Reported Alcohol Consumption Research Articles

Effects of the Response to the COVID-19 Pandemic on Assault-Related Head Injury in Melbourne: A Retrospective Study.

Assault is the leading preventable cause of death, traumatic brain injury (TBI), and associated mental health problems. The COVID-19 pandemic has had a profound impact on patterns of interpersonal violence across the world. In this retrospective cross-sectional study, we analysed medical records of 1232 assault victims (domestic violence: 111, random assault: 900, prison assault: 221) with head injuries who presented to the emergency department (ED) at St Vincent's Hospital in Melbourne, Australia, a city with one of the longest and most severe COVID-19 restrictions worldwide. We examined changes in prevalence in the assault group overall and in domestic violence, random assault, and prison assault victims, comparing data from 19.5 months before and after the first day of COVID-19 restrictions in Melbourne. Moreover, we investigated differences driven by demographic factors (Who: age group, sex, and nationality) and clinical variables (Where: assault location, and When: time of arrival to the ED and time from moment of injury until presentation at ED). Descriptive statistics and chi-square analyses were performed. We found the COVID-19 pandemic significantly affected the Where of assault-related TBI, with a shift in the location of assaults from the street to the home, and the increase at home being driven by random assaults on middle-aged adults. Overall, we observed that 86% of the random assault cases were males, whereas 74% of the domestic assault cases were females. Meanwhile, nearly half (44%) of the random assault victims reported alcohol consumption versus a fifth (20%) of domestic violence victims. These findings will have direct implications for developing screening tools and better preventive and ameliorative interventions to manage the sequelae of assault TBI, particularly in the context of future large-scale health crises or emergencies.

ALZHEIMER’S DISEASE RISK REDUCTION HEALTH COACHING: ALCOHOL EFFECTS

Abstract Lifestyle risk reduction at the community-level, is currently considered an effective method to decrease Alzheimer’s disease (AD). As part of the Virginia Commonwealth University iCubed Health and Wellness in Aging Core, diverse older adults (60+) in Richmond, VA, with incomes below $12,000/year and managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, support, and monitoring for AD lifestyle risk in 2020-21. The study sample (n=40, mean age 68 years (range: 60-77 years) was 88% African American/Black (n=35), 100% Non-Hispanic, 45% males (n=18)), 60% reporting memory problems and 53% reporting any alcohol consumption. Thirty-nine (95%) of subjects successfully participated in coaching sessions; on average 91.9% (11) sessions were completed. Participants provided positive anecdotal feedback and the need for continued coaching during COVID. Average drinks per day decreased across the study period (F=7.44; p=.01) and alcohol risk, defined as more than 1 drink/day, decreased (F=3.46;p=.07). Drinking at baseline was associated with differential change in nicotine dependence (F=14.00 ;p=.02), depression risk (F=3.20;p=.09), light physical activity (F=4.52;p=.05), and cognition (COGTEL) (F=6.35;p=.02). Drinking between-subject effects indicated poorer level differences for smoking risk (F=5.68;p=.02), physical inactivity risk (F=4.66;p=.04), and total health behavior risk (F=14.54;p=.001), but higher cognition-scores (F=3.18;p=.11) for drinkers. In conclusion, there may be a paradoxical health effect for alcohol, with associations for negative health behaviors, but positive cognitive functioning. In conclusion, this preliminary work creates the impetus for future large-scale AD risk reduction investigations to improve the lives of AD-risk, low-income, diverse older adults reporting alcohol consumption.

Identifying Non-Communicable Disease Risk Factors in Newly Employed and Experienced Professionals in Bangladesh

