老年男性性功能障碍危险因素

目的 研究≥65岁老年男性患者性功能障碍的患病情况及主要危险因素.方法 搜集该院655例老年男性体检患者作为研究对象,采用男性性功能问卷(O'Leary 1995)、国际勃起功能问卷评分(IIEF-5)评价患者的性功能障碍程度,并记录患者的国际前列腺症状评分(IPSS)、体质指数、前列腺体积、基础疾病、吸烟、饮酒等一般情况,采用logistic回归分析老年男性性功能障碍的危险因素.结果 655例患者中,性欲低下、勃起功能障碍及射精障碍的患病率分别为82.8％ 、86.4％ 、36.2％.性欲低下的危险因素主要包括:年龄、心脑血管疾病、糖尿病、夫妻感情不合.勃起功能障碍的危险因素包括:年龄、体质指数、IPSS评分、前列腺体积、糖尿病.而射精障碍的危险因素包括:年龄、前列腺体积、饮酒、糖尿病.结论 年龄及糖尿病是老年男性性欲低下、勃起功能障碍及射精障碍的共同危险因素,夫妻感情是性欲低下的危险因素,体质指数及前列腺体积是勃起功能障碍的危险因素,而射精障碍的危险因素主要包括前列腺体积和饮酒等.     

老年住院患者口腔卫生状况及其影响因素

目的 调查老年住院患者口腔卫生状况并分析其影响因素。方法 将2021年1月至2022年6月中部战区总医院收治的312例老年患者纳为研究对象。调查患者一般人口学资料,采用汉化版Kayser-Jones简明口腔健康检查(BOHSE)量表调查其口腔卫生状况,采用自制量表调查患者住院期间口腔卫生行为,采用日常生活能力量表评估患者生活自主活动能力。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、方差分析及χ²检验。采用多元线性回归模型分析影响老年住院患者口腔卫生状况的相关因素。结果 老年住院患者BOHSE量表总得分为(7.91±1.27)分,其中口腔卫生状况维度得分最高,为(1.46±0.26)分,其次是天然牙状况及牙齿周围和(或)义齿覆盖的牙龈维度。单因素分析提示,性别、吸烟、饮酒、受教育程度、住院期间刷牙频率、住院期间是否获得口腔护理帮助、是否获得口腔检查、患者日常生活活动能力、是否长期卧床等因素均影响老年住院患者口腔健康检查量表得分(P<0.05)。多元线性回归分析提示,性别、吸烟、饮酒、住院期间刷牙频率、获得口腔护理帮助、口腔检查...     

金华市某三级医院老年功能性消化不良患者生存质量及其影响因素分析

背景老年功能性消化不良(functional dyspepsia, FD)是临床常见疾病之一,多以中老年患者为主.目前认为精神心理因素导致的躯体化是影响老年FD生存质量的危险因素.由于我国医疗资源分布不平衡,对老年FD患者生存质量认识不足,再加上很多患者症状可能较轻,自身对疾病缺乏正确认识,对其生存质量的影响因素进行分析尤为必要.目的旨在探讨金华市某三级医院老年FD患者生存质量及其影响因素分析.方法选择2017-06/2019-08在我院就诊的134例老年FD患者为研究对象.采用生存质量量表、精神心理状况量表及健康行为自我效能量表卷进行测评,并分析老年FD患者生存质量的影响因素.结果老年FD患者功能性消化不良生存质量量表(functional digestive disorder quality of life questionnaire,FDDQL)总分为57.62分±8.16分,其中日常活动得分为75.48分±7.23分,受损最轻;健康感觉得分为45.61分±9.57分,受损最严重;其次疾病控制得分为47.38分±10.36分.不同性别、焦虑自评量表(self-rating anxietyscale,SAS)评分、抑郁自评量表(depression self-ratingscale,SDS)评分、自我效能、体质指数(bodymassindex,BMI)、饮酒史、病程、居住情况、症状严重程度、自我调节情绪及是否规律运动等FDDQL得分比较,差异有统计学意义(P0.05,或P 0.01);不同BMI患者FDDQL得分比较,差异无统计学意义(P0.05).老年FD患者的性别、自我效能、B M I、饮酒史、病程、居住情况及规律运动等与FDDQL呈正相关(r=0.147-0.215, P 0.05);老年FD患者的SAS、SDS评分,症状严重程度及自我调节等与FDDQL呈负相关[r=-0.765-(-0.284), P 0.05].通过多元回归分析发现,焦虑、症状严重程度、病程、自我效能和抑郁是老年FD患者生存质量的影响因素.结论老年FD患者生存质量影响因素较多,而焦虑、症状严重程度、病程、自我效能和抑郁是重要危险因素,在临床工作中应通过上述影响因素采取合理的干预以提高患者生存质量.     

