Harmful Alcohol Use Research Articles

Traumatization in the Medical Profession: Initiating Events, Roles and Process Factors

Physicians show an increased prevalence of post-traumatic stress disorder (PTSD). Potentially traumatic events in the medical profession include confrontation with suffering, death, violent experiences, and medical errors. The aim of the present analysis is to record traumatic events (TE) in physicians seeking help and to qualitatively analyze the roles and process factors involved. Using an online questionnaire, physicians who had experienced a traumatic event (TE) were surveyed regarding posttraumatic stress (PCL-5), depression (PHQ-9), alcohol abuse (CAGE test), and suicidality (BSIS). Reports of TEs were qualitatively analyzed using structured content analysis. N=41 physicians described at least one TE. K=54 descriptions of TEs were qualitatively analyzed. In some cases, the physicians were victims of e. g., accidents or violence; in other cases, they were involved as witnesses or helpers. The following themes could be identified: Accompaniment of and confrontation with suffering and dying, negative courses of treatment (especially complications and medical errors), and lack of support (especially lack of error management). 53,7% of physicians had PTSD, and 36,6% showed symptoms of posttraumatic stress. Harmful alcohol use was observed in 24,4% of the sample. Psychotropic medication was taken by 31,7% of the respondents. The results show a high burden of TE in the medical profession. In this context, physicians are affected by traumatization in their role as victims, witnesses, or treatment providers and confronted with the death or dying process of others. Residency presumably represents a particularly vulnerable phase. Easily accessible forms of therapy (e. g., online therapy), structural changes (e. g., adequate support for residents), and programs for functional error management in hospitals could have a positive effect on the mental health of physicians.

A Smartphone-Based Information Communication Technology Solution for Primary Modifiable Risk Factors for Noncommunicable Diseases: Pilot and Feasibility Study in Norway.

BackgroundCardiovascular diseases, cancers, chronic respiratory diseases, and diabetes are the 4 main noncommunicable diseases. These noncommunicable diseases share 4 modifiable risk factors (tobacco use, harmful use of alcohol, physical inactivity, and unhealthy diet). Short smartphone surveys have the potential to identify modifiable risk factors for individuals to monitor trends.ObjectiveWe aimed to pilot a smartphone-based information communication technology solution to collect nationally representative data, annually, on 4 modifiable risk factors.MethodsWe developed an information communication technology solution with functionalities for capturing sensitive data from smartphones, receiving, and handling data in accordance with general data protection regulations. The main survey comprised 26 questions: 8 on socioeconomic factors, 17 on the 4 risk factors, and 1 about current or previous noncommunicable diseases. For answers to the continuous questions, a keyboard was displayed for entering numbers; there were preset upper and lower limits for acceptable response values. For categorical questions, pull-down menus with response options were displayed. The second survey comprised 9 yes-or-no questions. For both surveys, we used SMS text messaging. For the main survey, we invited 11,000 individuals, aged 16 to 69 years, selected randomly from the Norwegian National Population Registry (1000 from each of the 11 counties). For the second survey, we invited a random sample of 100 individuals from each county who had not responded to the main survey. All data, except county of residence, were self-reported. We calculated the distribution for socioeconomic background, tobacco use, diet, physical activity, and health condition factors overall and by sex.ResultsThe response rate was 21.9% (2303/11,000; women: 1397/2263; 61.7%, men: 866/2263, 38.3%; missing: 40/2303, 1.7%). The median age for men was 52 years (IQR 40-61); the median age for women was 48 years (IQR 35-58). The main reported reason for nonparticipation in the main survey was that the sender of the initial SMS was unknown.ConclusionsWe successfully developed and piloted a smartphone-based information communication technology solution for collecting data on the 4 modifiable risk factors for the 4 main noncommunicable diseases. Approximately 1 in 5 invitees responded; thus, these data may not be nationally representative. The smartphone-based information communication technology solution should be further developed with the long-term goal to reduce premature mortality from the 4 main noncommunicable diseases.

