Trends in public opinion on alcohol policy measures: Ontario 1989-1998.

OBJECTIVE: This article presents trend data concerning public opinion on alcohol policy in the Canadian province of Ontario over a 10-year period (1989-98), highlights the currently debated issue of private venues for retail alcohol sales and assesses correspondence between public opinion and actual and proposed policy decisions. METHOD: Selected policy-related items from nine probability surveys on representative samples of male and female Ontario adults (range of unweighted n 's: 953 to 1,947) were analyzed by means of logistic regression. RESULTS: We found strong support for the status quo for a number of items, including beer and liquor store hours, corner store sales and taxes. Across all years, less than 6% of the total sample wanted to lower the legal drinking age. Over time, a linear trend showed a gradual but not entirely consistent development of attitudes among the Ontario public, favoring relaxation of some controls. However, contrary to this trend, disapproval of retail sales in corner stores increased significantly from 1992 to 1996. Demographic breakdown shows that relaxation of controls is most favored by those who report consumption of five or more drinks per occasion at least weekly over the past 12 months, and most strongly opposed by women and nondrinkers. Of those who seldom or never consume five or more drinks per occasion, the majority express satisfaction with the status quo. CONCLUSIONS: These data call into question the suitability of changes in alcohol policy that would diminish controls. It is of particular interest that there seems to be little public support for privatization proposals in the province. Public opinion against comer store sales of alcoholic beverages increased over time.

Alcohol-related policy measures in Ontario: who supports what and to what degree?

Using 1998 provincial survey data (n = 1,205), the authors examine responses to 7 items concerning public opinion on alcohol-related policy in Ontario. The purpose of the study is to get a sense of overall public opinion on certain topical policy-related measures and to see whether this opinion is predicted by demographic characteristics of respondents (sex, age and self-reported drinking pattern). Cross-tabulations of opinion items with demographic variables revealed strong majority support for the status quo with regard to number of liquor and beer stores, beer and liquor store hours, and prohibition of the sale of alcohol in corner stores. A somewhat less robust majority also supported the status quo for alcohol taxes and legal drinking age. Among the demographic groups, high-risk heavy drinkers stood out for their greater support of relaxation of controls and this finding was confirmed by means of logistic regression. The majority of all groups, except frequent bar-goers, liked the idea of warning labels on alcoholic beverage containers. The authors conclude that, according to these survey data, policy initiatives towards greater access to alcohol, such as extended liquor store hours and sale of alcohol in corner stores, are not mandated by the majority of the population of Ontario.

Moderate-intensity exercise: for our patients, for ourselves.

Even more than the general population, orthopaedic patients suffer from multiple consequences of immobility. Fortunately, most of these patients are physically able to participate in some degree of moderately intense exercise. Helping the orthopaedic patient initiate and adhere to a moderately intense exercise routine is a nursing challenge. This challenge is even more difficult because as nurses, we are often expecting our patients to make a lifestyle change that we have been unable or unwilling to make ourselves. Understanding the health-related benefits that can be derived from participation in moderately intense exercise routines and the recommended guidelines for exercise frequency and intensity is a first step toward initiating a fitness routine. Using information acquired from research, nurses can assess for specific facilitators and barriers to exercise participation. This assessment data can then be used to individualize plans for exercise that meet the fitness needs of our patients and ourselves.

A deficiency in a 230 kDa DNA repair protein in fanconi anemia complementation group A cells is corrected by the FANCA cDNA.

Cells from individuals with the cancer-prone, inherited disorder Fanconi anemia (FA) are hypersensitive to DNA interstrand cross-linking agents and this hypersensitivity correlates with a defect in ability to repair this type of damage to their DNA. We have isolated a DNA endonuclease complex from the nuclei of normal human cells which is involved in repair of DNA interstrand cross-links and have shown that in FA complementation group A (FA-A) cells there is a defect in ability of this complex to incise DNA containing interstrand cross-links. In order to identify the specific protein(s) in this complex which is defective in FA-A cells, monoclonal antibodies (mAbs) were developed against proteins in the normal complex. One of these mAbs, which is against a protein with a molecular weight of approximately 230 kDa, completely inhibited the ability of the normal complex to incise cross-linked DNA. Western blot analysis has shown that there is a deficiency in this protein in FA-A cells. Electophoretic analysis has also indicated that there are reduced levels of this protein in FA-A compared with normal cells. Studies carried out utilizing FA-A cells which have been stably transduced with a retroviral vector expressing the FANCA cDNA have shown that the DNA repair defect in these cells has been corrected; levels of unscheduled DNA synthesis are at least as great as those of normal human cells. In addition, in the transduced cells the deficiency in the 230 kDa protein has been corrected, as determined by both western blot and electrophoretic analysis. These results indicate that the FANCA gene plays a role in the expression or stability of the 230 kDa protein.

Effects of others' drinking as perceived by community members.

