Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool.

OBJECTIVE: Alexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use. METHOD: As part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator. RESULTS: The current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher). CONCLUSION: These results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects. PLAIN LANGUAGE TITLE: Does difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?

In a recent study we recruited participants who were concerned with both their alcohol use and low mood. We provided two different online interventions. Half of the participants received an intervention designed for both concerns and half received an intervention that addressed only depression. We hypothesized that receiving the combined intervention for both concerns would result in greater benefits, however, our results indicated no apparent difference. This analysis uses the same data, but investigated the influences of alexithymia on the effectiveness of the interventions. Alexithymia is defined as having difficulty identifying/describing emotions and/or thinking more about external events than internal feelings. It commonly co-occurs with depression and with hazardous alcohol use and can increase the challenge of supporting individuals with these co-occurring concerns. The results of this analysis showed support for our original hypothesis that participants who received the intervention that addressed both their mood and alcohol concerns had lower depression scores 6-months later, but only among individuals who also had alexithymia scores above 60.5. Taking alexithymia severity into consideration during treatment planning may help optimize the effectiveness of interventions. These results show merit for future research to consider alexithymia as a variable that could potentially impact outcomes among individuals with co-occurring depression and hazardous alcohol use.

Prévalence et facteurs associés à la co-consommation d'alcool et de tabac dans la commune de Natitingou, Bénin.

INTRODUCTION: La consommation d'alcool et la consommation de tabac entraînent chacune des risques importants pour la santé. L'objectif de cette étude était d'étudier la prévalence de la co-consommation d'alcool et de tabac ainsi que les facteurs associés dans la commune de Natitingou en 2016. MÉTHODES: Il s'agissait d'une étude transversale à caractère analytique. L'enquête s'est déroulée en octobre 2016 et a porté sur un échantillon de 270 sujets. Elle a été menée selon une technique de sondage aléatoire à plusieurs degrés. Les données collectées ont été analysées avec le logiciel R. RÉSULTATS: Sur les 270 sujets interrogés, 72,2 % étaient des hommes. L'âge moyen était de 30,7 ± 9,2 ans. La prévalence de la co-consommation était de 33,7 % [IC95% : 28,1 %-39,7 %]). Les facteurs associés à la co-consommation d'alcool et de tabac étaient : le sexe masculin (ORa = 2,1 ; p = 0,023), la dipsomanie (ORa = 1,4 ; p = 0,032), le fait d'avoir des amis buveurs ou fumeurs (ORa = 2,8 ; p = 0,004), le fait de suivre les publicités des médias sur les boissons alcoolisées (ORa = 1,9 ; p = 0,029) et le faible coût /accessibilité des deux substances (ORa = 2,1 ; p = 0,011). CONCLUSION: Cette étude a montré qu'il est important de dépasser la prévention centrée sur la personne qui consiste à sensibiliser et à prendre en charge pour adopter des mesures de prévention structurelle (notamment législatives).

Association of Alcohol Consumption with Cognition and Functionality in Older Adults Aged 75+ Years: The Pietà Study.

The relationship between alcohol consumption and cognition is still controversial. This is a cross-sectional population-based study conducted in Caeté (MG), Brazil, where 602 individuals aged 75+ years, 63.6% female, and with a mean education of 2.68 years, were submitted to thorough clinical assessments and categorized according to the number of alcoholic beverages consumed weekly. The prevalence rates of previous and current alcohol consumption were 34.6% and 12.3%, respectively. No association emerged between cognitive diagnoses and current/previous alcohol consumption categories. Considering current alcohol intake as a dichotomous variable, the absence of alcohol consumption was associated with dementia (OR = 2.34; 95%CI: 1.39-3.90) and worse functionality (p = 0.001). Previous consumption of cachaça (sugar cane liquor) increased the risk of dementia by 2.52 (95%CI: 1.25-5.04). The association between the consumption of cachaça and dementia diagnosis has not been described before.