Intimate Partner Violence (IPV) and Associated Factors in HPTN 071 (PopART) Study Communities in Zambia and South Africa\u2014A Comparison by HIV Status

The HPTN 071(PopART) study was a community-randomised trial in Zambia andSouth Africa, examining the impact of combination-prevention including universaltesting and treatment (UTT), on HIV-incidence. This sub-study evaluated factorsassociated with IPV (physical and/or sexual) to identify differences by HIV status.During 2015–16, a random subset of adults who participated in the first year of thePopART intervention were recruited and standardised questionnaires wereadministered. Logistic regression was performed to estimate odds ratios of factors associated with IPV. Among > 700 women studied (300 HIV-negative;400 HIV-positive),~ 20% reported experiencing physical and/or sexual violence in the last 12-months.Sexual violence was similar by HIV status, but physical violence and reporting bothphysical/sexual violence was more common among HIV-positive women. Spendingnights away from the community in the last 12-months was associated with higher oddsof IPV among both HIV-negative (aOR 3.17, 95% CI 1.02–9.81) and HIV-positive women(aOR 1.79, 95% CI 0.99–3.24). Among HIV-positive women, financial autonomy wasassociated with reduced IPV (aOR:0.41,95%CI:0.23-0.75) while pregnancy in the last12-months (aOR 2.25, 95% CI 1.07–4.74), risk of alcohol dependence(aOR 2.75, 95% CI 1.51–5.00) and risk of mental distress (aOR 2.62, 95% CI 1.33–5.16)were associated with increased IPV. Among HIV-negative women reporting sex in thelast 12-months, transactional sex (aOR 3.97, 95% CI 1.02–15.37) and not knowingpartner’s HIV status (aOR 3.01, 95% CI 1.24–7.29) were associated with IPV. IPV wascommonly reported in the study population and factors associated with IPV differed byHIV status. The association of mobility with IPV warrants further research. The highprevalence of harmful alcohol use and mental distress, and their association with IPVamong HIV-positive women require urgent attention.

Social determinants of Health and Alcohol consumption in the UK


 
 
 Addressing the social determinants of health (SDH) and health inequities are essential for successfully combating alcohol-related harm. In U.K, excessive consumption of alcohol is a huge public health concern. An estimated 9 million adults drink at level that increase the risk of harm to their health; 1.6 million adults in England have some degree of alcohol dependence; and of these some 250,000 are believed to be moderately or severely dependent and may benefit from intensive specialist treatment. To be able to devise effective action, it is essential to comprehend these inequities in the healthcare system. Health inequities are not solely related to access to health care services; there are many other determinants related to living and working conditions, as well as the overall macro-policies prevailing in a country. The key intention of this review was to critically analyse the degree to which social determinants have impacted on excess alcohol consumption. A comprehensive approach to reduce inequities in alcohol-related harm requires action that includes mix of long- and short-term impacts, addressing the consequences and the root causes of inequities, and acting on both individuals and environments. Whereas, consequences of harmful alcohol use are more severe for those already experiencing social exclusion. We suggest that (1) the effective legislation, (2) modifying marketing strategies, (3) enhancing cooperation with regional organizations, (4) more effectively implementing existing regulation and (5) consulting expert will enhance SDH for this vulnerable population.
 

Psychological impact of neonatal intensive care unit admissions on parents: A regional perspective.

This study aimed to report the prevalence of adverse psychological symptoms and health behaviours of parents who had a baby admitted to a regional neonatal intensive care unit to spotlight mental health care in these unique settings. This was a prospective, prevalence-based study using quantitative data. The study was conducted at the Townsville University Hospital, Queensland. Participants comprised 114 parents of 79 infants enrolled in the study (mothers=69 and fathers=45). Trauma, depression, anxiety, stress, alcohol and drug use, prior mental health history and bonding experience were assessed by standardised self-report questionnaires and a structured diagnostic interview within 2weeks and at 3months post-admission to neonatal intensive care unit. Clinically significant acute trauma symptoms (16% of mothers only), depression (22% mothers; 4% of fathers), anxiety (27% mothers; 11% fathers) and stress (24% mothers; 13% fathers) were reported within the first 2weeks after their baby was admitted to the neonatal intensive care unit. Notably, 18% of parents reported engaging in harmful alcohol use behaviour within 2weeks post-birth; 29% of fathers continued to report risky drinking at 3months. At 3months, 21%, 8% and 6% of mothers met diagnostic criteria for generalised anxiety disorder, major depressive disorder and post-traumatic stress disorder, respectively. Screening for psychological distress and alcohol use of parents of neonatal intensive care unit babies can ensure that support services are made available post-discharge to optimise family function and development of the preterm infant.

