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Borodovsky JT, Hasin DS, Shmulewitz D, Walsh C, Livne O, Aharonovich E, Struble CA, Habib MI, Budney AJ. Typical Hits, Grams, or Joints: Evaluating Cannabis Survey Measurement Strategies for Quantifying Consumption. Cannabis Cannabinoid Res 2024; 9:646-658. [PMID: 36577020 PMCID: PMC10998027 DOI: 10.1089/can.2022.0237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: Standardized survey measures that capture diverse cannabis consumption patterns are needed to inform public health and policy. Our team is developing a flexible, personalized, low-burden survey item inventory to measure cannabis use patterns and estimate milligrams of THC (mgTHC) consumption in large samples. This study aimed to identify measurement gaps and analysis implications associated with an initial pool of candidate items that assessed use of cannabis flower and concentrate products (smoked and/or vaporized). Methods: Adult cannabis consumers (n=4247) completed an online survey assessing cannabis use frequency, quantity, product types, product potencies (%THC), and methods of administration. Participants chose to report their consumption quantities using one of three units: "hits per day," "grams per week," or "joints per week." Respondents also indicated whether their past 7-day consumption pattern represented their typical pattern. Results: Eighty-one percent had used cannabis daily in the past week. Thirty-two percent, 53%, and 15% chose to report flower and concentrate consumption quantity in hits, grams, and joints, respectively. Approximately 80-90% of responses for the number of hits, grams, and joints consumed were less than the maximum response option-suggesting that response options captured the full range of potential cannabis consumption behaviors. Those who chose grams or joints units were generally more likely to endorse higher risk cannabis use (e.g., morning use, high %THC products) in the past week than those who chose the hits unit (adjusted Odds Ratio range: 1.2-3.9). Among those who reported that the past week represented their typical behavior (83%), past 30-day and past 7-day frequencies were highly correlated (Spearman's Rho=0.77)-supporting the feasibility of using lower burden "typical week" items to extrapolate patterns beyond a 1-week time frame. Conclusion: Results from this online convenience sample of frequent cannabis consumers suggest that the current items yield coherent and expected response patterns. Although additional testing is required, a standardized, flexible survey instrument for large-scale assessment of cannabis patterns and calculation of mgTHC seems within reach.
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Affiliation(s)
- Jacob T. Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Deborah S. Hasin
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Dvora Shmulewitz
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, New York, USA
| | - Ofir Livne
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Efrat Aharonovich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Cara A. Struble
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Mohammad I. Habib
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Alan J. Budney
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
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2
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Vallentin-Holbech L, Karsberg SH, Nielsen AS, Feldstein Ewing SW, Rømer Thomsen K. Preliminary evaluation of a novel group-based motivational interviewing intervention with adolescents: a feasibility study. Front Public Health 2024; 12:1344286. [PMID: 38510360 PMCID: PMC10951374 DOI: 10.3389/fpubh.2024.1344286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
Drinking is closely intertwined with social life among many adolescents, particularly in Europe. Group-based interventions, such as group-based motivational interviewing (group MI), have shown the capacity to prevent and reduce hazardous drinking and related problems among adolescents, but few examinations have been conducted in a European high school setting. This study examines the preliminary outcomes of a pilot group MI intervention among Danish adolescents. High school students (ages 15-18 years) were randomly allocated to two 1-h group MI sessions delivered in a school setting (N = 65) or an assessment only control condition (N = 67). Data were collected in August and November 2020 using online self-administrated questionnaires regarding the acceptability of the intervention and past month alcohol use. The pilot group MI intervention showed high feasibility and acceptability in this setting and with this age group. Group MI adolescents significantly reduced peak drinks per drinking day compared to assessment only adolescents (-2.7 drinks, p < 0.05). Results are discussed in relation to the metrics being evaluated during COVID-19 lockdown, including increased social restrictions at follow-up compared to baseline. Group MI shows promise for reducing hazardous alcohol use among Danish adolescents. In addition, the findings indicate the importance of building on and extending this work in future larger, better-powered randomized controlled trials.
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Affiliation(s)
| | | | - Anette Søgaard Nielsen
- Unit for Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Sarah W. Feldstein Ewing
- Centre for Alcohol and Drug Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Department of Psychology, University of Rhode Island, Kingston, RI, United States
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3
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Sidorchuk A, Engström K, Möller J, Gémes K. Predictors of beverage-specific, alcohol consumption trajectories: A Swedish population-based cohort study. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:233-249. [PMID: 37255610 PMCID: PMC10225962 DOI: 10.1177/14550725221124386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/22/2022] [Indexed: 09/30/2023] Open
Abstract
Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups.
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Affiliation(s)
- Anna Sidorchuk
- Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
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4
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Schouten MJE, ten Have M, Tuithof M, de Graaf R, Dekker JJM, Goudriaan AE, Blankers M. Alcohol use as a predictor of the course of major depressive disorder: a prospective population-based study. Epidemiol Psychiatr Sci 2023; 32:e14. [PMID: 36847267 PMCID: PMC9971850 DOI: 10.1017/s2045796023000070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
AIMS There are indications that problematic alcohol use may negatively impact the course of major depressive disorder (MDD). However, most studies on alcohol use and adverse MDD outcomes are conducted amongst MDD populations with (severe) alcohol use disorder in psychiatric treatment settings. Therefore, it remains unclear whether these results can be generalised to the general population. In light of this, we examined the longitudinal relationship between alcohol use and MDD persistence after a 3-year follow-up amongst people with MDD from the general population. METHODS Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a psychiatric epidemiological prospective study comprising four waves amongst the adult Dutch general population (n = 6.646). The study sample (n = 642) consisted of those with 12-month MDD who participated at the follow-up wave. The outcome was 12-month MDD persistence after the 3-year follow-up, which was assessed via the Composite International Diagnostic Interview version 3.0. Weekly alcohol consumption was operationalised as non-drinking (0 drinks), low-risk drinking (⩽7 drinks; reference), at-risk drinking (women 8-13 drinks, men 8-20 drinks) and high-risk drinking (women ⩾14, men ⩾21 drinks). We performed univariate and multiple logistic regression analyses, which were adjusted for various socio-demographic and health-related factors. RESULTS The majority (67.4%) of the MDD sample were female, while the mean age was 47.1 years. Amongst these, 23.8% were non-drinkers, 52.0% were low-risk drinkers and 14.3% and 9.4% were at-risk and high-risk drinkers, respectively. Around one-quarter of the sample (23.6%) met the criteria for a persistent MDD after 3-year follow-up. No statistically significant association was found between alcohol use and MDD persistence, either for the crude model or the adjusted models. In comparison to low-risk drinking, the full adjusted model showed no statistically significant associations between MDD persistence and non-drinking (odds ratio (OR) = 1.15, p = 0.620), at-risk drinking (OR = 1.25, p = 0.423), or high-risk drinking (OR = 0.74, p = 0.501). CONCLUSIONS Contrary to our expectations, our findings showed that alcohol use was not a predictor of MDD persistence after 3-year follow-up amongst people with MDD from the general population.
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Affiliation(s)
- Maria J. E. Schouten
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Amsterdam Public Health research institute, Amsterdam, the Netherlands
- Author for correspondence: Maria J. E. Schouten, E-mail:
| | - Margreet ten Have
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marlous Tuithof
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Ron de Graaf
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Jack J. M. Dekker
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Anna E. Goudriaan
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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5
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Vallentin-Holbech L, Ewing SWF, Thomsen KR. Hazardous alcohol use among Danish adolescents during the second wave of COVID-19: Link between alcohol use and social life. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:127-145. [PMID: 37063817 PMCID: PMC10101166 DOI: 10.1177/14550725221149489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 12/19/2022] [Indexed: 01/28/2023] Open
Abstract
Background: Adolescent drinking has historically been closely linked to social events, and across many countries, students typically increase drinking rates when they transition to upper secondary school. COVID-19-related restrictions offered a unique possibility to examine how changes in social life impact adolescent drinking in the transition to upper secondary school. Aim: The current study investigated changes in hazardous alcohol use, social life and well-being among Danish first-year students (mean age = 16.8 years) during the second wave of the COVID-19 pandemic when restrictions gradually became more intensified. Methods: Data were collected at two time points among 352 Danish students in the first months of upper secondary school (August and November 2020). Multilevel regression models tested changes across time on past 30 days hazardous alcohol use (dependent variables). Separate models tested whether changes in alcohol use were related to gender, social interaction, loneliness and mental health. Results: During increased COVID-19-related restrictions in the second wave, students decreased the frequency and quantity of drinking (number of drinking days and binge drinking), which was associated with attending fewer parties. Students also reported less high-intensity drinking and fewer alcohol-related consequences. Students reported better mental health, but more students were affected by loneliness. Changes in mental health or loneliness were not related to reduced hazardous alcohol use. Conclusion: Our results provide evidence that alcohol use decreased among Danish students transitioning to upper secondary school during the COVID-19 pandemic when restrictions increased, thereby providing support for a close link between adolescent alcohol use and social life; this is an important frame that is relevant when designing interventions to promote healthier and less risky choices throughout the next phase(s) of the pandemic and in general.