Transtorno do espectro do autismo e o uso materno e paterno de medicamentos, tabaco, álcool e drogas ilícitas / Maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder

Resumo O presente estudo objetivou investigar a associação entre o TEA e o uso materno e paterno de medicamentos, tabaco, álcool e drogas ilícitas. Trata-se de um estudo caso-controle realizado com crianças e adolescentes diagnosticados com TEA e indivíduos neurotípicos. Os dados foram colhidos por meio de entrevista com as mães ou responsáveis. Foram analisadas as variáveis sexo e idade das crianças/adolescentes; idade dos pais; uso de medicamentos antes e durante a gestação; classes de medicamentos usados na gestação; tabagismo materno e paterno; etilismo materno e paterno; uso de drogas ilícitas pelos pais. Para a análise das informações, utilizou-se o modelo de regressão logística, além da razão de chances (OR) bruta e ajustada. Os resultados mostraram que, após os ajustes, foi encontrada associação entre o uso materno na gestação de antitérmicos/analgésicos (OR = 2,26; IC95% 1,29-3,95; p < 0,040) com o TEA. Já o uso de tabaco, álcool e drogas ilícitas materno e paterno, antes e durante a gestação, não apontou relação com o TEA. Os dados encontrados sugerem que existe influência de fatores ambientais no desenvolvimento do TEA.

Abstract The aim of this study was to investigate the association between maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder (ASD). We conducted a case-control study with children and adolescents diagnosed with ASD and neurotypical individuals. The data were collected using a semi-structured questionnaire administered during interviews with the children's mothers or guardians. The following variables were analyzed: child sex and age; maternal and parental age; use of medicines before and during pregnancy; classes of medicines used during pregnancy; maternal and paternal smoking; maternal and paternal drinking; maternal and paternal illicit drug use. The data were analyzed using logistic regression and crude and adjusted odds ratios (OR). After adjustment, the results showed an association between maternal use of antipyretics/pain killers during pregnancy (OR = 2.26; 95%CI 1.29-3.95; p < 0.040) and ASD. No association was found between maternal and paternal smoking, drinking and illicit drug use before and during pregnancy and ASD. The findings suggest that the development of ASD is influenced by environmental factors.

O ensino de ciências na educação básica: desvendando o sistema nervoso através de cartilhas e mapas mentais / Science teaching in basic education: unveiling the nervous system through primers and mental maps / Enseñanza de ciencias en educación básica: desvelando el sistema nervioso a través de primers y mapas mentales

Objetivo: o estudo visou um relato de experiências entre os autores sobre a tutoria do módulo três durante o curso EAD no ano de 2022. Método: Este curso com atividades síncronas e assíncronas, para professores da educação básica e estudantes de graduação, foi realizado em outubro e novembro, do ano de 2022 e culminou na construção de uma cartilha com mapas mentais, temas e estratégias trabalhados durante o curso comomateriais pedagógicos para o ensino fundamental II. Resultados:A cartilha intitulada: as consequências do consumo de álcool ao sistema nervoso, teve como parceria professores de duas escolas básicas. Esta apresenta informações anatomofisiológicas a respeito do funcionamento do sistema nervoso e o álcool. A temática explica como o funcionamento do sistema nervoso pode ser afetado pelo uso de bebidas alcoólicas; compreensão das alterações causadas ao funcionamento do sistema nervoso pela ingestão de álcool e instrumentalização dos professores com mais um recurso pedagógico. Conclusão:Dessa forma, foi possível a promoção da sensibilização dos estudantes quanto aos aspectos negativos do uso de bebidas alcoólicas. Assim como, prevenção nos jovens quanto ao seuuso indiscriminado, colaborando com a popularização da ciência.

Objective:the study aimed to report experiences between the authors regarding the tutoring of module three during the EAD course in the year 2022. Method:This course with synchronous and asynchronous activities, for basic education teachers and undergraduate students, was carried out in October and November, 2022 and culminated in the construction of a booklet with mental maps, themes and strategies workedon during the course as teaching materials for elementary school II. Results:The booklet entitled: the consequences of alcohol consumption on the nervous system, was partnered with teachers from two basic schools. This presents anatomophysiological information regarding the functioning of the nervous system and alcohol. The theme explains how the functioning of the nervous system can be affected by the use of alcoholic beverages; understanding the changes caused to the functioning of the nervous system byalcohol intake and providing teachers with yet another pedagogical resource. Conclusion:In this way, it was possible to promote student awareness regarding the negative aspects of the use of alcoholic beverages. As well as prevention among young people regarding its indiscriminate use, collaborating with the popularization of science.

