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Escaño GJ, Pridemore WA. Population-Level Alcohol Consumption and Homicide Rates in Latin America: A Fixed Effects Panel Analysis, 1961-2019. THE BRITISH JOURNAL OF CRIMINOLOGY 2024; 64:656-674. [PMID: 38638838 PMCID: PMC11022986 DOI: 10.1093/bjc/azad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Latin America and the Caribbean (LAC) possesses 8 per cent of the global population but approximately one-third of global homicides. The region also exhibits high per capita alcohol consumption, risky drinking patterns and a heterogeneous mix of beverage preferences. Despite this, LAC violence receives limited attention in the English-language literature and there are no studies of the population-level alcohol-homicide association in the region. We examined the effects on total, male and female homicide rates of total and beverage-specific alcohol consumption (22 nations, 1961-2019) and of risky drinking patterns (20 nations, 2005 and 2010). We collected homicide and alcohol data from the World Health Organization. Panel fixed effects models showed (1) per capita total and wine consumption were positively associated with total, male and female homicide rates, though effects were much stronger for males, (2) per capita beer consumption was positively associated with total and male homicide rates, (3) per capita spirits consumption was not associated with homicide rates, and (4) nations with riskier drinking patterns had higher total, male and female homicide rates than those with less risky drinking patterns.
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Affiliation(s)
- Guillermo J Escaño
- University at Albany, State University of New York, School of Criminal Justice, 135 Western Avenue, Albany, NY 12222, USA
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2
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Rivera-Lara L, Videtta W, Calvillo E, Mejia-Mantilla J, March K, Ortega-Gutierrez S, Obrego GC, Paranhos JE, Suarez JI. Reducing the incidence and mortality of traumatic brain injury in Latin America. Eur J Trauma Emerg Surg 2023; 49:2381-2388. [PMID: 36637481 DOI: 10.1007/s00068-022-02214-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 12/26/2022] [Indexed: 01/14/2023]
Abstract
Traumatic brain injury (TBI) represents a considerable portion of the global injury burden. The incidence of TBI will continue to increase in view of an increase in population density, an aging population, and the increased use of motor vehicles, motorcycles, and bicycles. The most common causes of TBI are falls and road traffic injuries. Deaths related to road traffic injury are three times higher in low-and middle-income countries (LMIC) than in high-income countries (HIC). The Latin American Caribbean region has the highest incidence of TBI worldwide, primarily caused by road traffic injuries. Data from HIC indicates that road traffic injuries can be successfully prevented through concerted efforts at the national level, with coordinated and multisector responses to the problem. Such actions require implementation of proven measures to address the safety of road users and the vehicles themselves, road infrastructure, and post-crash care. In this review, we focus on the epidemiology of TBI in Latin America and the implementation of solutions and preventive measures to decrease mortality and long-term disability.
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Affiliation(s)
- Lucia Rivera-Lara
- Department of Neurology, School of Medicine, Center for Academic Medicine, Stanford University, 453 Quarry Road, Palo Alto, CA, 94304, USA.
| | - Walter Videtta
- Department of National Hospital, Alejandro Posadas, Buenos Aires, Argentina
| | - Eusebia Calvillo
- Departments of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | | | - Karen March
- Clinical Development at Integra Life Sciences, Seattle, WA, USA
| | | | | | - Jorge E Paranhos
- Santa Casa da Misericordia de São João del Rey, Minas Gerais, Brazil
| | - Jose I Suarez
- Departments of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
- Departments of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
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Ayares G, Idalsoaga F, Arnold J, Fuentes-López E, Arab JP, Díaz LA. Public Health Measures and Prevention of Alcohol-Associated Liver Disease. J Clin Exp Hepatol 2022; 12:1480-1491. [PMID: 36340308 PMCID: PMC9630023 DOI: 10.1016/j.jceh.2022.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/25/2022] [Indexed: 12/12/2022] Open
Abstract
Hazardous alcohol consumption causes approximately 4% of deaths globally, constituting one of the leading risk factors for the burden of the disease worldwide. Alcohol has several health consequences, such as alcohol-associated liver disease, hepatocellular carcinoma, nonliver neoplasms, physical injury, cardiac disease, and psychiatric disorders. Alcohol misuse significantly affects workforce productivity, with elevated direct and indirect economic costs. Due to the high impact of alcohol consumption on the population, public health has led to the development of a range of strategies to reduce its harmful effects. Regulatory public health policies (PHP) for alcohol can exist at the global, regional, international, national, or subnational levels. Effective strategies incorporate a multilevel, multicomponent approach, targeting multiple determinants of drinking and alcohol-related harms. The World Health Organization categorizes the PHP into eight categories: national plan to fight the harmful consequences of alcohol, national license and production and selling control, taxes control and pricing policies, limiting drinking age, restrictions on alcohol access, driving-related alcohol policies, control over advertising and promotion, and government monitoring systems. These policies are supported by evidence from different populations, demonstrating that determinants of alcohol use depend on several factors such as socioeconomic level, age, sex, ethnicity, production, availability, marketing, and others. Although most policies have a significant individual effect, a higher number of PHP are associated with a lower burden of disease due to alcohol. The excessive consequences of alcohol constitute a call for action, and clinicians should advocate for developing and implementing a new PHP on alcohol consumption.