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Affiliation(s)
| | - Sarah W. Feldstein Ewing
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark; Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Akagi Y, Kabayama M, Gondo Y, Masui Y, Yasumoto S, Klinpudtan N, Srithumsuk W, Godai K, Ikebe K, Akasaka H, Yokoyama S, Nozato Y, Takami Y, Takeya Y, Yamamoto K, Sugimoto K, Arai Y, Inagaki H, Ishizaki T, Rakugi H, Kamide K. Alcohol drinking patterns have a positive association with cognitive function among older people: a cross-sectional study. BMC Geriatr 2022; 22:158. [PMID: 35220947 PMCID: PMC8883620 DOI: 10.1186/s12877-022-02852-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background The relationship between moderate alcohol drinking or other alcohol drinking patterns such as frequency, beverage type, and situation of drinking and cognitive function is not sufficiently clear in older people. The purpose of this study was to investigate the association between alcohol drinking patterns and cognitive function in community-dwelling Japanese people aged 75 and over. Methods This study was a cross-sectional design based on a prospective cohort study called the SONIC study. Subjects were older people aged 75-77 or 85-87 who voluntarily participated in 2016-2017. Drinking information was collected for daily drinking frequency, daily drinking intake, beverage type, and non-daily drinking opportunity. Cognitive function was measured using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). Other potential confounding factors evaluated were age, sex, medical factors, and psychosocial factors. An analysis of covariance was performed to evaluate the MoCA-J score relative to drinking frequency or alcohol intake. Multiple regression analysis was performed to investigate the association between beverage type or non-daily drinking opportunity and the MoCA-J score. Results The final number of participants analyzed was 1,226. The MoCA-J score for participants who reported drinking alcohol 1–6 days/week was significantly higher than that for those who reported drinking none or every day. No significant difference in the MoCA-J score was observed relative to daily alcohol intake. In terms of beverage type, wine was associated positively with the MoCA-J score. Non-daily drinking opportunity was also associated positively with the MoCA-J score. Conclusions Moderate-frequency drinking, wine consumption, and non-daily drinking opportunities were associated with higher cognitive function in community-dwelling Japanese aged 75 and over. Further longitudinal studies are needed to clarify the causal relationships. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02852-8.
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Affiliation(s)
- Yuya Akagi
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Yasuyuki Gondo
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Saori Yasumoto
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Nonglak Klinpudtan
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Werayuth Srithumsuk
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kayo Godai
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Serina Yokoyama
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoichi Nozato
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoichi Takami
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Takeya
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ken Sugimoto
- Department of General and Geriatric Medicine, Kawasaki Medical University, Okayama, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
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7
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Algren MH, Deen L, Tolstrup JS, Thygesen LC. Associations between health-risk behaviours and non-condom use among 28,620 Danish students: a cross-sectional study. EUR J CONTRACEP REPR 2021; 27:45-52. [PMID: 34907840 DOI: 10.1080/13625187.2021.2005018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Investigations into the associations between health-risk behaviours and non-condom use are important for planning effective preventive interventions targeted sexually transmitted infections. To date, there are no such studies on the Danish general population. The aim of this study was to examine associations between health-risk behaviours (including daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) and non-condom use among Danish students. MATERIAL AND METHOD Cross-sectional data from 28,620 sexually active students aged 15-25 years from the Danish National Youth Study 2014 were analysed using multilevel logistic regression. RESULTS Health-risk behaviours (daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) were significantly associated with higher odds for non-condom use among Danish students, even after adjustment for age, gender, education, religion, and geographical region. The associations remained significant after adjusting for the remaining health-risk behaviours. CONCLUSION Overall, the study showed a clear association between health-risk behaviours and non-condom use among Danish students. The findings of this study have important implications for future planning of more targeted health promotion intervention programmes aimed to increase condom use among young people as a means to reduce sexually transmitted infections.
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Affiliation(s)
- Maria Holst Algren
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Laura Deen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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8
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Imboden C, Claussen MC, Iff S, Quednow BB, Seifritz E, Spörri J, Scherr J, Fröhlich S. COVID-19 Lockdown 2020 Changed Patterns of Alcohol and Cannabis Use in Swiss Elite Athletes and Bodybuilders: Results From an Online Survey. Front Sports Act Living 2021; 3:759335. [PMID: 34870195 PMCID: PMC8635023 DOI: 10.3389/fspor.2021.759335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives: During the COVID-19 pandemic, increased patterns of substance use have been reported in the general population. However, whether this also applies to athletes is not yet clear. This study aimed to detect changes in alcohol consumption and cannabis use in elite athletes and bodybuilders during the first COVID-19 lockdown in Switzerland. Methods: Between April 25 and May 25, 2020, a cross-sectional online survey was conducted among bodybuilders and Swiss elite athletes who were active in Olympic sports and disciplines approved by the International Olympic Committee (IOC) on at least the national level. The collected data included information on alcohol and cannabis use during the last month (lockdown) and in the year before COVID-19 lockdown (pre-lockdown), daily training times, existential fears on a scale from 1 to 100, Patient Health Questionnaire-9 for depression (PHQ-9), Insomnia Severity Index (ISI), and State-Trait Anxiety Inventory (STAI). Results:N = 275 athletes (elite athletes: n = 193; bodybuilders: n = 82) was included in this study. Both pre-lockdown and during lockdown, more bodybuilders used cannabis (both time points: p < 0.001) than elite athletes, and more elite athletes drank alcohol (pre-lockdown: p = 0.005, lockdown: p = 0.002) compared to bodybuilders. During lockdown, fewer athletes drank alcohol compared to before, but those who continued drinking did so on more days per week (p < 0.001, Eta2 = 0.13). Elite athletes were more likely to increase their drinking with 17.7 vs. 8.2% in bodybuilders. When compared to pre-lockdown measures, the number of athletes using cannabis did not change during lockdown. Only three of 203 elite athletes reported using cannabis during lockdown; this contrasts with 16 of 85 bodybuilders. In a multivariate regression model, existential fears and a lower ISI score were significant predictors for increased alcohol consumption during the lockdown in the entire sample. In a model based on elite athletes only, male sex and a lower ISI score predicted increased alcohol consumption. In a bodybuilder-based model, predictors of increased alcohol consumption were existential fears and trait anxiety. Conclusion: We suggest identifying athletes who are at risk for increased alcohol and cannabis use; we suggest this to be able to professionally support them during stressful times, such as the COVID-19 pandemic.
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Affiliation(s)
| | - Malte Christian Claussen
- Private Clinic Wyss, Muenchenbuchsee, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Psychiatric Services Grisons, Chur, Switzerland
| | - Samuel Iff
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Experimental and Clinical Pharmacopsychology, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Jörg Spörri
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Johannes Scherr
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Fröhlich
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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9
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Bendtsen M, Seiterö A, Bendtsen P, Henriksson H, Henriksson P, Thomas K, Löf M, Müssener U. mHealth intervention for multiple lifestyle behaviour change among high school students in Sweden (LIFE4YOUth): protocol for a randomised controlled trial. BMC Public Health 2021; 21:1406. [PMID: 34271882 PMCID: PMC8283383 DOI: 10.1186/s12889-021-11446-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 07/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background National surveys in Sweden demonstrate that the majority of young people do not engage in health promoting behaviours at levels recommended by the Public Health Agency of Sweden. The objective of this study is to estimate the effectiveness of a novel mHealth intervention named LIFE4YOUth, which targets multiple lifestyle behaviours (alcohol, diet, physical activity, and smoking) among high school students in Sweden. Methods A 2-arm parallel groups single blind randomised controlled trial (1:1) will be employed to estimate the effectiveness of the novel mHealth intervention. Students will be recruited at high schools throughout Sweden, and will be included if they fulfil one of six criteria relating to unhealthy behaviours with respect to alcohol, diet, physical activity and smoking. Eligible participants will be randomised to either receive the novel intervention immediately, or to be placed on a waiting list for 4 months. The intervention consists of a combination of recurring screening, text messages, and an interactive platform which is adaptable to individual preferences. Outcome measures with respect to alcohol, diet, physical activity and smoking will be assessed through questionnaires at 2 and 4 months post randomisation. Discussion The findings of this trial could be generalised to a diverse high-school student population as our recruitment encompass a large proportion of schools throughout Sweden with various educational profiles. Furthermore, if effective, the mHealth intervention has good potential to be able to be scaled up and disseminated at high schools nationally. Trial registration Registered prospectively on 2020-05-20 in ISRCTN (ISRCTN34468623). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11446-9.
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Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
| | - Anna Seiterö
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
| | - Preben Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.,Department of Medical Specialist, Motala, Sweden
| | - Hanna Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Kristin Thomas
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Müssener
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
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10
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Pabst A, Bollen Z, Creupelandt C, Fontesse S, Orban T, de Duve M, Pinon N, Maurage P. Alcohol consumption changes during the first COVID-19 lockdown: an online population survey in a convenience sample of French-speaking Belgian residents. Psychiatry Res 2021; 300:113938. [PMID: 33910147 DOI: 10.1016/j.psychres.2021.113938] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
An online survey among French-speaking Belgians (N=7711) investigated self-reported changes in alcohol consumption during the first COVID-19-related lockdown (March 17th - May 4th 2020). Population-weighted estimates indicated that 31.37% of the population increased consumption during lockdown, 30.32% decreased consumption and 38.31% reported unchanged consumption. The magnitude of change was higher for "decreasers" than "increasers", resulting in a slight reduction in overall consumption. A multiple regression analysis revealed that age, occupational status, number of cohabitants, perceived alcohol accessibility, drinking motivations and previous consumption predicted consumption changes. The lockdown was thus associated with consumption modifications among French-speaking Belgians, without a prevailing direction of change.
