Moderate Alcohol Use Research Articles

The role of alcohol use in pesticide suicide and self-harm: a scoping review

PurposeSuicide and self-harm by pesticide self-poisoning is common in low- and middle-income countries (LMICs). Alcohol is an important risk factor for self-harm; however, little is known about its role in pesticide self-poisoning. This scoping review explores the role that alcohol plays in pesticide self-harm and suicide.MethodsThe review followed the Joanna Briggs Institute scoping review guidance. Searches were undertaken in 14 databases, Google Scholar, and relevant websites. Articles were included if they focussed on pesticide self-harm and/or suicide and involvement of alcohol.ResultsFollowing screening of 1281 articles, 52 were included. Almost half were case reports (n = 24) and 16 focussed on Sri Lanka. Just over half described the acute impact of alcohol (n = 286), followed by acute and chronic alcohol use (n = 9), chronic use, (n = 4,) and only two articles addressed harm to others. One systematic review/meta-analysis showed increased risk of intubation and death in patients with co-ingested alcohol and pesticides. Most individuals who consumed alcohol before self-harming with pesticides were men, but alcohol use among this group also led to pesticide self-harm among family members. Individual interventions were recognised as reducing or moderating alcohol use, but no study discussed population-level alcohol interventions as a strategy for pesticide suicide and self-harm prevention.ConclusionResearch on alcohol’s role in pesticide self-harm and suicide is limited. Future studies are needed to: further assess the toxicological effects of combined alcohol and pesticide ingestion, explore harm to others from alcohol including pesticide self-harm, and to integrate efforts to prevent harmful alcohol use and self-harm.

Alcohol use among people who inject drugs living with HIV in Kenya is associated with needle sharing, more new sex partners, and lower engagement in HIV care.

We assessed the prevalence and correlates of alcohol use among 870 people who inject drugs living with HIV in Kenya, with attention toward (1) sexual and injecting risk behaviors for HIV transmission and (2) HIV care engagement. We defined heavy alcohol use as > 14 drinks/week for men and > 7 drinks/week for women, moderate alcohol use as any lesser but non-zero amount, and any alcohol use as either moderate or heavy use. Approximately 39% of participants reported any alcohol use and 15% heavy use. In multivariate analysis, any alcohol use compared to no use was associated with needle sharing, > 3 new sex partners in the past 3 months, being unaware of HIV status, never enrolling in HIV care, and not being on ART (all p < 0.05). Heavy alcohol use as compared to no use was associated with needle sharing (aOR = 2.72; 95% CI 1.43,5.13), injection equipment sharing (aOR = 1.80; 95% CI 1.00,3.16), > 3 new sex partners in the past 3 months (aOR = 1.99; 95% CI 1.12,3.49), and being unaware of HIV status (aOR = 2.77; 95% CI 1.46,5.19). There was no association between any measure of alcohol use and unsuppressed viral load. Alcohol use among people who inject drugs living with HIV may carry elevated risk of HIV transmission mediated by sexual and injecting practices and is associated with lower engagement in multiple stages of the HIV care cascade.

Liver health and the interplay between obesity, alcohol and bariatric surgery.

The prevalence of obesity and metabolic consequences, including non-alcoholic fatty liver disease (NAFLD) has become a global health problem. Obesity has an important impact on chronic liver disease even beyond NAFLD, as it accelerates the progression of alcohol liver disease. Conversely, even moderate alcohol use can affect NAFLD disease severity. Weight loss is the gold standard treatment but adherence to lifestyle changes is very low in the clinical setting. Bariatric surgery can improve metabolic components and cause long-term weight loss. Therefore, bariatric surgery could serve as an attractive treatment option for NAFLD patients. A pitfall is the use of alcohol after bariatric surgery. This short review integrates data about the influence of obesity and alcohol on liver function and the role of bariatric surgery.