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Key Words
- ACLF, Acute-on-Chronic Liver Failure
- ALD, Alcohol-associated Liver Disease
- AUC, Area Under the Curve
- AUD, Alcohol Use Disorder
- AUDIT, Alcohol Use Disorders Identification Test
- AUDIT-C, Alcohol Use Disorders Identification Test Concise
- AVT, Alcohol Volumetric Tax
- BAC, Blood Alcohol Concentration
- DALYs, Disability-adjusted life years
- GDP, Gross domestic product
- PHP, Public Health Policies
- PNPLA3, Patatin-like Phospholipase Domain-containing 3
- USA, United States
- USD, United States Dollars
- WHO, World Health Organization
- alcohol use disorders
- alcohol-associated hepatitis
- cirrhosis
- fatty liver disease
- steatosis
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Affiliation(s)
- Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Departamento de Ciencias de La Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan P. Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis A. Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Brandão-Bezerra L, Aparecida da Rosa A, Figueiredo de Oliveira RM, Neves RH, Corrêa CL, Machado-Silva JR. Impact of acute schistosomiasis mansoni and long-term ethanol intake on mouse liver pathology. Exp Parasitol 2022; 242:108388. [PMID: 36174706 DOI: 10.1016/j.exppara.2022.108388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/08/2022] [Accepted: 09/21/2022] [Indexed: 11/26/2022]
Abstract
While the effect of ethanol and schistosomiasis mansoni on liver injury has been well-documented, the influence of comorbidity on liver pathology remains unclear. To address this gap, schistosomiasis-infected mice were given one daily dose of 18% ethanol for 28 consecutive days, from day 35 post-infection. Mice were assigned to four groups: A. control; B. uninfected/ethanol gavage; C. infected; and D. infected/ethanol gavage. At day 64 post-infection, mice were euthanized by CO2 asphyxiation, livers were excised, fixed in 10% buffered formalin, paraffin embedded and cut into 5 μm sections. These were stained with hematoxylin and eosin (HE), Lennert's Giemsa and picrosirius red (for polarization microscopy) to assess histopathological and stereological changes. Group B showed alcoholic liver disease (ALD), including microsteatosis, hepatocyte karyopyknosis, karyorrhexis, karyolysis, increased frequency of Kupffer cells, hydropic degeneration of hepatocyte, thickened plasma membrane and binucleated hepatocytes. Infected mice showed typical exudative and exudative-productive hepatic granulomas, and destruction of the adjacent hepatic parenchyma, resulting in necrotic tissue and periovular leukocyte infiltrate. Group D showed hyperemia (parenchymal panlobular lesions), and liquefactive necrosis in hepatic abscess area. There was also reduced liver collagen deposition (-76%; p = 0.0001) and reduced microsteatosis (-80%, p = 0.0079) compared to group C and group B, respectively. In conclusion, comorbidity exacerbated liver damage.
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Affiliation(s)
- Luciana Brandão-Bezerra
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Aline Aparecida da Rosa
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Regina Maria Figueiredo de Oliveira
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Renata Heisler Neves
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Christiane Leal Corrêa
- Department of Pathology and Laboratories, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Brazil. Medical College, Estácio de Sá University, Rio de Janeiro, Brazil
| | - José Roberto Machado-Silva
- Romero Lascasas Porto Laboratory of Helminthology, Department of Microbiology, Immunology and Parasitology, Medical Sciences College (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.
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Sornpaisarn B, Sornpaisarn S, Rehm J. The association between the time of alcohol drinking and injury risk in Thailand: a cross-sectional emergency department study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:28. [PMID: 33785034 PMCID: PMC8011167 DOI: 10.1186/s13011-021-00365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although the relationship between acute alcohol consumption and injuries is well recognized, studies exploring how the time of day the drinking commences affects alcohol-related injuries have been scarce. This contribution examines the associations between the time at which the drinking began and the duration of the drinking, the volume of alcohol consumed, the injury type, and the blood alcohol concentration (BAC) level. METHOD This study employed a cross-sectional survey, which was conducted in two hospital emergency departments (ED) in Chiangmai Province, Thailand. The sample was composed of 519 injured patients aged 18 years and older. Outcome measures included the BAC and type of injury. Exposures included the quantity of alcohol consumed, the time the drinking commenced, and the pattern of drinking involved. RESULTS The injured patients who drank alcohol within six hours prior to sustaining their injury were more likely to get injured and present themselves at the ED at night (20:00-04:00) compared to those who sustained an injury but did not drink in the hours prior. However, this relationship was only true for unintentional injuries, not intentional ones. The majority of participants consumed their first drink between 16:00 and 20:00. On average, among the 104 patients who drank prior to sustaining an injury, the total amount of alcohol consumed was 6.9 drinks, the duration of drinking was 2.6 h, the rate of drinking was 6.0 drinks/hour, and the BAC was 0.119 gm%. Every drink increased the BAC by 0.012 gm% and each year of increasing age increased the BAC by 0.003 gm%. People who were older, less educated, and drank more frequently tended to have their first drink earlier than other drinkers. An earlier start to their drinking resulted in a faster pace of drinking and a higher BAC. CONCLUSIONS BAC increased with the total amount of alcohol consumed and the age of the drinker. Different groups of people had their first drink at different times of the day, resulting in differences in the rate of drinking, the BAC, the time of injury, and the time they presented to the ED after injury.