Introduction: Non-communicable diseases (NCDs) pose a significant global health burden, accounting for a majority of global deaths and millions of premature deaths each year. In Bangladesh, NCDs contribute to a substantial proportion of annual mortality, with a concerning increase observed in recent decades. This study aimed to identify NCD risk factors among newly employed and experienced Bangladeshi professionals.
 Methods: A comparative cross-sectional study was conducted at the department of Cardiology, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh, from October 2021 to September 2022. A total of 102 participants, including both newly employed and experienced professionals, were included using purposive non-probability sampling. Data collection involved a pre-tested semi-structured questionnaire, as well as measurements of height, weight, and blood pressure.
 Result: The study involved a majority of female participants (65.7%), who were unmarried (68.6%) and had completed secondary school (71.6%). The average age was 25.67 years, with an average monthly income of $479.83. Approximately 20% reported smoking, while 13.7% reported alcohol consumption. Low physical activity was reported by 40.2%, and inadequate fruit and vegetable consumption by 31.4%. The prevalence of chronic diseases was found to be 12.7% for hypertension, 5.5% for diabetes, and 2.7% for cardiovascular diseases. These findings provide valuable information on participant characteristics, risk factors, and chronic disease prevalence, relevant to researchers and policymakers working on public health interventions.
 Conclusion: This study provides important insights into the distribution of NCD risk factors among newly employed individuals and experienced professionals in Bangladesh. The findings suggest that NCD risk factors are similar between these two groups, except for hypertension, which is more prevalent among experienced professionals. These findings have important implications for public health interventions aimed at reducing the burden of NCDs in Bangladesh.
 
 

Relationship between nutritional status, lifestyle and prognosis in patients diagnosed with COVID-19 hospitalized in the state of Pernambuco

Objective: To analyze the relationship between nutritional status and lifestyle habits and the prognosis of hospitalized patients with COVID-19 in Pernambuco. Methods: Multicenter, cross-sectional study, associated with prospective analysis variables, involving patients with COVID-19 and admitted to 8 hospitals. Individuals aged ≥ 18 years of both sexes, hospitalized from June 2020 to June 2021, were included. Socioeconomic, clinical, anthropometric, lifestyle and prognostic variables were collected. Results: The sample consisted of 263 individuals with a mean age of 62.9 ± 16.6 years and homogeneous distribution between genders. It was observed that 8.2% were smokers, 20.9% reported alcohol consumption, and 80.1% were sedentary. The anthropometric profile indicated that 49.5% were overweight and 7.0% were underweight. Malnutrition and excess weight were associated with more extended hospital stays (66.7% weight loss and 64.5% weight gain vs. 30.0% eutrophy; p = 0.021), smoking with death (tab 65 .0% vs. non-tab 33.7%; p = 0.006) and need for admission to the intensive care unit (yes 64.3%, no 31.5%; p = 0.014). The frequency of dyspnea was higher in patients who reported drinking alcohol (yes 69.6% vs. no 48.1%; p = 0.007). Physical activity was not associated with any prognostic factor. Conclusion: Nutritional extremes and bad lifestyle habits, such as smoking and alcohol consumption, are risk factors for a poor prognosis in individuals with COVID-19.

Presentations to the Emergency Department for Problems Related to Mental Health: Sex Differences in Adolescents.

Background: Adolescents aged sixteen to eighteen years are mostly treated in adult emergency departments. In a study at our tertiary adult emergency department (ED) at the University Hospital in Bern (Inselspital), Switzerland, we found that adolescents significantly more often present with psychiatric problems than adults. The study at hand aimed to characterise those adolescents presenting to the ED triaged with a chief complaint regarding mental health. Furthermore, the goal was to assess sex differences in terms of diagnosis, suicidal ideation, substance use, as well as social impact. Methods: We conducted a single-centre, retrospective review of presentations to our adult ED related to the mental health of adolescents aged 16 to 18 years, covering the period from January 2013 to July 2017. Anonymised data were extracted from medical reports referring to the ED visits that were triaged as mental-health-related, and we assessed these for diagnosis, acute and previous suicidal ideation, history of self-harm, external aggression, substance use and social problems. We focused on patient characterisation and defining sex differences. Results: Data were analysed for a total of 612 consultations by adolescents who presented to our ED with problems related to mental health. Women accounted for 61.1% of cases. The most frequent diagnoses were reactions to severe stress and adjustment disorders (19.1%), followed by alcohol use disorders (17.6%), intentional self-harm (17.3%), and affective disorders (13.7%). Males had lower odds for intentional self-harm (OR 0.10, 95% 0.05–0.21, p < 0.001) as well as disorders of personality and behaviour (OR 0.09, 95% 0.21–0.37, p < 0.001), whereas they had higher odds of being admitted due to use of alcohol (OR 2.51, 95% 1.65–3.83, p < 0.001). Of all cases, 31.7% reported acute suicidal ideation, with a significantly lower odds ratio in males (OR 0.58, 95% 0.41–0.84, p = 0.004). The most common source for referral to the ED was family members (25.2%). Males had twice the odds of reporting alcohol consumption as well as use of cannabis (in both cases p < 0.001). In 27.9% of all cases, familial problems were reported, with males having significantly lower odds of being exposed to these (OR 0.64, 95% 0.44–0.94, p = 0.021), whereas they had higher odds of reporting educational problems (OR 1.68, 95% 1.04–2.72, p = 0.035). Conclusions: Adolescents aged sixteen to eighteen years presenting to the ED with problems related to mental health are an important subgroup of ED presentations and should be thoroughly assessed for suicidal ideation, substance use, as well as familial and educational problems. Assessment and establishment of post-ED care are of particular importance in this vulnerable patient group.

