Use of pseudo-patrons to assess compliance with laws regarding under-age drinking

Abstract: The extent to which door and bar staff of licensed premises responded to possibly under-age patrons was assessed through the use of research assistants (young pseudo-patrons) selected for having the appearance of being under 18 years old. A total of 156 visits were made to 13 licensed premises: 1. before delivery of a server training program, 2. immediately after training, and 3. after three months. Staff rarely checked the age and/or identification (ID) of the young pseudo-patrons before or after training. However, a significant interaction was found between the sex of the pseudo-patron and the type of premises. Door staff, who were predominantly at nightclubs, were more likely to check the ID of female pseudo-patrons and hotel bar staff were more likely to check the ID of males. In most cases, however, nonphotographic ID was accepted. While some strategies are suggested, the strongest and most effective measure to prevent under-age drinking will be a more rigorous enforcement of existing liquor laws.     

Is thirst associated with disability in hospital inpatients?

Objectives: The study aimed to determine what factors prevent patients from drinking in hospital. It also investigated whether thirst is associated with disability and how patients obtain drinks.
Methods: Structured interviews with patients and staff were carried out using the Office of Population Censuses and Surveys (OPCS) disability instrument to measure patient's disability. The study took place in an oncology, orthopaedic and general medical ward in three Cardiff hospitals, with 50 patients studied on each ward (150 patients in total). The main outcome measures were thirst score, ease of reaching drinks, waiting before asking for assistance, availability of drinks and help to drink, and disability score.
Results: Fifty-two per cent ( n = 78) of the sample were more thirsty than usual since admission.
Thirty-seven per cent ( n = 56) were not able to drink as often as they needed to. For these patients the causes included: inability to reach the drink (89%) reluctance to ask for help to drink (45%), unavailability of drinks (32%) and unavailability of help to drink (29%). Of the patients who needed help to drink, 94% ( n = 33) waited before asking for help, and 91% did so because they did not want to trouble busy staff. Significant associations were found between thirst and various aspects of disability (locomotion, reaching and stretching, dexterity, personal care and continence).
Conclusion: Thirst was common in the sample of inpatients interviewed. Many patients were unable to drink as often as they needed. Inability to reach drinks, reluctance to ask busy staff for help and unavailability of drinks or help to drink were the main reasons for this. Thirst was associated with disability. No causal relationship was proved, but disabled dependant patients rely on the availability of drinks within reach and help to drink. Lack of these provisions may be important factors contributing to thirst in disabled inpatients.     

Effect of caffeine-deprivation on liking for a non-caffeinated drink

Liking for a novel non-caffeinated drink decreases when regular caffeine consumers are exposed repeatedly to that drink when caffeine-deprived; however, this dislike is not manifest if people are subsequently tested when not caffeine-deprived (Yeomans et al., 2000a). The present study investigated the basis for this effect, and in particular, whether the decrease in liking observed is specific to the drink flavour experienced during caffeine-deprivation. Twenty-four caffeine consumers evaluated five novel drinks (fruit teas) at pre-training. For each person, the drink with the median liking score was subsequently consumed mid-morning after 12 h caffeine-deprivation on four non-consecutive training days. Rated pleasantness of this drink decreased significantly over these four training days. Subjects subsequently re-evaluated all five drinks on a test day when half the consumers were given 100mg caffeine two hours prior to testing, with the remainder receiving placebo. The group who remained deprived continued to express depressed liking for the exposed (target) drink, compared to their pre-training rating of that drink. In contrast, rated pleasantness was not depressed compared to pre-training ratings in the group who had received caffeine prior to testing. Rated pleasantness of the four unexposed drinks was equivalent to pre-training ratings, for both groups, suggesting that the effect of exposure on ratings of the target drink was specific to that drink. As expected, there was some evidence of improved mood in the group receiving caffeine on the test day; but as it was only ratings of the target drink that differed across groups, the group difference cannot be attributed to general effects of mood on use of the rating scale. These data suggest that the reversal of acquired changes in liking for drinks when consumers are changed from a caffeine-deprived to an undeprived condition is best explained in terms of state-dependent learning, that is specific to the drink experienced during caffeine-deprivation.     