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Affiliation(s)
- Bundit Sornpaisarn
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Ontario, M5S 2S1, Toronto, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, M5T 3M7, Toronto, Ontario, Canada. .,Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, 10400, Bangkok, Thailand.
| | - Sarnti Sornpaisarn
- Faculty of Health Science, McMaster University, 1280 Main Street West, L8S 4L8, Hamilton, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, Ontario, M5S 2S1, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, M5T 3M7, Toronto, Ontario, Canada.,World Health Organization / Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, M5T 1R8, Toronto, Ontario, Canada.,Centre for Interdisciplinary Addiction Research, University of Hamburg, Martinstraße 52, 20246, Hamburg, Germany.,Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992, Moscow, Russian Federation
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Sornpaisarn B, Sornpaisarn S, Shield KD, Rehm J. Alcohol use and injury risk in Thailand: A case-crossover emergency department study. Drug Alcohol Rev 2020; 39:539-545. [PMID: 32515099 DOI: 10.1111/dar.13094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS While injuries and alcohol contribute to a large proportion of the disease burden in Thailand, no well-designed underlying study has yet been published. This study aims to evaluate the relationship between acute alcohol consumption and injury risk in Thailand. DESIGN AND METHODS Using the case-crossover design, this study examined 520 injured patients aged 18 years and older from two emergency departments in Meuang District, Chiang-Mai Province, Thailand, from June to August of 2016. The case period was defined as 6 h prior to injury, the two control periods as the same 6-h period at 1 day and 7 days prior to injury. Alcohol exposure and the amount consumed were measured for these periods. RESULTS Twenty percent of injured patients consumed alcohol within the 6 h prior to injury, averaging 6.9 drinks during that time. The odds of injury for those individuals consuming alcoholic beverages was 5.0 (95% confidence interval 3.0, 8.2) times greater compared to non-exposure individuals; every additional drink consumed increased the odds of injury by 1.3 (95% confidence interval 1.2, 1.4). Alcohol use significantly increased the odds of sustaining an unintentional injury, intentional injury inflicted by someone else or experiencing a road traffic injury (among drivers). The dose-response analysis indicated alcohol use significantly increased the risks of unintentional injury and road traffic injuries (among drivers). DISCUSSION AND CONCLUSIONS Exposure to alcohol increased the odds of injury in a dose-dependent fashion; hence, comprehensive, cost-effective strategies should be implemented in Thailand to reduce alcohol exposure, binge drinking and drunk driving.
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Affiliation(s)
- Bundit Sornpaisarn
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | | | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, World Health Organization/Pan American Health Organization Collaborating Centre, Toronto, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, World Health Organization/Pan American Health Organization Collaborating Centre, Toronto, Canada.,Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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7
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Brown AD, Müller M, Hirschi T, Henssler JF, Rönz K, Exadaktylos AK, Srivastava D. Acute and mixed alcohol intoxications in asylum seekers presenting to an urban emergency department in Switzerland. BMC Public Health 2019; 19:536. [PMID: 31077159 PMCID: PMC6511149 DOI: 10.1186/s12889-019-6910-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/29/2019] [Indexed: 12/02/2022] Open
Abstract
Background Previous studies have reported an increase in alcohol-and-mixed intoxication (AAMI)-related emergency department (ED) admissions, but less is known about the incidence and characteristics of AAMI admissions to EDs among asylum-seeking patients. Asylum seeking patients may be at higher risk for AAMI due stressors associated with forced migration. The aim of this study was to determine the proportional incidence, population characteristics, and predictors of ED admissions due to AAMI among patients with a residency status of asylum seeker as compared to those with a residency status of Swiss-national. Methods This retrospective analysis included all medical consultations from a large, adult ED in Switzerland between January 1, 2013 to December 31, 2016. The residency status of consultations was established if possible, and AAMI was determined utilizing a two-step screening procedure, blinded for residency status. A multivariable logistic regression was performed to determine the odds of AAMI in asylum-seeking patient consultations compared to consultations for Swiss-national patients. In addition, patient characteristics among asylum seekers admitted for AAMI were compared to patients with Swiss-national residency status for AAMI. Results In total, 117,716 eligible consultations (Swiss-national patient consultations: n = 115,226 and asylum-seeker consultations: n = 2490) were included in this study. The proportional incidence of AAMI among asylum seekers was 3.7% (n = 92) compared to 1.6% (n = 1841) among the Swiss-national patients. AAMI in asylum seekers was associated with higher levels of trauma (37.0% vs. 23.5%, p = 0.003), and hospital admission (35.4% vs. 14.1%, p < 0.001), but a smaller proportion of chronic alcohol consumption (13.0% vs. 43.5%, p < 0.001), and psychiatric referrals (26.1% vs. 49.0%, p < 0.001). Multivariable analysis controlling for age, sex, triage category, weekend admission, year of admission, and multiple visits showed a 1.6 times higher odds (95% CI: 1.3, 2.0; p < 0.001) for an AAMI-related ED consultation in asylum seeking patients. Conclusions These findings show that individuals seeking asylum in a high-income country may be at greater risk for AAMI-related admission than the local population. Given the observed association between AAMI-related ED admissions and trauma, suicidality, and psychiatric referrals among this subpopulation, the data also suggests that co-morbid mental health disorders associated with forced displacement may contribute to hazardous alcohol use.
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Affiliation(s)
- Adam D Brown
- Department of Psychology, New School for Social Research, 80 5th Avenue, New York, NY, 10011, USA. .,Department of Psychiatry, New York University School of Medicine, New York, USA.