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Affiliation(s)
- Arthur Pabst
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Zoé Bollen
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Coralie Creupelandt
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Sullivan Fontesse
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Thomas Orban
- Scientific Society for General Medicine, Brussels, Belgium
| | - Martin de Duve
- Univers Santé Prevention Center, UCLouvain, Louvain-la-Neuve, Belgium
| | - Nicolas Pinon
- Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium & De Vinci Higher Education School, Brussels, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
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11
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Jensen HAR, Bloomfield K, Lau CJ, Ekholm O. Trends in alcohol consumption among older adults in Denmark in the 21st century. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:481-490. [PMID: 35310775 PMCID: PMC8899067 DOI: 10.1177/1455072520954333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Previous studies have indicated that the alcohol consumption among older Danish
individuals has increased during the last three decades of the 20th century. However,
the research is limited and, hence, the aim of the present article is to describe the
trends and peculiarities in the development of the present situation in older people’s
drinking patterns in Denmark. Methods: Data were obtained from the Danish Health and Morbidity Survey (2005) and the Danish
National Health Survey (2010, 2013, and 2017). Data used in this study were collected
via self-administered questionnaires from random samples of the adult (≥ 16 years)
Danish population. Response rates varied between 50.8% (2005) and 59.5% (2010). Drinking
patterns are described using the following indicators: alcohol consumption during the
past 12 months; alcohol consumption at least two days a week; mean number of standard
drinks consumed in a typical week and heavy episodic drinking (at least monthly).
Results are presented as percentages or means. Results: The prevalence of overall 12-month alcohol use in all individuals aged 60 years or
older has slightly increased between 2010 (83.9%) and 2017 (85.2%). On the other hand,
the prevalence of consuming alcohol at least twice a week has overall decreased slightly
between 2010 (54.0%) and 2017 (52.0%) in the same age group. A decrease was also
observed in the mean number of standard drinks consumed in a typical week, from 8.3 in
2010 to 7.0 in 2017. Additionally, the prevalence of consuming at least five standard
drinks on one occasion at least monthly decreased markedly from 24.8% in 2005 to 14.8%
in 2013 (the prevalence remained stable between 2013 and 2017). The trends in prevalence
of various alcohol indicators varied by sex and age. Conclusions: The findings of this study suggest an overall decline in alcohol consumption among
older Danes in the study period. The continuation of this trend will be the subject of
future studies.
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Affiliation(s)
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
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12
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Neil-Sztramko SE, Belita E, Levinson AJ, Boyko J, Dobbins M. Evaluation of an online knowledge translation intervention to promote cancer risk reduction behaviours: findings from a randomized controlled trial. BMC Cancer 2019; 19:1138. [PMID: 31752751 PMCID: PMC6873728 DOI: 10.1186/s12885-019-6361-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/14/2019] [Indexed: 11/13/2022] Open
Abstract
Background Many cancers are preventable through lifestyle modification; however, few adults engage in behaviors that are in line with cancer prevention guidelines. This may be partly due to the mixed messages on effective cancer prevention strategies in popular media. The goal of the McMaster Optimal Aging Portal (the Portal) is to increase access to trustworthy health information. The purpose of this study was to explore if and how knowledge translation strategies to disseminate cancer prevention evidence using the Portal influence participants’ knowledge, intentions and health behaviors related to cancer risk. Methods Adults ≥40 years old, with no cancer history were randomized to a 12-week intervention (weekly emails and social media posts) or control group. Quantitative data on knowledge, intentions and behaviors (physical activity, diet, alcohol consumption and use of tobacco products) were collected at baseline, end of study and 3 months later. Participant engagement was assessed using Google Analytics, and participant satisfaction through open-ended survey questions and semi-structured interviews. Results Participants (n = 557, mean age 64.9) were predominantly retired (72%) females (81%). Knowledge of cancer prevention guidelines was higher in the intervention group at end of study only (+ 0.3, p = 0.01). Intentions to follow cancer prevention guidelines increased in both groups, with no between-group differences. Intervention participants reported greater light-intensity physical activity at end of study (+ 0.7 vs. 0.1, p = 0.03), and reduced alcohol intake at follow u (− 0.2 vs. + 0.3, p < 0.05), but no other between-group differences were found. Overall satisfaction with the Portal and intervention materials was high. Conclusions Dissemination of evidence-based cancer prevention information through the Portal results in small increases in knowledge of risk-reduction strategies and with little to no impact on self-reported health behaviours, except in particular groups. Further tailoring of knowledge translation strategies may be needed to see more meaningful change in knowledge and health behaviours. Trial registration ClinicalTrials.gov NCT03186703, June 14, 2017.
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Affiliation(s)
- Sarah E Neil-Sztramko
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada. .,The National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada.
| | - Emily Belita
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada
| | - Anthony J Levinson
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada
| | - Jennifer Boyko
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada
| | - Maureen Dobbins
- McMaster University, 175 Longwood Rd South, Suite 210a, Hamilton, ON, L8P 3Y2, Canada.,The National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
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13
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Vallentin-Holbech L, Rasmussen BM, Stock C. Does Level of Received Intervention Dose Have an Impact on the Effectiveness of the Social Norms Alcohol Prevention Program The GOOD Life?. Front Public Health 2019; 7:245. [PMID: 31555631 PMCID: PMC6722864 DOI: 10.3389/fpubh.2019.00245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Few studies have assessed how social norms messages are perceived and understood by adolescents in secondary school. We examined whether the self-reported level of exposure, satisfaction and recall of a social norms intervention had an impact on the preventive effect of the intervention The GOOD Life. Furthermore, we explored which factors were associated with high recall of the intervention. Methods: Data from pupils aged 13-17 years enrolled in a cluster-randomized controlled trial with 18 intervention schools (n = 641) and 20 control schools (n = 714) were analyzed using multilevel regressions. The intervention provided social norms messages through three different communication elements: classroom feedback session, posters, and web-application. At 3-months follow-up, pupils from the intervention schools were asked about their participation in, their satisfaction with and recall of the intervention. The effects were examined on: overestimation of peer drinking, binge drinking (5 or more drinks on one occasion) and alcohol-related harms. Results: Regards the outcome overestimation of peer drinking higher preventive effect sizes were observed for higher levels of exposure, satisfaction, and recall. Regards the outcome alcohol-related harms preventive intervention effects were observed for medium exposure and higher satisfaction. For binge drinking we found no significant effects for any level of exposure, satisfaction, or recall. Higher levels of satisfaction and exposure, and female sex were associated with better recall of the intervention. Conclusion: For higher levels of self-reported exposure, satisfaction, and retention regarding the social norms messages we observed stronger intervention effects regards several outcomes suggesting that these implementation parameters are important for intervention effectiveness. Trial registration: The trial is registered at Current Controlled Trials with study ID ISRCTN27491960.
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Affiliation(s)
- Lotte Vallentin-Holbech
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Birthe Marie Rasmussen
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Christiane Stock
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.,Institute for Health and Nursing Science, Charité Universitätsmedizin Berlin, Berlin, Germany
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14
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Abstract
Background: Alcohol consumption has been observed to be a contributing factor in liver damage. However, very few studies have tried to decipher the correlation between patients with liver disease and alcohol consumption. Therefore, this study was planned to determine the prevalence of alcohol consumption among patients with liver disease, and to evaluate the risk factors, liver diseases, and chronic medical conditions associated with alcohol drinking. Methods: A cross-sectional study was conducted among patients with liver disease in 30 provinces, autonomous regions, and municipalities across China. All participants answered the questionnaire, which led to the calculation of Alcohol Use Disorders Inventory Test (AUDIT) score for each patient. Based on this score, low-risk drinkers, hazardous drinkers, and harmful drinkers were defined as having AUDIT score of <8, between 8 and 15, and ≥16, respectively. Results: A total of 1489 participants completed the questionnaire. Based on this information, 900 (60.44%) participants were classified as alcohol drinkers. Among these, 8.66% were ex-drinkers, 22.10% were low-risk drinkers, 17.13% were hazardous drinkers, and 12.56% were harmful drinkers. Further investigation of the association between alcohol consumption and other baseline characteristics of patients with liver disease revealed that usually men <40 years old, participants having higher family annual income, having college degree or higher education, living alone, having higher body mass index (BMI), current smokers, and ex-smokers had significant association with higher risk of alcohol consumption. In addition, among the 18.07% of the participants with cirrhosis, it was observed that risk of cirrhosis increased with higher alcohol consumption. Furthermore, harmful drinkers showed greater odds of hypertension and heart diseases, while hazardous drinkers and harmful drinkers, both had greater odds of hyperlipidemia. Conclusions: Overall our analyses indicated that among the patients with liver disease in China, there was high rate of alcohol consumption and dependence. Alcohol consumption usually associated with men <40 years old, higher family income, education level, living alone, high BMI, and smoking. Increased alcohol consumption not only increased the risk of cirrhosis, but also enhanced the risk of hypertension, heart diseases, and hyperlipidemia.