青年与老年冠心病危险因素和冠状动脉造影比较分析

目的 :研究青年冠心病 (CHD)的危险因素 ,冠状动脉病变特点与老年CHD的区别。方法 :对青年 (≤ 4 5岁 )CHD179例和老年 (≥ 6 0岁 )CHD14 0例 ,青年非CHD10 9例的临床及冠状动脉造影资料进行回顾性分析和比较。结果 :青年CHD组吸烟、男性、血脂异常、心血管病家族史及大量饮酒明显多于老年组 (P <0 . 0 1或P <0 . 0 5 ) ,青年CHD组冠状动脉单支病变多 (P <0 . 0 5 ) ,老年组多支病变多 (P <0 .0 5 ) ,侧支循环多见于老年组。结论 :吸烟、男性、家族史、血脂异常及大量饮酒是青年CHD发病的重要因素 ,与超重也有关系。强调青年CHD的早期防治在于戒烟、限酒和控制体重     

老年心力衰竭患者营养状况及其影响因素

目的分析老年心力衰竭患者的营养状况及其影响因素。方法调查分析老年心力衰竭患者156例临床完整资料,采用微型营养评估量表(MNA)评价患者营养状况,将72例营养状况良好(MNA≥24分)患者纳入A组,将51例存在营养不良发生风险(17分≤MNA24分)患者纳入B组,将33例明确营养不良(MNA17分)患者纳入C组。设计一般情况调查表,记录3组一般资料、营养指标、心功能分级、吸烟史、生活质量、自我管理行为、社会支持及照顾者遵医行为等相关数据。经单因素与多因素分析找出老年心力衰竭患者营养状况的相关影响因素。结果经非条件多项Logistic回归分析,高龄、心功能分级高、生活质量差、自我管理行为、社会支持度低及照顾者遵医行为差均是影响老年心力衰竭患者营养状况的危险因素(OR1,P0.05)。结论高龄、心功能分级高、生活质量差、自我管理行为、社会支持度低及照顾者遵医行为差等可能临床应及时针对增加老年心力衰竭患者营养不良发生的危险因素进行早期干预,以维持患者营养状况。     

效能水平对老年骨质疏松患者骨折发生的影响

目的分析效能水平对老年骨质疏松(OP)患者骨折发生的影响。方法选择老年OP患者442例,采用一般自我效能感量表(GSES)进行效能水平评测,结合随访1年期间骨折事件,分析效能水平对老年OP患者骨折发生的影响。结果效能水平高、中和低三组中1年内累积骨折发生率分别为11.36%,19.7%和25.3%,三者差异显著(P0.05);Logistic多因素分析显示:中、高效能水平是老年OP骨折发生的保护因素,OR值分别为0.736、0.612;三组间与OP骨折发生相关行为因素的比较(吸烟、饮酒、体重、饮食、锻炼、跌倒行为)差异显著(χ2=20.906、19.364、15.571,15.575、13.256;F=26.26;P0.05);结论高效能水平可促进老年OP患者健康行为的转变,预防老年OP患者骨折事件的发生。     

老年2型糖尿病住院患者认知衰弱的检出率及影响因素分析

目的了解老年2型糖尿病住院患者认知衰弱现状及影响因素。方法收集290例老年2型糖尿病患者的资料, 使用一般资料调查表、2型糖尿病自我管理行为量表、简易衰弱量表、简易精神状态量表、临床痴呆评定量表、日常生活活动评估量表及5条目老年抑郁量表对研究对象进行调查。结果认知衰弱检出率12.8%, 二元Logistic回归分析显示文化程度(OR=0.114, P<0.05)、睡眠时长(OR=0.173, P<0.05)、合并糖尿病慢性并发症数量(OR=6.753, P<0.05)、抑郁(OR=5.706, P<0.05)及自我管理行为(OR=0.01, P<0.05)是认知衰弱的影响因素。结论老年2型糖尿病住院患者存在认知衰弱现象, 医护人员应该关注低教育水平、睡眠不足、合并糖尿病慢性并发症、自我管理水平差以及存在抑郁的患者, 在预防认知衰弱的同时提高老年人的生活质量。     