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - Trevor Hirschi
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Jonathan F Henssler
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital Berlin, Charité University Medicine, Berlin, Germany
| | - Katharina Rönz
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | | | - David Srivastava
- Department of Psychiatry, New York University School of Medicine, New York, USA
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Rodriguez C, Bonilla-Escobar FJ, Restrepo-Lopera C, Markovtsova A, Medina MT, Puyana JC. A trauma registry experience from the main referral center of Honduras: A call for action. Injury 2019; 50:883-889. [PMID: 30935746 DOI: 10.1016/j.injury.2019.03.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/16/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Honduras is one of the most violent countries in the world and it has limited epidemiological data that describes the extent of intentional and unintentional injuries. This research is needed to develop and inform prevention programs in Honduras, as well as to spread international awareness. METHODS A cross-sectional study was carried out on a paper-based injury surveillance system (InSS) with the help of Honduras' University Medical School Hospital (UMSH), the main referral medical center in Tegucigalpa-Honduras. Descriptive statistics and bivariate analysis were carried out using data from all registered injuries in 2013. RESULTS Of the 17,971 injuries reported, intentional injuries made up 18.14% of all injuries. Interpersonal violence from gun violence, robberies, and physical altercations accounted for 14.68%. Self-inflicted injuries made up 3.46% of injuries, with suicide falls and poison intoxications being the most frequent (1.9% and 1.2%, respectively). Sexual harassment was minimally reported (0.27%, n = 48). Unintentional injuries made up 81.79% of the total injuries. The most common causes of unintentional injuries were falls (38.01%) and road traffic injuries (16.65%). Motorocyclists made up 35.4% of those injured by road traffic accidents. In general, injuries occured during the weekend and mainly affected men during the ages when they would be most likely to work and maintain jobs. The modified Kampala trauma score (M-KTS) showed that most of the injuries were mild (range 3-11), with 59.59% of the patients with a M-KTS of 9, and an overall mortality rate of 0.65% (n = 117). CONCLUSION The description of injuries provides the basis for prevention. The disproportionate number of unintentional injuries (4:1) seen in Honduras' referral hospital calls for further research in: 1) trauma care logistics and emergency systems, 2) mortality and lethality of intentional injuries, and 3) analysis of the types of unintentional injuries. Further research is necessary to evaluate interventions and identify the socioeconomic effects of injuries in the region.
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Affiliation(s)
- Cristina Rodriguez
- Hospital Escuela Universitario, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras.
| | - Francisco J Bonilla-Escobar
- Institute for Clinical Research Education (ICRE), University of Pittsburgh, PA, USA; Global Health, Division of Trauma and Surgery, University of Pittsburgh, PA, USA; Cisalva Institute, Universidad del Valle, Cali, Colombia; SCISCO Foundation, Cali, Colombia.
| | - Catalina Restrepo-Lopera
- Global Health, Division of Trauma and Surgery, University of Pittsburgh, PA, USA; Radiology Department, Universidad CES, Medellin, Colombia.
| | | | - Marco T Medina
- Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.
| | - Juan Carlos Puyana
- Global Health, Division of Trauma and Surgery, University of Pittsburgh, PA, USA.
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Andreuccetti G, Cherpitel CJ, Carvalho HB, Leyton V, Miziara ID, Munoz DR, Reingold AL, Lemos NP. Alcohol in combination with illicit drugs among fatal injuries in Sao Paulo, Brazil: An epidemiological study on the association between acute substance use and injury. Injury 2018; 49:2186-2192. [PMID: 30270012 PMCID: PMC6289625 DOI: 10.1016/j.injury.2018.09.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/17/2018] [Indexed: 02/02/2023]
Abstract
Injury deaths have a major impact on public health systems, particularly in the Latin American region; however, little is known about how different drugs, in combination or not with alcohol, interact with each injury type. We tested an epidemiological protocol for investigating alcohol and other drug acute use among fatally injured victims taking into account the injury context for all injury causes in Sao Paulo, Brazil. Blood alcohol and drug content were fully screened and confirmed following a probability sample selection of decedents (n = 365) during 19 consecutive months (2014-2015). Drug concentrations, including benzodiazepines, cannabis, cocaine, and opioids were determined by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography tandem mass spectrometry (LC-MS/MS). Toxicology data were interpreted in combination with injury context retrieved from police records regarding cause, place of injury, and victims' criminal history. More than half of all fatally injured victims studied were under the influence of at least one substance (55.3%). Alcohol was the leading substance consumed before a fatal injury event (30.1%), followed by cocaine (21.9%) and cannabis (14%). Illicit drug use (cocaine and cannabis) comprised more than two thirds of all drug-related deaths. Alcohol-positive deaths are over-represented among road traffic injuries, while drug-positive deaths are more prevalent among intentional injuries. Victims who had previous criminal convictions were significantly more likely to have used illicit drugs compared to those who did not have a criminal background. We estimated that one in every two fatal injuries in the city of Sao Paulo is associated with acute substance use by the victim. The health burden attributed to alcohol- and drug-related fatal injury events has reached significant higher levels in Latin American cities such as Sao Paulo compared globally.