A 1994 survey of adults from a northern Ontario city contained questions about alcohol consumption, problems experienced as a result of others' drinking, and opinions concerning solutions to such problems. The 180-question survey was administered to about 900 respondents, the vast majority of whom said they had consumed alcohol within the previous 12 months. At least one in five said they had been bothered by three types of experience caused by other drinkers: loudness, humiliation, and arguments. Young adults stood out as the group most likely to experience each type of problem caused by other drinkers. There was a robust level of support for most solutions proposed, with the exception of a city ban on drinking in indoor public places. The data suggest that comprehensive prevention efforts may be more effective than those focused on a single approach geared towards only one group or person.

Introduction of high-alcohol beer in Ontario: preliminary observations on its use by underage drinkers.

Preliminary data are reported on the use of high-alcohol beer by underage drinkers in Ontario. Students in grades 11 and 12 with a valid driver's licence completed a questionnaire between January and May, 1994 (i.e., between three and seven months after the introduction of high-alcohol beer). About one-half of students who had drunk alcohol within the previous four weeks reported consuming high-alcohol beer within that period. In this group, males were much more likely to report high-alcohol beer consumption in the previous month. Both male and female high-alcohol beer consumers drank alcohol more frequently, got drunk more frequently, and drank five or more drinks on the same occasion more frequently than non-consumers. One reason for trying high-alcohol beer, "wanted a higher alcohol content", was endorsed by more than one-third of high-alcohol beer consumers. Our data suggest that the users of high-alcohol beer among this underage drinking sample tend to be heavier drinkers and more likely to experience alcohol-related problems.

Alcohol-related measures as factors in traffic fatalities.

OBJECTIVE: The purpose of this study was to determine if alcohol-related measures (per capita consumption, drinking-driving arrest rate, alcohol abuse treatment rate and Alcoholics Anonymous [AA] membership rate) were related to differences between states in traffic fatality rates (total and alcohol-related). METHOD: Fatality rates were regressed onto the alcohol-related variables, using state level data for 1982 and 1990 as well as measures of relative change between the 2 years. RESULTS: Fatality rates demonstrated significant positive relationships with per capita consumption and drinking-driving arrest rates, and significant negative relationships with AA membership rates, for the years 1982 and 1990. Also, changes in per capita consumption were significantly and positively related to changes in both traffic fatality measures. CONCLUSIONS: Per capita alcohol consumption measures were the strongest and most consistent determinants of traffic fatality measures. The negative relationship between AA membership rates and traffic fatality measures for 1982 and 1990 suggests a beneficial impact of AA on these measures at the aggregate level, although other explanations are possible.

Changes in cancer mortality rates and per capita alcohol consumption in Ontario, 1963-1983.

Data on Ontario per capita alcohol consumption and alcohol-related cancer mortality rates from 1963 to 1983 generally correlated positively and significantly. Correlations for the period of rising consumption (1963-1974) were similar to those observed for the total period, but during the period of stabilization and decline of alcohol consumption the magnitude of nearly all relationships decreased substantially. The overall positive and significant correlation between per capita alcohol consumption and various cancer site mortality rates may be partly due to lag effects from the period when consumption was on the rise.

Rehabilitation for convicted drinking drivers (second offenders): effects on mortality.

The mortality experience of convicted drinking drivers (second offenders) (N = 347) randomly assigned to rehabilitation and control groups in two Ontario cities was examined. Over a follow-up period ranging between 8 and 13 years, 14 (11.0%) of the controls and 17 (7.7%) of the rehabilitation group died. Direct comparisons of the randomly assigned control and treatment groups revealed a tendency for lower total mortality and significantly lower mortality from accidental and violent death in those assigned to rehabilitation. Additional comparisons involving a combined rehabilitation group (N = 487) (rehabilitation participants randomly and not randomly assigned) confirmed these observations.

Self-identified correlates of problem alcohol and drug use with comparisons between substances.

Open-ended questions on antecendents of problem substance use were administered to 195 men and women in treatment. Examination of responses revealed distinct differences between precursors of problems, depending on which of a possible 11 classes of substance was being discussed. A model in flow-chart form encapsulates the common elements generally shared by this population, and it highlights the central role of availability in the development of problems. The model also suggests a possible explanation for recidivism among misusers who have undergone treatment.

Incorporating play interventions into nursing care.

Play, as a nursing intervention, has often taken a back seat to all the technical skills performed by nurses. Nurses can and should contribute to implementing and designing play interventions. A review of the play literature forms the basis of a case illustration presented to assist the nurse to plan and implement play in the busy hospital setting.

Mortality in a sample of convicted drinking drivers.

Mortality rates for 639 drinking drivers were calculated. The sample consisted of all individuals convicted of a second offence in two Ontario cities (Oshawa and North Bay) between 1973 and late 1978. There were 53 deaths (51 males, 2 females) in the sample prior to the end of 1986. Among males, significant excess total mortality was observed (Standardized Mortality Ratio = 1.7); similar trends were observed among females. Age-related excess mortality and excess mortality by cause were strikingly similar to mortality patterns observed among alcoholics.

Caseload management. A model for agencies and staff nurses.

