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1.
Aust J Gen Pract ; 53(6): 403-407, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38840381

RESUMO

BACKGROUND AND OBJECTIVES: Our understanding of community members' expectations and experiences of discussing alcohol use in general practice settings is limited, particularly for people with heavy alcohol use. METHOD: Qualitative interviews were conducted with people with heavy alcohol use to explore their experiences of discussing alcohol use with their general practitioner (GP). Interviews were audio-recorded and transcribed, and data were analysed using an inductive thematic approach. RESULTS: Three themes were identified: (1) patient perceptions of alcohol discussions in primary care; (2) the importance of the doctor-patient relationship; and (3) consequences of unmet health needs and expectations. Patients expect their GPs to initiate conversations about alcohol use. Positive interactions are characterised by GPs' caring, non-judgemental and collaborative approach, whereas negative interactions focus on a perceived lack of knowledge or ability to manage excessive alcohol use. DISCUSSION: Alcohol harm reduction efforts should include strategies for bolstering the therapeutic relationship between GPs and their patients.


Assuntos
Consumo de Bebidas Alcoólicas , Medicina Geral , Entrevistas como Assunto , Relações Médico-Paciente , Pesquisa Qualitativa , Humanos , Masculino , Feminino , Austrália , Pessoa de Meia-Idade , Adulto , Medicina Geral/métodos , Medicina Geral/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/psicologia , Entrevistas como Assunto/métodos , Idoso , Alcoolismo/psicologia , Comunicação
2.
Front Endocrinol (Lausanne) ; 15: 1400573, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841303

RESUMO

Background and aims: Liver hepatocellular carcinoma (LIHC) exhibits a multifactorial etiology, insidious onset, and a significantly low 5-year survival rate. We aimed to evaluate the causal impact of exposure factors (Alzheimer's disease, platelet count, ambidextrousness, cigarettes smoked per day, alcohol consumption, and endocarditis) on the risk of LIHC using a two-sample Mendelian randomization (MR) study. Methods: Independent single nucleotide polymorphisms (SNPs) strongly associated with Alzheimer's disease, platelet count, ambidextrousness, daily cigarette consumption, alcohol intake, and endocarditis were selected as instrumental variables (IVs) from the corresponding genome-wide association studies (GWAS). Genetic summary statistics for LIHC came from a GWAS that included 168 cases and 372,016 controls of European individuals. Multivariable MR analyses were performed to find the causal association between 6 exposure factors and LIHC risk. The inverse-variance weighted (IVW)-MR was employed as the primary analysis, and the MR-Egger regression, LASSO regression, and weighted Median approaches were performed as complementary analyses. Results: Multivariable MR analysis showed causal association between Alzheimer's disease [Odds ratio (OR) = 0.9999, 95% confidence intervals (CI) = 0.9998-0.9999, p = 0.0010], platelet count (OR = 0.9997, 95% CI = 0.9995-0.9999, p = 0.0066), alcohol consumption (OR = 0.9994, 95% CI = 0.9990-0.9999, p = 0.0098) and the LIHC outcome. After IVW-MR, MR-Egger and LASSO tests, the results are still significant. Next, we used different MR Methods to analyze platelet count, alcohol consumption, and Alzheimer's disease separately. Moreover, both funnel plots and MR-Egger intercepts provided compelling evidence to refute the presence of directional pleiotropy in the association between platelet count, alcohol consumption, Alzheimer's disease and the risk of LIHC. The IVW-MR analysis revealed a significant causal association between an elevated platelet count and a reduced risk of LIHC (OR = 0.9996, 95% CI= 0.9995-0.9998, p = 0.0005). Similarly, the analysis of weighted median revealed a negative correlation between platelet count and the risk of LIHC (OR = 0.9995, 95% CI = 0.9993-0.9999; p = 0.0160). Conversely, we observed a positive causal effect of alcohol consumption on the incidence of LIHC (OR = 1.0004, 95% CI = 0.9999-1.0009). However, no significant causal relationship was found between alcohol assumption, Alzheimer's disease, and LIHC susceptibility. Conclusions: A significant causal relationship exists between platelet count, alcohol consumption, Alzheimer's disease, and an increased risk of LIHC. The study presents compelling evidence for a genetically predicted decreased susceptibility to LIHC based on platelet count. The research implies that elevated platelet count may serve as a protective mechanism against LIHC. These findings may inform clinical strategies for LIHC prevention.