0480 Psychoactive Substance Use and Sleep Characteristics Among Individuals with Untreated Obstructive Sleep Apnea

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by recurrent airway obstruction causing intermittent hypoxia, arousal from sleep, and autonomic instability, and is associated with a variety of long-term health sequala. The fragmented sleep resulting from these respiratory events leads to disruption in normal sleep architecture and progression to deeper stages of sleep, a potential mediator for some of the functional and neurocognitive impairments seen in this population. Similarly, psychoactive substance use (i.e., nicotine, alcohol, and caffeine) impacts sleep architecture in healthy individuals, but their effects in those with OSA have not been well described. We aimed to describe the association between psychoactive substance use and sleep characteristics and daytime symptoms in individuals with untreated OSA. Methods We performed a secondary, cross-sectional analysis of The Apnea Positive Pressure Long-term Efficacy Study (APPLES). Exposures included current smoking, alcohol, and caffeine use in individuals with untreated OSA. Outcome domains included subjective and objective sleep characteristics, daytime symptoms, and co-morbid conditions. Linear or logistic regression assessed the association between substance use and each domain (e.g., self-reported sleep duration, total polysomnographic sleep time, sleepiness, and anxiety). Results Of the 919 individuals with untreated OSA, 116 (12.6%) were current cigarette smokers, 585 (63.7%) were moderate or heavy alcohol users, and 769 (83.7%) were moderate or heavy caffeine users. Current smokers exhibited lower sleep duration (0.3 hours) and longer sleep latency (5 minutes) compared with non-smokers (all p-values&amp;lt; 0.05). REM sleep increased in those with moderate and heavy alcohol use (2.5 and 5% of total sleep time respectively), and moderate caffeine use (2%, all p-values &amp;lt; 0.05)). The combined smoker plus caffeine group exhibited shorter sleep duration (0.4 hours) and higher risk for chronic pain [Odds Ratio (95%CI) = 4.83 (1.57, 14.9). . Conclusion Both psychoactive substances and untreated OSA impact normal sleep architecture, their cumulative effect may have clinical implications in this subgroup. Stimulating or sedating substances may be used in OSA patients to mitigate daytime and nighttime symptoms respectively. Further investigation into the effects substances have on this population may present opportunities to better understand disease mechanisms and increase the effectiveness of treatment in OSA Support (if any)

Leveraging Dynamic Norms to Reduce College Student Alcohol Use: A Test of Four Mediators

ABSTRACT Social norms are common in persuasive messaging. For norms trending in a positive direction, it may be beneficial to emphasize change (i.e. dynamic norm) rather than the status quo (i.e. static norm). To test this proposition, we examined college students’ responses to social norm messages encouraging moderate alcohol use. Undergraduates (N = 842) were randomly assigned to view a dynamic norm (“More college students drinking in moderation”), a static descriptive norm (“Most college students drink in moderation”), or a no message control. Four mechanisms were examined as potential mediators, three of which have been examined in previous work (preconformity, perceived importance, self-efficacy) and one of which was novel (psychological reactance). Results revealed that exposure to either social norm message (dynamic or static descriptive) was associated with more favorable attitude relative to a no message control. Attitude did not differ between the dynamic norm and static descriptive norm conditions. Only psychological reactance mediated the relationship between message condition (dynamic vs. static descriptive norm) and favorable attitude. Implications and future directions are discussed.

Intention to Engage in Alcohol Use during Pregnancy: The Role of Attitudes and Prototypes

Background: There is no known risk-free level of alcohol use in pregnancy. Despite this, many still believe that occasional drinking is safe. To-date, there is limited evidence of the influences on women’s decisions about low to moderate alcohol use in pregnancy. The aim of this study was to explore alcohol use intentions during pregnancy, using variables from the theory of planned behavior, the prototype/willingness model and personality variables. The study also investigated whether priming participants with exposure to prototypes describing different alcohol use behaviors had an impact on intentions. Methods: Participants, 746 women aged 20 to 45 years, were randomized to be prompted to think of one of two different “types” of behaviors, i.e., small level of alcohol use in pregnancy and ambiguous level of alcohol use in pregnancy. They then completed measures of theoretical variables, impulsivity, venturesomeness, and self-efficacy. Participants then answered whether they intended to use alcohol during a future pregnancy. Results: Over half of the variance in intentions to consume alcohol while pregnant were predicted by the final model (R2 = .527, F (1, 438) = 13.201, p < .001). Positive attitudes toward alcohol use in pregnancy, from the theory of planned behavior, were the most significant predictor of intentions and intentions did not differ between groups according to prototype exposure. Conclusions: Future research should aim to explore the efficacy of interventions to reduce low to moderate alcohol use in pregnancy that utilize both the theory of planned behavior and prototype/willingness model to target determinants of intentions.

Commentary on Hyland et al.: Digital treatment for alcohol use disorders - challenges and opportunities.