With the theory behind case load management, home healthcare nurses are more likely to apply the theory to the management of their practice, instead of being treated like automatons that must provide 5 to 6 units of service every day to be productive, effective, and efficient.

Sentence severity and the drinking driver: relationships with traffic safety outcome.

While a major response to the drinking-driving problem has been to increase penalties for drinking-driving offences, the impact of sentence severity on the driving behaviour of offenders (specific deterrence) remains unclear. In this research, relationships between aspects of sentence severity (license suspension, fine, jail term, assignment to probation, or temporary absence programmes) and postconviction accidents and drinking-driving convictions were examined, while controlling statistically for demographic and previous driving record factors. License suspensions were consistently associated with traffic safety benefits. However, increasing severity of other aspects of punishment seemed unrelated to outcome or was associated with increased traffic safety problems. As well, important differences between first, second, and multiple offenders were observed, which may be related to the impact of different aspects of sentence severity on driving behaviour.

Reductions in cirrhosis deaths in the United States: associations with per capita consumption and AA membership.

Cirrhosis mortality and morbidity rates have declined in many jurisdictions, including the U.S., in recent years. Previous research in Canada and Europe suggests that these declines are linked to changes in per capita consumption of alcohol and changes in the availability and/or utilization of services to reduce abusive drinking (e.g., treatment, Alcoholics Anonymous). In this study, changes in cirrhosis death rates in the 50 U.S. states and the District of Columbia between 1974 and 1983 were regressed onto changes in per capita consumption (1974-83). AA membership (1974-83) and alcoholism treatment (1979-82). No significant relationship between treatment and cirrhosis changes was observed; however, the measure of change in treatment may not reflect the full extent of changes that occurred in the 1974-83 period. As predicted, decreases in per capita consumption and increases in AA membership were significantly associated with decreases in cirrhosis rates.

Decreases in alcohol problems and increased Alcoholics Anonymous membership.

In this study, the impact of changes in rates of Alcoholics Anonymous (AA) membership and per capita consumption of alcohol on changes in rates of cirrhosis, drinking-driving charges and liquor act charges are examined for the 10 provinces of Canada over the period 1974-1983. Neither measure was significantly related to changes in cirrhosis rates. However, AA membership and consumption changes were associated, in an interactive manner, with changes in drinking-driving and liquor act charges.

The relationship between alcohol-related traffic fatalities and per capita consumption of alcohol, Ontario, 1957-1983.

In this research, the impact of per capita consumption of alcohol on alcohol-related traffic fatalities in Ontario between 1957 and 1983 was examined. Three measures of alcohol involvement were selected. The first, drinking drivers (police reported) involved in fatal accidents, was a direct measure. The second and third, single-vehicle fatal accidents and nighttime fatal accidents, were surrogate measures. Also, three corresponding measures of fatal accidents not involving alcohol (normal drivers [police reported] involved in fatal accidents, multiple vehicle fatal accidents, and daytime fatal accidents) were chosen to control for general road safety trends. The results of regression analyses indicated that both per capita consumption and general road safety trends were significant contributors to all three measures of alcohol-involved fatalities. These and other recent data suggest that any effort to prevent alcohol-related problems such as liver cirrhosis through control of per capita consumption will also have a beneficial impact on alcohol-related accidents.

Reductions in liver cirrhosis mortality and morbidity in Canada: demographic differences and possible explanations.

In Canada, deaths from liver cirrhosis have declined by about 25% since 1974. To gain further insight into the nature of this decline, mortality rates for the years 1974-1984 and morbidity (hospital separation) rates for the years 1974-1980 were examined by age and sex and by province and sex. As well, survey data on drinking practices in Ontario were analyzed. Both mortality and morbidity declined over the time period involved, although variations over provinces, age groups, and sex were observed. The pattern of variations (largest declines in provinces with highest per capita alcohol consumption and in young to middle-aged males) strongly suggests decreased incidence of alcoholic liver cirrhosis. Among the factors which may be contributing to these declines are: the stabilization and small decreases in per capita consumption of alcohol; consumption pattern changes consistent with observed mortality and morbidity changes; expanded health promotion activities; and increases in the numbers of alcoholics receiving treatment.

Cognitions and alcohol-influenced performance: the impact of reinforcement contingencies.

The effects of different reinforcement conditions on self-reported cognitions and task performance under the influence of alcohol were examined. Four groups of male university students attended a series of four drinking sessions. During the sessions, the groups performed a visual tracking task under different reinforcement conditions which influence the speed of acquisition of behavioural tolerance to the impairing effects of alcohol. At the end of each session, subjects completed a questionnaire intended to elicit any thoughts, feelings, ideas or images they experienced during the session. Their responses were scored in categories related to alcohol effects, task performance and motivation. The groups differed significantly on numbers of self-reported cognitions related to general alcohol effects and to alcohol effects on task performance; these differences corresponded to differences in the speed of tolerance development. In the group that acquired tolerance most rapidly, several aspects of task performance were significantly correlated with cognitions. These data provide support for the suggestion that cognitive activity may be an important factor in individuals' responses to alcohol and other drugs.