American Indian (AI) women’s alcohol and birth control use. A framework analysis of 203 participants’ written responses during their experience in the Oglala Sioux Tribe (OST) CHOICES Program was conducted. As a conceptual framework, the transtheoretical model of behavior change was applied to the participants’ experiences, with two staff reading the open-ended responses and coding based on the stage of change. Participants’ responses suggest qualitatively distinct stages as well as a progression through the stages for both behaviors during the course of the program. Many participants mentioned their children, education, and work as inspiration to decrease their unhealthy behaviors. Common barriers to behavior change were found across both behaviors. The open-ended responses uncover common themes in the experiences of the participants. These results can help inform future programs which hope to address the needs of AI communities.

Incidence and risk factors for foot fractures in China: A retrospective population-based survey.

PurposeThe literature lacks population-based epidemiologic studies on the incidence and risk factors for traumatic foot fractures. The purpose of this study was to update information concerning the incidence of foot fractures in China and to identify associated risk factors.MethodsAll the data on foot fractures were available from the China National Fracture Survey (CNFS), which was conducted between January and May in 2015. A total of 8 provinces, 24 urban cities and 24 rural counties in China were selected, using stratified random sampling and the probability proportional to size method. Individuals who had lived in their current residence for 6 months or longer were personally interviewed about any foot fracture that had occurred in 2014. Questionnaires were completed by every participant for data collection and quality control was accomplished by our research team members. The information included age, gender, height, weight, ethnic group, education, occupation, smoking, alcohol consumption, sleeping time per day, dietary habits and others. Fracture was initially identified by patients' self report and further confirmed by their providing medical records.ResultsA total of 512187 individuals participated in the CNFS. There were 201 patients with foot fractures in 2014. Mean age at the time of fracture was 45.4 years. The incidence rate of foot fractures was 39.2 (95%CI: 33.8–44.7)/100000/year. Fall and traffic accident were the most common causes for foot fractures and over 60% of these occurred at home or on the road. Alcohol consumption, history of previous fracture and average sleep time <7h/d were identified as independent risk factors for foot fractures both in males and females. Cigarette smoking was identified as a significant risk factor for foot fracture in males. For females, BMI >24 kg/m2 was a risk factor whilst living in the west region was associated with a lower incidence rate of foot fracture.ConclusionsThe present study shows an incidence of 39.2/100000/year of foot fractures in China. Specific public health policies focusing on decreasing alcohol consumption and encouraging individuals to obtain sufficient sleep should be implemented. Females with a higher BMI should focus more on foot health care, especially in those with history of previous fracture.

Relationship between diet, atopy, family history, and premature hair graying.

Premature hair graying (PHG) is commonly observed in society, but there are a few studies evaluating risk factors associated with PHG. We aimed to evaluate the socio-clinical risk factors associated with PHG in this study. A total of 1192 volunteers between 18 and 20years old were included in this cross-sectional study. Volunteers were asked to fill in a questionnaire on socio-clinical risk factors associated with PHG such as smoking, alcohol consumption, diet preference, atopy history, and family history of PHG and Perceived Stress Scale (PSS). Three hundred and seventy-seven (31.6%) of the 1192 volunteers had PHG. Vegetarian diet preference, atopy history, and family history of PHG were significantly higher in subjects with PHG. Mean body mass index (BMI) and PSS scores were higher in subjects with PHG, but was not statistically significant. In the ordinal logistic regression analysis according to severity of PHG, male gender, BMI, alcohol consumption, and history of paternal PHG were significantly higher and onset age of PHG was significantly lower in PHG group. Our study is the first study reporting a relationship between PHG and diet. It may be possible to prevent PHG or reduce its severity with some lifestyle changes such as diet preference, having normal weight, and decreasing alcohol consumption.

Alcohol Intake and Weight Loss During Intensive Lifestyle Intervention for Adults with Overweight or Obesity and Diabetes.