Objetivo: el estudio tuvo como objetivo relatar experiencias entre los autores respecto a la tutoría del módulo tres durante el curso EAD en el año 2022. Método: Este curso con actividades sincrónicas y asincrónicas, para docentes de educación básica y estudiantes de pregrado, se realizó en los meses de octubre y noviembre de 2022 y culminó con la construcción de una cartilla con mapas mentales, temáticas y estrategias trabajadas durante el curso como material didáctico para la escuela primaria II. Resultados:El cuadernillo titulado: las consecuencias del consumo de alcohol en el sistema nervioso, fue elaborado en colaboración con docentes de dos escuelas básicas. Presenta información anatomofisiológica sobre el funcionamiento del sistema nervioso y el alcohol. El tema explica cómo el funcionamiento del sistema nervioso puede verse afectado por el uso de bebidas alcohólicas; comprender los cambios que provoca en el funcionamiento del sistema nervioso la ingesta de alcohol y dotar a los docentes de un recurso pedagógico más. Conclusión: De esta manera, fue posible sensibilizar a los estudiantes sobre los aspectos negativos del consumo de alcohol. Así como la prevención entre los jóvenes sobre su uso indiscriminado, contribuyendo a la popularización de la ciencia.

Treinamento aos agentes comunitários de saúde frente à assistência aos usuários de álcool / Entrenamiento de agentes de salud con respecto a la asistencia a usuarios de alcohol / Community health agent training regarding assistance to alcohol users

Objetivo: avaliar as percepções, conhecimentos e atitudes antes e após a realização de um treinamento aos Agentes Comunitários de Saúde (ACS). Método: estudo quase experimental e quantitativo, realizado no interior do estado de São Paulo. Para a coleta de dados foi utilizado ficha de identificação sociodemográfica, Seaman & Manello e Short Alcohol and Alcohol Problems Perception Questionnaire, aplicados em 31 ACS de serviços de Atenção Primária à Saúde. O estudo foi submetido e aprovado pelo Comitê de Ética. Resultados: as percepções foram positivas, mas ainda existem dificuldades para trabalhar na prática, os conhecimentos apresentaram mudanças em relação aos sinais e sintomas relacionados ao uso de álcool e as atitudes. Não foram observadas mudanças significativas após o treinamento. Conclusão: o treinamento é uma estratégia que possibilita mudanças nas práticas de saúde para a assistência integral e que deve ser incorporada nas rotinas das unidades de Atenção Primária à Saúde (APS).

Objetivo: evaluar percepciones, conocimientos, y actitudes antes y después de un entrenamiento de Agentes Comunitarios de Salud (ACS). Método: estudio cuasiexperimental y cuantitativo, realizado en el interior del estado de São Paulo. Para colectar a los datos se utilizó un formulario de identificación sociodemográfica, el Seaman & Manello y el Short Alcohol and Alcohol Problems Perception Questionnaire, aplicados a 31 ACS en servicios de atención primaria a la salud. El estudio fue aprobado por el comité de ética. Resultados: las percepciones fueran positivas, pero hay dificultades en la práctica del trabajo. Los conocimientos cambiaron con respecto a las señales y síntomas relacionados al uso de alcohol y a las actitudes. No se observó cambios significativos después del entrenamiento. Conclusión: el entrenamiento posibilita cambios en las prácticas de salud para la asistencia integral, y debe ser incorporado en las rutinas de las unidades de atención primaria a la salud (APS).

Objective: To evaluate the perceptions, knowledge, and attitudes, before and after a training session provided to community health workers (CHW). Method: Quasi-experimental, quantitative study, carried out in the countryside of the state of São Paulo. For data collection, we used Seaman and Manello's sociodemographic identification form and the Short Alcohol and Alcohol Problems Perception Questionnaire, applied to 31 CHWs of primary health care services. The study was submitted and approved by the research ethics committee. Results: Perceptions were positive, but there are still practical obstacles regarding the actual work. The knowledge related to signs and symptoms of alcohol use and related attitudes was changed, as were the attitudes. There were no significant changes after training. Conclusion: training is a strategy that enables changes in health practices for integral care. It should be incorporated in the routine of Primary Health Care (PHC) units.

[Women and alcohol: From risky use to addiction, the issues at stake]. / Les femmes et l'alcool : de l'usage à risque à l'addiction, les enjeux.

Present in all social circles with proven effects on health, alcohol is the second leading cause of avoidable death after tobacco. Like men, women can be affected by alcohol misuse, or even addiction. As the female organism is more vulnerable to the deleterious effects of alcohol, women are particularly exposed in terms of risks and complications for their physical and mental health.

[Women's vulnerability to alcohol and its impact on health]. / Vulnérabilité des femmes face à l'alcool et impacts sur la santé.