Robust Motion Biomarker for Alcohol Consumption

Excessive alcohol consumption is a dangerous risk for people's health. In fact, 3 million deaths worldwide were caused by the harmful use of alcohol in 2016, and it was responsible for 7.2% of all premature mortality in that year [1]. Alcohol consumption is a problem widely spread among young people and it is proved that high-frequency drinking patterns developed during college appear to persist several years after post-graduation [2].

Industry influence over global alcohol policies via the World Trade Organization: a qualitative analysis of discussions on alcohol health warning labelling, 2010–19

Accelerating progress to implement effective alcohol policies is necessary to achieve multiple targets within the WHO global strategy to reduce the harmful use of alcohol and the Sustainable Development Goals. However, the alcohol industry's role in shaping alcohol policy through international avenues, such as trade fora, is poorly understood. We investigate whether the World Trade Organization (WTO) is a forum for alcohol industry influence over alcohol policy. In this qualitative analysis, we studied discussions on alcohol health warning labelling policies that occurred at the WTO's Technical Barriers to Trade (TBT) Committee meetings. Using the WTO Documents Online archive, we searched the written minutes of all TBT Committee meetings available from Jan 1, 1995, to Dec 31, 2019, to identify minutes and referenced documents pertaining to discussions on health warning labelling policies. We specifically sought WTO member statements on health warning labelling policies. We identified instances in which WTO member representatives indicated that their statements represented industry. We further developed and applied a taxonomy of industry rhetoric to identify whether WTO member statements advanced arguments made by industry in domestic forums. Among 83 documents, comprising TBT Committee minutes, notifications to the WTO of the policy proposal, and written comments by WTO members, WTO members made 212 statements (between March 24, 2010, and Nov 15, 2019) on ten alcohol labelling policies proposed by Thailand, Kenya, the Dominican Republic, Israel, Turkey, Mexico, India, South Africa, Ireland, and South Korea. WTO members stated that their claims represented industry in seven (3·3%) of 212 statements, and 117 (55·2%) statements featured industry arguments. Member statements featured many arguments used by industry in domestic policy forums to stall alcohol policy. Arguments focused on descaling and reframing the nature and causes of alcohol-related problems, promoting alternative policies such as information campaigns, promoting industry partnerships, questioning the evidence, and emphasising manufacturing and wider economic costs and harms. WTO discussions at TBT Committee meetings on alcohol health warnings advanced arguments used by the alcohol industry in domestic settings to prevent potentially effective alcohol policies. WTO members appeared to be influenced by alcohol industry interests, although only a minority of challenges explicitly referenced industry demands. Increased transparency about vested interests might be needed to overcome industry influence. None.

Wellbeing, psychiatric morbidity and psychological distress amongst medical students in Denmark.

Medical students in Denmark undertake a demanding 6-year course which is generally during a critical age for the development of psychiatric disorder and harmful substance or alcohol use behaviours. Previous literature has highlighted significant rates of distress in Danish students. We surveyed medical students in Denmark to better understand wellbeing, psychiatric morbidity, sources of stress, substance and alcohol use, psychological distress and burnout. Medical students were invited to participate in a single survey via email and social media which was completed through an online form, available for a 6-month period. The survey used a mixture of pre-defined answer options alongside free-text responses. Embedded within the survey were standardised and reliable specific instruments related to alcohol use (the CAGE questionnaire), overall psychological wellbeing and burnout. There were 647 respondents, with a quite even year-group distribution, representing just over 16% of total number of students attending medical school in Denmark. Prior to medical school 35% had visited a professional regarding their mental health. While at medical school 16% reported a diagnosis of a mental health condition. 83% reported significant stress from study. Around 7 in 10 met case criteria using instruments designed to test for minor psychiatric morbidity and burnout. 13% tested CAGE positive, whilst 4% reported concerns from themselves or others about their substance use. Our study demonstrates high levels of psychiatric morbidity and worrying levels of burnout in this population. The striking 13% CAGE positive rate suggests this demographic is at risk of harm from alcohol. Our results suggest a high level of need to support this population - with further study required to demonstrate which interventions would be of most benefit for this population in light of our findings.

