Systematic Review of Guidelines on Managing Patients with Harmful Use of Alcohol in Primary Healthcare Settings.

AIM: To appraise existing alcohol guidelines for identifying and managing harmful alcohol use in primary healthcare settings. METHODS: Seven databases and 18 health organization or medical society websites were systematically searched from inception to 31 October 2016. Guidelines in English language, developed by a national or international medical specialty society, government or health organization, and containing recommendations for identifying and managing harmful use of alcohol in primary healthcare settings, were included. The Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument was used to appraise the guidelines. RESULTS: Of the 970 literature identified, 17 were included for review, with 13 guidelines developed for use in Western countries and 4 for international use. The AGREE II scores ranged from 2.0 to 5.3, out of 7. Variations in terminology of harmful alcohol use were seen, with 'harmful drinking' and 'problem drinking' being mostly used. All guidelines were in favor of screening and brief interventions due to their effectiveness and cost-effectiveness. Potential benefits and costs of applying screening and brief interventions were found, but there was a lack of evidence for long-term effects or specific populations. CONCLUSIONS: All 17 guidelines recommended screening and brief interventions due to its associated health and financial benefits. Policy makers are highly encouraged to integrate these practices into primary healthcare settings taking the drinking status, culture and resources into account. SHORT SUMMARY: Screening and brief interventions were recommended by all 17 guidelines on managing patients with harmful use of alcohol in primary healthcare settings. Policy makers and healthcare practitioners are highly encouraged to implement these recommendations.

Diet quality and eating behavioural patterns in preschool children in Hong Kong.

BACKGROUND AND OBJECTIVES: To assess the diet quality and eating behaviour of preschool children, investigate parents' feeding practices, and obtain information on the kindergarten nutrition environment of Hong Kong children aged 30-60 months. METHODS AND STUDY DESIGN: Dietary information was obtained using multiple 24-hour recalls. Questionnaires were developed to obtain information on children' seating behaviour, parents' feeding practices and preschool nutrition environment. RESULTS: A total of 302 children and 23 local kindergartens from three regions of Hong Kong were surveyed. The results showed consumption of vegetable and fruit were adequate; however, consumption of grain and meat were excessive, while milk and dairy intakes were inadequate. On average, the children consumed 1,280 kcal per day, or 92% of the Chinese Nutrition Society's energy recommendation. For macronutrients, the mean percentages of energy from carbohydrate, protein and fat were 55%, 17% and 28%, respectively, which are within the United States Acceptable Macronutrient Distribution Ranges. The mean intakes of carbohydrate and protein were 175 g and 53.4 g, respectively. For micronutrients, the mean intakes of vitamin D, calcium, iron and zinc were significantly lower than the reference nutrient intake or adequate intake (p<0.05), but those of sodium and niacin were significantly higher than the tolerable upper intake levels (p<0.05). CONCLUSION: This study showed that diet quality among children in Hong Kong needs to be improved, as some nutrients are consumed in excess whereas others are consumed in inadequate amounts. Other results on children's eating behaviour, parent's feeding practices and school nutrition environment are also reported.