Liver fibrosis might drive fibrogenesis in the heart in early alcoholic liver disease

Abstract Background/Introduction Alcohol use disorder (AUD) is associated with the development of psychiatric conditions as well as alcoholic liver disease (ALD). Ethanol toxicity but also the intestinal microbiota are important drivers of fibrogenesis in the liver and eventually also of the myocardium. Purpose The aim of our study was the investigation of simultaneous development of fibrosis in liver and heart in patients with early ALD. Methods The HALFWAY-Study is a cohort study, recruiting patients with ALD during a detoxification program. Liver stiffness was measured by non-invasive elastography (ARFI, Acoustic Radiation Force Impulse). Echocardiographic measured E/e' (early ventricle filling velocity, E / mitral annular early diastolic velocity, e') and left atrial volume (LaVol) were used as surrogate markers for atrial filling pressure, which in case of normal de-loading of the left ventricle, correlates with diastolic dysfunction. Results 50 patients were included into the study (females n=27, males n=23). Participants were young (mean age 43.3 years ± 7.3), non-obese (body mass index; BMI 23.9 kg/m2 ±3.9) and non-diabetic (HbA1c 5.1% ± 0.3), ruling out metabolic disease. All patients displayed normal ejection fraction (EF; 61.3% ± 9.1) a global longitudinal strain (4 chamber view) of −15.03±3.7 and NTproBNP (50 pg/ml; IQR 46.5). 95% of patients reported alcohol consumption more than four times a week, with 65% drinking 7–8 drinks per day and 25% consuming more than daily 10 drinks. The mean liver stiffness was 6.5 kPa ± 4.2, whereby in 18% of participants a significant liver fibrosis was diagnosed. We could observe a significant correlation between non-invasive liver stiffness measurements (ARFI) and E/e' (p=0.019, R=0.338) as well as LaVol (p=0.043, R=0.29). In a multivariate linear regression model using ARFI, EF, LaVol and global strain as independent variables, using the backward selection method (R2=0.114, p=0.022 for the final model), we identified ARFI as the only significant predictor of E/e' (B=0,337; p=0.022). Conclusion In patients with early ALD liver stiffness (measured by ARFI) independently predicts E/e' which might indicate simultaneous fibrogenesis of liver and heart. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): ÖGGH

Clinical-environment characteristics among Brazilian women diagnosed with benign breast disease

Introduction: Although benign breast disease (BBD) is one of the main breast cancer risk factors, its natural history is still unclear. The breast development, maturation, and differentiation suffer hormones and growth factors influence that may modulate BBD development. Thus, clinical-environment risk factors could influence BBD histological type. Aim: To evaluate the distribution of selected environmental, clinical, sociodemographic, and reproductive factors in cohorts of Brazilian women diagnosed with benign breast disease, according to histopathology group. Methodology: Cross-sectional study conducted with women with BBD diagnose referred to two hospitals in Rio de Janeiro (IFF/Fiocruz and HFL/Ministry of Health) from 2013 and 2018. A standardized questionnaire was applied by trained interviewers. Crude and adjusted odds ratios and 95% respective confidence interval were estimated using multinomial logistic regression. Results: From 353 women included, 62.9% had non-proliferative diseases, 27.8% had proliferative diseases without atypia, and 9.3% had proliferative diseases with atypia or lobular carcinoma in situ. About 30% were either current or former smokers, and reported alcohol consumption. Women exposed to hair dyes and hair straightening products (81.8%) were statistically higher in the proliferative lesion with atypia/lobular carcinoma in situ compared with non-proliferative and proliferative without atypia lesions. Compared to women with non-proliferative diseases, those with proliferative diseases with atypia or lobular carcinoma in situ were more likely to be older at diagnosis (OR =1.05;95%CI:1.01-1.09); to have 3+ histological types in biopsied lesion (OR=26.74;95%CI: 9.79-73.01); and to have regular menstrual cycles (OR=2.98; 95%CI: 1.03-8.66). Conclusion: Findings suggest that age at diagnosis, increased histological types found in biopsied tissue, and having presented regular menstrual cycles throughout the reproductive period may be associated with benign lesions with a high risk of breast cancer. Keywords: breast diseases; epidemiology; breast neoplasms.