睡眠质量差的老年患者主观睡眠质量调查及影响因素分析

目的 调查睡眠质量差的老年患者的主观睡眠质量,分析相关影响因素,为构建老年慢性失眠的新型综合干预模式提供理论依据。方法 选取400名睡眠质量差的老年患者,采用匹兹堡睡眠质量指数量表(PSQI)进行睡眠质量调查。结果 主观睡眠质量差的老年患者PSQI总分为(13.05±3.55)分,其中35.75%的睡眠质量差的老年患者被诊断为失眠,频次≥3次/周的易醒或早醒(53.00%)、入睡困难(49.50%)和夜间去厕所(41.75%)是引起睡眠质量差的主要原因。结论 老年患者的主观睡眠质量与睡眠习惯、睡眠影响因素关系密切。医护人员应充分了解老年患者的睡眠习惯及影响因素,针对性进行睡眠护理,帮助其建立良好睡眠卫生习惯,改善睡眠质量。     

邢台县农村老年脑卒中恢复期患者抑郁情况及相关因素分析

目的 探讨邢台县山区农村脑卒中恢复期老年患者抑郁发生情况及其影响因素.方法 在邢台县山区农村随机抽取320例老年脑卒中恢复期患者,采用老年抑郁量表(GDS)将其分为抑郁组及非抑郁组.分别进行一般情况调查、神经功能缺损程度评分量表(CSS)评分、改良巴氏指数评定量表(ADL)评分,计算发病率及相关因素分析.结果 320例脑卒中恢复期老年患者中抑郁发生率42.5%;抑郁组及非抑郁组在经济状况及家庭支持度方面有统计学意义,抑郁组CSS评分高于非抑郁组(P＜0.05),抑郁组ADL评分低于非抑郁组(P＜0.05).结论 邢台县山区农村老年脑卒中恢复期患者抑郁发生率较高,影响因素有经济状况、家庭支持度、神经功能缺损程度、日常生活能力依赖程度.     

老年高血压患者性别差异的相关性研究

目的探讨老年高血压患者的性别差异。方法通过随机整群抽样的方法,选择西安局部地区老年高血压患者329例,其中男性185例,女性144例。对不同性别老年高血压患者进行一般人口学特征、慢性病、辅助检查及心理健康等调查,并比较和分析影响因素。结果男性与女性老年高血压患者在教育程度、吸烟、饮酒、慢性阻塞性肺病、骨关节病、空腹血糖、TG、TC、HDL-C、LDL-C、尿酸、肌酐、抑郁症状等方面比较,差异有统计学意义(P<0.05,P<0.01)。生活不规律、受教育程度是男性老年高血压患者的影响因素(OR=1.609,95%CI:1.018².542,P=0.042;OR=0.678,95%CI:0.5532.542,P=0.042;OR=0.678,95%CI:0.553⁰.832,P=0.000),高TG、受教育程度是女性老年高血压患者的影响因素(OR=1.486,95%CI:1.1310.832,P=0.000),高TG、受教育程度是女性老年高血压患者的影响因素(OR=1.486,95%CI:1.131¹.950,P=0.004;OR=0.710,95%CI:0.5971.950,P=0.004;OR=0.710,95%CI:0.597⁰.844,P=0.000)。结论受教育程度是男性和女性老年高血压患者共同保护因素。男性影响因素为生活不规律,女性为高TG。     

Anxiety and Drinking Behavior: Moderating Effects of Tension-Reduction Alcohol Outcome Expectancies

We evaluated whether alcohol outcome expectancies moderate the association between measures of anxiety and alcohol use. Student subjects completed questionnaires related to their level of anxiety, recent alcohol-use patterns, and outcome expectancies for alcohol to be tension reducing. Interviews were used to determine the presence or absence of alcohol dependence in subjects and in their first- and second-degree relatives. Consistent with predictions, male subjects with high tension-reduction alcohol outcome expectancies showed a stronger positive correlation between measures of anxiety and drinking behavior than did male subjects with low tensionreduction outcome expectancies. However, this effect was not found for female subjects. We note past studies showing similar gender effects, and relate the overall study findings to the tension-reduction hypothesis of stress-induced drinking.     