At the same level of consumption as men, specific vulnerabilities often expose women to the more rapid onset of more serious illnesses (cardiovascular and liver diseases, cancers, brain and cognitive damage, sleep disorders, risk of accidents, etc.). This worrying fact is still little known by the general population. Special prevention measures are needed, such as dedicated campaigns for women, specific guidelines for lower-risk drinking, systematic early detection of risky drinking among women, and brief intervention in the event of problem drinking.

[Women and alcohol, the addictologist's point of view and treatment]. / Les femmes et l'alcool, point de vue de l'addictologue et prise en charge.

Women have difficulty seeking help for alcohol-related problems. Shame and guilt are often present, which is why the caregiver must succeed in establishing a climate of trust so that things can be said, in order to best assess the impact of consumption and find alternatives. Treatment is often multidisciplinary. The nurse's role is essential, not only to identify drug use, but also to provide a link between the various players involved.

[The psychopathological dimension of female alcoholism]. / La dimension psychopathologique de l'alcoolisme féminin.

In France, as in other countries, more and more women are affected by alcoholism. Progress needs to be made in the early detection and management of their physical and psychological dependence on alcohol, as well as their psychopathological comorbidities.

[Alcohol and pregnancy: talking about it without taboos to prevent pregnancy]. / Alcool et grossesse, en parler sans tabou pour faire de la prévention.

From the earliest stages of adolescence, the question of alcohol consumption should be addressed by health professionals (GPs, midwives, gynecologists, pediatricians, nurses) working in the field of perinatal care or public health. All alcohol consumption is prohibited during pregnancy. In fact, a 2022 study showed that even low exposure to alcohol in utero has measurable effects on the structure of children's brains.

El consumo colectivo de alcohol en jóvenes: un estudio cualitativo con perspectiva de género / O consumo coletivo de álcool em jovens: um estudo qualitativo com perspectiva de gênero / Binge drinking in young people: a qualitative study with a gender perspective

Objective. To explore the discourses and opinions about the collective consumption of alcohol with a gender perspective in university students. Methodology. Qualitative descriptive study. Information was collected through discussion groups in Seville in February and March 2019. 32 first-year nursing students participated. For data analysis, the Taylor & Bogdan steps were followed and a matrix was used for the categorization process. Four groups were made, aged between 18-24 years.Results. The following categories were obtained: type and form of consumption, social roles and behaviors.Conclusions. Gender differences are reflected in the students' discourse, highlighting the dissimilarities in behavior between genders and the greater guilt suffered by women. The female gender is the most noted for exceeding the limits and the most vulnerable in nightlife. This suggests the need to generate interventions aimed at redefining the stereotypes of the patriarchal model associated with gender and alcohol consumption, in order to minimize risk behaviors in youth leisure.(AU)

Objetivo. Explorar los discursos y opiniones acerca del consumo colectivo de alcohol con perspectiva de género en jóvenes universitarios. Metodología. Estudio cualitativo descriptivo. La recogida de información se realizó mediante grupos de discusión en Sevilla en febrero y marzo de 2019. Participaron 32 estudiantes de enfermería de primer curso. Para el análisis de los datos se siguieron los pasos de Taylor & Bogdan y se utilizó una matriz para el proceso de categorización. Se hicieron cuatro grupos, de edad entre 18-24 años. Resultados. Se obtuvieron las siguientes categorías: tipología y forma de consumo, roles sociales y conductas. Conclusiones. Las diferencias de género quedan plasmadas en el discurso del alumnado, destacando las disimilitudes de conducta entre géneros y la mayor culpabilidad que sufren las mujeres. El género femenino es el más señalado al exceder los límites y el más vulnerable en el ocio nocturno. Esto sugiere la necesidad de generar intervenciones orientadas a resignificar los estereotipos del modelo patriarcal asociados al género y al consumo de alcohol, para minimizar conductas de riesgo en el ocio juvenil.(AU)