Hyland and colleagues found no significant effects of an internet-delivered cognitive behavioral therapy intervention (iCBT) as addendum to treatment as usual in individuals with moderate alcohol use disorders. While findings can be attributed partially to methodological issues, future studies should focus upon patient preferences and include potential side effects of internet-based interventions. In the field of problematic alcohol consumption, digital interventions have shown promise in non-clinical populations [1]; however, little is known about their efficacy in clinical populations fulfilling criteria for alcohol use disorders (AUDs). Internet-delivered treatment has rapidly evolved as an option for various mental disorders. First meta-analyses show positive effects when compared to non-active controls in disorders such as depression and agoraphobia [2-4], but also for addictive disorders, especially behavioural addictions [5] and tobacco smoking [6]. Given that disorders due to alcohol and/or drugs are highly stigmatized, internet-delivered interventions might be a relevant tool for narrowing the treatment gap in the field. In their excellently conducted randomized controlled trial (RCT), Hyland and colleagues [7] found only weak evidence for an internet-delivered cognitive behavioral therapy (iCBT) intervention as addendum to treatment as usual (TAU) in individuals with AUDs compared to TAU. However, it has to be taken into account that, as comparator in this study, TAU included far more evidence-based components than would usually be expected in most treatment systems world-wide. The high rate of participants willing to take (and receiving) medication is particularly impressive: data from the United States show that only 16.3% of all speciality treatment programmes for alcohol use disorders offered any single medication for AUD treatment [8]. Furthermore, as all participants in the Hyland et al. study were self-selected, the initial motivation to change already might have produced strong effects, especially if we consider the high rates of unassisted recovery that are common in alcohol use disorders [9]. Another encouraging finding is that overall treatment initiation and completion rates are relatively high compared to digital self-help interventions in the field of affective and anxiety disorders [10], where efficacy of these interventions has already been demonstrated. There is no evidence that guided or unguided internet-delivered interventions for AUDs are associated with lower rates of treatment uptake compared to face-to-face delivery. A prior study from the research group of Hyland et al. on a therapist-guided iCBT intervention compared to therapist-delivered CBT showed no differences in uptake numbers between the two conditions, and both interventions did not differ on outcomes [11]. Another RCT on iCBT as a stand-alone intervention for individuals with AUDs [12] even showed that retention rates were better in the iCBT condition compared to therapist-delivered CBT, and that both conditions were superior compared to TAU (which included lower doses of treatment compared to the Hyland et al. study). Given that internet-delivered treatment requires a high level of patient engagement, future studies should take into account the interaction between type of treatment and patient preferences. Internet-delivered interventions might be a good option for some, but certainly not for all, patients suffering from AUDs. A systematic review on effects of matching patient preferences to treatment in the field of substance use disorders suggests that treatment effects might be improved, although findings were inconsistent [13]. Patient preferences have become increasingly important for the development of clinical interventions, and they could play an important role for improving treatment uptake and outcomes by affected individuals [14]. Finally, only recently have studies on the efficacy of treatment assessed potential side effects. A potential risk of digital interventions is that these interventions might incorrectly be viewed as sufficient by some individuals who otherwise would be willing to engage in other evidence-based treatments. The significant difference between the conditions in the Hyland et al. study regarding receipt of medication shows the need for further rigorous, well-conducted studies. For a more detailed understanding on processes of change in newly developed interventions, mixed-methods studies that include the experiences of patients are warranted. GB conceptualized and wrote the manuscript. None.

Nicotine, alcohol, and caffeine use among individuals with untreated obstructive sleep apnea.

Psychoactive substance use (i.e., nicotine, alcohol, and caffeine) has substantial effects on sleep architecture in healthy individuals, but their effects in those with obstructive sleep apnea (OSA) have not been well described. We aimed to describe the association between psychoactive substance use and sleep characteristics and daytime symptoms in individuals with untreated OSA. We performed a secondary, cross-sectional analysis of The Apnea Positive Pressure Long-term Efficacy Study (APPLES). Exposures included current smoking, alcohol and caffeine use in individuals with untreated OSA. Outcome domains included subjective and objective sleep characteristics, daytime symptoms, and comorbid conditions. Linear or logistic regression assessed the association between substance use and each domain (e.g., self-reported sleep duration, total polysomnographic sleep time, sleepiness, and anxiety). Of the 919 individuals with untreated OSA, 116 (12.6%) were current cigarette smokers, 585 (63.7%) were moderate or heavy alcohol users, and 769 (83.7%) were moderate or heavy caffeine users. Participants were on average 52.2±11.9years old, 65.2% were male with a median BMI of 30.6 (IQR: 27.2, 35.9, kg/m2). Current smokers exhibited lower sleep duration (0.3h), longer sleep latency (5min) compared with non-smokers (all p-values < 0.05). People with heavy or moderate alcohol use exhibited more REM sleep (2.5 and 5% of total sleep time respectively), as did those with moderate caffeine use (2%, p-values < 0.05). The combined smoker plus caffeine group exhibited shorter sleep duration (0.4h, p-value < 0.05) and higher risk for chronic pain [Odds Ratio (95%CI) = 4.83 (1.57, 14.9) compared with non-users. Psychoactive substance use is associated with sleep characteristics and clinically relevant correlates in people with untreated OSA. Further investigation into the effects that various substances have on this population may present opportunities to understand disease mechanisms more fullyand increase the effectiveness of treatment in OSA.