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Affiliation(s)
- G Andreuccetti
- Department of Preventive Medicine, University of Sao Paulo Medical School, Brazil; Alcohol Research Group, Emeryville, CA, United States; Department of Legal Medicine, University of Sao Paulo Medical School, Brazil.
| | - C J Cherpitel
- Alcohol Research Group, Emeryville, CA, United States
| | - H B Carvalho
- Department of Preventive Medicine, University of Sao Paulo Medical School, Brazil
| | - V Leyton
- Department of Legal Medicine, University of Sao Paulo Medical School, Brazil
| | - I D Miziara
- Department of Legal Medicine, University of Sao Paulo Medical School, Brazil; Technical-Scientific Police Superintendency of the State of Sao Paulo, Sao Paulo, Brazil
| | - D R Munoz
- Department of Legal Medicine, University of Sao Paulo Medical School, Brazil
| | - A L Reingold
- School of Public Health, University of California, Berkeley, CA, United States
| | - N P Lemos
- Department of Laboratory Medicine, School of Medicine, University of California, San Francisco, CA, United States
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Ramachandran A, Ranjit A, Zogg CK, Herrera-Escobar JP, Appelson JR, Pino LF, Aboutanous MB, Haider AH, Ordonez CA. Comparison of Epidemiology of the Injuries and Outcomes in Two First-Level Trauma Centers in Colombia Using the Pan-American Trauma Registry System. World J Surg 2018; 41:2224-2230. [PMID: 28417184 DOI: 10.1007/s00268-017-4013-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The aim of this study was to compare the epidemiology of traumatic injuries and mortality outcomes between two tertiary-care trauma centers in Colombia using data from Pan-American Trauma Registry (PATR). METHODS January 1-December 31, 2012, data from the Hospital Universitario del Valle (HUV, public) and Fundacion Valle del Lili (FVL, private) in Cali, Colombia, were considered. Differences in demographic and clinical information were compared using descriptive statistics. Propensity score matching was used to match patients on age, gender, and ISS. Within matched cohorts, multivariable logistic regression models were used to assess for differences in in-hospital mortality, further adjusting for insurance type, employment, heart rate, presence of hypotension (SBP < 90), and GCS score. RESULTS HUV (8539; 78% male) and FVL (10,456; 60% male) had a combined total of 18,995 trauma cases in 2012 with comparable mean ages of 29.7 years. There were significant differences in insurance status, injury severity, and mechanism of injury between patients at HUV and FLV. On risk-adjusted logistic regression analyses with propensity score matched cohorts, the odds of death in HUV was higher compared to patients presenting at FVL hospital (OR [95% CI]:4.93 [3.37-7.21], p < 0.001). CONCLUSION The study established the utility of the PATR and revealed important trends in patient demographics, injury epidemiology, and mortality outcomes, which can be used to target trauma initiatives throughout the region. It underscores the profound importance that differences in case mix play in the risk of trauma-related mortality, further emphasizing the need to monitor and evaluate unique aspects of trauma in LMIC. LEVEL OF EVIDENCE III.
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Affiliation(s)
| | - Anju Ranjit
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health, Boston, MA, USA
| | | | - Juan P Herrera-Escobar
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health, Boston, MA, USA
| | - Jessica R Appelson
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health, Boston, MA, USA
| | - Luis F Pino
- Department of Surgery from Division of Trauma and Acute Care Surgery, Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia
| | - Michel B Aboutanous
- Division of Acute Care Surgery, Virginia Commonwealth University Trauma Center, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Adil H Haider
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health, Boston, MA, USA.
| | - Carlos A Ordonez
- Department of Surgery from Division of Trauma and Acute Care Surgery, Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia
- Department of Surgery From Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
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Variance in the Efficacy of Brief Interventions to Reduce Hazardous and Harmful Alcohol Consumption Between Injury and Noninjury Patients in Emergency Departments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Ann Emerg Med 2017; 70:714-723.e13. [DOI: 10.1016/j.annemergmed.2017.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/19/2017] [Accepted: 05/02/2017] [Indexed: 01/03/2023]
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Korcha RA, Cherpitel CJ, Bond J, Ye Y, Monteiro M, Chou P, Borges G, Cook WK, Bassier-Paltoo M, Hao W. Drinking context and cause of injury: Emergency department studies from 22 countries. JOURNAL OF SUBSTANCE USE 2017; 23:240-246. [PMID: 30713470 DOI: 10.1080/14659891.2017.1378747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background It is estimated that up to a third of injuries requiring emergency department admission are alcohol-related. While injuries that are alcohol-related are unsurprising to emergency department staff, less is understood about the precursors to the injury event. Methods Using data from representative emergency department injury patients in 22 countries, we examined associations between context of injury (private or public), cause of injury (fall or trip, being stuck/cut/ or burned and violence) and alcohol use. Alcohol-related policy data were also obtained from each study locale. Results Injuries were similarly reported in private (54%) and public settings (46%) while cause of injury was most often due to falls (39%) or being struck/cut or burned (38%). Violence-related injuries were reported by approximately 1 in 5 patients (23%). Increased odds of drinking prior to the injury event was associated with injury due to violence in private settings but not public venues. Similarly, patients from regions with fewer restrictive alcohol policies were more likely to report drinking prior to an injury event and have elevated violence-related injuries in private settings. Conclusion Understanding the cause and context of injury and alcohol use are important components to evaluation and development of alcohol policies.