Expecting yoghurt drinks to taste sweet or pleasant increases liking

This experiment studied the effect of cues on liking of yoghurt drinks. We examined how hedonic (degrees of like/dislike) and sensory (level of sweetness/saltiness) cues affected liking ratings. In the learning phase, thirty-nine participants learned to associate cues with yoghurt drinks. Cues were learned for mildly and highly salty and sweet yoghurts. Sweet yoghurts were used as liked, salty yoghurts as disliked stimuli. Half the participants associated the cues with yoghurt liking (i.e. hedonic cues), the other half with the sweetness or saltiness of the yoghurt drink (i.e. sensory cues). In the test phase a cue was presented to participants subliminally (20 ms) or supraliminally (500 ms) before they tasted and rated liking of one of three yoghurt drinks in each category. The three yoghurt drinks consisted of the trained samples and a new third drink situated approximately half-way in between. The cue-drink combination was either congruent (the cued drink was given) or incongruent (two degrees of incongruence). For sweet yoghurt drinks cue-following assimilation effects were found for the supraliminal but not the subliminal cue presentations. For salty yoghurts, no effects of cue were found. This indicates that the nature of the drinks itself plays a critical role in modulating assimilation.     

Factors associated with soft drink consumption in school-aged children

OBJECTIVE: To identify factors associated with nonalcoholic carbonated beverage (soft drink) consumption in children. DESIGN: Mail-in surveys collected by Dragonfly, a children's educational magazine distributed nationally to elementary and middle schools, were analyzed. The survey included questions about frequency of soft drink consumption and factors related to soft drink consumption. SUBJECTS AND PARTICIPANTS: The sample consisted of 560 children, 8 to 13 years old, who completed and mailed in the survey. There was an equal distribution of boys and girls (51% and 49%, respectively). STATISTICAL ANALYSES: Frequency distributions were calculated and chi(2) tests were conducted to determine whether soft drink consumption and related factors varied by sex and age. Multivariate logistic regression analyses were conducted to examine the association of soft drink consumption with each factor after adjustment for potential confounders. RESULTS: Preference for the taste of soft drinks was the strongest predictor in the analysis, with those who reported the strongest taste preference 4.50 times more likely (95% confidence interval=2.89-7.04) to consume soft drinks five or more times per week than those with a lower taste preference. Youth whose parents regularly drank soft drinks were 2.88 times more likely (95% confidence interval=1.76-4.72) to consume soft drinks five or more times per week compared with those whose parents did not regularly drink soft drinks. CONCLUSIONS: Results suggest that several factors may be associated with soft drink intake in school-aged children, most notably taste preferences, soft drink consumption habits of parents and friends, soft drink availability in the home and school, and television viewing. Additional research is needed to verify these findings in a representative sample of children.     

The population attributable risk of hypertension from heavy alcohol consumption

The association between alcohol consumption and hypertension was studied in 11,899 men aged 40-55 years. The prevalence of hypertension among heavy drinkers was significantly higher than among those who did not drink heavily. Heavy drinking was defined as consumption of five or more drinks daily or four or more drinks daily. A total of 136 persons fulfilled the five drinks or more per day definition and 230, the four drinks daily definition. The population-attributable risk of hypertension contributed by heavy drinking, depending on the diagnostic criteria used to define each endpoint, varied from 3 to 12 percent. There is reason to suspect that the contribution of alcohol to hypertension in the general population may be somewhat higher at the present time than in the late 1950s when the study was conducted. Moderation of alcohol consumption, in addition to weight reduction and salt restriction, is another important nonpharmacological means to control hypertension.     

A gender-specific measure of binge drinking among college students.

This study examined the relationship of volume of alcohol consumed to the occurrence of alcohol-related problems among male and female college students to develop a gender-specific measure of heavy episodic or binge drinking by college students for public health research. A self-administered survey was mailed to a national representative sample of students at 140 4-year colleges in 40 states and the District of Columbia. A total of 17,592 college students completed the survey. Women who typically drink four drinks in a row were found to have roughly the same likelihood of experiencing drinking-related problems as men who typically drink five drinks in a row. Use of the same standard for both sexes underestimates binge drinking and the negative health risks for women.     

Correlates of University Students’ Soft and Energy Drink Consumption According to Gender and Residency

This study assessed personal and environmental correlates of Belgian university students’ soft and energy drink consumption and investigated whether these associations were moderated by gender or residency. Four hundred twenty-five university students completed a self-reported on-line questionnaire assessing socio-demographics, health status, soft and energy drink consumption, as well as personal and environmental factors related to soft and energy drink consumption. Multiple linear regression analyses were conducted. Students believing soft drink intake should be minimized (individual subjective norm), finding it less difficult to avoid soft drinks (perceived behavioral control), being convinced they could avoid soft drinks in different situations (self-efficacy), having family and friends who rarely consume soft drinks (modelling), and having stricter family rules about soft drink intake were less likely to consume soft drinks. Students showing stronger behavioral control, having stricter family rules about energy drink intake, and reporting lower energy drink availability were less likely to consume energy drinks. Gender and residency moderated several associations between psychosocial constructs and consumption. Future research should investigate whether interventions focusing on the above personal and environmental correlates can indeed improve university students’ beverage choices.     

