Clusters of drug involvement in Panama: results from Panama's 1996 National Youth Survey

This report is based on the first epidemiological investigation of clustering of tobacco, alcohol, inhalant, and other drug involvement within individual schools using data from Panama's 1996 National Youth Survey on Alcohol and Drug Use. Clustering was estimated with the Alternating Logistic Regression method. Adjusted estimates of pair-wise cross-product ratios (PWCPR), a measure of clustering, show modest clustering (i.e. PWCPR>1.0) at the school level for tobacco smoking (PWCPR=1.41; 95% confidence interval, CI=1.22–1.64), alcohol consumption (PWCPR=1.33; 95% CI=1.22–1.45), use of inhalants, (PWCPR=1.35; 95%CI=1.07–1.69), and other drug use (PWCPR=1.38; 95%CI=1.14–1.68). These findings provide preliminary evidence that the odds of drug use among school-attending youths increase when another youth in the same school uses drugs, and suggest a new line of research on within-school diffusion that should include the identification of school-level factors that contribute to student drug use.     

社区老年糖尿病人群血管并发症、合并症的发生情况及其影响因素

目的了解老年糖尿病(DM)人群中DM慢性并发症(微血管病变、大血管病变及神经病变等)和主要合并症(包括高血压、血脂代谢异常、肥胖等)的发生情况以及血管并发症的影响因素。方法采用横断面研究的方法,收集社区老年DM人群资料,并把DM血管并发症作为因变量,对其影响因素进行非条件logistic回归分析。结果老年DM慢性并发症以及高血压、血脂代谢紊乱、肥胖等合并症的发生率很高;经济水平较低社区、发病年限长、有DM家族史、医疗费支付有困难、空腹血糖控制不良、急性并发症、主要合并症是导致社区老年DM人群微血管并发症的主要独立因素;吸烟、嗜甜食、医疗费支付有困难、急性并发症、主要合并症是导致社区老年DM人群大血管并发症的主要独立因素。结论老年糖尿病人群糖尿病并发症及合并症的影响因素很多,这一方面说明其病情的复杂性,另一方面也为更好地控制其发生和发展及有效地降低致残率和致死率提供了综合控制的手段。     

Drinking in the presence of underage children: Attitudes and behaviour

The ambivalent characteristic of the Finnish drinking culture is particularly evident in the context of family life. While drinking to intoxication in the home environment is widely tolerated, attitudes towards drinking in the presence of children appear negative, and there is broad political concern about harms to children. This study aims to both illuminate the attitudes towards drinking and the actual drinking behaviour of parents living with their children. We use data on 19–59-year old Finns from a general population survey (n?=?2046). Respondents were asked about their drinking habits, recent drinking occasions and attitudes to drinking. Men under 40 years of age without underage children at home drank significantly more and more often to intoxication than those who had underage children. In a similar manner, women in all age groups without children at home drank significantly more often to intoxication than those who had children at home. Drinking to intoxication while children are present was almost unanimously considered inappropriate. Yet almost 40% of respondents considered it acceptable to drink to intoxication in the child's company if someone else is looking after the child. There was a significant relationship between these attitudes and actual behaviour among women. The drinking culture in Finland is very permissive, with intoxication often considered suitable for children's eyes as long as their safety is guaranteed. Prevention efforts should continue to target these attitudes and behaviour.     

Childhood physical punishment and the onset of drinking problems: evidence from metropolitan China

Background

Evidence in support of a suspected causal association linking childhood physical punishment (CPP) and later alcoholic beverage-related disturbances has been found in metropolitan China. Here, the focus shifts to the CPP association with the estimated risk of starting to drink, having the first drinking problem, and transitioning from first drink to the first drinking problem.

Methods

Data are from the World Mental Health Surveys-metropolitan China study, with representative samples of adult household residents living in two metropolitan cities, Beijing and Shanghai. Recalled information was available for early life experiences (including CPP, other childhood adversities, and parental alcohol and drug problems), as well as the onset age of drinking and drinking problems. Survival analyses were used to estimate the Hazard Ratio. A structural equation modeling approach was used to control for other inter-correlated childhood adversities.