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Affiliation(s)
- Rachael A Korcha
- Alcohol Research Group, 6475 Christie Ave. #400, Emeryville, CA USA 94608, 001-510-597-3440
| | - Cheryl J Cherpitel
- Alcohol Research Group, 6475 Christie Ave. #400, Emeryville, CA USA 94608, 001-510-597-3440
| | - Jason Bond
- Alcohol Research Group, 6475 Christie Ave. #400, Emeryville, CA USA 94608, 001-510-597-3440
| | - Yu Ye
- Alcohol Research Group, 6475 Christie Ave. #400, Emeryville, CA USA 94608, 001-510-597-3440
| | | | - Patricia Chou
- National Institute on Alcohol Abuse and Alcoholism, Washington, DC, USA
| | - Guiherme Borges
- National Institute of Psychiatry and Universidad Autonoma Metropolitana, Mexico City, Mexico
| | | | | | - Wei Hao
- WHO Collaborating Center for Drug Abuse and Health, China, Central South University, Changsha, China
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Borges G, Monteiro M, Cherpitel CJ, Orozco R, Ye Y, Poznyak V, Peden M, Pechansky F, Cremonte M, Reid SD, Mendez J. Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study. Alcohol Clin Exp Res 2017; 41:1731-1737. [PMID: 28905388 PMCID: PMC5679247 DOI: 10.1111/acer.13467] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/31/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study reports dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol use and road traffic injury (RTI). METHODS Data were analyzed on 1,119 RTI patients arriving at 16 emergency departments (EDs) in Argentina, Brazil, Costa Rica, Dominican Republic, Guatemala, Guyana, Mexico, Nicaragua, Panama, and Trinidad and Tobago. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the RTI with 2 control periods (prior d/wk), was performed using fractional polynomial analysis for dose-response. RESULTS About 1 in 6 RTI patients in EDs were positive for self-reported alcohol 6 hours prior to the injury (country range 8.6 to 24.1%). The likelihood of an RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50 to 15.00) and the more a person drinks the higher the risk. Every drink (12.8 g alcohol) increased the risk of an RTI by 13%, even 1 to 2 drinks were associated with a sizable increase in risk of an RTI and a dose-response was found. Differences in ORs for drivers (OR = 3.51; 95% CI = 2.25 to 5.45), passengers (OR = 8.12; 95% CI = 4.22 to 15.61), and pedestrians (OR = 6.30; 95% CI = 3.14 to 12.64) and attributable fractions were noted. Acute use of alcohol was attributable to 14% of all RTIs, varying from 7% for females to 19% for being injured as a passenger. CONCLUSIONS The finding that the presence of alcohol increases risk among drivers and nondrivers alike may further help to urge interventions targeting passengers and pedestrians. Routine screening and brief interventions in all health services could also have a beneficial impact in decreasing rates of RTIs. Higher priority should be given to alcohol as a risk factor for RTIs, particularly in Latin America and the Caribbean.
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Affiliation(s)
- Guilherme Borges
- National Institute of Psychiatry Ramon de la Fuente (Mexico City)- Calzada Mexico Xochimilco 101, Col. San Lorenzo Huipulco, Mexico City CP14370
| | | | | | - Ricardo Orozco
- National Institute of Psychiatry Ramon de la Fuente (Mexico City)- Calzada Mexico Xochimilco 101, Col. San Lorenzo Huipulco, Mexico City CP14370
| | - Yu Ye
- Alcohol Research Group (Emeryville, CA)
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, World Health Organization (WHO)
| | - Margie Peden
- Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization (WHO)
| | - Flavio Pechansky
- Center for Drug and Alcohol Research, Hospital de Clinicas de Porto Alegre - UFRGS / Federal University of Rio Grande do Sul, Brazil
| | | | - Sandra D Reid
- Caribbean Institute on Alcoholism and other Drug Problems, Trinidad & Tobago
| | - Jesus Mendez
- Instituto sobre Alcoholismo y Farmacodependencia, San Jose, Costa Rica
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Reid SD, Gentius J. Type and Context of Alcohol-Related Injury among Patients Presenting to Emergency Departments in a Caribbean Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080877. [PMID: 28777317 PMCID: PMC5580581 DOI: 10.3390/ijerph14080877] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 07/30/2017] [Accepted: 08/02/2017] [Indexed: 12/05/2022]
Abstract
There is an association between alcohol consumption and injuries in Latin America and the Caribbean. This cross-sectional study explores the socio-contextual factors of alcohol-related injuries in Trinidad and Tobago. Data on drinking patterns, injury type, drinking context prior to injury, and demographics were collected from patients presenting with injuries to the Emergency Departments (ED) of four hospitals. Findings show that 20.6% of patients had consumed alcohol, mainly beer, in the 6 h before injury. More than half were drinking at home (27%), or someone else’s home (27%). Injury most commonly occurred outdoors (36%) while in transit. Alcohol-related injuries occurred mainly because of falling or tripping (31.7%); these patients recorded the highest mean alcohol consumption prior to injury. Most persons who fell (50%) did so at home. Findings highlight the previously unreported significant risk of non-drivers sustaining injures through falling and tripping because of heavy alcohol use. Current interventions to reduce alcohol-related injury have focused on drink driving but there is a need for interventions targeting pedestrians and those who drink at home. A comprehensive multi-component approach including secondary prevention interventions in the medical setting, community educational interventions, enforcement of current legislative policies concerning the sale of alcohol, and policy initiatives surrounding road safety and alcohol outlet density should be implemented.
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Affiliation(s)
- Sandra D Reid
- Department of Psychiatry, The University of the West Indies, St. Augustine, Trinidad and Tobago.