Screening for colorectal cancer: awareness and adherence among Italian women.

To evaluate women's awareness about and attendance to colorectal cancer (CRC) screening programs in an area of Southern Italy, and to investigate related potential determinants. The survey was conducted among women through a self-administered questionnaire. Overall, only 20.3% of respondents knew the three cancer screening tests offered to women and this knowledge, at the multivariate logistic regression analysis, resulted to be significantly higher in women who knew the two most common cancers in females, in those who were graduated, had a personal or family history of cancer, and had been informed about cancer prevention by physicians. Only 29.2% of women had ever undergone FOBT, 25% for screening purposes and, of these, 76.4% in the previous 2 years. Among those who had never undergone FOBT, 28.9% reported they had not been invited to attend, 34.5% that the test had not been prescribed by anyone, and 19.1% had no time to undergo. The results of the multivariate logistic regression model revealed that significant determinants of having undergone FOBT for screening purposes were having undergone mammography, having at least one chronic disease, not reporting alcohol consumption and having been informed about cancer screening by physicians. Our findings have revealed a concerning low awareness about and adherence to CRC screening in women and have highlighted the fundamental role of healthcare workers and of enabling factors in the decision process. Interventions should be directed to increasing awareness, and to promote cancer prevention screening pathways more centered on women's health needs and convenience.

Mid-life alcohol consumption and survival to age 90 in men: The Tromsø Study 1979-1980 with follow-up to 2019.

The Tromsø Study 1979-1980 collected information on alcohol (beer, wine and spirits) consumption frequency and inebriation frequency, and the oldest male participants (aged 50-54 years) were followed for all-cause mortality. This study aimed to identify the impact of habitual alcohol consumption in mid-life on reaching up to 90 years of age. Among the study sample of 778, a total of 120 (15.4%) men reached the age of 90. The most common reported alcohol consumption frequency was 'never or a few times a year', and 18.9% of those in this group reached 90 compared with 11.9% of those who reported a more frequent beer consumption. Fifty per cent survival in these groups was 80.5 and 76.9 years, respectively. The pattern was similar for spirits consumption and for inebriation but not for wine consumption. Number of deaths increased gradually with increasing beer and spirits consumption frequency and with inebriation frequency. We observed no J-shape or pattern that revealed a beneficial influence of light alcohol consumption. Daily smoking, physical inactivity, marital status, blood pressure and total cholesterol reduced the contribution of alcohol consumption to a small degree. This study shows that all beer and spirits consumption frequencies in mid-life affect later life and total lifespan. Refraining from alcohol consumption or drinking only a few times a year increases one's chances of living longer, and the chance of reaching 90 years of age is 1.6-fold higher than in those with more frequent alcohol consumption.

Sleep and Alcohol Use Patterns During Federal Holidays and Daylight Saving Time Transitions in the United States.

We conducted a retrospective observational study using remote wearable and mobile application data to evaluate whether US public holidays or Daylight Saving Time transitions were associated with significant changes in sleep behaviors, including sleep duration, sleep onset and offset, and the consistency of sleep timing, as well as changes in the point prevalence of alcohol use. These metrics were analyzed using objective, high resolution sleep-wake data (10,350,760 sleep episodes) and 5,777,008 survey responses of 24,250 US subscribers (74.5% male; mean age of 37.6 ± 9.8 years) to the wrist-worn biometric device platform, WHOOP (Boston, Massachusetts, United States), who were active users during 1 May 2020, through 1 May 2021. Compared to baseline, statistically significant differences in sleep and alcohol measures were found on most DST transitions, US public holidays, and their eves. For example, New Year’s Eve corresponded with a sleep consistency decrease of 13.8 ± 0.3%, a sleep onset delay of 88.9 ± 3.2 min (00:01 vs. 22:33 baseline) later, a sleep offset delay of 78.1 ± 3.1 min (07:56 vs. 06:39), and an increase in the prevalence of alcohol consumption, with more than twice as many participants having reported alcohol consumption [+138.0% ± 6.7 (74.2% vs. 31.2%)] compared to baseline. In this analysis of a non-random sample of mostly male subscribers conducted during the COVID-19 pandemic, the majority of US public holidays and holiday eves were associated with sample-level increases in sleep duration, decreases in sleep consistency, later sleep onset and offset, and increases in the prevalence of alcohol consumption. Future work would be warranted to explore the generalizability of these findings and their public health implications, including in more representative samples and over longer time intervals.