Objective:To assess whether alcohol consumption decreases during an intensive lifestyle intervention (ILI) and whether alcohol consumption is associated with weight loss among participants with overweight/obesity and type 2 diabetes.Methods:Participants (n=4,901) were from the Action for Health in Diabetes (Look AHEAD) study, an RCT that compared an ILI to a diabetes support and education (DSE) control. Mixed effects models were used to estimate the effect of the ILI on alcohol consumption, and the influence of alcohol consumption on weight loss at year 4.Results:ILI and DSE participants did not differ in changes in alcohol consumption. Alcohol intake was not associated with weight loss at year 1 of the ILI. ILI participants who abstained from alcohol lost 5.1±0.3% of initial weight at year 4, compared to a significantly (p=0.04) smaller 2.4±1.3% for consistent-heavy drinkers. ILI participants who abstained from alcohol consumption over the 4 years lost 1.6±0.5% more weight relative to individuals who drank alcohol at any time during the intervention (p=0.003). DSE participants did not differ in weight loss by alcohol consumption.Conclusions:Heavy alcohol drinkers are at risk for suboptimal long-term weight loss. Decreasing alcohol consumption may improve weight management among individuals with diabetes.

Peer and parental influence in academic performance and alcohol use

This paper analyzes the interactions between peers and parents in the development of adolescent's cognitive skills, proxied by the academic performance of adolescents, and the predisposition to risky behavior, proxied by the frecuency of alcohol consumption. We estimate a technology of skill formation that identifies peer effects on the basis of quasi-random assignment of students across classes, time varying data, and the use of instrumental variables. We find that both peer and parental socialization efforts have a positive influence over adolescents’ academic skills, and that these effects are complementary: as parents invest more, peers amplify their effects. Our results suggest that peer effects are heterogenous (boys, popular students and high achievers are more likely to be influenced by peers academic abilities). On the other hand, we do not find robuts evidence of peer effects on the frecuency of alcohol consumption. We do find, however, that parental investment decreases alcohol consumption.

Effects of combined brief etomidate anesthesia and postnatal stress on amygdala expression of Cl− cotransporters and corticotropin-releasing hormone and alcohol intake in adult rats

Early life stressors, including general anesthesia, can have adverse effects on adult neural and behavioral outcomes, such as disruptions in inhibitory signaling, stress responsivity and increased risk of psychiatric disorders. Here we used a rat model to determine the effects of combined exposure to etomidate (ET) neonatal anesthesia and maternal separation on adult amygdala expression of genes for corticotropin-releasing hormone (Crh) and the chloride co-transporters Nkcc1 and Kcc2, as well as ethanol intake. Male and female Sprague-Dawley rats were subjected to 2 h of ET anesthesia on postnatal days (P) 4, 5, or 6 followed by maternal separation for 3 h on P10 (ET + SEP). During the P91-P120 period rats had daily 2 h access to three 0.05% saccharin solutions containing 0%, 5%, or 10% ethanol, followed by gene expression analyses. The ET + SEP group had increased Crh mRNA levels and Nkcc1/Kcc2 mRNA ratios in the amygdala, with greater increases in Nkcc1/Kcc2 mRNA ratios in males. A moderate increase in 5% ethanol intake was evident in the ET + SEP males, but not females, after calculation of the ratio of alcohol intake between the last week and first week of exposure. In contrast, control males tended to decrease alcohol consumption during the same period. A brief exposure to ET combined with a subsequent episode of stress early in life induced significant alterations in expression of amygdala Crh, Nkcc1 and Kcc2 with greater changes in the Cl− transporter expression in males. The possibility of increased alcohol intake in the exposed males requires further confirmation using different alcohol intake paradigms.

Demographic and socioeconomic factors influencing the incidence of ankle fractures, a national population-based survey of 512187 individuals

This study aimed to investigate the population-based incidence rate of ankle fracture and associated risk factors in China. All the data on ankle fractures were available from the China National Fracture Survey (CNFS) conducted between January and May in 2015. All eligible household members were sampled from 8 provinces, 24 urban cities and 24 rural counties in China, using stratified random sampling and the probability proportional to size method. Questionnaires were sent to every participant for data collection and quality control was accomplished by our quality control team members. A total of 512187 valid questionnaires were collected and relevant data were abstracted and analyzed. One hundred and ninety patients sustained 193 ankle fractures in 2014, indicating the incidence rate was 37.1 (95% CI, 31.8–42.4)/100,000 person-year. Alcohol consumption, living alone and average sleep time <7 h/d were identified as independent risk factors for ankle fracture in both males and females. Previous history of fracture was identified as significant risk factor of ankle fracture in females but not in males. Therefore, specific public health policies focusing on decreasing alcohol consumption and encouraging individuals to obtain sufficient sleep should be implemented. Individuals living alone should focus more on healthcare, especially in those with previous fracture.

Early post-natal neuroactive steroid manipulation modulates ondansetron effects on initial periods of alcohol consumption in rats.