- Caribbean Institute on Addictive Disorders, Petit Bourg, Trinidad and Tobago.
| | - Jannel Gentius
- Department of Behavioural Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
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Andreuccetti G, Leyton V, Lemos NP, Miziara ID, Ye Y, Takitane J, Munoz DR, Reingold AL, Cherpitel CJ, de Carvalho HB. Alcohol use among fatally injured victims in São Paulo, Brazil: bridging the gap between research and health services in developing countries. Addiction 2017; 112:596-603. [PMID: 28044383 PMCID: PMC5339026 DOI: 10.1111/add.13688] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/23/2016] [Accepted: 11/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Most studies reporting alcohol use among fatally injured victims are subject to bias, particularly those related to sample selection and to absence of injury context data. We developed a research method to estimate the prevalence of alcohol consumption and test correlates of alcohol use prior to fatal injuries. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study based on a probability sample of fatally injured adult victims (n = 365) autopsied in São Paulo, Brazil. Victims were sampled within systematically selected 8-hour sampling blocks, generating a representative sample of fatal injuries occurring during all hours of the day for each day of the week between June 2014 and December 2015. MEASUREMENTS The presence of alcohol and blood alcohol concentration (BAC) were the primary outcomes evaluated according to victims' socio-demographic, injury context data (type, day, time and injury place) and criminal history characteristics. FINDINGS Alcohol was detected in 30.1% [95% confidence interval (CI) = 25.6-35.1)] of the victims, with a mean blood alcohol level (BAC) level of 0.11% w/v (95% CI = 0.09-0.13) among alcohol-positive cases. Black and mixed race victims presented a higher mean BAC than white victims (P = 0.03). Fewer than one in every six suicides tested positive for alcohol, while almost half of traffic-related casualties were alcohol-positive. Having suffered traffic-related injuries, particularly those involving vehicle crashes, and injuries occurring during weekends and at night were associated significantly with alcohol use before injury (P < 0.05). CONCLUSIONS Nearly one-third of fatal injuries in São Paulo between June 2014 and December 2015 were alcohol-related, with traffic accidents showing a greater association with alcohol use than other injuries. The sampling methodology tested here, including the possibility of adding injury context data to improve population-based estimates of alcohol use before fatal injury, appears to be a reliable and lower-cost strategy for avoiding biases common in death investigations.
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Affiliation(s)
- Gabriel Andreuccetti
- University of Sao Paulo Medical School, Sao Paulo, Brazil,Alcohol Research Group, Emeryville, California, United States of America,Correspondence author at: Department of Preventive Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455, 01246-903, Sao Paulo, Brazil.,
| | - Vilma Leyton
- University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Nikolas P. Lemos
- Forensic Laboratory Division, Office of the Chief Medical Examiner, San Francisco, California, United States of America,Department of Laboratory Medicine, School of Medicine, University of California, San Francisco, California, United States of America
| | - Ivan Dieb Miziara
- University of Sao Paulo Medical School, Sao Paulo, Brazil,Technical-Scientific Police Superintendency of the State of Sao Paulo, Sao Paulo, Brazil
| | - Yu Ye
- Alcohol Research Group, Emeryville, California, United States of America
| | | | | | - Arthur L. Reingold
- School of Public Health, University of California, Berkeley, California, United States of America
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Kaljee L, Wang B, Deveaux L, Lunn S, Rolle G, Villar ME, Stanton B. Cross-sectional data on alcohol and marijuana use and sexual behavior among male and female secondary school students in New Providence, The Bahamas. Int J Adolesc Med Health 2016; 28:133-40. [PMID: 25781669 DOI: 10.1515/ijamh-2014-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/17/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND While The Bahamas have significantly reduced poor reproductive health outcomes among adolescents and emerging adults, data indicate that youth are engaged in sexual risk behaviors. Substance use has been linked to increased risk for HIV and sexually transmitted infections in other contexts. There are limited data on Bahamian youth in relation to consumption of alcohol and marijuana use and engagement in sexual behaviors. OBJECTIVE This study aimed to assess potential relationships between alcohol and marijuana use and engagement in sexual behavior among government secondary school students in New Providence, The Bahamas. MATERIALS AND METHODS Total sample size was 2572, and about 56% of respondents were female. Mean age was 14.2 (SD 2.7 years). Cross-sectional data came from a baseline survey conducted as part of a longitudinal randomized controlled evaluation of a school-based HIV prevention and reproductive health program in New Providence. RESULTS Overall, 46.5% (519) males and 44.8% (652) females reported alcohol consumption; 7.3% (82) males and 1.7% (25) females reported use of marijuana in the last 6 months. About 43% (477) male respondents and 16% (231) female respondents reported ever having vaginal sex. Logistic regression analysis indicates that increased likelihood of engaging in sex during the past 6 months is associated with being older, male, and consuming alcohol and marijuana. CONCLUSION These data provide a 'global correlation' between substance use and engagement in sexual behaviors among Bahamian adolescents. Longitudinal research is needed to assess event specific risks and identify mediating and moderating factors. These findings indicate the importance of integrating reproductive health and substance use education.
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Time for a regional alcohol policy – A literature review of the burden of normative alcohol use in the Caribbean. J Public Health Policy 2015; 36:469-83. [DOI: 10.1057/jphp.2015.27] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Lu S, Du S, Ren Z, Zhao J, Chambers C, Wang J, Ma G. Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7208-19. [PMID: 26132475 PMCID: PMC4515651 DOI: 10.3390/ijerph120707208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/01/2015] [Accepted: 06/10/2015] [Indexed: 11/16/2022]
Abstract
This study assessed the association between accessibility of catering service venues and adolescents' alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p < 0.001 for trend test). This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.