Risk Factors For Hearing Decline From Childhood To Early Adolescence.

To identify risk factors of hearing decline between 9 and 13 years of age. The risk factors examined included sociodemographic, health, and lifestyle-related factors. This study was embedded within a population-based prospective cohort study from fetal life onwards in the Netherlands. Pure-tone audiometry and tympanometry were performed at the age of 9 and 13 years. The hearing decline was defined as an increase in low-frequency or high-frequency pure-tone average of at least 5 dB in one of both ears. Multivariable logistic regression was performed to examine the association of possible risk factors with hearing decline. The study was conducted from April 2012 to October 2015, and from April 2016 to September 2019. Of the 3,508 participants included, 7.8% demonstrated a hearing decline in the low frequencies, and 11.3% in the high frequencies. Participants who reported alcohol consumption were more likely to have a hearing decline in the low frequencies (OR 1.5, 95% CI 1.1; 2.0). Moreover, a lower educational level was associated with an increased odds of having a hearing decline in the high frequencies (OR 1.4, 95% CI 1.0; 1.8). Age, sex, household income, personal music player use, and body mass index were not associated with hearing decline. Educational level and risky behavior were significantly associated with hearing decline from childhood to early adolescence. The findings of the present study can help in the design of public health interventions to prevent hearing loss at a young age. 2 (prospective cohort study) Laryngoscope, 133:389-395, 2023.

Minimizing sample bias due to stigmatized behaviours: the representativeness of participants in a cohort study of alcohol in pregnancy

BackgroundStigmatized behaviours are often underreported, especially in pregnancy, making them challenging to address. The Alcohol and Child Development Study (ACDS) seeks to inform prevention of foetal alcohol harm, linking self-report as well as a maternal blood alcohol biomarker with child developmental outcomes. Samples were requested using passive, generic consent. The success of this approach at minimizing bias is presented comparing characteristics of women who provided samples to those who did not.MethodsAll pregnant women in the study city were sent a Patient Information Sheet (PIS) with their first NHS obstetric appointment letter. The PIS informed them that the NHS would like to take an extra blood sample for research purposes, unless they opted out. Neither the women nor the midwives were informed that the samples might be tested for an alcohol biomarker. This paper examines the extent to which women who provided the extra sample were representative of women where no sample was provided, in terms of routinely collected information: age; body mass index; area-based deprivation; previous pregnancies, abortions and caesarians; smoking status and carbon monoxide level; self-reported alcohol use, gestation and birth weight of their baby. Chi-square and Mann-Whitney U tests were used to compare groups.Results3436 (85%) of the 4049 pregnant women who attended their appointment provided the extra sample. Women who did not were significantly younger (p < 0.001), more materially deprived (p < 0.001), and less likely to be considered for intervention based on self-reported alcohol use (p < 0.001). There were no significant differences between the two groups on other routine data.ConclusionsThe use of passive consent without disclosure of the specific research focus resulted in a high level of sample provision. There was no evidence that study blinding was breached, and women who provided a sample were more likely to report alcohol consumption. Passive consent to draw additional blood for research purposes at routine antenatal venipuncture reduced sampling bias compared to asking women to give blood for an alcohol study. This methodology may be useful for other stigmatised behaviours.

Preconception Substance Use and Risk of Unintended Pregnancy: Pregnancy Risk Assessment Monitoring System 2016-17.