Both Moderate and Heavy Alcohol Use Amplify the Adverse Cardiovascular Effects of Smoking in Young Patients with Hypertension.

To evaluate the association of alcohol and smoking combined with cardiovascular and renal events and investigate whether moderate and heavy alcohol consumption have a different impact on this association. The study was conducted in 1208 young-to-middle-age stage 1 hypertensive patients. Subjects were classified into three categories of cigarette smoking and alcohol use, and the risk of adverse outcomes was assessed over a 17.4-year follow-up. In multivariable Cox models, smoking showed a different prognostic impact on alcohol drinkers and abstainers. In the former, an increase in the risk of cardiovascular and renal events was observed compared to nonsmokers (hazard ratio, 2.6, 95% CI, 1.5-4.3, p < 0.001), whereas in the latter, the risk did not achieve the level of statistical significance (p = 0.27) with a significant interaction between smoking and alcohol use (p < 0.001). Among the heavy smokers who also drank alcoholic beverages, the hazard ratio from the fully adjusted model was 4.3 (95% CI, 2.3-8.0, p < 0.0001). In the subjects with moderate alcohol consumption, the risk of smoking and alcohol combined was similar to that found in the whole population (hazard ratio, 2.7; 95% CI, 1.5-3.9, p < 0.001). Among the subjects with heavy alcohol consumption, the hazard ratio was 3.4 (95% CI, 1.3-8.6, p = 0.011). These findings indicate that the detrimental cardiovascular effects of smoking can be worsened by concomitant alcohol use. This synergistic effect occurs not only for heavy alcohol consumption but also for moderate use. Smokers should be aware of the increased risk associated with concomitant alcohol consumption.

HIV risk profile and prevention needs of individuals seeking monkeypox (mpox) vaccination in an urban clinic in the U.S.: a brief report

BackgroundOur study survey assessed HIV risk profile and pre-exposure prophylaxis (PrEP) use among HIV-negative individuals seeking mpox vaccination, elucidating HIV prevention gaps and opportunities.MethodsAnonymous cross-sectional surveys were self-administered at an urban academic center clinic in New Haven, CT, U.S. (August 18–November 18, 2022). Inclusion criteria included adults presenting for mpox vaccination who consented to the study. The study assessed STI risk (sexual practices, STI history, substance use). For HIV-negative participants, PrEP knowledge, attitudes, and preferences were assessed.ResultsEighty-one of 210 individuals approached completed surveys (survey acceptance and completion rate 38.6%). Majority were cisgender-male (76/81; 93.8%), Caucasian (48/79; 60.8%), with median age 28 years (IQR-15). Nine of 81 (11.5%) self-reported HIV-positivity. Median sexual partner number (6 months prior) was 4 (IQR-5.8). Majority, 89.9% and 75.9%, reported insertive and receptive anal intercourse, respectively. 41% reported lifetime STI history, of whom 12.3% had an STI 6 months prior. Majority (55.8%) used ≥ 1 illicit substance; 87.7% moderate alcohol use. Among HIV-negative respondents, most (95.7%) were aware of PrEP, but only 48.4% used PrEP.ConclusionIndividuals seeking mpox vaccination engage in behaviors placing them at increased STI risk and would benefit from PrEP assessment.

Animal models for studies of alcohol effects on the trajectory of age-related cognitive decline.