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15
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Bendtsen M, McCambridge J. Reducing Alcohol Consumption Among Risky Drinkers in the General Population of Sweden Using an Interactive Mobile Health Intervention: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13119. [PMID: 30998221 PMCID: PMC6495288 DOI: 10.2196/13119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Harmful use of alcohol continues to be a leading contributor to premature deaths globally. Not only does harmful drinking have consequences for the individuals consuming at increased levels, but it may also result in a range of negative consequences for their family members and friends. Interventions delivered via mobile phones (mobile health [mHealth] interventions) could potentially support risky drinkers seeking help to reduce their alcohol consumption. Objective This protocol describes a randomized controlled trial that aims to validly estimate the effect of a novel mHealth intervention targeting risky drinkers in the general population of Sweden. Nested within the trial are 3 substudies that focus on methodological and user satisfaction research questions. Methods A 2-arm parallel group randomized controlled trial will be employed to estimate the effect of the novel intervention. Participants will be recruited through Web advertisements and social media. The inclusion criteria are as follows: 18 years or older, ownership of a mobile phone, and being classified as a risky drinker according to Swedish guidelines. Participants allocated to the intervention group will receive a novel mHealth intervention. The intervention consists of weekly screening, personalized feedback on current consumption, functions allowing for planning of future consumption, as well as a series of messages delivered throughout the week. Participants allocated to the control group will receive a short message regarding negative consequences of alcohol consumption and a hyperlink that offers more information. Following 2 and 4 months after randomization, both groups will be asked to complete follow-up questionnaires (2-month interval being primary). Primary outcomes are weekly alcohol consumption and heavy episodic drinking. Participants in the control group will be given access to the novel intervention after completing the 4-month follow-up. The trial includes 3 substudies: We will explore whether the mode of presenting information before participants giving informed consent affects participation rates and recall of trial parameters, investigate if the content of the short message received by the control group affects study outcomes and requests for more information, and explore user satisfaction with the intervention and reactions of the control group. Results Participant recruitment is planned to begin in April 2019 and to last for a maximum of 24 months. The first dataset will be available approximately 2 months after the final participant has been recruited, and the final dataset will be available approximately 2 months later. No participants had been recruited at the time of submitting this protocol. Conclusions If found effective, the intervention has the potential to reduce negative consequences of alcohol consumption for individuals. The technology has been designed to have potential for extensive reach among those who may benefit. Trial Registration ISRCTN Registry ISRCTN48317451; http://www.isrctn.com/ISRCTN48317451 (Archived by WebCite at http://www.webcitation.org/779tKLsu3) International Registered Report Identifier (IRRID) PRR1-10.2196/13119
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Affiliation(s)
- Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
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16
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Im PK, Millwood IY, Guo Y, Du H, Chen Y, Bian Z, Tan Y, Guo Z, Wu S, Hua Y, Li L, Yang L, Chen Z. Patterns and trends of alcohol consumption in rural and urban areas of China: findings from the China Kadoorie Biobank. BMC Public Health 2019; 19:217. [PMID: 30786877 PMCID: PMC6383236 DOI: 10.1186/s12889-019-6502-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 01/31/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In China, alcohol consumption has increased significantly in recent decades. Little evidence exists, however, about temporal trends in levels and patterns of alcohol consumption and associated factors in adult populations. METHODS In 2004-08, the China Kadoorie Biobank recruited ~ 512,000 adults (41% men, mean age 52 years [SD 10.7]) from 10 (5 urban, 5 rural) geographically diverse regions across China, with ~ 25,000 randomly selected participants resurveyed in 2013-14. The self-reported prevalence and patterns (e.g., amount, beverage type, heavy drinking episodes) of alcohol drinking at baseline and resurvey were compared and related to socio-demographic, health and other factors. RESULTS At baseline, 33% of men drank alcohol at least weekly (i.e., current regular), compared to only 2% of women. In men, current regular drinking was more common in urban (38%) than in rural (29%) areas at baseline. Among men, the proportion of current regular drinkers slightly decreased at resurvey (33% baseline vs. 29% resurvey), while the proportion of ex-regular drinkers slightly increased (4% vs. 6%), particularly among older men, with more than half of ex-regular drinkers stopping for health reasons. Among current regular drinkers, the proportion engaging in heavy episodic drinking (i.e., > 60 g/session) increased (30% baseline vs. 35% resurvey) in both rural (29% vs. 33%) and urban (31% vs. 36%) areas, particularly among younger men born in the 1970s (41% vs. 47%). Alcohol intake involved primarily spirits, at both baseline and resurvey. Those engaging in heavy drinking episodes tended to have multiple other health-related risk factors (e.g., regular smoking, low fruit intake, low physical activity and hypertension). CONCLUSIONS Among Chinese men, the proportion of drinkers engaging in harmful drinking behaviours increased in the past decade, particularly among younger men. Harmful drinking patterns tended to cluster with other unhealthy lifestyles and health-related risk factors.
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Affiliation(s)
- Pek Kei Im
- 0000 0004 1936 8948grid.4991.5Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y. Millwood
- 0000 0004 1936 8948grid.4991.5Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yu Guo
- 0000 0001 0662 3178grid.12527.33Chinese Academy of Medical Sciences, Beijing, China
| | - Huaidong Du
- 0000 0004 1936 8948grid.4991.5Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- 0000 0004 1936 8948grid.4991.5Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zheng Bian
- 0000 0001 0662 3178grid.12527.33Chinese Academy of Medical Sciences, Beijing, China
| | - Yunlong Tan
- 0000 0001 0662 3178grid.12527.33Chinese Academy of Medical Sciences, Beijing, China
| | | | | | | | - Liming Li
- 0000 0001 2256 9319grid.11135.37Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ling Yang
- 0000 0004 1936 8948grid.4991.5Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- 0000 0004 1936 8948grid.4991.5Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
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17
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Jørgensen MB, Pedersen J, Thygesen LC, Lau CJ, Christensen AI, Becker U, Tolstrup JS. Alcohol consumption and labour market participation: a prospective cohort study of transitions between work, unemployment, sickness absence, and social benefits. Eur J Epidemiol 2019; 34:397-407. [PMID: 30627937 PMCID: PMC6451700 DOI: 10.1007/s10654-018-0476-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/15/2018] [Indexed: 12/18/2022]
Abstract
The aim of this study was to investigate the association of alcohol consumption and problem drinking on transitions between work, unemployment, sickness absence and social benefits. Participants were 86,417 men and women aged 18-60 years who participated in the Danish National Health Survey in 2010. Information on alcohol consumption (units per week) and problem drinking (CAGE-C score of 4-6) was obtained by questionnaire. The primary outcome was labour market attachment. Information on labour market attachment was obtained from the national administrative registers during a 5-year follow-up period. Using Cox proportional hazards models, we estimated hazard ratios (HR) for transitions between work, unemployment, sickness absence and social benefits. Analyses were adjusted for potential confounders associated with demography, health, and socio-economy. High alcohol consumption and problem drinking was associated with higher probability of unemployment, sickness absence and social benefits among participants employed at baseline compared with participants who consumed 1-6 drinks/week. High alcohol consumption and problem drinking was associated with lower probability of returning to work among participants receiving sickness absence at baseline compared with participants who consumed 1-6 drinks/week and with non-problem drinkers: HRs were 0.75 (0.58-0.98) for 35+ drinks per week and 0.81 (0.65-1.00) for problem drinking (CAGE-C score of 4-6). Similar trends for weekly alcohol consumption and problem drinking were observed among participants who were unemployed at baseline. In summary, problem drinking has adverse consequences for labour market participation and is associated with higher probability of losing a job and a lower chance of becoming employed again.
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Affiliation(s)
- Maja Bæksgaard Jørgensen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark.
| | - Jacob Pedersen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Anne Illemann Christensen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark.,Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, 2650, Hvidovre, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
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18
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Yoon BH, Jones LC, Chen CH, Cheng EY, Cui Q, Drescher W, Fukushima W, Gangji V, Goodman SB, Ha YC, Hernigou P, Hungerford M, Iorio R, Jo WL, Khanduja V, Kim H, Kim SY, Kim TY, Lee HY, Lee MS, Lee YK, Lee YJ, Mont MA, Sakai T, Sugano N, Takao M, Yamamoto T, Koo KH. Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 2: Alcohol-Associated Osteonecrosis. J Arthroplasty 2019; 34:169-174.e1. [PMID: 30348559 DOI: 10.1016/j.arth.2018.09.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/28/2018] [Accepted: 09/10/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Although alcohol is a leading risk factor for osteonecrosis of the femoral head (ONFH) and its prevalence reportedly ranges from 20% to 45%, there are no unified classification criteria for this subpopulation. In 2015, Association Research Circulation Osseous decided to develop classification criteria for alcohol-associated ONFH. METHODS In June of 2017, Association Research Circulation Osseous formed a task force to conduct a Delphi survey. The task force invited 28 experts in osteonecrosis/bone circulation from 8 countries. Each round of the Delphi survey included questionnaires, analysis of replies, and feedback reports to the panel. After 3 rounds of the survey, consensus was reached on the classification criteria. The response rates for the 3 Delphi rounds were 100% (round 1), 96% (round 2), and 100% (round 3). RESULTS The consensus on the classification criteria of alcohol-associated ONFH included the following: (1) patients should have a history of alcohol intake >400 mL/wk (320 g/wk, any type of alcoholic beverage) of pure ethanol for more than 6 months; (2) ONFH should be diagnosed within 1 year after alcohol intake of this dose; and (3) patients should not have other risk factor(s). CONCLUSION ARCO-established classification criteria to standardize clinical studies concerning AA-ONFH.