Carbohydrate-deficient transferrin levels reflect heavy drinking in alcohol-dependent women seeking treatment

BACKGROUND: Carbohydrate-deficient transferrin (CDT) is a biochemical marker that has been shown to be sensitive in detecting heavy drinking in men, but studies examining CDT in women have been inconsistent because of small sample sizes and failure to consider hormonal status. In healthy female subjects, CDT levels are significantly higher in premenopausal women with higher estradiol (E2) levels (>30 pg/ml) and those taking exogenous estrogens (oral contraceptives, hormone replacement therapy) compared with men and postmenopausal women. This study examined the relationship between drinking behavior and CDT levels in a large sample of alcohol-dependent women and contrasted findings in a comparison group of alcohol-dependent men. The study also examined the extent that E2 levels mediated the relationship between CDT levels and heavy drinking in the alcohol-dependent women. METHODS: This study examined the association between CDT level at treatment entry and alcohol consumption the month before initiating treatment in 96 women with a DSM-III-R diagnosis of alcohol dependence, as compared with similar data in 123 male alcoholics. To explore the relationship between E2 and CDT, E2 was measured in women at the time of CDT sampling. Linear regression was used to examine whether patterns of alcohol consumption in the 28 days before the CDT blood sampling predicted the CDT level in women and men presenting for treatment for alcohol dependence. RESULTS: CDT levels were higher in women than men and were related to quantitative alcohol consumption (total standard drinks, percentage of days drinking, percentage of days of heavy drinking) in the month before initiating treatment, irrespective of E2 levels in women. CONCLUSIONS: These results suggest that in a larger sample of female alcoholics, the amount of alcohol consumed predicted CDT, similar to what has been reported in male alcoholics. The E2 status did not seem to mediate these results.     

P rats develop physical dependence on alcohol via voluntary drinking: changes in seizure thresholds, anxiety, and patterns of alcohol drinking

BACKGROUND: It has been proposed that the alcohol-preferring P rat meets many of the criteria for an animal model of alcoholism. However, the development of alcohol dependence has not been explored in rats that self-administer ethanol for less than 15-20 weeks. The present study investigated the development of physical dependence upon alcohol after 2-6 weeks of voluntary alcohol intake. Changes in bicuculline-induced seizure thresholds, microstructure of alcohol drinking, and anxiety-related behavior were used as indices of alcohol dependence. In addition, we evaluated the microstructure of alcohol drinking associated with the development of physical dependence upon alcohol. METHODS: Alcohol (10% ethanol solution) was measured in graduated drinking tubes with both alcohol and water available continuously. Microstructure of alcohol intake was monitored by a computerized drinkometer. Physical dependence upon alcohol was determined by measuring bicuculline-induced seizure thresholds after alcohol withdrawal. Anxiety-related behavior of P rats after alcohol withdrawal was determined by the social interaction and elevated plus maze tests. RESULTS: Initial alcohol intake in the alcohol-preferring P rat was relatively modest (3.9 +/- 0.4 g/kg/day). Four days of forced alcohol exposure (initiation) followed by 6 weeks of voluntary drinking resulted in an increase of alcohol intake to 5.5 +/- 0.2 g/kg/day. Ethanol self-administration for 6 weeks, but not for 2 or 4 weeks, produced a significant reduction (30%; p < 0.05) in bicuculline-induced seizure thresholds during alcohol withdrawal. Alterations in the microstructure of alcohol intake (i.e., 90% increase in the size of alcohol drinking bouts compared to the baseline [p < 0.001] with no change in bout frequency) were associated with the development of alcohol dependence. Termination of alcohol intake after 6 weeks of voluntary alcohol consumption resulted in increased anxiety according to both the social interaction and elevated plus maze tests. CONCLUSIONS: The results of this study indicate that 6 weeks of voluntary alcohol intake are sufficient for the development of physical dependence upon alcohol in the alcohol-preferring P rats as measured by susceptibility to bicuculline-induced seizures. This time is much shorter than the 15-20 weeks reported earlier. Development of physical dependence to alcohol was associated with an increase in daily alcohol intake (40% over the baseline), an increase in alcohol intake during each drinking bout (90% over the baseline), and elevated anxiety during alcohol withdrawal.     