Assuntos
Consumo de Bebidas Alcoólicas , Carcinoma Hepatocelular , Estudo de Associação Genômica Ampla , Neoplasias Hepáticas , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo Único , Humanos , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/etiologia , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/etiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Contagem de Plaquetas , Fatores de Risco
3.
Front Public Health ; 12: 1294492, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841662

RESUMO

Background: Alcohol consumption has been associated with the occurrence of many health conditions. We analyzed UK Biobank data to explore associations of various conditions to type and amount of alcohol consumed. UK Biobank is a large biomedical database providing information from UK participants, including lifestyle questionnaires and diagnosis data. Methods: Using UK Biobank, we examined the relationship between weekly alcohol consumption, alcohol type and the incidence of eight select conditions. We calculated counts of individuals consuming each type diagnosed with these conditions. To assess the effect of alcohol consumption on each condition's prevalence, we used log-logistic regression models to generate dose-response models for each alcohol type. Results: The alcohol consumed included: red wine (228,439 participants), white wine (188811), beer (182648), spirits (129418), and fortified wine (34598). We observed increased condition prevalence with increasing amounts of alcohol. This was especially seen for chronic obstructive lung disease, cirrhosis of liver, hypertension, gastritis, and type 2 diabetes. Beer consumers showed higher prevalence for most conditions while fortified wine had the largest increases in incidence rates. Only white wine showed decreased incidence for acute myocardial infarction. In general, the prevalence of many conditions was higher among alcohol consumers, particularly for hypertension, 33.8%, compared to 28.6% for non-drinkers. Conclusion: Although many conditions were already prevalent among non-drinkers, participants consuming increasing amounts of alcohol had increased incidence rates for many of the studied conditions. This was especially true for consumers of beer and fortified wine, but also true to a lesser extent for consumers of spirits, red and white wine.


Assuntos
Consumo de Bebidas Alcoólicas , Bancos de Espécimes Biológicos , Humanos , Reino Unido/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Bancos de Espécimes Biológicos/estatística & dados numéricos , Idoso , Prevalência , Incidência , Adulto , Vinho/estatística & dados numéricos , Inquéritos e Questionários , Cerveja/estatística & dados numéricos , Diabetes Mellitus Tipo 2/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Biobanco do Reino Unido
4.
Front Public Health ; 12: 1335865, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841683

RESUMO

Alcohol is a favorite psychoactive substance of Canadians. It is also a leading risk factor for death and disability, playing a causal role in a broad spectrum of health and social issues. Alcohol: No Ordinary Commodity is a collaborative, integrative review of the scientific literature. This paper describes the epidemiology of alcohol use and current state of alcohol policy in Canada, best practices in policy identified by the third edition of Alcohol: No Ordinary Commodity, and the implications for the development of effective alcohol policy in Canada. Best practices - strongly supported by the evidence, highly effective in reducing harm, and relatively low-cost to implement - have been identified. Measures that control affordability, limit availability, and restrict marketing would reduce population levels of alcohol consumption and the burden of disease attributable to it.


Assuntos
Consumo de Bebidas Alcoólicas , Política de Saúde , Humanos , Canadá , Consumo de Bebidas Alcoólicas/epidemiologia , Bebidas Alcoólicas/economia
5.
JMIR Res Protoc ; 13: e50650, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38842927