Training bar personnel to prevent drunken driving: a field evaluation.

The potential of a server intervention program to decrease the likelihood that a bar patron will leave a bar intoxicated was evaluated. Research assistants posing as regular patrons ("pseudopatrons") visited two bars where about half of the servers had received server intervention training. Pseudopatrons set the occasion for server intervention to occur by drinking six alcoholic beverages in two hours. The blood-alcohol concentration (BAC) of the pseudopatrons was measured after they left the bar. Results revealed that trained servers initiated more server interventions than did untrained personnel. Moreover, pseudopatrons served by trained personnel reached substantially lower BACs than those served by untrained servers. These results suggest that, if implemented on a large scale, server intervention programs have the potential of reducing drunken driving by helping to decrease the exit BACs of bar patrons.     

The accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area

OBJECTIVE: To examine the accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area. METHOD: Two hundred licensed premises were contacted, which resulted in the location of 36 wall-mounted, coin-operated breath analysers. One instrument was removed prior to testing. These premises were then visited and the accuracy of the instruments was tested in situ using National Association of Testing Authorities Australia (NATA) certified 0.080% and 0.100% ethanol in nitrogen gas. RESULTS: The instruments were installed in the licensed premises as follows: 15 in the lounge bar, 10 in the main entrance, six in the public bar, two in the passageway to the toilets, and one in the male toilets. One licensed premise provided a handheld breath instrument. All instruments were accompanied by warning and operating instructions, but only five had any educational material. Only seven of the licensed premises had staff who had received any training in the operation of the wall-mounted instruments. Half of the licensees were unaware of the servicing requirements of the instruments. The testing found that only nine (25%) of the instruments provided acceptable results. CONCLUSION: The low level of accuracy of coin-operated breath analysers in the Perth metropolitan area is alarming and users should be informed of the potential inaccuracies. This paper, however, does not rule out that some wall-mounted breath analysing instruments may provide accurate results when properly maintained.     

Implementation of effective alcohol control strategies is needed at large sports and entertainment events

Objective: To assess the implementation and effectiveness of strategies and actions to eliminate and/or reduce alcohol‐related problems at large sports and entertainment events in New Zealand. Methods: We conducted site visits and monitoring observations at venues before, during and after a variety of large events between March 2009 and November 2010. Thirteen events were attended at nine different venues. Events included rugby, rugby league and cricket matches, motor racing, rowing, horse racing, an outdoor music festival, and food and wine festivals. Results: Most large events appeared to pass with few or no alcohol‐related problems. The exceptions were one of the horse‐race meetings, a rugby league match and one food and wine festival. Common contexts at events where alcohol‐related problems were seen included: inadequate alcohol control and management by security staff; the ability to purchase four alcoholic drinks (rather than two) at a time; inexperienced bar staff untrained in responsible alcohol service; no or little promotion of low and non‐alcoholic drinks; and a lack of monitoring and enforcement of the law on intoxication. Conclusions: An important approach to prevent and reduce alcohol‐related problems at large spots and entertainment events is the use of specific alcohol‐control strategies. The management of alcohol consumption is a major part of event management that must be planned with harm‐minimisation strategies well in advance of the event itself. Implications: If strategies and actions are not properly implemented to manage the sale and supply of alcohol at large events, there is significant risk of alcohol‐related problems and harm resulting from them.     

Effects of Native Whey Protein and Carbohydrate Supplement on Physical Performance and Plasma Markers of Muscle Damage and Inflammation during a Simulated Rugby Sevens Tournament: A Double-Blind,Randomized, Placebo-Controlled,Crossover Study