There is growing interest in understanding how ethanol use interacts with advancing age to influence the brain and cognition. Animal models are employed to investigate the cellular and molecular mechanisms of brain aging and age-related neurodegenerative diseases that underlie cognitive decline. However, all too often research on problems and diseases of the elderly are conducted in healthy young animals, providing little clinical relevance. The validity of animal models is discussed, and confounds due to age-related differences in anxiety, sensory-motor function, and procedural learning are highlighted in order to enhance the successful translation of preclinical results into clinical settings. The mechanism of action of ethanol on brain aging will depend on the dose, acute or chronic treatment, or withdrawal from treatment and the age examined. Due to the fact that humans experience alcohol use throughout life, important questions concern the effects of the dose and duration of ethanol treatment on the trajectory of cognitive function. Central to this research will be questions of the specificity of alcohol effects on cognitive functions and related brain regions that decline with age, as well as the interaction of alcohol with mechanisms or biomarkers of brain aging. Alternatively, moderate alcohol use may provide a source of reserve and resilience against brain aging. Longitudinal studies have the advantage of being sensitive to detecting the effects of treatment on the emergence of cognitive impairment in middle age and can minimize effects of stress/anxiety associated with the novelty of alcohol exposure and behavioral testing, which disproportionately influence aged animals. Finally, the effect of alcohol on senescent neurophysiology and biomarkers of brain aging are discussed. In particular, the interaction of age and effects of alcohol on inflammation, oxidative stress, N-methyl-d-aspartate receptor function, and the balance of excitatory and inhibitory synaptic transmission are highlighted.

Neuroimaging-Derived Predicted Brain Age and Alcohol Use Among Community-Dwelling Older Adults

ObjectivesObservational studies have suggested that moderate alcohol use is associated with reduced risk of dementia. However, the nature of this association is not understood. We investigated whether light to moderate alcohol use may be associated with slower brain aging, among a cohort of older community-dwelling adults using a biomarker of brain age based on structural neuroimaging measures. DesignCross-sectional observational study. ParticipantsWell-characterized members of a longitudinal cohort study who underwent neuroimaging. We categorized the 163 participants (mean age 76.7 ± 7.7, 60% women) into current nondrinkers, light drinkers (1–7 drinks/week) moderate drinkers (>7–14 drinks/week), or heavier drinkers (>14 drinks/week). MeasurementsWe calculated brain-predicted age using structural MRIs processed with the BrainAgeR program, and calculated the difference between brain-predicted age and chronological age (brain-predicted age difference, or brain-PAD). We used analysis of variance to determine if brain-PAD differed across alcohol groups, controlling for potential confounders. ResultsBrain-PAD differed across alcohol groups (F[3, 150] = 4.02; p = 0.009) with heavier drinkers showing older brain-PAD than light drinkers (by about 6 years). Brain-PAD did not differ across light, moderate, and nondrinkers. Similar results were obtained after adjusting for potentially mediating health-related measures, and after excluding individuals with a history of heavier drinking. DiscussionAmong this sample of healthy older adults, consumption of more than 14 drinks/week was associated with a biomarker of advanced brain aging. Light and moderate drinking was not associated with slower brain aging relative to non-drinking.

Alcohol and Cannabis Use Within Emerging Adults’ Committed Romantic Relationships: Associations With Relationship Functioning and Quality of Life

This study examines alcohol and cannabis use within emerging adults’ committed romantic relationships and its association with relationship functioning (satisfaction, stability) and well-being (life satisfaction, anxiety, depression). Participants completed surveys in 2020 and 2021 ( N = 1214). Latent profile analysis identified four classes of couples’ substance use patterns: concordant (similar) infrequent use (81.9% of sample), near-daily partner cannabis use (6.0%), near-daily respondent cannabis use (6.5%), and concordant moderate alcohol and near-daily cannabis use (5.5%). Cross-sectionally, respondents who reported concordant infrequent use had significantly higher well-being than those who reported concordant heavier use; there were no class differences involving the two types of discordant couples. In general, class membership did not predict changes in well-being or relationship functioning over a 1-year period. Results provide new insights into patterns of both alcohol and cannabis use within committed romantic relationships of emerging adults that may have implications for well-being during this developmental period.