Prolactin serum levels during alcohol withdrawal are associated with the severity of alcohol dependence and withdrawal symptoms

Background: Prolactin serum levels have been described to be elevated during alcohol withdrawal in alcohol‐dependent patients and normalize during abstinence. Alterations in prolactin levels may reflect disturbances of dopaminergic neurotransmission which is of crucial importance for alcohol‐seeking behavior. Methods: In this longitudinal observational study, we investigated prolactin serum levels in 99 male patients during the first 14 days of alcohol withdrawal and early abstinence and in 43 healthy controls. To assess the severity of alcohol dependence, the extent of withdrawal symptoms, craving, depressive symptoms, and anxiety, we employed a structured interview including psychologic measurements. Results: Prolactin serum levels were elevated during the whole study period in alcohol‐dependent patients compared to the healthy control group. Prolactin levels at admission (first day of alcohol withdrawal) were associated with the severity of alcohol withdrawal (CIWA‐Ar) and of alcohol dependence (SESA) but not with the other assessed psychologic parameters. Conclusions: The presented findings confirm that prolactin is significantly elevated in alcohol‐dependent patients during alcohol withdrawal and early abstinence, not showing a rapid decline after cessation of drinking. The association with the severity of withdrawal and dependence may reflect at least partially the individual alterations in the dopaminergic and glutamatergic pathways.     

A Cross-cultural Study of Alcohol Dependence in Singapore

This is a comparative study of alcohol dependence in Chinese and Indian patients admitted to a hospital in Singapore. There were 46 patients-21 Chinese and 35 Indians. In both ethnic groups there was a preponderance of male over female patients. There was no significant difference in the mean ages of the two groups but Indian patients started drinking at an earlier age and more of them had a family history of alcohol problems. Comparing the severity of alcohol dependence, Indian patients scored higher on the SADQ but no patients scored above 30 points.     

Drinking Culture of Elderly Korean Immigrants in Canada: A Focus Group Study

The purpose of this study was to explore the drinking culture of elderly Korean immigrants in Canada. Using a focus group approach, qualitative data were collected from 19 elderly Korean immigrants (14 men; 5 women) residing in Canada. Data were analyzed using the techniques of grounded theory. The findings indicated that elderly Korean immigrants did not dramatically change their understanding of drinking or their ways of drinking. Instead, they modified their drinking behavior in accordance with the social and legal environment of their new country. In particular, Canadian alcohol policies, including the higher cost of alcohol, lower accessibility, and strict law enforcement, discouraged excessive drinking. Policy implications and recommendations for future research are presented.     

"Never believe an alcoholic"? On the validity of self-report measures of alcohol dependence and related constructs

A study of 114 male and female alcoholics was conducted to evaluate the validity of information obtained by means of self-report questionnaires. Factor analysis was used to derive composite measures of alcohol dependence, withdrawal symptomatology, pathological intoxication, and alcoholic psychosis. Validation was conducted by comparing these measures with independent and external criteria; that is drinking estimates made by collateral informants, measures of general alcohol involvement, and drinking behavior 6 months after treatment. The results support each type of validity, and thereby contradict the assumption that the alcoholics' self-reports were not accurate. The question of unreliable self-report data due to the demand characteristics of the situation under which the information is obtained is also addressed.     

Influence of age at drinking onset on long-term ethanol self-administration with deprivation and stress phases

