Trends in alcohol consumption in relation to the COVID-19 pandemic: A cross-country analysis

Social isolation recruits amygdala-cortical circuitry to escalate alcohol drinking

How do social factors impact the brain and contribute to increased alcohol drinking? We found that social rank predicts alcohol drinking, where subordinates drink more than dominants. Furthermore, social isolation escalates alcohol drinking, particularly impacting subordinates who display a greater increase in alcohol drinking compared to dominants. Using cellular resolution calcium imaging, we show that the basolateral amygdala-medial prefrontal cortex (BLA-mPFC) circuit predicts alcohol drinking in a rank-dependent manner, unlike non-specific BLA activity. The BLA-mPFC circuit becomes hyperexcitable during social isolation, detecting social isolation states. Mimicking the observed increases in BLA-mPFC activity using optogenetics was sufficient to increase alcohol drinking, suggesting the BLA-mPFC circuit may be a neural substrate for the negative impact of social isolation. To test the hypothesis that the BLA-mPFC circuit conveys a signal induced by social isolation to motivate alcohol consumption, we first determined if this circuit detects social information. Leveraging optogenetics in combination with calcium imaging and computer vision pose tracking, we found that BLA-mPFC circuitry governs social behavior and neural representation of social contact. We further show that BLA-mPFC stimulation mimics social isolation-induced mPFC encoding of sucrose and alcohol, and inhibition of the BLA-mPFC circuit decreases alcohol drinking following social isolation. Collectively, these data suggest the amygdala-cortical circuit mirrors a neural encoding state similar to social isolation and underlies social isolation-associated alcohol drinking.

Effects on Cancer Prevention from the COVID-19 Pandemic

The COVID-19 pandemic led to disruption of health services around the world, including cancer services. We carried out a narrative review of the effect of the pandemic on cancer prevention services, including screening. Services were severely affected in the early months of the pandemic, and in some areas are still recovering. Large numbers of additional cancers or additional late-stage cancers have been predicted to arise over the coming years as a result of this disruption. To minimize the effects on cancer outcomes, it is necessary to return as quickly as possible to prepandemic levels of screening and prevention activity or indeed to exceed these levels. The recovery of services should address health inequalities.

Digital health coaching to improve patient preparedness for elective lower limb arthroplasty: a quality improvement project

Major surgery carries high risks with comorbidities, frailty and health risk behaviours meaning patients are often unprepared for the physiological insult. Since 2018, the Prepwell programme at South Tees Hospitals NHS Foundation Trust has supported patients to improve their preoperative health and fitness. In April 2020, the face-to-face service was suspended due to the pandemic, leading to the team implementing a three-tiered remote digital support pathway, including digital health coaching via a mobile phone application.

METHODS

Patients scheduled for elective lower limb arthroplasty were offered 8 weeks of digital health coaching preoperatively. Following consent, participants were assigned a personal health coach to set individual behaviour change goals supported by online resources, alongside a digitally delivered exercise programme. Participants completed self-assessment questionnaires at Entry to, and Exit from, the programme, with outcome data collected 21 days postoperatively. The primary outcome was the change in Patient Activation Measure (PAM).

RESULTS

Fifty-seven of 189 patients (30.2%) consented to referral for digital health coaching. Forty participants completed the 8-week programme. Median PAM increased from 58.1 to 67.8 (p=0.002). Thirty-five per cent of participants were in a non-activated PAM level at Entry, reducing to 15% at Exit with no participants in PAM level 1 at completion. Seventy-one percent of non-activated participants improved their PAM by one level or more, compared with 45% for the whole cohort. Median LOS was 2 days, 1 day less than the Trust's arthroplasty patient population during the study period (unadjusted comparison).

CONCLUSIONS

Digital health coaching was successfully implemented for patients awaiting elective lower limb arthroplasty. We observed significant improvements in participants' PAM scores after the programme, with the largest increase in participants with lower activation scores at Entry. Further study is needed to confirm the effects of digital health coaching in this and other perioperative groups.