Abstract P060: A case of stage II hepatocellular carcinoma diagnosed using a multi-cancer early detection test

Abstract Introduction: Liver cancer is the third leading cause of cancer-related deaths in the world, with liver cancer incidence and related deaths increasing in the United States. Although there is no guideline-recommending screening for liver cancer for the general population, the American Association for the Study of Liver Diseases recommends liver cancer surveillance in individuals with cirrhosis through ultrasound imaging, with or without alpha-fetoprotein (AFP) testing, every 6 months. A multi-cancer early detection (MCED) test was developed that detects a shared cancer signal from methylation patterns of cell-free DNA in blood. A ‘cancer signal detected’ result (positive result) is reported with 1 or 2 cancer signal origin (CSO) prediction(s). Here, an early-stage liver cancer case is presented to review the diagnostic pathway guided by a positive MCED test result. Case Description/Methods: A 62-year-old White male (BMI: 25.2 kg/m2) with chronic hepatitis B (low viral load since 9 years ago; no active therapy) underwent MCED testing. He reported moderate alcohol use (2-3 drinks/day) and that he formerly smoked over 10 years ago. He had a prostatectomy for prostate cancer 2 years prior to using the test. Three days after a blood sample was collected for analysis by the MCED test, computed tomography (CT) of the abdomen was performed as follow-up on a 1.9 cm indeterminate nodule without interval change for 1 year; CT of the abdomen showed a 1.9x1.9x1.9 cm left hepatic lobe nodule. Ten days after the CT scan, a positive MCED test result (top-CSO prediction=Liver/Bile duct; second-CSO prediction=Lung) was reported to the provider (Day 1). The result was communicated to the patient the next day (Day 2). The positive MCED test result resulted in aggressive evaluation of the mass. Biopsy of the liver nodule revealed hepatocellular carcinoma, moderately differentiated (Day 10). The cancer was subsequently classified as stage II. The mass was completely resected (Day 52). Prior to surgery, AFP level was 29.3 ng/mL (Day 13); after surgery, AFP level was 5.7 ng/mL (Day 66). The patient currently has no clinical symptoms (normal appetite and no weight loss, pain, or jaundice; Day 234). Discussion: The MCED test detected a cancer signal and predicted a liver CSO for an individual with stage II liver cancer. An indeterminate nodule was found in the patient 1 year prior to MCED test use with no resolution. Neither the CT scan results nor AFP level, which was lower than the AFP threshold (400 ng/mL) potentially indicative of hepatocellular carcinoma, would have led to this cancer being worked up without the MCED test. In conjunction with a positive MCED test result with a top-CSO prediction of liver, an aggressive workup took place resulting in diagnostic resolution within 1 month. Early-stage hepatocellular carcinoma has better prognosis and outcomes than late-stage disease. The use of the MCED test guided aggressive diagnostic workup and potentially improved outcomes for this patient. Citation Format: Martin Poliak. A case of stage II hepatocellular carcinoma diagnosed using a multi-cancer early detection test. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P060.

Abstract P059: A case of stage I esophageal adenocarcinoma diagnosed using a multi-cancer early detection test

Abstract Introduction: There is no guideline-recommended screening test for esophageal cancer, a cancer that occurs in approximately 1 in 125 men and 1 in 417 women in the US. Risk factors for esophageal adenocarcinoma include gastroesophageal reflux disease, Barrett’s esophagus, obesity, and smoking. A multi-cancer early detection (MCED) test that analyzes methylation patterns of cell-free DNA in the blood using sequencing assays and machine-learning classifiers is available as a complement to existing single-cancer screening tests. The MCED test reports either (1) ‘cancer signal detected’ with 1 or 2 cancer signal origin (CSO) prediction(s) or (2) ‘cancer signal not detected’. A case of esophageal adenocarcinoma is presented here to demonstrate early detection using the MCED test and to review the diagnostic journey following a cancer signal detected (positive) test result. Case Description/Methods: An asymptomatic 63-year-old White male (BMI: 27 kg/m2) with history of peptic ulcer disease was screened using the MCED test. He reported moderate alcohol use (6/week) and no tobacco use. His last colonoscopy was 5 years prior to using the test. Nine days after a blood sample was collected for analysis by the MCED test, a positive test result (CSO prediction=Stomach/Esophagus) was reported and communicated to the patient (Day 1). Computed tomography (CT) of the chest, abdomen, and pelvis with contrast showed no significant findings (Day 13). A submucosal bulge just below the gastroesophageal junction (GEJ) was noted on upper endoscopy. The lesion, and area above the GEJ were extensively biopsied (Day 15). Pathologic evaluation confirmed diagnosis of Clinical Stage I esophageal adenocarcinoma with superficial focally invasive adenocarcinoma arising in a background of intestinal metaplasia with high grade dysplasia (Day 29). The patient underwent total gastrectomy without complications (Day 104). He will undergo appropriate follow-up 6 months post-op. Discussion: The MCED test detected a cancer signal and predicted a gastrointestinal CSO for an asymptomatic individual with Clinical Stage I esophageal cancer. Diagnostic resolution was achieved within 1 month and treatment was provided with curative intent. Given that there is no guideline-recommended screening test available for esophageal cancer, the use of this MCED test detected cancer early, directed diagnostic workup, and potentially improved outcomes for this asymptomatic patient. Citation Format: David DeAtkine Jr. A case of stage I esophageal adenocarcinoma diagnosed using a multi-cancer early detection test. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P059.