Objetivo. Explorar os discursos e opiniões sobre o consumo coletivo de álcool com perspectiva de gênero em estudantes universitários. Metodologia. Estudo descritivo qualitativo. As informações foram coletadas por meio de grupos de discussão em Sevilha em fevereiro e março de 2019. Participaram 32 estudantes de enfermagem do primeiro ano. Para análise dos dados, seguiramse os passos de Taylor & Bogdan e utilizouse uma matriz para o processo de categorização. Foram constituídos quatro grupos, com idades compreendidas entre os 18 e os 24 anos. Resultados. Obtiveramse as seguintes categorias: tipo e forma de consumo, papéis sociais e comportamentos.Conclusões. As diferenças de gênero se refletem no discurso dos alunos, destacandose as diferenças de comportamento entre os gêneros e a maior culpa sofrida pelas mulheres. O gênero feminino é o mais destacado por ultrapassar os limites e o mais vulnerável na vida noturna. Isso sugere a necessidade de gerar intervenções que visem a redefinição dos estereótipos do modelo patriarcal associados ao gênero e ao consumo de álcool, a fim de minimizar comportamentos de risco no lazer juvenil.(AU)

Traducción, adaptación cultural y validación de la Escala de Apoyo a Políticas Asociadas al Alcohol en universitarios mexicanos / Tradução, adaptação cultural e validação da Escala de Apoio a Políticas Associadas ao Álcool em universitários mexicanos / Translation, cultural adaptation, and validation of the Support for Public Policies to Reduce Alcohol-Related Problems Scale among Mexican university students

Resumen Marco contextual: La protección de la salud por medio de la prevención y la reducción del consumo de alcohol es una prioridad para la salud pública. Se han identificado algunas escalas para evaluar políticas públicas de alcohol, pero en idioma inglés. Objetivo: Evaluar las propiedades psicométricas de la traducción y adaptación cultural de una escala para evaluar el apoyo a políticas de alcohol en jóvenes universitarios mexicanos. Metodología: Estudio metodológico, con la participación de 367 estudiantes universitarios del sur de México. La validez del constructo se estimó mediante un análisis factorial exploratorio y se verificó la consistencia interna del cuestionario para comprobar su fiabilidad. Resultados: La consistencia interna fue de 0.96. La validez de constructo se realizó mediante el análisis factorial exploratorio y se identificó una estructura de tres factores: la reducción del daño, el mercadeo e información, y el precio y la disponibilidad. Conclusión: La escala mostró fiabilidad y validez adecuada, y puede ser aplicada en español como indicador empírico en estudios referentes a las políticas públicas de alcohol en jóvenes universitarios.

Abstract Background: Health protection through prevention and reduction of alcohol consumption is a public health priority. Some scales have been identified to assess public alcohol policies but in English language. Objective: To evaluate the psychometric properties of the translation and cultural adaptation of a scale to assess support for alcohol policies in young Mexican university students. Methodology: Methodological study, with the participation of 367 university students from southern Mexico. Construct validity was estimated by means of an exploratory factor analysis and the internal consistency of the questionnaire was checked to verify its reliability. Results: Internal consistency was 0.96. Construct validity was performed through exploratory factor analysis, identifying a three factors structure: harm reduction, marketing and information, and price and availability. Conclusion: The scale showed adequate reliability and validity, and can be applied in Spanish as an empirical indicator in studies concerning alcohol public policies in young university students.

Resumo Enquadramento: A proteção da saúde através da prevenção e redução do consumo de álcool é uma prioridade de saúde pública. Foram identificadas algumas escalas para avaliar as políticas públicas em matéria de álcool, mas em língua inglesa. Objetivo: Avaliar as propriedades psicométricas da tradução e adaptação cultural de uma escala para avaliar o apoio às políticas sobre o álcool em jovens estudantes universitários mexicanos. Metodologia: Estudo metodológico, com a participação de 367 estudantes universitários do sul do México. A validade do constructo foi estimada através de uma análise exploratória dos fatores e a consistência interna do questionário foi verificada para verificar a sua fiabilidade. Resultados: A consistência interna foi de 0,96. A validade de constructo foi realizada por médio de análise fatorial exploratória, identificando uma estrutura de três fatores: redução de danos, marketing e informação, e preço e disponibilidade. Conclusão: A escala mostrou fiabilidade e validade adequadas, e pode ser aplicada em espanhol como um indicador empírico em estudos relativos a políticas públicas sobre o álcool em jovens estudantes universitários.