The prevalence and determinant factors for alcohol abuse in Gondar city's preparatory schools: a cross-sectional study

Objectives

Alcohol abuse is more prevalent among preparatory schools in Ethiopia. Although alcohol abuse has become a significant health problem in Ethiopia, governmental and non-governmental organizations have not devoted enough attention to preventing and rehabilitating those who have difficulties with alcoholism. This study examined the prevalence and related factors of alcohol abuse in Gondar's preparatory schools.

Methods

The study used a mixed-methods research approach supported by a school-based cross-sectional design from April 2020 to June 2020 to get reliable and valid data. Through the use of stratified sampling techniques, the study drew a total of 196 students who were addicted to alcohol consumption.

Results

The result of this study revealed that most of the students in the study areas drink alcohol occasionally; the reason they engage in alcoholic consumption is to satisfy personal desires and get respite from strain. Moreover, peer pressure and societal and student familial backgrounds were among the factors that exposed students to the heavy drinking habit.

Conclusions

To avoid such barriers, the study urges the schools to work on a wakefulness campaign or make students aware of the adverse effects of alcohol and related substances through school media.

The Impact of (COVID)-19 on Beverage Purchasing Behaviors in Korea

Objective: In this study, we examined changes in purchase behavior of alcoholic beverages (ie, soju, beer, wine, traditional Korean liquor, and liquor) and non-alcoholic beverages (ie, fruit and vegetable juices, coffee, tea, bottled water, milk, yogurt, and plant-based milk) before and after the COVID-19 pandemic. Methods: Monthly beverage expenditure data, based on Korean household demographic information, was used for 3 years and 6 months. The 2-part model was used for analysis. To examine the effect of COVID-19, beverage expenditure was analyzed after dividing it into short-term and long-term effects. Results: Our results show that the probability of purchasing alcoholic beverages increased owing to the long-term effect of the COVID-19 pandemic. The amounts of beer, wine, and traditional Korean liquor purchased increased in the long-term. The purchase of sweet drinks decreased (ie, fruit and vegetable juices and yogurt) in the long-term because of the effect of the pandemic. On the other hand, tea, water, and plant-based milk expenditures increased. Conclusion: This beverage consumption pattern reflects both unhealthy (ie, an increase in alcoholic beverage purchases) and healthy drinking behaviors (ie, a decrease in sweet beverage purchases and an increase in tea, water, and plant-based milk purchases).

Alcohol misuse, health-related behaviors, and burnout among clinical therapists in China during the early Covid-19 pandemic: A Nationwide survey

Objectives

This study aimed to assess the extent of alcohol use and misuse among clinical therapists working in psychiatric hospitals in China during the early COVID-19 Pandemic, and to identify associated factors.

Methods

An anonymous nationwide survey was conducted in 41 tertiary psychiatric hospitals. We collected demographic data as well as alcohol use using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and burnout using the Maslach Burnout Inventory Human Services Survey.

Results

In total, 396 clinical therapists completed the survey, representing 89.0% of all potential participants we targeted. The mean age of participants was 33.8 years old, and more than three-quarters (77.5%) were female. Nearly two-fifths (39.1%) self-reported as current alcohol users. The overall prevalence of alcohol misuse was 6.6%. Nearly one-fifth (19.9%) reported symptoms of burnout with high emotional exhaustion in 46 (11.6%), and high depersonalization in 61 (15.4%). Multiple logistic regression showed alcohol use was associated with male gender (OR = 4.392; 95% CI =2.443-7.894), single marital status (OR = 1.652; 95% CI =0.970-2.814), smoking habit (OR = 3.847; 95%CI =1.160-12.758) and regular exercise (OR = 2.719; 95%CI =1.490-4.963). Alcohol misuse was associated with male gender (OR = 3.367; 95% CI =1.174-9.655), a lower education level (OR = 3.788; 95%CI =1.009-14.224), smoking habit (OR = 4.626; 95%CI =1.277-16.754) and high burnout (depersonalization, OR = 4.848; 95%CI =1.433-16.406).

Conclusion

During the COVID-19 pandemic, clinical therapists' alcohol consumption did not increase significantly. Male gender, cigarette smoking, and burnout are associated with an increased risk of alcohol misuse among clinical therapists. Targeted intervention is needed when developing strategies to reduce alcohol misuse and improve clinical therapists' wellness and mental health.