The changing relationship between health risk behaviors and depression among birth cohorts of Canadians 65+, 1994-2014.

The older adult residents of Canada form an increasingly larger proportion of the population and are becoming better educated and have more income. Depression is a common mental disorder, particularly among seniors. Several health risk behaviors-physical inactivity, tobacco use, and alcohol consumption-are linked to mental health problems. This study examines whether these health risk behaviors and their association with depression among Canadians 65+ born in eight cohorts between 1910-1914 and 1945-1949, have changed. Pooled data drawn from 11 nationally representative health surveys conducted by Statistics Canada between 1994 and 2014 are analyzed-88,675 survey participants met inclusion criteria. Depression was assessed by the Composite International Diagnostic Interview-Short Form. Health risk behaviors examined were physical activity/inactivity, smoking, and alcohol use. A Cochran Armitage trend test for categorical outcomes and a log-binomial modeling for binary outcomes were used to estimate the risk ratios across cohorts. The proportions of Canadians 65+ who are physically active, regular drinkers, and regular smokers have increased; however, depression prevalence fluctuated non-significantly. Depression increased among all health risk behaviors, particularly in recent birth cohorts. Depression among physically inactive seniors, current smokers, and non-drinkers was significantly higher than among active, non-smokers, and regular drinkers (all P < 0.05). Physical inactivity and smoking-attributable depression risk showed an increasing linear trend across birth cohorts (RR = 1.67, P < 0.001; RR = 1.79, P < 0.001). For seniors born between 1915 and 1944, regular drinking was associated with a significant decrease in depression (all P < 0.001), but the protective effects of regular drinking became non-existent in the most recent 1945-1949 birth cohort (RR = 1.09, P < 0.05, after adjusting for covariates). Inactivity and smoking were consistently associated with a significantly increased risk of depression among Canadian residents 65+, with smoking becoming more firmly connected to depression risk in more recent birth cohorts. In contrast, moderate alcohol use was associated with a decreased risk of depression, but that protective effect ceased in most recent birth cohort. Identifying the changing relationships between health risk behaviors and depression is meaningful for developing prevention strategies for depression and other emotional and mental health problems.

Nonheavy Alcohol Use Associates With Liver Fibrosis and Nonalcoholic Steatohepatitis in the Framingham Heart Study

Background and AimsWhile heavy alcohol use consistently associates with liver disease, the effects of nonheavy alcohol consumption are less understood. We aimed to investigate the relationship between nonheavy alcohol use and chronic liver disease. MethodsThis cross-sectional study included 2629 current drinkers in the Framingham Heart Study who completed alcohol use questionnaires and transient elastography. We defined fibrosis as liver stiffness measurement (LSM) ≥8.2 kPa. We defined at-risk nonalcoholic steatohepatitis (NASH) as FibroScan-aspartate aminotransferase (FAST) score >0.35 (90% sensitivity) or ≥0.67 (90% specificity). We performed logistic regression to investigate associations of alcohol use measures with fibrosis and NASH, adjusting for sociodemographic and metabolic factors. Subgroup analysis excluded heavy drinkers (>14 drinks per week for women or >21 for men). ResultsIn this sample (mean age 54.4 ± 8.9 years, 53.3% women), mean LSM was 5.6 ± 3.4 kPa, 8.2% had fibrosis, 1.9% had NASH by FAST ≥0.67, and 12.4% had NASH by FAST >0.35. Participants drank 6.2 ± 7.4 drinks per week. Total drinks per week and frequency of drinking associated with increased odds of fibrosis (adjusted odds ratio [aOR], 1.18; 95% confidence interval [CI], 1.04–1.33; and aOR, 1.08; 95% CI, 1.01–1.16, respectively). Risky weekly drinking, present in 17.4%, also associated with fibrosis (aOR, 1.49; 95% CI, 1.03–2.14). After excluding 158 heavy drinkers, total drinks per week remained associated with fibrosis (aOR, 1.16; 95% CI, 1.001–1.35). Multiple alcohol use measures positively associated with FAST >0.35. ConclusionsIn this community cohort, we demonstrate that nonheavy alcohol use associates with fibrosis and NASH, after adjustment for metabolic factors. Longitudinal studies are needed to determine the benefits of moderating alcohol use to reduce liver-related morbidity and mortality.