This study examined the association between preconception substance use and unintended pregnancy in a large, nationally representative sample of women. In this cross-sectional study, we used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) comprising, 74,543women who had birth during 2016-17. Logistic regression was used to assess the independent association of unintended pregnancy overall and by subtypes to preconception substance use (smoking and other nicotine/tobacco use, alcohol consumption, and use of cannabis, illicit/recreational drugs) and specific medication including prescription opioids, antidepressants and over the counter pain relief. Overall, 41% of pregnancies were unintended. Nearly 57% of participants reported alcohol consumption during the preconception period, with 32% indicating binge drinking, 17% reported preconception smoking, and 10% cannabis use. Unintended pregnancy was significantly associated with substance use, including smoking (adjusted odds ratio [AOR]:1.5, 95% confidence interval [CI]: 1.4-1.6); as well as the use of other nicotine/tobacco (AOR:1.4, 95% CI: 1.3-1.5); cannabis (AOR: 1.9, 95% CI: 1.5-2.3); illicit/recreational drugs (AOR:1.7, 95% CI: 1.2-2.4), prescription opioids (AOR:1.4, 95% CI: 1.02-1.9), and prescription antidepressants (AOR 1.8, 95% CI: 1.1-3.0). The likelihood of unintended pregnancy was significantly elevated with heavy smoking, heavy alcohol consumption, and binge drinking. Analyses by unintended pregnancy subtype yielded similar results. Preconception substance use was significantly and positively associated with unintended pregnancy. Evidence-based interventions are needed addressing substance use behavior and effective contraceptive use to prevent unintended pregnancy and related adverse effects on maternal and child health.

A Mixed Methods Study of Self-Care Behavior in Patients of Type 2 Diabetes Mellitus Availing Out-Patient Services in A Hilly Tribal Area of Ahmednagar District of Maharashtra in India

Background: Management of Diabetes in tribal populations who have lower access to education and health care services poses unique challenges. Understanding patterns at local level will help implement comprehensive primary care services better. Objectives: To record self-care behaviors and identify barriers to self-care among tribal diabetics. Material and Methods: A triangulation (Quant + Qual) mixed-methods study was undertaken in 124 patients with type 2 Diabetes mellitus attending tribal health clinics in Bhandardara and Rajur in Akole taluka between April 2019 to April 2020. Socio-demographic profile, clinical history, Diabetes Self-Management Questionnaire (DSMQ) scores, and themes from Focus group discussion with patients were analyzed. Results: There was negative correlation between all domains of self-care with age. Being married correlated with better diet management (ρ= 0.344, p=0.001), physical activity (ρ= 0.184, p=0.04), and health service utilization (ρ= 0.274, p=0.002). Tobacco consumption was reported by 66.9% of patients and 74.49% of patients reported alcohol consumption. Presence of addictions showed negative correlation with all domains of self-care behaviors. Conclusion: Patients have led a relatively active lifestyle and are willing to comply with advice. Areas that need special attention are high prevalence of addictions, lack of foot care, lack of knowledge, depression &amp; lack of supportive care. Family circumstances and socio-cultural factors need to be taken into account. Supportive care, family involvement in diet planning, improving health service utilization by addressing health beliefs, availability of time and money, competing priorities, perceived quality of care, and patient’s expectations from care providers. Efforts to improve community participation and inclusive care will foster confidence among patients to avail of services.

"Testing Affect Regulation Models of Drinking Prior to and After Drinking Initiation Using Ecological Momentary Assessment": Correction.

Two hundred twenty-two regularly drinking young adults (21-29 years, 84% undergraduates), completed an ecological momentary assessment (EMA) protocol for five consecutive 24-hr periods stretching across 6 days (Wednesday-Monday). Participants provided PA and NA reports three times daily and every half hour during drinking episodes. Alcohol consumption reports were provided each morning and every half hour during drinking episodes. Multi-level models showed that greater pre-drinking PA predicted higher odds of drinking, but not number of drinks consumed. Pre-drinking NA did not predict same day odds of drinking or drinks consumed. Episode-level results revealed different associations for PA and NA with drinking. Current PA did not predict drinks consumed over the next half hour; however, increased drinking was associated with greater increases in PA over the next half hour. Higher NA predicted fewer drinks consumed in the next half hour and higher odds of the end of a drinking episode; however, increased drinking was not associated with changes in NA. PA increased following drinking during episodes. Our results suggest that a focus on PA prior to episodes and a focus on NA during episodes may interrupt processes leading to heavy drinking, and may therefore aid prevention efforts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Remotely Educating Young Women About Alcohol: A Randomized Trial of the PartyWise Intervention.