Results

Cox proportional hazards modeling discloses statistically robust associations linking CPP with drinking and drinking problems, as well as more rapid transitions from first drink to first drinking problem, even after accounting for other childhood adversities and parental drinking problems. These associations cannot be attributed to a more general noxious family environment.

Conclusions

These results lay a foundation for future experimental studies on the possible causal relationship linking CPP with the onset of drinking problems and the transition from drinking to drinking problems.     

The influence of paternal and maternal drinking patterns within two-partner families on the initiation and development of adolescent drinking

As it is still unclear to what extent parental drinking is a predictor of children's alcohol use, we tested the association of specific paternal and maternal drinking patterns with both initiation and development of adolescent alcohol use. Longitudinal data (four annual measurements) of parent-child dyads (N=2319) have been used. Parental drinking patterns have been identified using latent class analysis. The association of parental drinking patterns with the initiation and development of 12-15 year olds' drinking have been examined with latent growth curve modeling. Only two out of six parental drinking patterns were related to adolescent drinking. That is, having a heavy drinking father or two heavy episodic drinking parents particularly predicts early and heavier adolescent drinking. When controlled for parenting behaviors and background variables, such as adolescent gender, age and socioeconomic status (SES), these findings remained significant. Interaction analyses revealed that the influence of parental heavy (episodic) drinking differs across gender and is especially strong among adolescents with lower SES. Thus, parental heavy (episodic) drinking, and not so much the frequency of drinking, predicts the initiation and development of alcohol consumption in their offspring. Parents and professionals must be aware that parental heavy drinking affects their offspring, particularly adolescents with lower SES, resulting in earlier and heavier drinking among this high-risk group.     

产后抑郁症发病特点及社区干预策略

目的了解本地区产后抑郁症在不同年龄段，独生子女与非独生子女的发病特点和相关因素，为社区干预策略提供干预依据。方法用自行设计的产后抑郁症知晓率问卷，一般情况调查表和爱丁堡产后抑郁量表对800名产妇进行调查。知晓率问卷用百分比表示，一般情况调查表各因素用P值。结果产后抑郁症发生率为18．63％。80后独生子女发病率高，产后7～14天为疾病高发期，产妇对产后抑郁症的知晓率低，多因素共同影响产后抑郁症发生。结论提高产后抑郁症知晓率和社区医疗干预很有必要。社区干预的重点在健康教育，心理干预。     

Exploring the boundary between health protective and hazardous drinking in a community cohort

We sought to identify a level of alcohol consumption representing the boundary between health protective and hazardous drinking. The Winnipeg Health and Drinking Survey began in 1990–91 (n = 1257). Seven years later, a third wave of interviews (n = 785) expanded questions on heavy episodic drinking (HED) and assessed the consumption of ≥ 3, ≥ 5, ≥ 8, and ≥ 12 drinks at a sitting for each of wine, beer and liquor (equivalent to about 40 g, 65 g, 105 g and 155 g of ethanol). Cox proportional hazards models were based on seven years of illness and mortality data following the Wave 3 interview, and were stratified by gender and HED definition. For HED of ≥ 40 g, ≥ 65 g, ≥ 105 g, or ≥ 155 g per occasion, the hazard ratios for morbidity and mortality from all causes were 1.06, 1.09, 1.17, and 1.16 respectively in women, and 1.00, 0.98, 1.02, and 1.02 in men. Most of these hazard ratios were significant in women, whereas none was significant in men. This study did not provide support for a definition of HED that could divide protective from hazardous alcohol consumption.     

Racial/Ethnic and Educational Differences in the Estimated Odds of Recent Nitrite Use among Adult Household Residents in the United States: An Illustration of Matching and Conditional Logistic Regression

This article compares estimates of the relative odds of nitrite use obtained from weighted unconditional logistic regression with estimates obtained from conditional logistic regression after post-stratification and matching of cases with controls by neighborhood of residence. We illustrate these methods by comparing the odds associated with nitrite use among adults of four racial/ethnic groups, with and without a high school education. We used aggregated data from the 1994-B through 1996 National Household Survey on Drug Abuse (NHSDA). Difference between the methods and implications for analysis and inference are discussed. [Translations are provided in the International Abstracts Section of this issue.]     