Neuroactive steroids (NS) such as allopregnanolone are crucial for brain development and adult behaviour. Early post-natal alterations of NS by administering finasteride induce a decrease in the sensitivity to stimulant effects of low alcohol doses, an increase in alcohol consumption, and a decrease in ventrostriatal dopamine and serotonin levels. The aim of the present study is to observe if the effects of the 5HT3 receptor antagonist ondansetron on initial alcohol consumption are modulated by post-natal NS manipulation. For this purpose, allopregnanolone, finasteride, or vehicle was injected from day 5 to 9. In adulthood, a novel object preference test was carried out in order to detect a possible novelty-seeking pattern in our animals, which has been related to vulnerability to drug abuse. The subjects then had access to two bottles (alcohol or control solutions) one hour daily for two consecutive weeks. Ondansetron (0.01 mg/kg, 0.1 mg/kg or vehicle) was administered before the hour of consumption in the initial phase (days 1, 2, 3) of the procedure, and after prolonged alcohol intake (days 11, 12, 13). Results indicated that finasteride animals showed a higher preference to explore the new object, as well as a higher alcohol consumption than the rest of the groups. Moreover, 0.1 mg/kg of ondansetron decreased alcohol consumption, but only in the post-natal finasteride group, suggesting a possible increase in 5HT3 receptor sensitivity in these animals. In conclusion, NS manipulation in crucial stages of development, such as early post-natal periods, seems to play an important role on the effects of ondansetron on alcohol intake and in the vulnerability to develop drug use or abuse.

Socioeconomic factors and individual lifestyles influencing the incidence of patella fractures: a national population-based survey in China.

We aimed to do a national survey on the population-based incidence of patella fractures and related risk factors fracture in China. All the data on patella fractures were available from the China National Fracture Survey (CNFS) between January and May in 2015. And in the CNFS, all eligible household members were selected from 24 urban cities and 24 rural counties of eight provinces of China, with stratified random sampling and the probability proportional to size method used. Questionnaire was sent to every participant for data collection and quality control was accomplished by our research team members. A total of 512,187 valid questionnaires were collected, and relevant data were abstracted. There were a total of 69 patients with 69 patella fractures that occurred in 2014, indicating that the incidence was 13.5 (95% CI, 10.3-16.7))/100,000 person-years. Slip, trip, or fall from standing height was the most common cause, leading to 69.6% (48/69) of patella factures, followed by traffic accidents (18.8%, 13/69). Home and road were the first two most common places, where 86.9% of the overall injuries occurred. Age of 45-64 and 65-74years, alcohol consumption and previous history of fractures were identified as independent risk factors for patella fracture. Specific public health policies focusing on decreasing alcohol consumption should be implemented. Individuals aged 45-64 and 65-74 should pay more attention to bone mass density and prevention of falls, especially those with previous history of fracture.

The Effect of Parental Education on Children's Drug and Alcohol Use

This research is the first to uncover evidence of an intergenerational effect of education on substance use in the United States. Using data from the NLSY79 and variation in education induced by changes in compulsory schooling laws, we study the effect of parental education on children's use of drugs and alcohol. We find that an increase in parental education decreases alcohol consumption – binge drinking, in particular – and has no effect on marijuana consumption among youth. Given the high social costs associated with alcohol abuse, we conclude that previous research on education may appreciably underestimate the benefits of investments in education.

Critical Role for Gi/o-Protein Activity in the Dorsal Striatum in the Reduction of Voluntary Alcohol Intake in C57Bl/6 Mice.

The transition from non-dependent alcohol use to alcohol dependence involves increased activity of the dorsal striatum. Interestingly, the dorsal striatum expresses a large number of inhibitory G-protein-coupled receptors (GPCRs), which when activated may inhibit alcohol-induced increased activity and can decrease alcohol consumption. Here, we explore the hypothesis that dorsal striatal Gi/o-protein activation is sufficient to reduce voluntary alcohol intake. Using a voluntary, limited-access, two-bottle choice, drink-in-the-dark model of alcohol (10%) consumption, we validated the importance of Gi/o signaling in this region by locally expressing neuron-specific, adeno-associated-virus encoded Gi/o-coupled muscarinic M4 designer receptors exclusively activated by designer drugs (DREADD) in the dorsal striatum and observed a decrease in alcohol intake upon DREADD activation. We validated our findings by activating Gi/o-coupled delta-opioid receptors (DORs), which are natively expressed in the dorsal striatum, using either a G-protein biased agonist or a β-arrestin-biased agonist. Local infusion of TAN-67, an in vitro-determined Gi/o-protein biased DOR agonist, decreased voluntary alcohol intake in wild-type and β-arrestin-2 knockout (KO) mice. SNC80, a β-arrestin-2 biased DOR agonist, increased alcohol intake in wild-type mice; however, SNC80 decreased alcohol intake in β-arrestin-2 KO mice, thus resulting in a behavioral outcome generally observed for Gi/o-biased agonists and suggesting that β-arrestin recruitment is required for SNC80-increased alcohol intake. Overall, these results suggest that activation Gi/o-coupled GPCRs expressed in the dorsal striatum, such as the DOR, by G-protein biased agonists may be a potential strategy to decrease voluntary alcohol consumption and β-arrestin recruitment is to be avoided.