RESUMO

BACKGROUND: High-risk alcohol consumption among young adults frequently occurs in the presence of peers who are also drinking. A high-risk drinking situation may consist of particular social network members who have a primary association with drinking. Fine-grained approaches such as ecological momentary assessment (EMA) are growing in popularity for studying real-time social influence, but studies using these approaches exclusively rely on participant self-report. Passive indicators of peer presence using Bluetooth-based technology to detect real-time interactions have the potential to assist in the development of just-in-time interventions. OBJECTIVE: This study seeks to examine the feasibility and acceptability of using a Bluetooth-based sensor and smartphone app to measure social contact in real-world drinking situations. METHODS: Young adults (N=20) who drink heavily and report social drinking will be recruited from the community to participate in a 3-week EMA study. Using a social network interview, index participants will identify and recruit 3 of their friends to carry a Bluetooth beacon. Participants will complete a series of EMA reports on their own personal Android devices including random reports; morning reports; first-drink reports; and signal-contingent reports, which are triggered following the detection of a beacon carried by a peer participant. EMA will assess alcohol use and characteristics of the social environment, including who is nearby and who is drinking. For items about peer proximity and peer drinking, a customized peer list will be presented to participants. Feedback about the study protocol will be ascertained through weekly contact with both index and peer participants, followed by a qualitative interview at the end of the study. We will examine the feasibility and acceptability of recruitment, enrollment of participants and peers, and retention. Feasibility will be determined using indexes of eligibility, enrollment, and recruitment. Acceptability will be determined through participant enrollment and retention, protocol compliance, and participant-reported measures of acceptability. Feasibility and acceptability for peer participants will be informed by enrollment rates, latency to enrollment, compliance with carrying the beacon, and self-reported reasons for compliance or noncompliance with beacon procedures. Finally, EMA data about peer proximity and peer drinking will support the validity of the peer selection process. RESULTS: Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025. CONCLUSIONS: The protocol allows us to examine the feasibility and acceptability of a Bluetooth-based sensor for the detection of social contact between index participants and their friends, including social interactions during real-world drinking situations. Data from this study will inform just-in-time adaptive interventions seeking to address drinking in the natural environment by providing personalized feedback about a high-risk social context and alerting an individual that they are in a potentially unsafe situation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50650.


Assuntos
Consumo de Bebidas Alcoólicas , Estudos de Viabilidade , Humanos , Consumo de Bebidas Alcoólicas/psicologia , Adulto Jovem , Masculino , Feminino , Adulto , Aplicativos Móveis , Avaliação Momentânea Ecológica , Adolescente , Grupo Associado
7.
Indian J Public Health ; 68(1): 75-82, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38847637

RESUMO

BACKGROUND: Childhood malnutrition in India remains among the highest in the world. Adult alcohol consumption and severe malnutrition have increased among indigenous people in South India. However, the association between them is poorly understood. OBJECTIVES: We aimed to evaluate this association, which could help design better intervention strategies. METHODS: This case-control observational study was conducted in the Nilgiri district in South India. Cases included children aged 1-5 years with moderate malnutrition. Controls were defined as children in the same age group with normal weight-for-age. A questionnaire was used to collect data on demographics, socioeconomic status (SES), and parental education. The WHO Alcohol Use Disorders Identification Test (AUDIT) questionnaire was used to estimate parental alcohol use. Health-care workers collected data from within the community. RESULTS: The baseline demographics of the children in the control (n = 250) and case groups (n = 177) were similar. Paternal age and AUDIT scores were not different in the two groups. SES was lower in the malnourished group, while maternal education among cases was significantly lower. Maternal and paternal education were associated with childhood malnutrition (odds ratio [OR]: 0.728 [95% confidence interval (CI): 0.583-0.903] and OR: 0.753 [95% CI: 0.589-0.957], respectively). After adjustment for covariates, paternal alcohol use was associated with a higher risk of malnutrition (OR: 1.56 [95% CI: 1.00-2.47]), which SES partly mediated. CONCLUSION: Paternal alcohol consumption is associated with childhood malnutrition, partially mediated by lower SES. Furthermore, lower SES appeared to be strongly associated with paternal alcohol consumption.


Assuntos
Consumo de Bebidas Alcoólicas , Transtornos da Nutrição Infantil , População Rural , Fatores Socioeconômicos , Humanos , Índia/epidemiologia , Masculino , Estudos de Casos e Controles , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Pré-Escolar , Lactente , Transtornos da Nutrição Infantil/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Pai/estatística & dados numéricos , Fatores de Risco
8.
Int J Geriatr Psychiatry ; 39(6): e6105, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38822571