Individual and community correlates of young people's high-risk drinking in Victoria, Australia

Objectives

To examine key individual- and community-level correlates of regular very high-risk drinking (more than 20 drinks at least 12 times a year for males and more than 11 drinks at least 12 times a year for females) among young (16–24) drinkers in Victoria.

Methods

CATI survey of 10,879 young Victorian drinkers. Multi-level modelling of correlates of proportion drinking at very high-risk levels at both individual (e.g. age, gender) and community levels (e.g. alcohol outlet density, remoteness).

Results

One-fifth of the sample reported regular (at least monthly) very high-risk drinking. Significant individual-level correlates of very high-risk drinking included age, gender, cultural background, recreational spending money, life stage, living situation, family conflict and age at first drink. Significant community-level correlates included remoteness (living in a rural area) and packaged liquor outlet density.

Conclusions

The study highlights a range of important factors relating to regular drinking of dangerous amounts of alcohol by youth. Interventions aimed at preventing early initiation or managing recreational spending should be explored. Further, regulatory management of packaged liquor outlets and or remote rural communities in Victoria with high levels of dangerous drinking should be a priority.     

Beyond personality—Experimental investigations of the effects of personality traits on in situ alcohol consumption in social and solitary drinking contexts

Numerous studies have highlighted that personality traits are associated with alcohol problems and disorders; however, little is known on the link between personality and the quantities of alcohol actually ingested during given drinking episodes (i.e. in situ alcohol consumption, in grams of pure alcohol). Based on data of 123 young adults who participated in two wine-tasting assignments (one performed in group, the other individually; sequence of participation assigned at random), the results from regression models suggest that individual characteristics and personality traits are, to some extent, associated with in situ alcohol consumption, but contextual factors (e.g., in line with behavioral exposition and perceptions of norms) might overwhelm such associations in a social context, or later on in similar drinking contexts. These findings argue for the development of early preventive initiatives focusing on social influences and on specific drinking context.     

The Influence of Parent,Sibling, and Peer Modeling and Attitudes on Adolescent Use of Alcohol

This 1-year prospective study of 173 families with two or more children examines the influence of parent, sibling, and peer modeling (i.e., use) and attitudes on adolescent use of alcohol. Independent questionnaire data were obtained from the adolescent, father, mother, and sibling(s). Structural equation modeling methods were employed to examine these relationships. Parent attitude toward youth alcohol use and parent modeling of alcohol use were strongly related to change in adolescent alcohol use, suggesting that parents can influence the future use of alcohol by their children. Peer and sibling modeling and peer attitudes also influenced adolescent alcohol use     

Peer influence in a micro-perspective: Imitation of alcoholic and non-alcoholic beverages

Ample experimental research has found evidence for imitation of alcohol consumption in social encounters. However, these studies cannot reveal whether imitation is specifically related to alcohol and not to consumption in general. We investigated whether imitation is more evident when peers drink alcohol compared to other beverages. We observed sipping behavior during a 30-minute interaction between same-sex confederates and participants in an ad lib semi-naturalistic drinking context (bar lab). We expected a stronger imitation effect when both participant and confederate drank alcoholic beverages. A random occasion multilevel analysis was conducted to take repeated measurements into account. Findings showed that participants imitated the sips of the confederates, but that the likelihood of participants imitating a sip was lower when confederates were drinking alcoholic beverages and participants non-alcoholic beverages compared to when both were consuming alcohol.     

The influence of religious affiliation on heavy drinking,heavy smoking and heavy betel nut chewing

The results of a national survey of determinants of drinking, smoking and betel-nut chewing behaviors are analyzed. The purpose of this paper is to empirically investigate whether drinking, smoking and betel-nut chewing are influenced by a variety of religions based on Taiwan data. Our results suggest that Buddhism, Taoism and practitioners of Chinese folk region are positively associated with heavy betel nut chewing while the religion effects on heavy smoking and drinking are statistically insignificant. Our findings on religion effects in Taiwan can be a valuable reference for comparison in Christian and western countries.     