The importance of optimized recovery during a sport competition is undisputed. The objective of this study was to determine the effects of recovery drinks comprising either carbohydrate only, or a mix of native whey proteins and carbohydrate to maintain physical performance and minimize muscle damage during a simulated rugby sevens (rugby 7s) tournament. Twelve well-trained male rugby players participated in three simulated rugby 7s tournament days with a week’s interval in between. Each tournament comprised a sequence of three simulated matches, interspersed with 2 h of recovery. Three different recovery drinks were tested: a placebo (PLA, nonenergetic chocolate-flavored drink), a carbohydrate drink (CHO, 80 g of carbohydrate) or an isoenergetic carbohydrate–protein drink (P-CHO, 20 g of Pronativ^®, native whey protein and 60 g of carbohydrate). A different recovery drink, consumed after each match, was tested during each simulated tournament. Physical performance, muscle damage and muscle pain were assessed before and after each simulated tournament. Regarding physical performance, both P-CHO and CHO drinks had a positive effect on the maintenance of 50 m sprint time compared to the PLA drink (effect sizes large and moderate, respectively). Regarding muscle damage, the P-CHO supplement attenuated the creatine phosphokinase increase at POST6 compared to PLA (effect size, moderate). Finally, P-CHO and CHO drinks reduced the exercise-induced DOMS (effect size, moderate), compared to the PLA condition (effect size, large), while P-CHO only reduced pain on muscle palpation and pain when descending stairs compared to PLA 24 h post-tournament (effect size, small). This study suggests that consuming a recovery drink containing native whey proteins and carbohydrate or carbohydrate only after each match of a rugby 7s tournament may attenuate the exercise-induced increase in markers of muscle damage and maintain physical performance.     

The effect of ‘standard drink’ labelling on the ability of drinkers to pour a ‘standard drink’

Abstract: Australia's National Health Policy on Alcohol has recommended that beverage containers be labelled so that alcohol content is ‘readily understandable by the public’. Health promotion to increase the responsible use of alcohol now relies extensively on the concept of a standard drink—usually defined as 10 g of ethyl alcohol. Numerous difficulties confront a drinker who wishes to apply the standard drink system to monitor alcohol intake. This report describes a series of experimental tests of the proposal that these difficulties are minimised if alcohol containers have their alcohol content indicated in terms of standard drinks in addition to the usual percentage alcohol by volume method. Subjects were drinkers recruited from a Perth shopping mall and were tested only on beverage types they had consumed within the previous week. They were required to pour what they judged to be a single standard drink from a 750 ml bottle of either wine or beer. Beer drinkers achieved greater accuracy in this task when the bottles had standard drink labels, even when the glass size and beverage strength were varied. Wine drinkers had equal difficulty with this task whether standard drink or percentage labels were used. The addition of a ‘ladder’ up the side of a wine bottle with graduations in standard drinks would be necessary for wine drinkers to achieve a high level of accuracy. We conclude that labelling drink containers with their alcohol content in terms of standard drinks would better equip all drinkers to follow the advice of health educators.     

The effect of 'standard drink' labelling on the ability of drinkers to pour a 'standard drink'

Australia's National Health Policy on Alcohol has recommended that beverage containers be labelled so that alcohol content is 'readily understandable by the public'. Health promotion to increase the responsible use of alcohol now relies extensively on the concept of a standard drink--usually defined as 10 g of ethyl alcohol. Numerous difficulties confront a drinker who wishes to apply the standard drink system to monitor alcohol intake. This report describes a series of experimental tests of the proposal that these difficulties are minimised if alcohol containers have their alcohol content indicated in terms of standard drinks in addition to the usual percentage alcohol by volume method. Subjects were drinkers recruited from a Perth shopping mall and were tested only on beverage types they had consumed within the previous week. They were required to pour what they judged to be a single standard drink from a 750 ml bottle of either wine or beer. Beer drinkers achieved greater accuracy in this task when the bottles had standard drink labels, even when the glass size and beverage strength were varied. Wine drinkers had equal difficulty with this task whether standard drink or percentage labels were used. The addition of a 'ladder' up the side of a wine bottle with graduations in standard drinks would be necessary for wine drinkers to achieve a high level of accuracy. We conclude that labelling drink containers with their alcohol content in terms of standard drinks would better equip all drinkers to follow the advice of health educators.     

The impact of training on knowledge and standards of food hygiene Eth a pilot study

The UK Committee on the Microbiological Safety of Foods (1991) recommended that managers and supervisors of food businesses should be trained in food hygiene. Legislative changes in the UK now require proprietors of food businesses to be instructed, supervised and/or trained in food hygiene ton appropriate level. Twelve food premises were used in the study. All staff ( n = 50) were surveyed to establish the level of food hygiene knowledge and the food premises were inspected to establish general food hygiene standards. Results showed that there was no relationship between the level of knowledge of the staff and hygiene standard of the premises. This study established the feasibility of gathering data appropriate to establish such indicators of the influence of training and makes recommendations for further research.     