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Affiliation(s)
- Byung-Ho Yoon
- Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea
| | - Lynne C Jones
- Department of Orthopaedic Surgery, Center for Metabolism and Obesity Research Johns Hopkins University School of Medicine, Baltimore, MD
| | - Chung-Hwan Chen
- Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Edward Y Cheng
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, MN
| | - Quanjun Cui
- Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Wolf Drescher
- Department of Orthopedic and Trauma Surgery, RWTH Aachen University, Aachen, Germany
| | - Wakaba Fukushima
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Valerie Gangji
- Department of Rheumatology and Physical Medicine, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Philippe Hernigou
- Department of Orthopaedic Surgery, Hôpital Henri Mondor, Creteil, France
| | - Marc Hungerford
- Department of Orthopedic Surgery, Mercy Medical Center, Baltimore, MD
| | - Richard Iorio
- Department of Orthopaedic Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY
| | - Woo-Lam Jo
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Vikas Khanduja
- Department of Trauma & Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Harry Kim
- Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX
| | - Shin-Yoon Kim
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Tae-Young Kim
- Department of Orthopedic Surgery, KonKuk University Medical Center, Seoul, South Korea
| | - Hee Young Lee
- Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Mel S Lee
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yun Jong Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital and Medical College of Seoul National University, Seongnam, South Korea
| | - Michael A Mont
- Department of Orthopaedic Surgery, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement Sinai Hospital of Baltimore, Baltimore, MD
| | - Takashi Sakai
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Takao
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
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Brochmann N, Flachs EM, Christensen AI, Bak M, Andersen CL, Juel K, Hasselbalch HC, Zwisler AD, Rottmann N. Anxiety and depression in patients with Philadelphia-negative myeloproliferative neoplasms: a nationwide population-based survey in Denmark. Clin Epidemiol 2018; 11:23-33. [PMID: 30588121 PMCID: PMC6302798 DOI: 10.2147/clep.s162688] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective We sought to determine the prevalence and severity of anxiety and depression among patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) and respective associations of anxiety and depression with demographic and lifestyle factors, comorbidity burden, duration of MPN disease, financial difficulties, and health-related quality of life (QoL). Methods This study used data from a nationwide, population-based, cross-sectional survey of health-related QoL in MPN patients in Denmark called the MPNhealthSurvey. Individuals with a diagnosis of MPN in the National Patient Register were invited. The Hospital Anxiety and Depression Scale was used to assess the prevalence and severity of anxiety and depression. The associations of anxiety and depression with age, sex, education, body mass index (BMI), smoking, alcohol intake, physical activity, comorbidity burden, duration of MPN disease, financial difficulties, symptom burden, sexual problems, fatigue, functioning, and global health/QoL were examined. Results In total, 2,029 patients completed the Hospital Anxiety and Depression Scale. The prevalence of anxiety, depression, and both was 21%, 12%, and 8%, respectively. Many participants who reported anxiety or depression exhibited mild symptoms. Middle-aged and elderly participants had lower odds of experiencing anxiety and depression when compared to younger participants, and females had higher odds of anxiety compared to males. Participants with higher education had lower odds of anxiety compared to those with lower education. Current smokers and ex-smokers had higher odds of anxiety and depression compared to those who had never smoked, and sedentary participants and participants with a lower level of physical activity had higher odds of anxiety and depression compared to participants who performed hard training several times a week. Higher comorbidity burden increased the odds of depression, and greater financial difficulties increased the odds of anxiety and depression. Higher total symptom burden and fatigue burden and higher level of sexual problems increased the odds of anxiety and depression. Finally, lower functional level and global health/quality of life increased the odds of anxiety and depression. BMI, alcohol intake, comorbidity burden, and duration of disease were not substantially associated with anxiety, whereas sex, educational level, and duration of MPN disease were not substantially associated with depression. Conclusion There may be an unmet need in handling psychological distress in MPN patients. Future research might explore the utility of screening for psychological distress and the effectiveness of lifestyle interventions, rehabilitation, and MPN-symptom reduction in preventing and treating psychological distress.
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Affiliation(s)
- Nana Brochmann
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark,
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | | | - Marie Bak
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark,
| | | | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Hans Carl Hasselbalch
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark,
| | - Ann-Dorthe Zwisler
- Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, University of Southern Denmark, Nyborg, Denmark
| | - Nina Rottmann
- Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, University of Southern Denmark, Nyborg, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark.,Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Vallentin-Holbech L, Rasmussen BM, Stock C. Effects of the social norms intervention The GOOD Life on norm perceptions, binge drinking and alcohol-related harms: A cluster-randomised controlled trial. Prev Med Rep 2018; 12:304-311. [PMID: 30406009 PMCID: PMC6218643 DOI: 10.1016/j.pmedr.2018.10.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/16/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022] Open
Abstract
The study aimed to investigate if the school-based social norms intervention The GOOD Life was effective in reducing misperceptions, heavy alcohol use and alcohol-related harms among Danish pupils aged 13–17 years. In total 38 schools were included in a cluster-randomised controlled trial and allocated to either intervention (n = 641) or control group (n = 714) during 2015/2016. Both groups completed an online survey before the intervention and 3 months after baseline. The GOOD Life intervention provided normative feedback tailored for each school-grade using three communication channels: classroom sessions, posters and web application. Outcome measures were overestimation of peers' lifetime binge drinking, binge drinking (5 or more drinks on one occasion) and alcohol-related harms. Intervention effects at follow-up were examined using multilevel logistic regression models. Pupils in the intervention group were less likely to overestimate peers' lifetime binge drinking compared to those in the control group (OR: 0.52, 95%CI: 0.33–0.83) and were less likely to report two or more alcohol-related harms (OR: 0.59, 95%CI: 0.37–0.93). Overall, no significant effect of the intervention was found on binge drinking. However, among pupils stating it would be ok, if they drank more (n = 296), a preventive effect was found on binge drinking four or more times during the last 30 days (OR: 0.37, 95%CI: 0.15–0.95). Additionally, the intervention effect on overestimation was higher among pupils who reported binge drinking at baseline. Receiving the intervention had a positive effect on norm perceptions and alcohol-related harms. We also found that the intervention effect differed by baseline status of alcohol use.
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Type and Pattern of Alcohol Consumption is Associated With Liver Fibrosis in Patients With Non-alcoholic Fatty Liver Disease. Am J Gastroenterol 2018; 113:1484-1493. [PMID: 29899440 DOI: 10.1038/s41395-018-0133-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 05/01/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION It is unclear whether low levels of alcohol are harmful in patients with non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether quantity, binge pattern consumption, or type of alcohol was associated with liver fibrosis in patients with NAFLD. METHODS Previous and current alcohol consumption was assessed in NAFLD patients undergoing liver biopsy. All subjects currently consumed <210 g per week (male) or <140 g per week (female). Binge consumption was defined as ≥4 standard drinks (female) or ≥5 standard drinks (male) in one sitting. Liver biopsies were scored according to the NASH CRN system with F3/4 fibrosis defined as advanced. RESULTS Among 187 patients (24% with advanced fibrosis), the median weekly alcohol consumption was 20 (2.3-60) g over an average of 18 years. Modest consumption (1-70 g per week) was associated with lower mean fibrosis stage compared to lifetime abstainers (p < 0.05) and a decreased risk of advanced fibrosis (OR 0.33, 95% CI 0.14-0.78, p = 0.01). The association with reduced fibrosis was not seen in subjects drinking in a binge-type fashion. Exclusive wine drinkers but not exclusive beer drinkers, had lower mean fibrosis stage and lower odds of advanced fibrosis (OR 0.20, 95% CI 0.06-0.69, p = 0.01), compared to lifetime abstinent subjects. No interaction between gender and alcohol quantity, type, or binge consumption on fibrosis was observed. DISCUSSION Modest (1-70 g per week) alcohol consumption, particularly wine in a non-binge pattern, is associated with lower fibrosis in patients with NAFLD. Prospective longitudinal studies into fibrosis progression, cardiovascular outcomes, and mortality are required before clinical recommendations can be made.