Alcohol use in New York after the terrorist attacks: a study of the effects of psychological trauma on drinking behavior

Research has suggested that exposure to psychological trauma is associated with increased abuse of psychoactive substances, particularly alcohol. To assess this, we analyzed alcohol consumption, binge drinking, and alcohol dependence among a random sample of 1681 New York City adults 1 year and 2 years after the September 11 attacks. In multivariate models controlling for demographic factors, other stressor exposures, social psychological resources, and history of anti-social behavior, we found that greater exposure to the World Trade Center disaster (WTCD) was associated with greater alcohol consumption at 1 year and 2 years after this event. In addition, our analyses also indicated that exposure to the WTCD was associated with binge drinking at 1 year after but not 2 years after this event. Alcohol dependence, assessed as present in either year 1 or year 2, also was positively associated with greater WTCD exposures. Posttraumatic stress disorder was not associated with alcohol use, once WTCD exposure and other covariates were controlled. Our study suggests that exposure to psychological trauma may be associated with increases in problem drinking long after exposure and deserves further investigation.     

Stability of scores and correlations with drinking behaviors over 15 years for the self-report of the effects of alcohol questionnaire

Background

The low level of response (LR) to alcohol is an endophenotype that predicts future heavy drinking and alcohol use disorders (AUDs). LR can be measured by laboratory-based alcohol challenges or by the retrospective Self-Report of the Effects of Alcohol (SRE) questionnaire. This paper reports the relationships among these two measures and how each related to both recent and future drinking quantities and problems across 15 years in 235 men.

Methods

Probands from the San Diego Prospective Study (SDPS) participated in alcohol challenges to determine their LR at age 20, and subsequently at ages 35, 40, 45 and 50 filled out an SRE regarding the number of standard drinks needed for up to four effects early in life (SRE5) and across early, recent, and heaviest drinking life epochs (SRET). Changes in SRE scores across time were evaluated with ANOVAs and Pearson correlations were used to evaluate how SRE5, SRET and earlier alcohol challenge-based LRs related to prior five-year drinking histories and future alcohol involvement.

Results

While SRE scores decreased 9% over the 15 years, the relationships between SRE values with prior five-year drinking parameters and with future alcohol intake and problems remained robust, and even improved with advancing age. A similar pattern was seen for correlations between SRE and alcohol challenge-based LRs 15–30 years previously.

Conclusions

Alcohol challenge and SRE-based LRs related to each other, to alcohol use patterns, and to future alcohol problems across age 35–50 in the men studied here.     

健康教育对提高社区高血压患者用药依从性的影响研究

目的：探讨健康教育对提高社区高血压患者用药依从性的影响。方法选择2010年1月~2013年3月收治的220例高血压患者作为研究对象,随机分为观察组与对照组,各110例。对照组给予临床常规用药治疗,观察组在对照组的基础上给予健康教育,比较两组的高血压知识评分、个人健康行为率、用药依从性。结果观察组的高血压知识评分、个人健康行为率、用药依从性显著高于对照组,差异有统计学意义(P<0.05)。对照组的健康饮食者为69例(62.7%),适量运动者为48例(72.7%)；观察组的健康饮食者为80例(43.6%),适量运动者为90例(81.8%),两组比较差异有统计学意义(P<0.05)。观察组的SBP为(100.61±12.35)mm Hg,DBP为(80.82±10.41)mm Hg；对照组的SBP为(123.45±11.78)mm Hg,DBP为(103.79±11.65)mm Hg,两组比较差异有统计学意义(P<0.05)。观察组体育锻炼、低盐饮食、服药、主动测压等健康行为的比率显著优于对照组,差异有统计学意义(P<0.05)。结论健康教育在社区高血压护理中的效果显著,不仅提高了高血压患者的用药依从性,也提高了患者的高血压知晓率和控制率,值得临床推广应用。     