Perception of peer drinking and access to alcohol mediate the effect of residence status on alcohol consumption

Alcohol consumption is common in college attending populations and can have a negative impact on an individual's academic, physical, and mental health. Previous research suggests that living at home could act as a protective measure. The current research looks at potential mediators of the association between living with parents while attending college and amount of alcohol consumed. In particular, this study examined access to alcohol, parental involvement, and perception of peer drinking as mediators of the association. This study examined freshman data collected from a survey conducted at a large public university in the mid-Atlantic United States. A pathway model was fit to test the relationships between residence status, access to alcohol, parental involvement, and perception of peer drinking on alcohol consumption. We observed statistically significant indirect effects of residence status on alcohol consumption through the perception of peer drinking and access to alcohol. Parental involvement was significantly related to lower alcohol consumption and there was a direct effect of residence status on alcohol consumption. There were significant indirect effects of residence status on alcohol consumption through both peer drinking and access to alcohol. Parental involvement was associated with decreased alcohol consumption, with no indirect effect in association with residence status. These effects were persistent in the presence of a range of covariates, including age, gender, ethnicity, and parental education. KEYWORDS: Emerging Adult; Alcohol; Residence Status; Peer Drinking; Access to Alcohol; Parental involvement; Path Analysis

The effect on emergency department visits of raised alcohol minimum prices in Saskatchewan, Canada

The province of Saskatchewan, Canada introduced minimum prices graded by alcohol strength in April 2010. As previous research found this intervention significantly decreased alcohol consumption and alcohol-attributable morbidity, we aim to test the association between the intervention and the rate of emergency department (ED) visits in four alcohol-related injury categories [motor vehicle collisions (MVC), assaults, falls and total alcohol-related injuries]. Data on ED visits in the city of Regina were obtained from the Saskatchewan Ministry of Health. Auto-regressive integrated moving average time series models were used to test the immediate and lagged effects of the pricing intervention on rates of alcohol-related nighttime. ED visits and controlled for daytime rates of ED visits, economic variables, linear and seasonal trends, and auto-regressive and moving average effects. The implementation of an alcohol minimum pricing strategy in Saskatchewan was associated with decreased MVC-related ED visits for women aged 26 and over after a 6 month lag period (-39.4%, P < 0.001). There was no significant abrupt effect of this intervention on ED visits of four injury types in any of four gender-age categories; however, rates of ED visits among young males for MVCs and assaults decreased substantially during this study. The minimum pricing policy change led to a lagged decrease in motor vehicle-collision-related ED visits for women older than 25. Of note, there did not appear to be an instantaneous effect on the rate of alcohol-related injury ED visits immediately after the policy implementation nor lagged effects for other gender-age groups.

Demographic and socioeconomic factors influencing the incidence of clavicle fractures, a national population-based survey of five hundred and twelve thousand, onehundred and eighty sevenindividuals.