RESUMO

INTRODUCTION: Alcohol and substance use are increasing in older adults, many of whom have depression, and treatment in this context may be more hazardous. We assessed alcohol and other substance use patterns in older adults with treatment-resistant depression (TRD). We examined patient characteristics associated with higher alcohol consumption and examined the moderating effect of alcohol on the association between clinical variables and falls during antidepressant treatment. METHODS: This secondary and exploratory analysis used baseline clinical data and data on falls during treatment from a large randomized antidepressant trial in older adults with TRD (the OPTIMUM trial). Multivariable ordinal logistic regression was used to identify variables associated with higher alcohol use. An interaction model was used to evaluate the moderating effect of alcohol on falls during treatment. RESULTS: Of 687 participants, 51% acknowledged using alcohol: 10% were hazardous drinkers (AUDIT-10 score ≥5) and 41% were low-risk drinkers (score 1-4). Benzodiazepine use was seen in 24% of all participants and in 21% of drinkers. Use of other substances (mostly cannabis) was associated with alcohol consumption: it was seen in 5%, 9%, and 15% of abstainers, low-risk drinkers, and hazardous drinkers, respectively. Unexpectedly, use of other substances predicted increased risk of falls during antidepressant treatment only in abstainers. CONCLUSIONS: One-half of older adults with TRD in this study acknowledged using alcohol. Use of alcohol concurrent with benzodiazepine and other substances was common. Risks-such as falls-of using alcohol and other substances during antidepressant treatment needs further study.


Assuntos
Acidentes por Quedas , Consumo de Bebidas Alcoólicas , Antidepressivos , Transtorno Depressivo Resistente a Tratamento , Humanos , Masculino , Feminino , Idoso , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Acidentes por Quedas/estatística & dados numéricos , Antidepressivos/uso terapêutico , Pessoa de Meia-Idade , Modelos Logísticos , Idoso de 80 Anos ou mais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Benzodiazepinas/uso terapêutico , Benzodiazepinas/efeitos adversos , Fatores de Risco
9.
J Addict Nurs ; 35(2): 51-58, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38829994

RESUMO

OBJECTIVE: This research aimed to evaluate the impact of custom-developed software on nursing students' alcohol consumption and perception of social support. METHOD: A quasi-experimental study was conducted with 88 students in the early years of nursing courses at a Brazilian public university. The members of the intervention group (n = 40) participated in a lecture delivered by a nurse and used online software developed based on cognitive behavioral techniques and social skills training. The members of the control group (n = 48) participated only in the lecture. Data on alcohol consumption profiles and social support characteristics were collected. Descriptive statistics, an analysis of variance test, and the Dunnett's test were utilized for data analysis. RESULTS: Alcohol consumption decreased in both groups without significant differences between them. However, in terms of frequency of use, binge drinking, and the number of drinks consumed, a significant decrease occurred among participants in the intervention group. Regarding social support, both groups showed an increase in satisfaction with support and a decrease in the number of supporters. This reduction was less pronounced in the intervention group than in the control group. CONCLUSION: This investigation presents relevant results that suggest the potential of using online technologies as supplemental materials for promoting students' mental health.


Assuntos
Consumo de Bebidas Alcoólicas , Apoio Social , Estudantes de Enfermagem , Humanos , Feminino , Estudantes de Enfermagem/psicologia , Masculino , Consumo de Bebidas Alcoólicas/epidemiologia , Adulto Jovem , Adulto , Brasil
11.
Alcohol Alcohol ; 59(4)2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38832907

RESUMO

AIMS: Alcohol drinking is associated with central obesity, hypertension, and hyperlipidemia, which further causes metabolic syndrome (MetS). However, prior epidemiological studies on such associations lack experimental evidence for a causal relationship. This study aims to explore the causal relationship between drinking behavior and MetS in Taiwan population by using Mendelian randomization (MR) analysis. METHODS: A cross-sectional study was conducted using the Taiwan Biobank database, which comprised 50 640 Han Chinese who were 30-70 years old without cancer from 2008 to 2020. In MR analysis, we constructed weighted and unweighted genetic risk scores by calculating SNP alleles significantly associated with alcohol drinking. We calculated odds ratios and 95% confidence interval (CI) by using a two-stage regression model. RESULTS: A total of 50 640 participants were included with a mean age of 49.5 years (SD: 1.67 years), 36.6% were men. The adjusted odds ratio (aOR) of MetS per 5% increase in the likelihood of genetic predisposition to drink based on weighted genetic risk score with adjustment was 1.11 (95% CI: 1.10, 1.12, P < .001). Analysis was also conducted by grouping the likelihood of genetic predisposition to drink based on quartiles with multivariate adjustment. Using Q1 as the reference group, the aORs of MetS for Q2, Q3, and Q4 were 1.19 (1.12, 1.27, p < .001), 1.31 (1.23, 1.40, p < .001), and 1.87 (1.75, 2.00, p < .001), respectively, for the weighted genetic risk score. CONCLUSIONS: This study shows a modest relationship between drinking behavior and MetS by using MR analysis.