Consumo de substâncias psicoativas entre estudantes de medicina antes e depois do ingresso no curso / Use of psychoactive substances among medicine students before and after admission to course

Introdução: Substâncias psicoativas são capazes de alterar a consciência, o humor ou o pensamento de um indivíduo, resultando em mudanças fisiológicas ou de comportamento. Objetivo: Este estudo avaliou se houve diferença no consumo de 13 substâncias psicoativas por estudantes de medicina, de uma faculdade privada do interior paulista, antes e depois do ingresso no curso. Método: Um questionário estruturado e impresso foi apresentado a ingressantes no curso de medicina, em abril de 2019, e, novamente, em dezembro, ao final do primeiro ano da graduação. Resultados: Na análise dos dados, foi realizado o Teste de Wilcoxon, com o emprego do programa estatístico JASP. No total, 90 estudantes participaram do estudo. Dentre as 13 substâncias consideradas, apenas para o álcool foram encontradas evidências estatísticas que indicaram ter ocorrido um aumento significativo no consumo após o ingresso no curso (W = 1308,00, p < 0,001). Conclusão: A continuidade dos estudos sobre o uso de substâncias lícitas e ilícitas entre os estudantes da instituição de ensino considerada será fundamental para garantir um monitoramento contínuo. Desse modo, a instituição poderá identificar usos abusivos e implementar políticas de prevenção, garantindo o bem-estar de seus alunos

Introduction: Psychoactive substances are capable of altering an individual's consciousness, mood or thinking, resulting in physiological or behavioral changes. Objective: This study assessed whether there was a difference in the consumption of 13 psychoactive substances by medical students at a private college in the interior of São Paulo, before and after enrolling in the course. Method: A structured, printed questionnaire was presented to new medicine students in April 2019, and again in December, at the end of the first year of graduation. Results: In data analysis, the Wilcoxon Test was performed, using the JASP statistical program. In total, 90 students participated in the study. Among the 13 substances considered, only for alcohol was statistical evidence found that indicated that there had been a significant increase in consumption after enrolling in the course (W = 1308.00, p < 0.001). Conclusion: Continuing studies on the use of legal and illicit substances among students at the educational institution considered will be essential to ensure continuous monitoring. In this way, the institution will be able to identify abusive uses and implement prevention policies, ensuring the well-being of its students

Introducción: Las sustancias psicoactivas son capaces de alterar la conciencia, el estado de ánimo o el pensamiento de un individuo, resultando en cambios fisiológicos o de comportamiento. Objetivo: Este estudio evaluó si existía diferencia en el consumo de 13 sustancias psicoactivas por estudiantes de medicina de una facultad privada del interior de São Paulo, antes y después de matricularse en el curso. Método: Se presentó un cuestionario impreso estructurado a los nuevos estudiantes de medicina en abril de 2019, y nuevamente en diciembre, al final del primer año de graduación. Resultados: En el análisis de los datos se realizó la Prueba de Wilcoxon, utilizando el programa estadístico JASP. En total, 90 estudiantes participaron en el estudio. Entre las 13 sustancias consideradas, sólo para el alcohol se encontró evidencia estadística que indicaba que había habido un aumento significativo en el consumo después de la inscripción al curso (W = 1308,00, p < 0,001). Conclusión: Continuar con los estudios sobre el uso de sustancias legales e ilícitas entre los estudiantes de la institución educativa considerada será fundamental para garantizar un seguimiento continuo. De esta manera, la institución podrá identificar usos abusivos e implementar políticas de prevención, asegurando el bienestar de sus estudiantes

[Alcohol consumption by health students: Ifsi protected?] / Consommation d'alcool des étudiants en santé : Ifsi protégé ?

A study of health students at the Université de Bretagne Occidentale showed that nursing students smoked more than those in other fields. The present study of health students in the same city shows that, conversely, students in nursing training institutes (Ifsi) consumed less alcohol.

[Male infertility, environment and lifestyle]. / Infertilité masculine, environnement et mode de vie.

BACKGROUND: Since the 1970s, there has been a quantitative and qualitative decline in sperm parameters. The main hypothesis to explain such a rapid evolution is the involvement of environmental and behavioral phenomena. METHODS: A bibliographic search limited to English and French literature in men published before 7/2023 was carried out on the links between fertility and pollution, xenobiotics, tobacco, narcotics, cannabis, alcohol, weight, sport, sedentary lifestyle, sleep and anabolics. RESULTS: Profound changes in lifestyle have occurred over the past 50 years: reduced sleep time, sedentary lifestyle, dietary changes, tobacco consumption, use of narcotics and anabolics. These changes have a proven impact on spermogram parameters, and should be corrected in an effort to optimize reproductive health. Other environmental parameters: pollution, exposure to heavy metals, exposure to xenobiotics, phthalates and pesticides… will be more difficult to exclude from patients' daily lives, but deserve to be taken more into account. CONCLUSION: This review should help the urologist to assess and counsel patients in order to improve their reproductive health. These factors should be routinely investigated in infertile men.