Adverse childhood experiences, alcohol consumption, and the modifying role of social participation: population-based study of adults in southwestern Uganda

BackgroundAdverse childhood experiences (ACEs) include multiple forms of child maltreatment, including abuse and neglect, as well as other forms of household dysfunction. Studies from Uganda have revealed a high prevalence of child abuse, as well as one of the highest levels of alcohol consumption in Africa. Few population-based studies from Africa have estimated associations between ACEs and adult alcohol use, or assessed the potential buffering effects of social participation. MethodsThis cross-sectional, population-based study was conducted in a rural parish in southwestern Uganda between 2016 and 2018. We assessed self-reported ACEs using a modified version of the Adverse Childhood Experiences – International Questionnaire (ACE-IQ) scale. We measured heavy alcohol consumption using a 3-item scale previously validated in this population. We measured social participation using a 10-item scale eliciting participants’ membership and participation in different community groups over the past two months. We fitted multivariable Poisson regression models to estimate the associations between ACEs and heavy alcohol consumption, and to assess for the potential buffering effects of social participation. ResultsWe estimated statistically significant associations between the total ACE score and heavy alcohol consumption (adjusted relative risk [ARR] per ACE ​= ​1.17; 95% CI, 1.09–1.25; P ​≤ ​0.001). Social participation had a statistically significant moderating effect on the association between total ACE score and heavy alcohol consumption (P ​= ​0.047 for interaction): the estimated association between total ACE score and heavy alcohol consumption among study participants who did not participate in a community group was larger, with a narrower confidence interval (ARR ​= ​1.21 per ACE; 95% CI, 1.11–1.33; P ​< ​0.001), while the estimated association among study participants who did participate in a community group was smaller and less precisely estimated (ARR ​= ​1.12 per ACE; 95% CI, 1.02–1.24; P ​= ​0.02). ConclusionsOur findings demonstrate an association between ACEs and heavy alcohol consumption behavior among adults in rural Uganda. The adverse effects of ACEs were buffered in part by social participation. To prevent or reduce harmful alcohol use behaviors among adults, it is important to address the chronic stress caused by ACEs.

PrEP acceptability and initiation among women engaged in sex work in Uganda: Implications for HIV prevention.

SummaryBackgroundWomen engaged in sex work (WESW) are disproportionately affected by HIV. In Uganda, HIV prevalence among WESW is estimated at 37%, accounting for 18% of all new infections in the country. WESW experience poverty, gender-based violence, and other issues that reduce their power and limit their ability to negotiate condom use. Female-controlled strategies, including pre-exposure prophylaxis (PrEP), may afford women more transmission protection, but barriers to access and use persist. This cross-sectional study examined baseline PrEP acceptability and initiation among WESW recently enrolled in a randomized clinical trial in Uganda to test the impact of a combination HIV risk reduction and economic empowerment intervention on sexual risk outcomes (clinicaltrials.gov, NCT03583541).MethodsA total of 542 WESW from 19 high HIV-prevalent geographical areas were enrolled in the Kyaterekera study between June 2019 and March 2020. Women were eligible for the study if they: (1) were age 18 or over; (2) reported engagement in transactional sex (a sex act in exchange for pay) in the past 30 days; and (3) reported engagement in one or more episodes of unprotected sex in the past 30 days. Women completed a baseline assessment, were tested for HIV and other sexually transmitted infections (STIs) at enrollment, and were connected with antiretroviral therapy (ART), STI treatment, or PrEP, based on need and interest. Descriptive statistics examined baseline data on PrEP acceptability and initiation. Independent variables (i.e. years in sex work, recent sexual coercion, perceived HIV and sex work stigmas, harmful alcohol use, barriers to medical care, and social support) were derived from the empirical literature and women's self-report. Bivariate analysis was performed to test associations between main effects of these variables. Using binomial logistic regression, predictive models were evaluated for two distinct outcomes—PrEP acceptability and PrEP initiation/uptake.FindingsAt baseline, 59% of women (n = 322) tested HIV negative. Among WESW testing negative, 11% (n = 36) were already PrEP enrolled. Most women reported willingness to use PrEP (n = 317; 91%). Slightly over half of WESW not already on PrEP agreed to initiate PrEP (n = 158; 55%). Logistic regression models demonstrate that acceptability of or willingness to use PrEP was significantly associated with fewer years engaged in sex work (AOR= ·18, 95% CI 0·05-·66, p<·01) and greater perceived social support from family (AOR= 1·39, 95% CI 1·03 -1.88, p<·05). PrEP initiation was negatively associated with greater perceived social support from friends (AOR=·81, 95% CI ·68–0·97, p<·05) and positively associated with higher perceived stigma due to sex work among family members (AOR=2·20, 95% CI 1·15–4·22, p<·05).InterpretationDespite endorsing PrEP use, many WESW remain reluctant to use it. This gap in prevention practice highlights the heart of a failing PrEP prevention cascade. Findings point to the important role family and friend support may play in destigmatizing sex work and PrEP use for women. Social and structural-level efforts are needed to improve educational messaging and to integrate positive messaging into health promotion campaigns for women and their families, while also working toward decriminalizing sex work.FundingThis paper was made possible with funding from United States National Institute of Mental Health (Grant number: R01MH116768).