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de Vocht F, Brown J, Beard E, West R, Michie S, Campbell R, Hickman M. Motivation to reduce alcohol consumption and subsequent attempts at reduction and changes in consumption in increasing and higher-risk drinkers in England: a prospective population survey. Addiction 2018; 113:817-827. [PMID: 29368391 PMCID: PMC5947299 DOI: 10.1111/add.14132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/18/2017] [Accepted: 12/01/2017] [Indexed: 01/06/2023]
Abstract
AIMS To assess how far motivation to reduce alcohol consumption in increasing and higher-risk drinkers in England predicts self-reported attempts to reduce alcohol consumption and changes in alcohol intake during the following 6 months. METHODS This study used self-reported data from 2928 higher-risk drinkers in the Alcohol Toolkit Study (ATS): a series of monthly cross-sectional household surveys of adults aged 16+ years of age in England. Alcohol consumption was measured in an initial survey and in a 6-month telephone follow-up interview using the Alcohol Use Disorders Identification Test (AUDIT)-C questionnaire. Motivation was measured in the initial survey using the Motivation to Reduce Alcohol Consumption (MRAC) scale. Attempts to reduce alcohol consumption during the past 6 months were recorded at follow-up. Data were analysed using repeated-measures difference-in-differences and logistic regression models. RESULTS Participants with higher initial motivation to reduce alcohol consumption were more likely to report that they had made an attempt to reduce consumption at follow-up [adjusted odds ratio (ORadj ) = 2.39, 95% confidence interval (CI) = 1.75-3.29]. There was an overall reduction in alcohol consumption between initial survey and follow-up (ORadj = 0.72, 95% CI = 0.65-0.79), but there was insufficient evidence of an additional effect of motivation to reduce consumption on subsequent changes in alcohol consumption, with the difference-in-differences effect instead suggesting an average increase (ORadj = 1.37, 95% CI = 1.00-1.88). CONCLUSIONS Increasing and higher-risk drinkers in England who report greater motivation to reduce their consumption are more likely to report making an attempt to reduce during the next 6 months, but this may not be associated with a reduction in alcohol consumption.
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Affiliation(s)
- Frank de Vocht
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Jamie Brown
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Emma Beard
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Robert West
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Susan Michie
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Rona Campbell
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Matthew Hickman
- NIHR School for Public Health Research (SPHR)Newcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
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Jørgensen MB, Thygesen LC, Becker U, Tolstrup JS. Alcohol consumption and risk of unemployment, sickness absence and disability pension in Denmark: a prospective cohort study. Addiction 2017; 112:1754-1764. [PMID: 28544338 DOI: 10.1111/add.13875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 01/13/2017] [Accepted: 05/12/2017] [Indexed: 12/15/2022]
Abstract
AIMS We investigated the association between weekly alcohol consumption and binge drinking and the risk of unemployment, sickness absence and disability pension. DESIGN Prospective register-based cohort study. SETTING Denmark. PARTICIPANTS A sample of 17 690 men and women, aged 18-60 years from the Danish Health and Morbidity Survey in 2000, 2005 and 2010 participated in the study. Participants worked the entire year prior to baseline. MEASUREMENTS Administrative registers were used to obtain information on unemployment, sickness absence and disability pension during a 5-year follow-up period. Data were analysed by multivariate Cox regression model with random effect (frailty) adjusted for cohabitation status, educational level, Charlson comorbidity index, smoking habits, calendar year and geographic region. FINDINGS Among males, adjusted hazards ratios (HR) of unemployment were 1.24 (95% CI 1.05-1.46, P = 0.01), 1.28 (95% CI 1.04-1.59, P =0.02) and 1.48 (95% CI 1.21-1.81, P = 0.00) respectively, for abstainers and those with alcohol consumption of 21-27 and ≥ 28 drinks per week when compared with individuals who had 1-13 drinks per week. Corresponding HRs for sickness absence were 1.16 (95% CI 1.02-1.33, P = 0.03), 1.02 (95% CI 0.85-1.23, P = 0.84), and 1.23 (95 % CI 1.04-1.46, P = 0.02). Male abstainers had increased HR for subsequently receiving disability pension. Female abstainers had increased HR of unemployment, sickness absence and disability pension compared to women with moderate alcohol consumption. Binge drinking was associated with higher HR of unemployment compared to non-binge drinking in women: HR of 1.21 (95 % CI 1.03-1.41, P = 0.02). CONCLUSIONS In Danish men aged 18-60, alcohol abstinence and heavy consumption is associated with increased subsequent risk of unemployment and sickness absence compared with low consumption. In Danish women abstainers have increased risk of unemployment, sickness absence and disability pension, while binge drinkers are more likely to become unemployed subsequently.
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Affiliation(s)
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Vallentin-Holbech L, Rasmussen BM, Stock C. Are perceptions of social norms regarding peer alcohol and other drug use associated with personal use in Danish adolescents? Scand J Public Health 2017; 45:757-764. [DOI: 10.1177/1403494817724313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: This study aims to describe norm perceptions among Danish pupils aged 13–17 years related to the prevalence of personal lifetime use of alcohol and other drugs (AODs). Further we examined if norm perceptions were associated with personal lifetime AOD use. Method: The data were collected as baseline data in the trial The GOOD Life. A total of 2601 pupils from 42 public schools in the Region of Southern Denmark completed an online questionnaire measuring personal lifetime AOD use and personal approval of use. Additionally the perceived frequency of AOD use and approval of use among peers of their own grade were measured. Lifetime AOD outcome variables were alcohol consumption (at least one drink, being drunk and had five or more drinks on one occasion), smoking, and cannabis use. Results: Pupils’ perceptions of peer approval were significantly higher than pupils’ personal approval of AOD use among adolescents for all outcomes. With the exception of cannabis use the estimated AOD prevalence among peers (median) were higher than the actual prevalence of personal lifetime use. Multilevel logistic regression models showed a significantly increased risk of personal AOD use for pupils that overestimated their peers’ AOD use and also for pupils that perceived peers to approve of AOD use. Conclusions: The findings highlight that pupils’ exaggerated perceptions regarding their peers’ use and approval of AOD use are related to personal experience with AODs.
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Affiliation(s)
| | | | - Christiane Stock
- Unit for Health Promotion Research, University of Southern Denmark, Denmark
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25
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Algren MH, Ekholm O, van Lenthe F, Mackenbach J, Bak CK, Andersen PT. Health-risk behaviour among residents in deprived neighbourhoods compared with those of the general population in Denmark: A cross-sectional study. Health Place 2017; 45:189-198. [PMID: 28412595 DOI: 10.1016/j.healthplace.2017.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
This study compares health-risk behaviours (including the co-occurrence of health-risk behaviours) of residents in the deprived neighbourhoods with those of the general population of Denmark. It also examines associations between sociodemographic and socioeconomic characteristics and health-risk behaviours in deprived neighbourhoods in Denmark. Even after adjustment for socioeconomic characteristics there were large differences in health-risk behaviours between residents in deprived neighbourhoods and the general population. In the deprived neighbourhoods large sociodemographic and socioeconomic differences in health-risk behaviours were found among the residents. Our findings highlight the need for health promotion programmes targeting residents in deprived neighbourhoods.
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Affiliation(s)
- Maria Holst Algren
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9-10, 6700 Esbjerg, Denmark.
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Frank van Lenthe
- Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, Netherlands
| | - Johan Mackenbach
- Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, Netherlands
| | - Carsten Kronborg Bak
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220 Aalborg, Denmark
| | - Pernille Tanggaard Andersen
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9-10, 6700 Esbjerg, Denmark
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Assessing Problematic Substance Use in HIV Care: Which Questions Elicit Accurate Patient Disclosures? J Gen Intern Med 2016; 31:1141-7. [PMID: 27197974 PMCID: PMC5023601 DOI: 10.1007/s11606-016-3733-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/08/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Substance use is associated with higher rates of antiretroviral non-adherence and poor HIV outcomes. This study examined how HIV care providers assess substance use, and which questions elicit accurate patient disclosures. METHODS We conducted a conversation analysis of audio-recorded encounters between 56 providers and 162 patients living with HIV (PLWH) reporting active substance use in post-encounter interviews (cocaine or heroin use in the past 30 days, > 4 days intoxicated in past 30 days, or AUDIT score ≥ 8). We assessed the frequency of substance use discussion, characterized the types of questions used by providers, and determined the frequency of accurate patient disclosure by question type. RESULTS In 55 reports of active substance use, providers already knew about the use (n = 16) or patients disclosed unpromptednn = 39). Among the remaining 155 instances of substance use in which providers had the opportunity to elicit disclosure, 78 reports (50 %) of substance use were not discussed. Of the remaining 77 reports in which the provider asked about substance use, 55 (71 %) patients disclosed and 22 (29 %) did not disclose. Questions were classified as: open-ended (n = 18, "How's the drinking going?"); normalizing (n = 14, "When was the last time you used?"); closed-ended (n = 36, "Have you used any cocaine?"); leading towards non-use (n = 9, "Have you been clean?"). Accurate disclosure followed 100 % of open-ended and normalizing questions, 58 % of closed-ended questions, and 22 % of leading questions. After adjusting for drug type, closed-ended questions were 41 % less likely (p < 0.001), and 'leading' questions 78 % less likely (p = 0.016) than broad and normalizing questions to elicit disclosures. CONCLUSION Providers in this sample missed almost half of the opportunities to identify and discuss substance use with PLWH. Providers can increase the probability of patient disclosure by using open-ended or normalizing questions that ask about the "last time" that the patient used drugs or alcohol.