[Interest and mechanisms of action of ketamine in alcohol addiction- A review of clinical and preclinical studies]. / Intérêt et mécanismes d'action de la kétamine dans le traitement de l'addiction à l'alcool ­ Revue des études cliniques et précliniques.

Alcohol Use Disorder (AUD) is a psychiatric condition characterized by chronic and excessive drinking despite negative consequences on overall health and social or occupational functioning. There are currently limited treatment options available for AUD, and the effects size and the response rates to these treatments are often low to moderate. The World Health Organization has identified the development of medications to treat AUD as one of its 24 priorities. This past decade was marked by a renewed interest in psychedelic use in psychiatry. At the centre of this renaissance, ketamine, an atypical psychedelic already used in the treatment of major depression, is an NMDA receptor antagonist that exists as a racemic compound made of two enantiomers, S-ketamine, and R-ketamine. Each form can be metabolized into different metabolites, some of which having antidepressant properties. In this article, we review both clinical and preclinical studies on ketamine and its metabolites in the treatment of AUD. Preclinical as well as clinical studies have revealed that ketamine is effective in reducing withdrawal symptoms and alcohol craving. Convergent data showed that antidepressant properties of ketamine largely contribute to the decreased likelihood of alcohol relapse, especially in patients undergoing ketamine-assisted psychotherapies. Its effectiveness is believed to be linked with its ability to regulate the glutamatergic pathway, enhance neuroplasticity, rewire brain resting state network functional connectivity and decrease depressive-like states. However, it remains to further investigate (i) why strong differences exist between male and female responses in preclinical studies and (ii) the respective roles of each of the metabolites in the ketamine effects in both genders. Interestingly, current studies are also focusing on ketamine addiction and the comorbidity between alcohol addiction and depression occurring more frequently in females.

Title: Intérêt et mécanismes d'action de la kétamine dans le traitement de l'addiction à l'alcool ­ Revue des études cliniques et précliniques. Abstract: Le Trouble de l'Usage d'Alcool (TUA) est une maladie psychiatrique caractérisée par une consommation chronique et excessive d'alcool malgré des conséquences négatives sur la santé et le fonctionnement social ou professionnel. Les options de traitements du TUA sont actuellement limitées et les tailles d'effet et taux de réponse à ces traitements sont souvent faibles à modérés. L'Organisation Mondiale de la Santé a identifié le développement des médicaments pour traiter le TUA comme l'une de ses 24 priorités. Cette dernière décennie a été marquée par un intérêt renouvelé pour l'utilisation de psychédéliques en psychiatrie. La kétamine, un psychédélique atypique déjà utilisé dans le traitement de la dépression majeure, est au centre de cette renaissance. Cet antagoniste des récepteurs NMDA existe sous deux formes énantiomères, la S-kétamine et la R-kétamine, qui peuvent être métabolisées en différents dérivés, dont certains ont montré des propriétés antidépressives. Cet article de revue vise à faire le bilan des études cliniques et précliniques sur l'utilisation de la kétamine et de ses métabolites dans le traitement du TUA. L'ensemble de ces études montre que la kétamine est efficace pour réduire les symptômes de sevrage et les envies irrépressibles d'alcool. Les propriétés antidépressives avérées de la kétamine contribuent à la diminution du risque de rechute dans le mésusage d'alcool, notamment chez les patients suivant des psychothérapies. Son efficacité est supposée être liée à sa capacité à réguler la voie glutamatergique, à améliorer la neuroplasticité, à réorganiser la connectivité fonctionnelle des réseaux d'état de repos (resting state networks) du cerveau et à réduire les états dépressifs. Bien que ces premiers résultats soient prometteurs, la mise en évidence de différences importantes entre les sexes, et la méconnaissance du rôle de chacun des métabolites dans les effets observés justifient la poursuite des recherches précliniques pour mieux comprendre comment agissent véritablement la kétamine et ses métabolites sur le TUA. En clinique, les études récentes s'intéressent désormais à la dépendance à la kétamine et à la dépression comorbide, ainsi qu'à l'influence du sexe, une comorbidité plus forte entre la dépendance à l'alcool et la dépression semblant exister chez la femme.