Current state of prevalence and dynamics of alcohol-associated narcopathology: a retrospective study

Background. The population prevalence of alcohol abuse-associated drug-related diseases bears high social impact. This indicator holds special value both as a potential indirect estimator of the quality of life, availability and efficiency of drug addiction treatment, a well as parameter for qualitative prognostic models of social and economic development. The burden of alcohol-associated drug diseases is typically ambiguous in prevalence estimation, both across Russian Federation and worldwide.Objectives. A study of the alcohol abuse-associated drug-related morbidity prevalence in Krasnodar Krai for period 2000–2020.Methods. A retrospective descriptive study included legal-paper data of the “Information on Drug-Related Disorders” federal statistics survey (Form 11) of Krasnodar Krai, years 2000-2020, describing the re-registration rate of alcohol use-associated drug disorders. The inclusion criterion was an established drug-related disease among all age cohorts. The main study indicators were regional prevalence values of alcoholic psychosis, alcohol dependence syndrome and harmful alcohol use relative to gender, area and age.Results. Prevalence trends in alcohol use-related drug pathology were more favourable in Krasnodar Krai over Southern Federal District and country-wide. The decline rate among males was significantly higher (22.1-fold) vs. the female population (3.0-fold). The prevalence of alcohol use-related drug pathology remained higher in urban vs. rural areas, with higher rural vs. urban decline rates. Over the entire study period, the 40–59 years-age population was leading by the incidence of overall alcohol use-related drug pathology and, separately, of alcoholic psychosis and alcohol dependence syndrome. Highest harmful alcohol use values were registered for 20–39-year population.Conclusion. The revealed dynamics of legal-registered alcoholic drug pathology prevalence has a multifactorial origin. The changes are conditioned by improvement in the narcological aid institutional regulation within the state guarantee programme, federal and regional preventive measures, current progress in drug therapy, regional demography, as well as underreporting of alcohol-associated drug diseases due to a missing strict vertical statistic registration at the level of any-type medical institutions.

The Prevalence of Alcohol Consumption: A Cheap Liquor Consumers Perspective during Pandemic

The study was conducted using an established Alcohol use disorder identification test and accompanied by a face-to-face interview with the consented respondents. The main of this study is to understand motives of cheap liquor consumption among youngsters. The information has been gathered from 10 respondents from rural vicinity in Perak. The outcomes indicated the primary motive for consuming cheap liquor is because of the monetary burden faced by the drinkers. It was observed that male drinkers might devour alcohol to kill boredom and at the same time to release body aches after a day’s task. The findings of this study are imperative in providing direction for future studies on alcohol consumption amongst Malaysian adolescents and information for the strategy to reduce the harmful use of alcohol in the communities.

Alcohol-attributable burden of cancer in Argentina

IntroductionAlcohol consumption is a risk factor for several types of cancer. Alcohol consumption levels in Argentina are among the highest in the world, and malignant neoplasms are the second cause of death in the country. Public health strategies aimed at reducing alcohol consumption could possibly lead to a decrease in cancer burden. Alcohol-attributable burden has been estimated before in neighboring countries Chile and Brazil. We now aimed to quantify the burden for Argentina.MethodsWe obtained data on alcohol consumption levels from a national representative health survey and etiologic effect sizes for the association between alcohol and cancer from the most recent comprehensive meta-analysis. We estimated the number of alcohol-attributable cancer-related deaths and disability-adjusted life years (DALYs), stratified by consumption level (light (0.1–12.5 g/day), moderate (12.6–50 g/day), or heavy (> 50 g/day) drinking). We additionally explored which hypothetical scenario would achieve the highest reduction in alcohol-attributable cancer burden: 1) heavy drinkers shifting to moderate drinking or 2) moderate drinkers shifting to light drinking.ResultsIn 2018, 53% of the Argentinean population consumed alcohol. In men 3.7% of all cancer deaths and DALYs were attributable to alcohol consumption, in women this was 0.8% of all cancer deaths and DALYs. When moderate drinkers would shift to light drinking, 46% of alcohol-attributable cancer deaths and DALYs would be prevented, opposed to only 24% when heavy drinkers would shift to moderate drinking.ConclusionMost cancer deaths and DALYs were attributable to moderate alcohol consumption (50%). This calls for implementation of population-wide strategies—instead of targeting heavy drinking only—to effectively reduce harmful use of alcohol and its impact on disease burden.