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de Vocht F, Brown J, Beard E, Angus C, Brennan A, Michie S, Campbell R, Hickman M. Temporal patterns of alcohol consumption and attempts to reduce alcohol intake in England. BMC Public Health 2016; 16:917. [PMID: 27585991 PMCID: PMC5009608 DOI: 10.1186/s12889-016-3542-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 08/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Alcohol Toolkit Study (ATS) is a monthly survey of approximately 1700 adults per month aged 16 years of age or more in England. We aimed to explore patterns of alcohol consumption and motivation to reduce alcohol use in England throughout the year. METHODS Data from 38,372 participants who answered questions about alcohol consumption (March 2014 to January 2016) were analysed using weighted regression using the R survey package. Questions assessed alcohol consumption (AUDIT-C) and attempts to reduce consumption. RESULTS Sixty-seven percent of participants reported using alcohol, with a small negative trend of about 2 % reduction over 12 months in the studied period (P < 0.01). These include ~25 % higher risk drinkers and ~10 % regular binge drinkers. About 20 % of higher risk drinkers indicated they were attempting to reduce their alcohol consumption. Attempts were lowest in December (-20 %; 95 % CI 0-35 %), but increases significantly in January (+41 %; 95 % CI 16-73 %) compared with other months (P < 0.001), indicating a small net gain; at least in attempts to reduce. However, there was no evidence that the increased motivation in January was accompanied by a reported decrease in consumption or binge drinking events. This could be an artefact of the use of AUDIT questions, but could also reflect a disconnect between attempting to reduce alcohol consumption and subsequent change; maybe as a result of lack of continuing support. CONCLUSIONS January is associated with moderate increased attempts to reduce alcohol consumption. However, we find little evidence of a change in alcohol consumption. In part, this may be due to temporal insensitivity of the AUDIT questions.
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Affiliation(s)
- Frank de Vocht
- NIHR School for Public Health Research, Bristol, United Kingdom. .,School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Jamie Brown
- NIHR School for Public Health Research, Bristol, United Kingdom.,Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Emma Beard
- NIHR School for Public Health Research, Bristol, United Kingdom.,Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Colin Angus
- NIHR School for Public Health Research, Bristol, United Kingdom.,ScHARR, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- NIHR School for Public Health Research, Bristol, United Kingdom.,ScHARR, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Susan Michie
- NIHR School for Public Health Research, Bristol, United Kingdom.,Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rona Campbell
- NIHR School for Public Health Research, Bristol, United Kingdom.,School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Matthew Hickman
- NIHR School for Public Health Research, Bristol, United Kingdom.,School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
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He J, Assanangkornchai S, Cai L, McNeil E. Patterns of Alcohol Consumption in Yunnan Province of China: Which Measure is Optimal? Alcohol Alcohol 2015; 50:579-87. [DOI: 10.1093/alcalc/agv039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/01/2015] [Indexed: 11/14/2022] Open
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Kydd RM, Connor J. Inconsistency in reporting abstention and heavy drinking frequency: associations with sex and socioeconomic status, and potential impacts. Alcohol Alcohol 2015; 50:333-45. [PMID: 25648932 DOI: 10.1093/alcalc/agu106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 12/22/2014] [Indexed: 01/18/2023] Open
Abstract
AIMS To describe inconsistencies in reporting past-year drinking status and heavy drinking occasions (HDOs) on single questions from two different instruments, and to identify associated characteristics and impacts. METHODS We compared computer-presented Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) with categorical response options, and mental health interview (MHI) with open-ended consumption questions, completed on the same day. Participants were 464 men and 459 women aged 38 (91.7% of surviving birth cohort members). Differences in dichotomous single-item measures of abstention and HDO frequency, associations of inconsistent reporting with sex, socioeconomic status (SES) and survey order, and impacts of instrument choice on associations of alcohol with sex and SES were examined. RESULTS The AUDIT-C drinking frequency question estimated higher past-year abstention prevalence (AUDIT = 7.6%, MHI = 5.4%), with one-third of AUDIT-C abstainers being MHI drinkers. Only AUDIT-C produced significant sex differences in abstainer prevalence. Inconsistencies in HDO classifications were bidirectional, but with fewer HDOs reported on the MHI than AUDIT-C question. Lower SES was associated with inconsistency in abstention and weekly+ HDOs. Abstention and higher HDO frequency were associated with lower SES overall, but sex-specific associations differed by instrument. CONCLUSIONS In this context, data collection method affected findings, with inconsistencies in abstention reports having most impact. Future studies should: (a) confirm self-reported abstention; (b) consider piloting data collection methods in target populations; (c) expect impacts of sex and SES on measurements and analyses.
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Affiliation(s)
- Robyn M Kydd
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Jennie Connor
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
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30
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Himes SK, Dukes KA, Tripp T, Petersen JM, Raffo C, Burd L, Odendaal H, Elliott AJ, Hereld D, Signore C, Willinger M, Huestis MA. Clinical sensitivity and specificity of meconium fatty acid ethyl ester, ethyl glucuronide, and ethyl sulfate for detecting maternal drinking during pregnancy. Clin Chem 2015; 61:523-32. [PMID: 25595440 DOI: 10.1373/clinchem.2014.233718] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND We investigated agreement between self-reported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. METHODS Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified by LC-MS/MS in 0.1 g meconium from infants of Safe Passage Study participants. Detailed PAE information was collected from women with a validated timeline follow-back interview. Because meconium formation begins during weeks 12-20, maternal self-reported drinking at or beyond 19 weeks was our exposure variable. RESULTS Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 third-trimester drinkers). There was moderate to substantial agreement between self-reported PAE at ≥19 weeks and meconium EtG ≥30 ng/g (κ = 0.57, 95% CI 0.41-0.73). This biomarker and associated cutoff was superior to a 7 FAEE sum ≥2 nmol/g and all other individual and combination marker cutoffs. With meconium EtG ≥30 ng/g as the gold standard condition and maternal self-report at ≥19 weeks' gestation as the test condition, 82% clinical sensitivity (95% CI 71.6-92.0) and 75% specificity (95% CI 63.2-86.8) were observed. A significant dose-concentration relationship between self-reported drinks per drinking day and meconium EtG ≥30 ng/g also was observed (all P < 0.01). CONCLUSIONS Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs.
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Affiliation(s)
- Sarah K Himes
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
| | | | | | | | | | - Larry Burd
- Department of Pediatrics, University of North Dakota School of Medicine, Grand Forks, ND
| | - Hein Odendaal
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Science, Stellenbosch University, Tygerberg, South Africa
| | - Amy J Elliott
- Center for Health Outcomes and Prevention Research, Sanford Research, Sioux Falls, SD
| | - Dale Hereld
- Division of Metabolism and Health Effects, National Institute on Alcohol Abuse and Alcoholism, NIH, Rockville, MD
| | - Caroline Signore
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD
| | - Marian Willinger
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD
| | - Marilyn A Huestis
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD;
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Park B, Jung KW, Oh CM, Choi KS, Suh M, Jun JK. Factors associated with alcohol consumption in hepatitis B carriers: a nationwide study in the Republic of Korea. PLoS One 2014; 9:e110144. [PMID: 25387237 PMCID: PMC4227656 DOI: 10.1371/journal.pone.0110144] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 09/16/2014] [Indexed: 12/11/2022] Open
Abstract
This study was conducted to investigate the prevalence of alcohol consumption and identify the sociodemographic factors associated with alcohol consumption among individuals with hepatitis B virus(HBV) infection. We used data from the Korean National Health and Nutrition Examination Surveys, a nationwide survey conducted between 2007 and 2011. “Monthly alcohol consumption” was defined as having consumed alcohol at least once per month during the past year, and “high-risk alcohol consumption” was defined as having consumed alcohol twice or more per week and, for males, having consumed at least 60 g of alcohol on one occasion or, for females, having consumed at least 40 g of alcohol on more than one occasion. The prevalence of monthly alcohol consumption was 53.2%, and that of high-risk alcohol consumption was 11.8% among HBV carriers. Less education was associated with both monthly and high-risk alcohol consumption(OR = 1.75 [95% CI = 1.02−3.02] for monthly alcohol consumption among those with less than a high school education; OR = 2.48 [95% CI = 1.19−5.17] for high-risk alcohol consumption among those with less than a high school education and OR = 2.02 [95% CI = 1.12−3.64] among those with a high school education). Additionally, smoking and being male increased the risk of alcohol consumption, and older age and having a normal body mass index decreased the risk. HBV carriers who were less educated, overweight, and smokers were more likely to consume alcohol or meet criteria for high-risk drinking. Health policies and intervention programs aimed at promoting a generally healthy lifestyle in HBV carriers should consider educational inequalities and alcohol consumption.