Background: Alcohol and binge drinking pose significant health risks, especially for underage women; nonetheless, binge drinking is common. Materials and Methods: To evaluate the effectiveness of the PartyWise intervention in increasing awareness of sex differences in the risks of binge drinking, we used social media to enroll 520 female adolescents aged 15-19 years in a randomized controlled trial. Intervention participants received telephone screening, a brief counseling intervention with web-based resources (http://www.partywise.org), and up to 8 weekly text messages. Results: At baseline, most (71%) participants reported alcohol consumption in the prior month and 44% reported binge drinking (four or more drinks on one occasion), without differences between study groups; 79% of participants were aware of sex-based differences in alcohol risks. At follow-up, intervention recipients were more knowledgeable about sex-based differences in alcohol risks (adjusted odds ratio [adj OR] 8.87, 95% confidence interval [CI] 3.35-23.49 at 3 months; adj OR 2.44, 95% CI 1.21-4.90 at 9 months) and more likely to accurately define binge drinking (adj OR 1.63, 95% CI 1.02-2.60 at 3 months; OR 1.37, 95% CI 0.89-2.06 at 9 months). Although rates of any binge drinking in the past month remained similar between groups, intervention recipients were less likely to report binge drinking more than once in the past 30 days (22% vs. 32%, adj OR 0.58, 95% CI 0.35-0.99 at 3 months; 27% vs. 30%, adj OR 0.97, 95% CI 0.60-1.55 at 9 months). Conclusions: The PartyWise intervention is a promising approach to increasing awareness of the risks of binge drinking for underage women in a remotely delivered platform. Clinical Trials Registration: The Share Health Study: Teen Social Connections and Health (Phase 2), NCT03842540, https://clinicaltrials.gov/ct2/show/NCT03842540?id=NCT03842540&draw=2&rank=1.

Alcohol use is prevalent among adults with the fontan circulation but does not correlate with liver disease

BackgroundAlcohol consumption is associated with an increased risk of liver disease. There are limited studies on the epidemiology of alcohol use and its effects on Fontan-associated liver disease (FALD) in adulthood. MethodsIn this single-center prospective cohort study, patients were enrolled from the Fontan clinic between November 2019 and November 2020, excluding those with chronic hepatitis C or B. Alcohol consumption was quantified by Alcohol Use Disorders Identification Test (AUDIT) questionnaire and a supplementary questionnaire. Participants were stratified into alcohol consumers and non-consumers. Alcohol consumption was correlated to the magnitude of fibrosis on liver biopsy and the varices, ascites, splenomegaly, and thrombocytopenia (VAST) score. ResultsForty-three patients (age 30 ​± ​6.5 years) were enrolled, and most were in NYHA FC 1 or 2. Twenty-six (60.5%) participants consumed alcohol regularly in the past year (twenty with low-risk consumption and six with hazardous consumption). Alcohol consumers were more likely to have better NYHA FC. Of those, half reported alcohol consumption for longer than one year before enrollment. Eleven (25.6%) participants reported underage drinking. After multivariable adjustment, male sex was associated with increased severity of liver fibrosis (OR 3.7 [1.0 to 13.6]). Alcohol consumption was not associated with liver fibrosis (OR 1.2 [0.3 to 4.9]) or VAST scores (OR 1.2 [0.01 to 2.2]). ConclusionsAlcohol consumption is prevalent among adults with the Fontan circulation but does not correlate with FALD. However, further studies are required to validate the results in cohorts with heavier alcohol consumption. Underage drinking was prevalent and warrants screening in pediatrics.

Efficacy of a theory-driven program to implement alcohol screening and brief interventions in primary health-care: a cluster randomized controlled trial.