Perspectives on the Underlying Etiology of HCC and Its Effects on Treatment Outcomes

Hepatocellular carcinoma (HCC) continues to be a serious medical problem with poor prognosis worldwide. The distribution of the major etiologies of HCC is changing due to the progress of anti-viral treatments, including hepatitis B virus (HBV) suppression by nucleoside/nucleotide analogues (NAs) and increased sustained virologic response (SVR) rates by direct-acting antivirals (DAAs) for hepatitis C virus (HCV), as well as the rising trend of nonviral liver disease. Although viral hepatitis remains the most common cause of HCC, non-alcoholic liver disease (NAFLD) with metabolic syndrome and alcohol-associated liver disease (ALD) are increasing. Effective and well-tolerated NAs treatment can slow the disease progression of chronic HBV infection to cirrhosis, end-stage liver disease, and reduce HCC risk. Treatment with NAs is also associated with significant improvement in the long-term survival of patients with HBV infection who already have HCC. DAAs have achieved viral elimination in almost all patients with HCV without significant adverse events, even in patients with decompensated liver cirrhosis and HCC. Similarly, DAA therapy can reduce disease progression, liver and non-liver complications, and improve the long-term survival of patients with chronic HCV infection with or without HCC. Meanwhile, NAFLD is a rapidly increasing cause of HCC along with the epidemics of obesity and type 2 diabetes globally. NAFLD-related HCC can occur in patients without cirrhosis and is known to have a lower survival rate than viral hepatitis-related HCC. Since there is currently no specific pharmacotherapy effective for NAFLD, lifestyle modification and prevention of complications are important to improve prognosis. Additionally, ALD is the second fastest-growing cause of HCC-related deaths, especially with an accelerated trend since the COVID-19 pandemic. This review provides an overview of the epidemiologic trends in the etiologies of HCC, and the progress of treatments for each etiology and the impact on outcome in the patients with HCC.

Cloud-Based Commensality: Enjoy the Company of Co-diners Without Social Facilitation of Eating

Previous research has associated frequently enforced solo dining with negative consequences on psychological well-being, but the problem of having to eat alone may be solved by seeking mealtime companions in the digital space by watching an eating broadcast (i.e., Mukbang) or videoconferencing with others (i.e., cloud-based commensality). We conducted the present study to compare the consequences of Mukbang-based, cloud-based, and in-person commensality. Ninety-five healthy Chinese young adults were instructed to rate images of eating scenarios and foods. The results revealed that they expected loneliness to be reduced by Mukbang-based or in-person commensality, but they were also aware of the risks of enhancing food intake and/or being shifted toward less healthy food choices in these two scenarios. By contrast, the participants expected cloud-based commensality to provide the benefits of reducing loneliness without the health-compromising risks of increasing food intake or unhealthy eating. Collectively, these findings suggest the beliefs of the participants that cloud-based commensality can provide an "alone but together" context to balance the need for social interactions with the strategic avoidance of a social context facilitating unhealthy eating. The findings also provide some novel insights into how the application of technologies for eating behavior can be used to integrate social factors and food pleasure, and shed light on the promising future of cloud-based commensality as a combination of the strengths of solitary and commensal eating.

The Effects of the COVID-19 Pandemic on the Mass Market Retailing of Wine in Italy

The purpose of this study was to provide a detailed framework of wine purchases in supermarkets during the COVID-19 pandemic. The unexpected diffusion of the virus and the restrictions imposed in Italy to prevent its spread have significantly affected the food purchasing habits of consumers. By analyzing the scanner data of the wine sales in the Italian mass market retail channel, this study was intended to show whether and how the dynamics triggered by the pandemic have modified the overall value and type of wine purchases, focusing on prices, formats, and promotional sales. In particular, this study explores sales in two separate periods, namely March-April (the "lockdown", with general compulsory closing and severe restrictions) and June-July 2020 (the "post-lockdown", in which some limitations were no longer effective). The analysis of wine sales during lockdown and post-lockdown and the study of the variations compared to the sales of the previous years showed some significant changes in purchase behavior. The results could provide managers, researchers, and policy makers with extensive insights into the purchasing patterns of consumers during this unprecedented time and reveal trends that may characterize the structure of the future wine demand.