Assuntos
Consumo de Bebidas Alcoólicas , Análise da Randomização Mendeliana , Síndrome Metabólica , Humanos , Síndrome Metabólica/genética , Síndrome Metabólica/epidemiologia , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Transversais , Adulto , Consumo de Bebidas Alcoólicas/genética , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Taiwan/epidemiologia , Idoso , Predisposição Genética para Doença/genética , Polimorfismo de Nucleotídeo Único/genética
12.
Sci Rep ; 14(1): 12648, 2024 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-38825629

RESUMO

Observational studies have shown controversial associations between alcohol intake and radiographic osteoarthritis (OA). This study investigated whether this association was causal using a Mendelian randomization (MR) study in a population-based cohort in Korean. The study enrolled 2429 subjects (1058 men, 1371 women) from the Dong-gu Study. X-rays of the hand and knee joints were scored using a semi-quantitative grading system to calculate the total score of the hand and knee joints. ALDH2 rs671 genotyping was performed by high-resolution melting analysis. MR instrumental variable analysis and observational multivariable regression analysis were used to estimate the association between genetically predicted alcohol intake and the radiographic severity of OA. Subjects with the G/G genotype had a higher current alcohol intake than those with the G/A and A/A genotypes in both men and women (all P < 0.001). Men with the G/G genotype had higher total knee (P < 0.001) and hand scores (P = 0.042) compared to those with the G/A and A/A genotypes after adjusting for age and body mass index, but not in women. In the observational multivariable regression analysis, each alcohol drink per day in men was associated with increased knee (P = 0.001) and hand joint scores (P = 0.013) after adjustment, but not in women. In our MR analysis, utilizing ALDH2 rs671 genotypes as instrumental variables for alcohol consumption, has shown a significant link between each additional daily alcohol drink and increased radiographic joint severity in men.


Assuntos
Consumo de Bebidas Alcoólicas , Aldeído-Desidrogenase Mitocondrial , Osteoartrite do Joelho , Humanos , Masculino , Consumo de Bebidas Alcoólicas/efeitos adversos , Feminino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/genética , Aldeído-Desidrogenase Mitocondrial/genética , Osteoartrite/genética , Osteoartrite/diagnóstico por imagem , Idoso , Radiografia , Índice de Gravidade de Doença , Articulação da Mão/diagnóstico por imagem , Articulação da Mão/patologia , Genótipo , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo Único , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia
13.
BMC Med Inform Decis Mak ; 24(1): 151, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38831420

RESUMO

BACKGROUND: BERT models have seen widespread use on unstructured text within the clinical domain. However, little to no research has been conducted into classifying unstructured clinical notes on the basis of patient lifestyle indicators, especially in Dutch. This article aims to test the feasibility of deep BERT models on the task of patient lifestyle classification, as well as introducing an experimental framework that is easily reproducible in future research. METHODS: This study makes use of unstructured general patient text data from HagaZiekenhuis, a large hospital in The Netherlands. Over 148 000 notes were provided to us, which were each automatically labelled on the basis of the respective patients' smoking, alcohol usage and drug usage statuses. In this paper we test feasibility of automatically assigning labels, and justify it using hand-labelled input. Ultimately, we compare macro F1-scores of string matching, SGD and several BERT models on the task of classifying smoking, alcohol and drug usage. We test Dutch BERT models and English models with translated input. RESULTS: We find that our further pre-trained MedRoBERTa.nl-HAGA model outperformed every other model on smoking (0.93) and drug usage (0.77). Interestingly, our ClinicalBERT model that was merely fine-tuned on translated text performed best on the alcohol task (0.80). In t-SNE visualisations, we show our MedRoBERTa.nl-HAGA model is the best model to differentiate between classes in the embedding space, explaining its superior classification performance. CONCLUSIONS: We suggest MedRoBERTa.nl-HAGA to be used as a baseline in future research on Dutch free text patient lifestyle classification. We furthermore strongly suggest further exploring the application of translation to input text in non-English clinical BERT research, as we only translated a subset of the full set and yet achieved very promising results.