BACKGROUND: Onset of alcohol use during adolescence has potentially long-lasting consequences, e.g., prospective alcohol dependence. To obtain new insight into the effects of early chronic ethanol consumption, we compared the drinking behavior of two adult male Wistar rat groups: one that initiated alcohol consumption during adolescence (adolescent group) and the other that initiated their drinking during adulthood (adult group) in a model of long-term alcohol self-administration. We investigated the magnitude of the effects of deprivation and stress on alcohol intake and the influence of these events on the alcohol drinking behavior across time. METHODS: Heterogeneous Wistar rats aged 31 days (adolescents) and 71 days (adults) were given ad libitum access to water, as well as 5% and 20% ethanol solutions during an observation period of 30 wk. A deprivation phase of 14 days was instituted after eight wk of access to alcohol. After 16 and 26 wk of alcohol access, all animals were subjected for three consecutive days to forced swimming and electric foot shocks, respectively. RESULTS: At the onset of drinking, adolescent animals consumed less alcohol and showed lower preference than adults. The deprivation phase was followed by increased intake of highly concentrated ethanol solution without appreciable differences between age groups. Repeated swim stress produced a slight increase in ethanol consumption in both animal groups; however, alcohol intake was not significantly different between groups, whereas the foot shock stress-induced increase in alcohol intake was significantly higher in the animal group that initiated alcohol consumption during adolescence. After swim stress, the drinking behavior of the adolescent group resembled that of the adult group. In particular, the adolescent group increased their preference for 20% ethanol solution for the remainder of the experiment. CONCLUSIONS: Age of voluntary alcohol drinking onset does not appear to be a strong predictor for prospective alcohol intake and relapse-like drinking behavior under the present experimental conditions. However, male Wistar rats that initiated alcohol consumption during adolescence seem to be more susceptible to acute stressor-specific effects in terms of alcohol consumption.     

Development of Alcohol Drinking Behavior in Rat Lines Selectively Bred for Divergent Alcohol Preference

A characteristic of heritable alcoholism is an early onset of alcohol abuse, which may begin at or before the age of adolescence. The objective of the present study was to determine the ontogeny of alcohol drinking behavior before and during puberty in the selectively bred alcohol-preferring (P), alcohol-nonpreferring (NP), high alcohol drinking (HAD), and low alcohol drinking (LAD) lines of rats. In addition, the effects of postweaning housing conditions (single- or pair-housed) and initiation procedure (4 days forced ethanol or free-choice) were evaluated in male and female P rats. Results indicate that high alcohol drinking in P and HAD (replicate line 2) rats, as well as low alcohol drinking behavior in NP and LAD (replicate line 2) rats, is present as early as 3 to 4 weeks of age. Ethanol intakes in juvenile P and HAD rats reached levels of ∼4 to 5 g/kg/day by 38 to 41 days of age and were comparable with levels observed in adults. Neither housing conditions nor ethanol initiation procedure significantly altered the acquisition or magnitude of alcohol intake levels in juvenile male and female P rats. These results suggest that the neural substrates underlying divergent ethanol drinking behavior in P/NP and HAD/LAD lines of rats are present early in life.     

Acculturation, drinking, and alcohol abuse and dependence among Hispanics in the Texas-Mexico border

Background:  Acculturation has been linked to an increased prevalence of alcohol‐related problems. However, most of the research has been conducted with Hispanic populations in metropolitan areas of the United States, none of which is on the U.S.–Mexico border. This study examines the association between acculturation, heavy episodic drinking, and DSM‐IV alcohol abuse and dependence among Hispanics in the Texas–Mexico border. Methods:  The study used data from a survey conducted (2002 to 2003) along the Texas–Mexico border and included 472 male and 484 female Hispanic adults from El Paso, the Rio Grande Valley, and colonias. Based on the Acculturation Rating Scale for Mexican Americans‐II scale, respondents were coded into 4 acculturation categories: “very Mexican oriented,”“Mexican bicultural,”“Anglo bicultural,” or “very Anglo/Anglicized.”. Results:  Acculturation was related to lower rates of alcohol use disorders among men and a higher frequency of heavy episodic drinking among women. Multivariate analyses indicate that men who report heavy episodic drinking and those who are “very Mexican,”“bicultural Mexican,” or “bicultural Anglo” are more at higher risk for alcohol abuse and/or dependence compared with “very Anglo/Anglicized” men. For women, acculturation level did not predict alcohol disorders. Statistical analyses included testing for bivariate associations and multivariate logistic regression predicting heavy episodic drinking alcohol abuse or dependence. Conclusions:  This study suggests that acculturation has different effects on drinking for men and women. This finding needs some attention as literature also indicates that women drink more and may develop more alcohol‐related problems as they acculturate. This increase in women’s drinking is probably because of U.S. society’s more liberal norms governing female drinking. The “bimodal” distribution of risk, in which only men in “very Anglo” group are at a lower risk than the others, may be unique to the Border. The association between acculturation and alcohol use disorders does not appear to be linear and the effect of acculturation is not uniform on individuals’ drinking behavior.