Frailty and osteoporosis in patients with hip fractures under the age of 60\u2014a prospective cohort of 218 individuals

SummaryResearch on younger patients with hip fractures is limited. This study adds knowledge on patient and injury characteristics, and DXA was investigated at the time of the fracture. Risk factors for osteoporosis and fractures were numerous among young patients, and osteoporosis was markedly more prevalent than in the general population.IntroductionKnowledge on younger patients with hip fractures is limited. Common preconceptions are that they suffer fractures due to high-energy trauma, alcohol or substance use disorder but not associated to osteoporosis. We aimed to descriptively analyze the characteristics of young and middle-aged patients with hip fractures and examine bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) at the time of the fracture.MethodsA prospective multicenter cohort study on adult patients with hip fractures below age 60 collected detailed information on patient characteristics regarding demographics, trauma mechanism, previous fractures, comorbidity and medication, and lifestyle factors. DXA results were compared to population-based reference data.ResultsThe cohort contains 91 women and 127 men, median age 53 (IQR 47–57). Most fractures, 83%, occurred in patients aged 45–59. Two-thirds of all fractures resulted from low-energy trauma. Half of the patients had prior fractures after age 20. Thirty-four percent were healthy, 31% had one previous disease, and 35% had multiple comorbidities. Use of medication associated with increased fracture risk was 32%. Smoking was prevalent in 42%, harmful alcohol use reported by 29%, and signs of drug-related problems by 8%. Osteoporosis according to WHO criteria was found in 31%, osteopenia in 57%, and normal BMD in 12%.ConclusionIn patients with hip fractures below age 60, risk factors for osteoporosis and fractures were numerous. Moreover, the prevalence of osteoporosis was markedly higher than in the general population. We suggest that young and middle-aged patients with hip fractures undergo a thorough health investigation including DXA, regardless of trauma mechanism.

The Relationship Between Harmful Alcohol Use and Antiretroviral Non-adherence in People Accessing HIV Treatment in Cape Town, South Africa: An Event-Level Analysis.

Harmful alcohol consumption can significantly compromise adherence to antiretroviral therapy (ART). Prior research has identified aggregate relationships between alcohol use and ART non-adherence, largely relying on concurrent assessment of these domains. There is relatively limited evidence on more nuanced day-level associations between alcohol use and ART non-adherence, despite potentially important clinical implications. We recruited adults with HIV treatment adherence challenges and harmful alcohol use (n = 53) from HIV care in South Africa. Weexamined relationships between alcohol use and same and next day ART adherence, accounting for the role of weekends/holidays and participant demographics, including gender. Results demonstrated thatART adherence wassignificantly worseon weekend/holidaydays. Next day adherence was significantly worse in the context of weekend alcohol use and among men. These results suggest the importance of tailoring intervention strategies to support ART adherence during weekend drinking and for men engaged in heavy episodic drinking.

LIFESTYLE DISORDERS IN CHILDREN: AN AYURVEDIC OVERVIEW

Lifestyle Disorders (LSD) are common problems among upper-middle and higher society children. Lifestyle has long been associated with the development of many chronic diseases. It affects both genders. WHO has recognized Noncommunicable diseases (NCDs), especially diabetes, obesity, cardiovascular disease, cancer, and chronic lung disease, have everyday lifestyle linked risk factors like lack of physical activity, unhealthy diet and feeding habits and harmful use of alcohol. Worldwide, the current scenario of NCDs is the primary cause of morbidity and mortality, even in young children. According to WHO Report 2004, these account for nearly 60% of deaths and 47% of the global burden of illness. The rise in NCDs is substantially accelerating in most developing countries like India. In India, 53% of the deaths in 2008 were due to NCDs, and cardiovascular disease (CVDs) alone accounted for 24% of deaths (WHO). In 2005 India experienced the highest loss in potentially productive years of life globally, and the leading cause of death was cardiovascular disease. The cumulative loss of national income for India due to NCDs mortality for 2006-2015 was around USD237 billion. By 2030, this productivity loss is estimated to double to 17.9 million years lost. These major NCDs are preventable through effective Ayurvedic interventions by judiciously treating lifestyle-related modifiable risk factors. This review confers the current scenario of NCDs in children and their Ayurvedic Management.