The temporality and accessibility of message types (TAMT) model: Examining social media message types and the associations between exposure to alcohol and binge drinking

Scholars have indicated that social media contribute to various health-related behaviors (e.g., substance use, body dissatisfaction) among adolescents. This study adds to the literature on health-related social media effects through theoretical advances supported by empirical evidence. First, we introduce the TAMT model, in which we assess the media environment along a continuum of two dimensions: the temporality (from ephemeral to persistent) and accessibility (from private to public) of message types. By combining these dimensions, we argue that there are four message types: ephemeral private, persistent private, ephemeral public, and persistent public. Second, we draw on the TAMT model to advance our knowledge of the role of social media in alcohol-related behaviors. We expected that, due to the distinctive characteristics of the four message types, they would be differently related to alcohol references and binge drinking. Based on cross-sectional data (N = 1,636, Mage = 15, SD = 1.17), we found that moderate alcohol references are encountered across all message types, while more extreme references are more likely to be prevalent in ephemeral public and ephemeral private messages. We show that exposure to moderate and extreme alcohol use references in ephemeral private and persistent private messages was associated with a higher probability of engaging in binge drinking, whereas exposure to ephemeral public and persistent public messages was not. Ephemeral private messages played the most crucial role in the association with binge drinking. These findings illustrate the importance of broadening the scope of research to ephemeral private environments when studying health-related behaviors. While we have illustrated the usefulness of the TAMT model against the background of two specific types of alcohol references, this new model can be extended to other behaviors (e.g., sexual risk-taking behaviors, cyberbullying).

Perceptions of two different alcohol use behaviours in pregnancy: an application of the prototype/willingness model

ABSTRACT Objective This study explored whether exposure to either an ‘ambiguous consumption’ prototype (no amount of alcohol specified) or a ‘small consumption’ prototype (‘small’ amount of alcohol specified) had an impact on prototype perceptions of, and willingness to use, small amounts of alcohol during pregnancy. Method Participants were 140 women living in the UK, aged 20–45 years old, of whom 92% had previously been, or intended to become, pregnant. Participants completed measures to assess how favourably they viewed alcohol use in pregnancy, how similar they felt to those who would use alcohol in pregnancy and how responsible they perceived those who would use alcohol in pregnancy to be. Participant’s own willingness to use small amounts of alcohol during pregnancy was also assessed. Results Having at least one child was positively correlated with being willing to accept an alcoholic drink while pregnant for those exposed to the ‘ambiguous consumption’ prototype only. Although perceptions of favourability, similarity and responsibility were consistently higher for those exposed to a ‘small consumption’ condition, there were no differences in willingness to drink according to exposure. Conclusion This research suggests that women’s perceptions of those who drink alcohol while pregnant differ according to the amount of alcohol that they perceive as typical. This may have implications for how alcohol use in pregnancy is portrayed in public health messaging, particularly regarding the level of acceptance that may be associated with low to moderate alcohol use.

Parental monitoring, family conflict, and adolescent alcohol use: A longitudinal latent class analysis.

This study examined relationships among parental monitoring, family conflict, and subgroups of adolescent alcohol use identified through longitudinal latent class analyses (LLCA). Differences in these subgroups across sex and race/ethnicity were also examined. The present study used data (N = 4,067; 51% male, 49% female) collected during a longitudinal study in which adolescents completed questionnaires each semester for seven semesters, beginning in spring of their freshman year of high school until spring of their senior year. LLCA demonstrated three classes of drinking over time (low, increasing, and moderate use). The majority of adolescents were increasing-use drinkers. Moderate drinkers were more likely to be male than female; nondrinkers were most likely to be African American; and increasing-use drinkers were more likely to be Mexican American. Adolescents who received less maternal monitoring and experienced more family conflict were more likely to be identified in the class of moderate alcohol use compared to nonuse. These results highlight the importance of encouraging parental monitoring and decreasing family conflict to reduce the likelihood of adolescent alcohol use throughout the high school years (PsycInfo Database Record (c) 2022 APA, all rights reserved).