Assuntos
Estilo de Vida , Humanos , Países Baixos , Registros Eletrônicos de Saúde , Fumar , Consumo de Bebidas Alcoólicas , Estudos de Viabilidade , Transtornos Relacionados ao Uso de Substâncias
14.
Int J Public Health ; 69: 1607275, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38832212

RESUMO

Objectives: This study aimed to assess the burden of high blood pressure and its associated factors among students at Aksum University. Methods: A total of 240 participants were included; participants were selected through simple random sampling from May 2019 to July 2019. Logistic regression analysis was performed, with statistical significance set at a p-value <0.05 and a 95% confidence level. Results: This study found that 17.9% of the participants had high blood pressure, with higher rates observed in males (62.79%) than in females (37.21%). Several factors were identified as associated with high blood pressure, including a family history of high blood pressure [AOR 1.72, 95% CI (1. 75-4.04)], regular physical exercise [AOR 0.64, 95% CI (0.30-0.94)], alcohol consumption [AOR 2.16, 95% CI (1.07-4.62)], tobacco smoking [AOR 5.46, 95% CI (1.98-15.07)], and central obesity [AOR 2.72, 95% CI (1.12-6.58)]. Conclusion: This study reveals that one out of six students had high blood pressure. Factors such as a family history of high blood pressure, physical inactivity, tobacco smoking, and central obesity were associated with this condition.


Assuntos
Hipertensão , Estudantes , Humanos , Masculino , Feminino , Etiópia/epidemiologia , Estudos Transversais , Estudantes/estatística & dados numéricos , Universidades , Hipertensão/epidemiologia , Fatores de Risco , Adulto Jovem , Exercício Físico , Adulto , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia
15.
Afr J Prim Health Care Fam Med ; 16(1): e1-e7, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38832373

RESUMO

BACKGROUND:  Cardiovascular diseases pose a risk to population health in South Africa and are responsible for almost one in six deaths (17.3%). AIM:  To determine the cardiovascular risk among community members who attended a community outreach programme. SETTING:  Three communities in the Cape Metropole of the Western Cape. METHODS:  A health survey was conducted with 783 participants, 18 years and older, conveniently sampled. The survey included questions about cardiovascular risk factors, and biometric measurements of blood pressure (BP), height and weight were conducted. RESULTS:  A total of 777 participants were included in the study. Most participants were female (529, 68.1%), with an average age of 42.3 years (s.d. 14.2). Risk behaviours reported included smoking (216, 27.8%), consuming more than two drinks of alcohol daily (78, 10%), low physical activity (384, 49.4%), being stressed on most days (436, 56.1%) and unhealthy eating habits (253, 32.6%). More than half of the participants (402, 51.7%) had a body mass index (BMI) ≥ 30, 26.0% (202) had a systolic BP of ≥ 140 mm Hg and 22.4% (174) had a diastolic BP of ≥ 90 mm Hg; 16.6% (130) had a cardiovascular disease (CVD) risk of 10-20 and 19.3% (150) had a CVD risk of 20%. CONCLUSION:  Nearly a fifth of the participants had a significant probability of developing heart disease or experiencing a stroke over the next 10 years.Contribution: There is an urgent need for comprehensive health promotion and behaviour change interventions focused on reducing CVD risk factors at the community level.


Assuntos
Doenças Cardiovasculares , Humanos , África do Sul/epidemiologia , Feminino , Masculino , Adulto , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Pessoa de Meia-Idade , Adulto Jovem , Fatores de Risco de Doenças Cardíacas , Inquéritos Epidemiológicos , Adolescente , Fumar/epidemiologia , Fatores de Risco , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Índice de Massa Corporal , Idoso , Pressão Sanguínea
16.
J Clin Invest ; 134(11)2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38828724