This study aims to investigate the population-based incidence of clavicle fracture and the related risk factors in China. All the data on clavicle fractures were available from the China National Fracture Survey (CNFS) database performed in 2015. In the CNFS, all eligible household members were sampled from eight provinces, 24 urban cities, and 24 rural counties in China, using stratified random sampling and the probability proportional to size method. Questionnaires were sent to every participant for data collection. Information on age, gender, height, weight, ethnic group, education, professional, smoking, alcohol consumption, sleeping time per day, dietary habits, and others was collected. Fracture case was identified by patients' self report and further confirmation by medical data. A total of 512,187 valid questionnaires were collected, and relevant data were extracted and analyzed. There were 89 patients with 89 clavicle fractures in 2014, indicating that the incidence was 17.4 (95%CI, 13.8-21.0) per 100,000 person-years. Traffic accidents and falls were the most predominant cause for clavicle factures, leading to 91.0% of all the injuries. Over 85% of them occurred on the road and at home. Age of 45-64, average sleep time < seven hours/day, smoking, alcohol consumption and history of previous fracture were identified as independent risk factors for clavicle fracture. Overweight (BMI, 24.0-27.9) was a significant protective factor, which was estimated to reduce 72% of the clavicle fractures, compared to normal BMI (18.5-23.9). Public health policies focusing on decreasing alcohol consumption, smoking cessation, and encouraging individuals to obtain sufficient sleep should be implemented. Middle-aged individuals with previous history of fracture should strengthen the awareness of prevention and health care and decrease risky activities to reduce the clavicle fractures.

Varenicline for tobacco-dependence treatment in alcohol-dependent smokers: A randomized controlled trial

BackgroundTobacco use is prevalent among persons with alcohol abuse and dependence. Varenicline has been shown to be the most effective pharmacotherapy for smoking cessation and may decrease alcohol consumption. The purpose of this study was to evaluate the efficacy of 12 weeks of varenicline for increasing smoking abstinence rates in smokers with alcohol abuse or dependence. MethodsParticipants were eligible for enrollment if they were 18 years or older, smoked 10 or more cigarettes per day for at least 6 months, had current alcohol abuse or dependence, and were interested in quitting smoking. Participants were randomly assigned to receive 12 weeks of varenicline 1 mg twice daily or matching placebo. The primary end point was 7-day point prevalence smoking abstinence at week 12. ResultsThe 7-day point prevalence smoking abstinence rate at 12 weeks was significantly higher with varenicline (n = 16) than placebo (n = 17) (43.8% vs 5.9%; P = .01). At 24 weeks, the 7-day point prevalence smoking abstinence rate was still significantly higher with varenicline than placebo (31.3% vs 0%; P = .02). At 12 weeks, mean (SD) drinks per drinking day was significantly lower with varenicline than placebo (5.7 [3.9] vs 9.0 [5.3] drinks; treatment effect estimate, −2.8 [90% CI, −6.6 to −1.0]). Adverse events were minor and comparable to varenicline clinical trials. ConclusionsVarenicline is safe and efficacious for increasing smoking abstinence rates in smokers with alcohol abuse or dependence. Varenicline may decrease alcohol consumption in this population of smokers.

ИЗУЧЕНИЕ УПОТРЕБЛЕНИЯ АЛКОГОЛЯ БЕРЕМЕННЫМИ И НЕБЕРЕМЕННЫМИ ЖЕНЩИНАМИ В РОССИИ

Background. Russia has one of the highest levels of alcohol consumption in the world and increasingly hazardous drinking inyoung women. Prenatal alcohol exposure is associated with adverse pregnancy outcomes and Fetal Alcohol Spectrum Disorders (FASD) in children. Data on women's alcohol consumption and risk for alcohol-exposed pregnancies necessary for developing prevention of FASD in Russia are limited. Aims: to estimate the prevalence of alcohol use and hazardous drinking and risk for alcohol-exposed pregnancies in women of childbearing age. Materials and methods. Women were recruited at public women's clinics in two regions in Russia. Women of childbearing age (n = 648) completed a face-to-face structured interview which assessed alcohol consumption and contraception use. Results. Among non-pregnant women, 89 % reported consuming alcohol and 65 % reported binge drinking in the last three months; 70 % of women in Nizhny Novgorod Region and 44 % in Saint-Petersburg may become pregnant, including 12 % in Nizhny Novgorod Region and 9 % in Saint-Petersburg who were trying to conceive. These women consumed alcohol at similar rates and amounts as women who were not at-risk for pregnancy. Among currently non-pregnant women, 32 % in Saint-Petersburg and 54 % in Nizhny Novgorod Region reported not using contraception consistently and at-risk drinking; therefore, they were at risk for alcohol-exposed pregnancy. After pregnancy identification: 20 % reported continued drinking. Significant differences in drinking and risk for alcohol-exposed pregnancy between women in Saint-Petersburg and Nizhny Novgorod Region were identified. Conclusions. Although the majority of Russian women decrease alcohol consumption after pregnancy identification, high levels of drinking were reported around conceptions and prior to pregnancy identification.