Men's decrease and women's increase in harmful alcohol use from the 2014 to 2018 national surveys in Taiwan: A harbinger for an emerging national trend in East Asia?

Gender differences in alcohol use have narrowed in Western societies, but that in Asia has been less investigated. By comparing the 2014 and 2018 waves of the national survey in Taiwan, we aimed to examine the gender differences in population trends in past-month alcohol use, binge drinking, and harmful alcohol use. The national survey enrolled 17,837 participants in 2014 and 18,626 participants in 2018. Binge drinking was defined as having ≥5 drinks on one occasion in the past month, and harmful alcohol use as having an Alcohol Use Disorders Identification Test score of ≥8. There were significant decreases from 2014 to 2018 in the population's prevalence of past-month alcohol use, binge drinking, and harmful alcohol use. However, males and females had different trends: males showed significant reductions in all three alcohol use behaviours (a decrease of 3.79%, 1.59%, and 2.60%, respectively), while females exhibited a significant rise in harmful alcohol use (from 1.32% to 1.72%), particularly among those aged 18-29 years. There was gender convergence in alcohol use in Taiwan, mainly due to men's decrease and women's increase in harmful alcohol use. Our findings have important implications for the intervention and prevention of the problematic use of alcohol in East Asia.

THE COVID-19 PANDEMIC AS A GLOBAL THREAT TO THE MENTAL HEALTH OF THE POPULATION

The article considered the main principles of the impact of the COVID-19 pandemic on the mental state of the population, both at the individual and population levels. The main factors affecting a person’s emotional state and causing its deterioration have been identified. With the help of bibliographic, analytical and statistical methods, the main patterns of the spread of the negative phenomenon of the pandemic on the family life of the population and on suicidal attitudes among people were determined. As a result of the work, it was concluded that the situation with COVID-19 has caused both material and moral damage to everyone, because a constant life in anxiety and uncertainty has affected the mental health of society with such manifestations as excessive anxiety, insomnia, depression, harmful use of alcohol and drugs.

O território, as redes e suas (im)potências: o cuidado aos usuários de álcool e outras drogas em um CAPSad

In the present work, we seek to carry out an analysis of the potential and possibilities of CAPS ad as an offer of care to people who make harmful use of alcohol and other drugs and its performance with the network, from an experience report in a CAPS ad of a city located in the interior of the state of São Paulo. This is an excerpt from a master’s research, in which we used Cartography as a methodological option. As the main challenge encountered, we present the network’s mismatches, both in its protocols and in the look at the use of alcohol and other drugs. We also evidenced the potentialities and inventiveness that make possible the creation of networks/rhizomes autonomous of the dominant networks, which operate intensifying the effects of the capitalist mode of production. We understand, therefore, the CAPS ad as a provisional institutional arrangement, or as a strategy, which, in its offerings, can become a network of emancipation, as well as a rhizome, susceptible to constant changes. The power of Psychosocial Care is, therefore, in the inventive dimension present in relationships and encounters and in breaking with the fragmenting processes of care, in order to guarantee the expansion of access to services for people who suffer so much from the effects of a society like ours

Understanding alcohol-related indicators from population surveys: answering the "Five W's of Epidemiology".

The harmful use of alcohol is a major risk factor for the global burden of disease, and public policies are the most effective strategies to prevent it. Population-based surveys are milestones for planning, implementing, and monitoring those policies. However, there are numerous ways to measure alcohol consumption which may result in different indicators. Researchers and stakeholders should find common ground in the understanding of these measures to avoid misinterpretation and confusion in the field. Answering to the "Five W's Epidemiology", when interpreting alcohol-related information, may improve the communication, as well as reproducibility and comparability of research findings. This paper aims to exemplify this approach by describing some indicators from the World Health Organization's Global Information System on Alcohol and Health (GISAH) and the corresponding data available from the latest Brazilian household surveys. Notably, none of the Brazilian surveys reports on all the nine selected GISAH indicators, and only two provided the necessary methodological details to be fully reproducible. A stronger agenda is of the utmost importancefor advancing in the monitoring and prevention of alcohol-related harms in Brazil.