RESUMO

Alcohol-related harm, a major cause of disease burden globally, affects people along a spectrum of use. When a harmful pattern of drinking is present in the absence of significant behavioral pathology, low-intensity brief interventions that provide information about health consequences of continued use provide large health benefits. At the other end of the spectrum, profound behavioral pathology, including continued use despite knowledge of potentially fatal consequences, warrants a medical diagnosis, and treatment is strongly indicated. Available behavioral and pharmacological treatments are supported by scientific evidence but are vastly underutilized. Discovery of additional medications, with a favorable balance of efficacy versus safety and tolerability can improve clinical uptake of treatment, allow personalized treatment, and improve outcomes. Here, we delineate the clinical conditions when pharmacotherapy should be considered in relation to the main diagnostic systems in use and discuss clinical endpoints that represent meaningful clinical benefits. We then review specific developments in three categories of targets that show promise for expanding the treatment toolkit. GPCRs remain the largest category of successful drug targets across contemporary medicine, and several GPCR targets are currently pursued for alcohol-related indications. Endocrine systems are another established category, and several promising targets have emerged for alcohol indications. Finally, immune modulators have revolutionized treatment of multiple medical conditions, and they may also hold potential to produce benefits in patients with alcohol problems.


Assuntos
Alcoolismo , Humanos , Alcoolismo/tratamento farmacológico , Consumo de Bebidas Alcoólicas , Animais
17.
J Safety Res ; 89: 1-12, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38858032

RESUMO

INTRODUCTION: Almost a third of car accidents involve driving after alcohol consumption. Autonomous vehicles (AVs) may offer accident-prevention benefits, but at current automation levels, drivers must still perform manual driving tasks when automated systems fail. Therefore, understanding how alcohol affects driving in both manual and automated contexts offers insight into the role of future vehicle design in mediating crash risks for alcohol-impaired driving. METHOD: This study conducted a systematic review on alcohol effects on manual and automated (takeover) driving performance. Fifty-three articles from eight databases were analyzed, with findings structured based on the information processing model, which can be extended to the AV takeover model. RESULTS: The literature indicates that different Blood Alcohol Concentration (BAC) levels affect driving skills essential for traffic safety at various information processing stages, such as delayed reacting time, impaired cognitive abilities, and hindered execution of driving tasks. Additionally, the driver's driving experience, drinking habits, and external driving environment play important roles in influencing driving performance. CONCLUSIONS: Future work is needed to examine the effects of alcohol on driving performance, particularly in AVs and takeover situations, and to develop driver monitoring systems. PRACTICAL APPLICATIONS: Findings from this review can inform future experiments, AV technology design, and the development of driver state monitoring systems.


Assuntos
Consumo de Bebidas Alcoólicas , Automação , Condução de Veículo , Humanos , Acidentes de Trânsito/prevenção & controle , Dirigir sob a Influência/estatística & dados numéricos , Dirigir sob a Influência/prevenção & controle , Concentração Alcoólica no Sangue , Automóveis
18.
J Korean Med Sci ; 39(22): e185, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38859742

RESUMO

BACKGROUND: Alcohol consumption is a major risk factor for cancer, and when combined with smoking, the risk increases. Nevertheless, few studies have comprehensively evaluated the combined effects of alcohol consumption and smoking on the risk of various cancer types. Therefore, to assess these effects, we conducted a systematic review and meta-analysis. METHODS: We performed a systematic search of five literature databases, focusing on cohort and case-control studies. Considering exposure levels, we quantified the combined effects of alcohol consumption and smoking on cancer risk and assessed multiplicative interaction effects. RESULTS: Of 4,452 studies identified, 24 (4 cohort studies and 20 case-control studies) were included in the meta-analysis. We detected interaction effect of light alcohol and moderate smoking on head and neck cancer risk (relative risk [RR], 4.26; 95% confidence interval [CI], 2.50-7.26; I² = 65%). A synergistic interaction was observed in heavy alcohol and heavy smoking group (RR, 35.24; 95% CI, 23.17-53.58; I² = 69%). In more detailed cancer types, the interaction effect of heavy alcohol and heavy smoking was noticeable on oral (RR, 36.42; 95% CI, 24.62-53.87; I² = 46%) and laryngeal (RR, 38.75; 95% CI, 19.25-78.01; I² = 69%) cancer risk. CONCLUSION: Our study provided a comprehensive summary of the combined effects of alcohol consumption and smoking on cancers. As their consumption increased, the synergy effect became more pronounced, and the synergy effect was evident especially for head and neck cancer. These findings provide additional evidence for the combined effect of alcohol and smoking in alcohol guidelines for cancer prevention.