Screening and brief interventions (SBI) in primary health-care practices (PHCP) are effective in reducing reported alcohol consumption, but have not been routinely implemented. Most programs seeking to improve implementation rates have lacked a theoretical rationale. This study aimed to test whether a theory-based intervention for PHCPs could significantly increase alcohol SBI delivery. Two-arm, cluster-randomized controlled, parallel, 12-month follow-up, trial. PHCPs in Portugal. Staff from 12 PHCPs (n = 222, 81.1% women): nurses (35.6%), general practitioners (28.8%), receptionists (26.1%) and family medicine residents (9.5%); patients screened for alcohol use: intervention n = 8062; controls n = 58. PHCPs were randomized to receive a training and support program (n = 6; 110 participants) tailored to the barriers and facilitators for implementing alcohol SBIs following the principles of the Behavior Change Wheel/Theoretical Domains Framework approach, or to a waiting-list control (n = 6; 112 participants). Training was delivered over the first 12 weeks of the trial. The primary outcome was the proportion of eligible patients screened (unit of analysis: patient list). Secondary outcomes included the brief intervention (BI) rate per screen-positive patient and the population-based BI rate (unit of analysis: patient list), and changes in health providers' perceptions of barriers to implementation and alcohol-related knowledge (unit of analysis: health provider). The implementation program had a significant effect on the screening activity in the intervention practices compared with control practices at the 12-month follow-up (21.7% vs. 0.16%, intention-to-treat analysis, p = 0.003). Although no significant difference was found on the BI rate per screen-positive patient (intervention 85.7% vs. control 63.6%, p = 0.55, Bayes factor = 0.28), the intervention was effective in increasing the population-based BI rate (intervention 0.69% vs. control 0.02%, p = 0.006). Health providers in the intervention arm reported fewer barriers to SBI implementation and higher levels of alcohol-related knowledge at 12-month follow-up than those in control practices. A theory-based implementation program, which included training and support activities, significantly increased alcohol screening and population-based brief intervention rates in primary care.

Profile of cancer patients requiring dental and oral-maxillofacial prostheses in a Brazilian subpopulation.

BackgroundThe aim of the present study was to identify the profile of cancer patients in need of rehabilitation with dental and/or oral-maxillofacial prostheses and evaluate possible reasons for not concluding the rehabilitation process. Material and MethodsA retrospective observational study was conducted at the Dentistry Department of the Mato Grosso Cancer Hospital in the city of Cuiabá, Brazil, involving the analysis of the medical records of patients under care from April 2017 to November 2019. ResultsThe study population comprised 256 patients who met the inclusion criteria. A total of 30.90% of the patients were older adults, 65.6% were men, 70.3% had brown skin color, 27.3% were retired, 49.2% were married and 52% resided in municipalities in the state of Mato Grosso other than the capital. A total of 67.23% reported smoking and 53.9% reported alcohol consumption. The tumor was located in the head and neck region in 57.4%. The most frequent histological type was epidermoid carcinoma (55.1%). A total of 28.9% of cases were in disease stage IV. Most patients (60.2%) completed prosthetic rehabilitation, with a predominance of total prosthesis. The main reasons for not completing rehabilitation were the patient’s death and weakness. ConclusionsPatients who started treatment in more advanced stages of cancer had a greater chance of not completing the prosthetic rehabilitation. The non-completion of treatment was directly related to death and the state of weakness. Key words:Cancer, dental prosthesis, epidemiology, maxillofacial prosthesis, oral rehabilitation.

Factors Associated With Increased Alcohol Consumption During Physical and Social Distancing Measures During the COVID-19 Pandemic in a University in Brazil.

Objective:To report alcohol consumption during the first month of social home-isolation and physical distancing measures during the COVID-19 pandemic in an public University in Mid-West Brazil.Methods:We designed an online observational study. Initial data of 2166 participants was obtained between April and May, 2020, less than a month after University’s measures of social distancing with remote work and classes. We used Poisson regression model with robust variance to identify the significant factors associated with self-reported increase in alcohol consumption during social and physical distancing measures.Results:Increased alcohol consumption during social and physical distancing was reported by 22.9% of 1371 alcohol drinkers. Factors associated with reporting increased alcoholic consumption during University’s physical and social distancing measures were: not professing any religion (1.52, 95% CI 1.25-1.83), having signs/symptom suggesting SARS-COV-2 infection (1.56, 95% CI 1.26-1.93), missing social interaction with peers carried out without any mediating technology (1.57, 95% CI 1.13-2.20), experiencing financial distress/hardship (1.25, 95% CI 1.02-1.54), perceiving duration of social isolation as long (1.62, 95% CI 1.10-2.41), reporting worsening of emotional/mental wellbeing (1.76, 95% CI 1.34-2.33), and previous psychological disorders (1.25, 95% CI 1.03-1.52).Conclusions:This study highlights several individual, psychological, and social determinants of increase in consumption of alcoholic beverages during physical and social distancing measures due to the pandemic and the results may reflect the presence of emotional changes due to the COVID-19 pandemic. It urges that sanitary authorities adopt measures to avoid excessive alcohol consumption during social distancing measures.