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Affiliation(s)
- Shijun Lu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Songming Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, A11 Datun Road, Chaoyang District, Beijing 100101, China.
| | - Jing Zhao
- Beijing Chaoyang District Center for Disease and Prevention, 25 Huaweili, Chaoyang District, Beijing 100021, China.
| | - Christina Chambers
- Department of Pediatrics, Family Medicine and Public Health, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla CA 92093, USA.
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, A11 Datun Road, Chaoyang District, Beijing 100101, China.
| | - Guansheng Ma
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Xicheng District, Beijing 100050, China.
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China.
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Santos JLGD, Pestana AL, Higashi GDC, Oliveira RJTD, Cassetari SDSR, Erdmann AL. Organizational context and care management by nurses at emergency care units. Rev Gaucha Enferm 2014; 35:58-64. [DOI: 10.1590/1983-1447.2014.04.45221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The purpose of this study was to understand the meanings attributed to the organizational context and the role of nurses in care management at emergency care units. This study was based on qualitative research and the Grounded Theory methodological framework. Data were collected from September 2011 to June 2012 by means of semi-structured interviews with 20 participants from two emergency care units (UPA) in southern Brazil, divided into three sample groups. The context is marked by constraints that hinder communication and interaction between professionals and the search of assistance by patients with demands that are not resolved at other levels of care. This scenario highlights the performance of nurses in the managerial dimension of their work, who assume the responsibility for managing care and coordinating professional actions in favour of improved care practices.
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Andreuccetti G, Carvalho HB, Ye Y, Bond J, Monteiro M, Borges G, Cherpitel CJ. Does beverage type and drinking context matter in an alcohol-related injury? Evidence from emergency department patients in Latin America. Drug Alcohol Depend 2014; 137:90-7. [PMID: 24556276 PMCID: PMC3961529 DOI: 10.1016/j.drugalcdep.2014.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 01/13/2014] [Accepted: 01/13/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Previous studies have already substantiated alcohol's causal role in injuries. Yet the role that alcoholic beverage preferences and the drinking context play in the risk for injury is still under-investigated. In this study, a cross-national comparison of the association between alcohol and injury focusing on beverage type preference and the drinking context is reported. METHODS Emergency department (ED) injured patients were interviewed in eight countries from the Latin American and Caribbean (LAC) region. Data on the type of alcoholic beverage, total alcohol volume, and the place where the injury occurred were obtained from patients who reported any alcohol consumption within 6h prior to being injured. Patients who did not drink prior to injury were also asked about their typical drinking pattern and the injury place. Differences within- and between-groups were evaluated regarding patients' typical drinking and drinking before injury. RESULTS Beer was the most prevalent beverage type usually consumed among injured patients across countries, however, patients who drank before injury had a higher typical consumption of spirits than those not drinking prior to injury. The total alcohol volume typically consumed and drinking in public settings were also found to be positively associated with alcohol-related injury. CONCLUSIONS A similar beverage-specific association with alcohol-related injury was found across LAC countries, mainly attributed to beer consumption, and spirits drinkers seem to have a greater chance of becoming involved in injury events. Future prevention strategies should inform the public about harms from drinking associated with the context in which drinking takes place.
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Affiliation(s)
- Gabriel Andreuccetti
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil.
| | - Heraclito B Carvalho
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil
| | - Yu Ye
- Alcohol Research Group, Emeryville, CA 94608, United States
| | - Jason Bond
- Alcohol Research Group, Emeryville, CA 94608, United States
| | - Maristela Monteiro
- Alcohol and Substance Abuse, Pan American Health Organization, Washington, DC 20037, United States
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales and Universidad Autónoma Metropolitana, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, México, DF 14370, Mexico
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Ye Y, Bond JC, Cherpitel CJ, Borges G, Monteiro M, Vallance K. Evaluating recall bias in a case-crossover design estimating risk of injury related to alcohol: data from six countries. Drug Alcohol Rev 2013; 32:512-8. [PMID: 23574580 DOI: 10.1111/dar.12042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 03/12/2013] [Indexed: 01/17/2023]
Abstract
INTRODUCTION AND AIMS Prior work suggests that recall bias may be a threat to the validity of relative risk estimation of injury due to alcohol consumption, when the case-crossover method is used based on drinking during the same six hours period the week prior to injury as the control period. This work explores the issue of alcohol recall bias used in the case-crossover design. DESIGN AND METHODS Data were collected on injury patients from emergency room studies across six countries (Dominican Republic, Guatemala, Guyana, Nicaragua, Panama and Canada), conducted in 2009-2011, each with n ≈ 500 except Canada (n = 249). Recall bias was evaluated comparing drinking during two control periods: the same six hours period the day before versus the week before injury. RESULTS A greater likelihood of drinking yesterday compared with last week was seen using data from the Dominican Republic, while lower likelihood of drinking yesterday was found in Guatemala and Nicaragua. When the data from all six countries were combined, no differential drinking between the two control periods was observed. DISCUSSION AND CONCLUSIONS These findings are in contrast to earlier studies showing a downward recall bias of drinking, and suggest that it may be premature to dismiss the last week case-crossover method as a valid approach to estimating risk of injury related to drinking. However, the heterogeneity across countries suggests that there may be some unexplained measurement error beyond random sampling error.
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Affiliation(s)
- Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, USA
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