Mudanças nos comportamentos de saúde em idosos brasileiros: dados das Pesquisa Nacional de Saúde 2013 e 2019 / Changes in health behaviors in elderly Brazilians: data from the 2013 and 2019 National Health Surveys

Resumo Analisaram-se as mudanças nos comportamentos de saúde de idosos (≥65 anos) no Brasil incluídos na Pesquisa Nacional Saúde 2013 (n=7.712) e 2019 (n=15.926). Estudo transversal comparou as estimativas de prevalência e intervalos de confiança à 95% (IC95%) do tabagismo atual e passado; uso abusivo de álcool; atividade física no lazer; consumo de frutas e vegetais ou legumes. Diferenças foram consideradas estatisticamente significante ao nível de 5%. Todos os comportamentos positivos de saúde aumentaram significativamente no período. O consumo de frutas e de vegetais ou legumes foram os mais prevalentes, e a cessação do fumo o que mais cresceu. O consumo de frutas e vegetais ou legumes, atividade física no lazer e uso abusivo de álcool prevaleceram nas capitais, já fumo atual e passado no interior. Homens tiveram maiores estimativas de fumo atual, passado e uso abusivo de álcool. Nas mulheres mais jovens aumentou significativamente o uso abusivo de álcool. A atividade física no lazer não diferiu entre os sexos. Mulheres consumiram mais frutas em todas as idades e ano, mas verduras ou legumes dependeu da idade e ano. Aumentaram as prevalências dos comportamentos saudáveis de saúde no Brasil. Mas, desigualdades individuais e contextuais permaneceram e afetaram a conquista de níveis mais saudáveis de saúde.

Abstract Changes in health behaviors of elderly people (≥65 years old) in Brazil included in the National Health Survey 2013 (n=7,712) and 2019 (n=15,926) were analyzed. Cross-sectional study compared prevalence estimates and 95% confidence intervals (95% CI) of current and past smoking; alcohol abuse; leisure-time physical activity; consumption of fruit and vegetables. Differences were considered statistically significant at the 5% level. All positive health behaviors increased significantly over the period. The consumption of fruit and vegetables was the most prevalent, and smoking cessation the one that grew the most. The consumption of fruit and vegetables, physical activity during leisure time and alcohol abuse prevailed in the capitals, with current and past smokers prevailing in the interior. Men had higher estimates of current and past smoking and alcohol abuse. In younger women, alcohol abuse significantly increased. Leisure-time physical activity did not differ between the sexes. Women consumed more fruit at all ages and years, but vegetables depended on age and year. The prevalence of healthy behavior has increased in Brazil. However, individual and contextual inequalities have remained and affect the achievement of more positive levels of health.

Uso de substâncias psicoativas entre adolescentes escolares de Distritos Municipais

Objetivo: analisar o uso de substâncias psicoativas entre adolescentes escolares. Método: estudo transversal, de abordagem quantitativa, realizado em 2021, com 199 alunos de quatro escolas estaduais de Ensino Médio localizadas nos Distritos de um Município do interior do Ceará. Utilizou-se um questionário autoaplicável, DUSI (Drug Use Screening Inventory). Resultados: 92 (46,2%) alunos cursavam o primeiro ano do ensino médio, eram do sexo feminino 114 (57,3%), com idade predominante de 15 a 16 anos (N 31 65,9%). Os adolescentes relataram o uso de todas as substâncias pesquisadas, ainda que fosse somente de uma a duas vezes no último mês. Foram prevalentes: analgésicos (25,6%), álcool (15,1%), tranquilizantes (4,5%) e maconha (3,5%). Quase a totalidade dos participantes negou o uso de tabaco nos últimos 30 dias. A maioria dos participantes negou ter problemas associados ao uso dessas substâncias psicoativas. Conclusão: o estudo auxiliou a compreensão das substâncias psicoativas mais consumidas entre os alunos do Ensino Médio de Distritos Municipais, permitindo ampliar os conhecimentos sobre o uso de drogas no ambiente escolar. Esse achado demonstra a presença dessas substâncias e o uso entre os adolescentes, mesmo nos locais mais distantes dos grandes centros urbanos.

[What to do when faced with a chronic elevation of transaminases]. / Conduite à tenir devant une élévation chronique du taux des transaminases.

Chronic elevation of transaminases is recurring issue in primary care. This article aims to be practical. It offers a quick reminder of epidemiology, pathophysiology, concept of normal values of transaminases, main causes (alcohol, fatty liver disease, viral hepatitis) and first-line assessment. Then, we will go further in less frequent causes, extra-hepatic causes and additional tests. We will precise what is the role of general practitioner in this care pathway and when to address patient to specialist.