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Affiliation(s)
- Boyoung Park
- National Cancer Control Institute, National Cancer Center, Goyang-si, Korea
| | - Kyu-Won Jung
- National Cancer Control Institute, National Cancer Center, Goyang-si, Korea
| | - Chang-Mo Oh
- National Cancer Control Institute, National Cancer Center, Goyang-si, Korea
| | - Kui Son Choi
- National Cancer Control Institute, National Cancer Center, Goyang-si, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang-si, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang-si, Korea
- * E-mail:
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Bjerregaard P, Becker U. Validation of survey information on smoking and alcohol consumption against import statistics, Greenland 1993-2010. Int J Circumpolar Health 2013; 72:20314. [PMID: 23471142 PMCID: PMC3590397 DOI: 10.3402/ijch.v72i0.20314] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/01/2013] [Accepted: 02/02/2013] [Indexed: 11/25/2022] Open
Abstract
Background Questionnaires are widely used to obtain information on health-related behaviour, and they are more often than not the only method that can be used to assess the distribution of behaviour in subgroups of the population. No validation studies of reported consumption of tobacco or alcohol have been published from circumpolar indigenous communities. Objective The purpose of the study is to compare information on the consumption of tobacco and alcohol obtained from 3 population surveys in Greenland with import statistics. Design Estimates of consumption of cigarettes and alcohol using several different survey instruments in cross-sectional population studies from 1993–1994, 1999–2001 and 2005–2010 were compared with import statistics from the same years. Results For cigarettes, survey results accounted for virtually the total import. Alcohol consumption was significantly under-reported with reporting completeness ranging from 40% to 51% for different estimates of habitual weekly consumption in the 3 study periods. Including an estimate of binge drinking increased the estimated total consumption to 78% of the import. Conclusion Compared with import statistics, questionnaire-based population surveys capture the consumption of cigarettes well in Greenland. Consumption of alcohol is under-reported, but asking about binge episodes in addition to the usual intake considerably increased the reported intake in this population and made it more in agreement with import statistics. It is unknown to what extent these findings at the population level can be inferred to population subgroups.
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Affiliation(s)
- Peter Bjerregaard
- Centre for Health Research in Greenland, National Institute of Public Health, University of Southern Denmark, Odense, Denmark.
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Bidstrup PE, Dalton SO, Christensen J, Tjonneland A, Larsen SB, Karlsen R, Brewster A, Bondy M, Johansen C. Changes in body mass index and alcohol and tobacco consumption among breast cancer survivors and cancer-free women: a prospective study in the Danish Diet, Cancer and Health Cohort. Acta Oncol 2013; 52:327-35. [PMID: 23244678 DOI: 10.3109/0284186x.2012.746466] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A breast cancer diagnosis has been suggested as a teachable moment when a woman is more open to making healthier lifestyle changes. Little is known about the health behaviour changes women with breast cancer initiate compared to those made by other women. MATERIAL AND METHODS We examined changes in body mass index (BMI) and tobacco and alcohol consumption among women with a diagnosis of breast cancer and among cancer-free women. We used data from 23 420 women aged 50-64 years who participated in the Diet, Cancer and Health cohort, of whom 449 were diagnosed with breast cancer between baseline (1993-1997) and follow-up (2000-2002), and 22 971 remained cancer-free. We used multiple linear regression analysis to examine differences in BMI and alcohol and tobacco consumption between the two groups and to examine whether demographic and prognostic factors were associated with behavioural changes in women with breast cancer. RESULTS There were no significant differences in changes in BMI, alcohol and tobacco consumption between the two groups. Only in sub-analyses among women who lost weight between baseline and follow-up, women with breast cancer lost more weight than cancer-free women (β = 0.2; CI 0.1; 0.4), but residual confounding from stage cannot be excluded. Among the women with breast cancer we found no significant changes in BMI, alcohol and tobacco consumption by level of education, marital status, chemotherapy, hormone therapy or radiation. CONCLUSION Women with breast cancer did not reduce their BMI, or modify their alcohol use or tobacco consumption compared with cancer-free women. This study indicates that guidelines and interventions to change health behaviour are needed after a cancer diagnosis.
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Men with cancer change their health behaviour: a prospective study from the Danish diet, cancer and health study. Br J Cancer 2012; 107:201-6. [PMID: 22644301 PMCID: PMC3389426 DOI: 10.1038/bjc.2012.238] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Health behaviour changes may improve the quality of life and survival among cancer survivors. We prospectively examined changes in health behaviour among and between men with prostate cancer (PC), men with cancers other than PC and cancer-free men. Methods: We analysed data for 20 914 men (50–65 years), 426 with cancer, and 20 488 persons who were cancer-free between baseline (1993–1997) and follow-up (2000–2002) in multiple linear regression models to determine differences in changes in body mass index (BMI) and in alcohol and tobacco consumption. Results Body mass index and tobacco and alcohol consumption decreased significantly (P<0.001) between baseline and follow-up among both men with cancer and cancer-free men. Men with cancers other than PC significantly decreased their BMI (β=−058; 95% confidence interval (CI): −0.77, −0.40) and tobacco consumption (β=−1.36; 95% CI: −2.22, −0.49) compared with cancer-free men and were significantly more likely to quit smoking and lose weight. Conclusion: Men with cancers other than PC decreased their tobacco consumption and BMI significantly more than cancer-free men. Men with cancer do change their health behaviour; clinicians should take this into account in planning follow-up care for cancer survivors.
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Ekholm O, Strandberg-Larsen K, Grønbæk M. Influence of the recall period on a beverage-specific weekly drinking measure for alcohol intake. Eur J Clin Nutr 2011; 65:520-5. [DOI: 10.1038/ejcn.2011.1] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Rey G, Boniol M, Jougla E. Estimating the number of alcohol-attributable deaths: methodological issues and illustration with French data for 2006. Addiction 2010; 105:1018-29. [PMID: 20331552 DOI: 10.1111/j.1360-0443.2010.02910.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIMS Computing the number of alcohol-attributable deaths requires a series of hypotheses. Using French data for 2006, the potential biases are reviewed and the sensitivity of estimates to various hypotheses evaluated. METHODS Self-reported alcohol consumption data were derived from large population-based surveys. The risks of occurrence of diseases associated with alcohol consumption and relative risks for all-cause mortality were obtained through literature searches. All-cause and cause-specific population alcohol-attributable fractions (PAAFs) were calculated. In order to account for potential under-reporting, the impact of adjustment on sales data was tested. The 2006 mortality data were restricted to people aged between 15 and 75 years. RESULTS When alcohol consumption distribution was adjusted for sales data, the estimated number of alcohol-attributable deaths, the sum of the cause-specific estimates, was 20 255. Without adjustment, the estimate fell to 7158. Using an all-cause mortality approach, the adjusted number of alcohol-attributable deaths was 15 950, while the non-adjusted estimate was a negative number. Other methodological issues, such as computation based on risk estimates for all causes for 'all countries' or only 'European countries', also influenced the results, but to a lesser extent. DISCUSSION The estimates of the number of alcohol-attributable deaths varied greatly, depending upon the hypothesis used. The most realistic and evidence-based estimate seems to be obtained by adjusting the consumption data for national alcohol sales, and by summing the cause-specific estimates. However, interpretation of the estimates must be cautious in view of their potentially large imprecision.
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Affiliation(s)
- Grégoire Rey
- INSERM, CépiDc, Université Paris Sud 11, IFR69 Le Vésinet, France.
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Brighina L, Schneider NK, Lesnick TG, de Andrade M, Cunningham JM, Mrazek D, Rocca WA, Maraganore DM. Alpha-synuclein, alcohol use disorders, and Parkinson disease: a case-control study. Parkinsonism Relat Disord 2009; 15:430-4. [PMID: 19196539 DOI: 10.1016/j.parkreldis.2008.11.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Revised: 11/06/2008] [Accepted: 11/13/2008] [Indexed: 10/21/2022]
Abstract
Collaborative pooled analyses demonstrated that allele length variability of the dinucleotide repeat sequence within the alpha-synuclein gene promoter (SNCA REP1) is associated with Parkinson disease (PD) worldwide. Other studies demonstrated that variability in the SNCA promoter is also associated with alcohol use disorders, but not consistently. Yet other studies demonstrated that alcohol use disorders are inversely associated with PD, but not consistently. The aim of this study was to clarify the patterns of association between REP1 genotype, alcohol use disorders, and PD. Cases were recruited from the Department of Neurology of the Mayo Clinic in Rochester, MN. The controls included unaffected siblings and unrelated controls. We assessed alcohol use via a structured telephone interview and screened for alcohol use disorders using the CAGE questionnaire. REP1 genotyping was performed using an ABI 3730XL platform. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using conditional logistic regression models. We recruited 893 case-control pairs. There was an increasing risk of PD with increasing SNCA REP1 allele length (OR 1.18 for each REP1 genotype score unit, 95% CI 1.02-1.35; p=0.02). There was a decreasing risk of PD with increasing CAGE score (p=0.01). The association of REP1 score with PD remained significant after adjusting for CAGE score, and the association of CAGE score with PD remained significant after adjusting for REP1 score. There were no pairwise interactions. Our findings suggest that SNCA REP1 genotype and alcohol use disorders are independently associated with PD.
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Affiliation(s)
- Laura Brighina
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy
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