社区团队医师以责任制形式进行健康教育对社区高血压人群的影响

目的了解社区团队医师以责任制形式进行健康教育对社区高血压患者健康知识的知晓率、血压控制率以及心脑血管事件发生的影响。方法以富阳市场口镇5个行政村818例高血压患者为研究对象,按照随机分组的原则将其分为健康教育组和对照组。健康教育组采取定期随访并健康教育和用药指导进行干预,对照组采取定期随访和自愿服药的模式,随访2年,记录两组高血压人群知识知晓情况、血压控制情况以及心脑血管事件发生情况。结果两组人群的高血压相关知识知晓率和血压控制率均较干预前提高（P〈0．01）,且健康教育组明显优于对照组（P〈0．01）;收缩压与舒张压均较干预前下降（P〈0．01）,健康教育组比对照组下降更明显（P〈0．01）;健康教育组心脑血管事件的发生率低于对照组（P〈0．01）。结论强化健康教育可提高社区人群高血压知识的知晓率．降低高血压患者心脑血管事件发病的风险．     

Part-time work and adolescent heavy episodic drinking: the influence of family and community context

OBJECTIVE: Previous studies on part-time work and alcohol use suggest that teenagers who work longer hours drink more heavily. The purpose of this study was to investigate whether family- and community-level factors moderate the relationship between part-time work hours and heavy episodic drinking. METHOD: Data were drawn from the Canadian Community Health Survey, a cross-sectional study of a nationally representative sample of Canadians. The survey included 8,080 respondents 15-19 years of age who reported work hours and frequency of heavy episodic drinking over the past 12 months. These respondents were located in 136 counties or municipalities across Canada. RESULTS: On average, work hours were positively associated with the frequency of heavy drinking by teenagers in the past 12 months. At the community level, the proportion of teenagers in each community drinking any alcohol was independently and positively associated with respondents' frequency of heavy drinking. In terms of moderating effects, we found that the work hours-drinking association was weaker among youth from low socioeconomic status families. Examination of community-level factors indicated that longer work hours were more strongly associated with heavy episodic drinking in communities with high rates of teen alcohol abstinence. CONCLUSIONS: Although the cross-sectional data prohibit any firm conclusions on how family and community factors influence the work-alcohol use relationship, these data suggest that interventions to reduce heavy episodic drinking among teens should address the broader environmental as well as the individual determinants.     

Alexithymia,reward sensitivity and risky drinking: the role of internal drinking motives

Two personality dimensions, alexithymia and reward sensitivity, are known risk factors for problematic alcohol consumption. Internal or mood-change motives of drinking to cope with negative mood, as well as drinking to enhance positive mood (“get high”), have also been implicated as risk factors. The present study sought to determine whether the association between alexithymia and risky drinking is mediated by the motive of drinking to cope with negative mood, and whether the association between reward sensitivity and risky drinking is mediated by the motive of drinking to enhance positive mood. Social drinkers aged 18–45 years were recruited from an Australian university and the local community, with the final sample consisting of 155 participants (80 females, 75 males). They completed an online questionnaire battery that included the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales 21 (DASS-21), Drinking Motives Questionnaire – Revised (DMQ-R), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), and Alcohol Use Disorders Identification Test (AUDIT). The positive relationship between TAS-20 alexithymia and AUDIT index of risky drinking was mediated by coping motives for drinking, with the relationship of TAS-20 to the latter mediated by negative mood as indexed by DASS-21. Further, the positive relationship between SPSRQ sensitivity to reward scores and AUDIT was mediated by enhancement motives for drinking. Although results were obtained in a non-clinical sample, they are consistent with the differential drinking motives said to characterize Type I versus Type II alcoholism and suggest distinct trajectories from inherent personality traits to problematic drinking.     

社区药学服务对ACS患者预后的影响

目的 探讨社区药学服务对急性冠脉综合征(ACS)患者预后的影响.方法 收集2020年1月～12月在我中心就诊的ACS患者200例,随机分成对照组和药师干预组.对照组提供家庭医生服务,药师干预组提供家庭医生服务和药学服务,随访1年后,比较两组患者预后情况.结果 药师干预组认知水平和危险因素控制达标率均高于对照组(P<0....