Assuntos
Consumo de Bebidas Alcoólicas , Neoplasias , Fumar , Humanos , Consumo de Bebidas Alcoólicas/efeitos adversos , Fumar/efeitos adversos , Fatores de Risco , Neoplasias/etiologia , Neoplasias/epidemiologia , Neoplasias de Cabeça e Pescoço/etiologia , Bases de Dados Factuais , Razão de Chances
19.
Neurotox Res ; 42(3): 29, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38856796

RESUMO

Ethanol (EtOH) intake and noise exposure are particularly concerning among human adolescents because the potential to harm brain. Unfortunately, putative underlying mechanisms remain to be elucidated. Moreover, implementing non-pharmacological strategies, such as enriched environments (EE), would be pertinent in the field of neuroprotection. This study aims to explore possible underlying triggering mechanism of hippocampus-dependent behaviors in adolescent animals of both sexes following ethanol intake, noise exposure, or a combination of both, as well as the impact of EE. Adolescent Wistar rats of both sexes were subjected to an intermittent voluntary EtOH intake paradigm for one week. A subgroup of animals was exposed to white noise for two hours after the last session of EtOH intake. Some animals of both groups were housed in EE cages. Hippocampal-dependent behavioral assessment and hippocampal oxidative state evaluation were performed. Results show that different hippocampal-dependent behavioral alterations might be induced in animals of both sexes after EtOH intake and sequential noise exposure, that in some cases are sex-specific. Moreover, hippocampal oxidative imbalance seems to be one of the potential underlying mechanisms. Additionally, most behavioral and oxidative alterations were prevented by EE. These findings suggest that two frequently found environmental agents may impact behavior and oxidative pathways in both sexes in an animal model. In addition, EE resulted a partially effective neuroprotective strategy. Therefore, it could be suggested that the implementation of a non-pharmacological approach might also potentially provide neuroprotective advantages against other challenges. Finally, considering its potential for translational human benefit might be worth.


Assuntos
Etanol , Hipocampo , Ruído , Ratos Wistar , Animais , Hipocampo/efeitos dos fármacos , Masculino , Feminino , Etanol/administração & dosagem , Etanol/toxicidade , Ruído/efeitos adversos , Ratos , Consumo de Bebidas Alcoólicas , Caracteres Sexuais , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia
20.
PLoS One ; 19(6): e0303354, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38843274

RESUMO

BACKGROUND: Vietnam is experiencing an increasing prevalence of hypertension in its adult population. In addition to medical therapy, modifying adverse lifestyle practices is important for effective blood pressure control. There are limited data on unhealthy lifestyle practices in patients with chronic diseases, however, particularly among hypertensive patients living in rural Vietnam. Our study objectives were to examine the prevalence of unhealthy lifestyle practices and associated factors among rural Vietnamese adults with uncontrolled hypertension. METHODS: Data from the baseline survey of a cluster randomized trial among hypertensive Vietnamese adults (2017-2022) were utilized. Information on unhealthy lifestyle practices including smoking, excessive alcohol consumption, physical inactivity, and inadequate fruit and vegetable intake was collected from study participants. The primary study outcome was having ≥2 unhealthy lifestyle practices. A multivariable logistic regression model was used to examine factors associated with the primary study outcome. RESULTS: The mean age of the 671 patients was 67 years and 45.0% were men. Nearly three out of every four participants had one or fewer unhealthy practices, 24.0% had two, and 3.3% had three or all four unhealthy lifestyle practices. Men, individuals who did unpaid work or were unemployed, and individuals with hypertension level III were more likely to have ≥2 unhealthy lifestyle practices, whereas individuals with higher education were less likely to have ≥2 unhealthy lifestyle practices compared with respective comparison groups. CONCLUSIONS: We observed a high prevalence of unhealthy lifestyle practices among rural Vietnamese patients with uncontrolled hypertension. Several demographic factors were associated with a greater number of unhealthy lifestyle practices. Newer interventions and educational programs encouraging lifestyle modification practices are needed to control hypertension among adults living in rural settings of Vietnam.


Assuntos
Hipertensão , Estilo de Vida , Humanos , Hipertensão/epidemiologia , Masculino , Feminino , Vietnã/epidemiologia , Pessoa de Meia-Idade , Idoso , População Rural/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Prevalência , Fatores de Risco , Fumar/epidemiologia
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