Characteristics Associated with Consumption of Sports and Energy Drinks among US Adults: National Health Interview Survey, 2010

Sales of sports and energy drinks have increased dramatically, but there is limited information on regular consumers of sports and energy drinks. Characteristics associated with sports and energy drink intake were examined among a sample representing the civilian noninstitutionalized US adult population. The 2010 National Health Interview Survey data for 25,492 adults (18 years of age or older; 48% males) were used. Nationwide, 31.3% of adults were sports and energy drink consumers during the past 7 days, with 21.5% consuming sports and energy drinks one or more times per week and 11.5% consuming sports and energy drinks three or more times per week. Based on multivariable logistic regression, younger adults, males, non-Hispanic blacks and Hispanics, not-married individuals, adults with higher family income, those who lived in the South or West, adults who engaged in leisure-time physical activity, current smokers, and individuals whose satisfaction with their social activities/relationships was excellent had significantly higher odds for drinking sports and energy drinks one or more times per week. In this model, the factor most strongly associated with weekly sports and energy drink consumption was age (odds ratio [OR]=10.70 for 18- to 24-year-olds, OR=6.40 for 25- to 39-year-olds, OR=3.17 for 40- to 59-year-olds vs 60 years or older). Lower odds for consuming sports and energy drinks one or more times per week were associated with other/multiracial (OR=0.80 vs non-Hispanic white) and obesity (OR=0.87 vs underweight/normal weight). Separate modeling of the association between other beverage intake and sports and energy drink intake showed that higher intake of regular soda, sweetened coffee/tea drinks, fruit drinks, milk, 100% fruit juice, and alcohol were significantly associated with greater odds for drinking sports and energy drinks one or more times per week. These findings can help medical care providers and public health officials identify adults most in need of encouragement to reduce sports and energy drink intake and increase healthier beverage intake.     

Effects of a herbal ergogenic drink on cycling performance in young cyclists

It is essential to replace fluids lost so as to remain well hydrated during exercise. The intake of fluids is considered a physiological ergogenic aid to enhance exercise performance. There are currently several products in the market that are believed to have ergogenic properties which act as fluid replacement drinks during exercise. One such drink available in the Malaysian market is 'AgroMas?' herbal drink whose efficacy is yet to be proven. The purpose of this study was, therefore, to evaluate the effects of acute ingestion of this herbal drink (H) or a coloured water placebo (P) on cycling performance. Nine healthy and trained young male cyclists (age: 16.2 ± 0.5 years) exercised on a cycle ergometer at 71.9 ± 0.7% of maximal oxygen consumption (VO2max) until exhaustion on two occasions at 1-week intervals. During each exercise bout, subjects received 3ml kg-1 body weight of H or P every 20 min in a double-blind randomised study design. There was no significant difference between H and P trials in the total work time to exhaustion (83.7 ± 4.6 and 81.5 ± 5.0 min respectively). Changes in oxygen consumption, heart rate and perceived rate of exertion were similar for both types of drinks. These results demonstrate that the herbal drink and the placebo elicited similar physiological responses and exercise performance during endurance cycling. It is therefore concluded that AgroMas? herbal drink and water ingestion resulted in a similar ergogenic response on cycling performance in young cyclists.     

Sugary drink consumption behaviours among young adults at university

Aim: Sugary drink consumption is associated with weight gain, and young adults are the highest consumers. To inform a university healthy beverage intervention, we studied the settings and the types and amounts of sugary drinks consumed by a sample drawn from the student population. Methods: Fifty university students (24 male) were recruited to keep records of all beverages consumed over four consecutive days. The records were analysed by gender, drink category and consumption setting. Results: Males drank marginally more sugary drinks than females (median daily intake of 526 mL compared with 300 mL, P = 0.06). Median energy intake from sugary drinks was 928 kJ for males and 481 kJ for females. Carbonated soft drinks and fruit‐based drinks accounted for 64% of energy from sugary drinks for males; and fruit and sweetened milk‐based drinks accounted for 68% of energy for females. Half of all sugary drink consumption occurred at home followed by social settings. Conclusion: Health promotion programmes aiming to reduce sugary drink consumption in this group would benefit from gender‐differentiated strategies with respect to types of drinks consumed with a focus on the home and social settings.     

Environmental correlates of underage alcohol use and related problems of college students

BACKGROUND: Underage alcohol use is a major contributor to morbidity and mortality in adolescents and young adults. This study examined drinking levels and ensuing problems among college students and factors associated with binge drinking. METHOD: The Harvard School of Public Health College Alcohol Study conducted a self-administered survey. The participants include a random sample of 7061 students aged <21 years (defined as underage drinkers), and 4989 between ages 21 and 23 in 1997 at 116 nationally representative 4-year colleges in 39 states. The outcomes of the study include self-reports of alcohol use, binge drinking (defined as five or more drinks in a row for men and four or more for women at least once in a 2-week period), alcohol-related problems, preferred type of drink, access to alcohol, and price paid per drink. RESULTS: Underage students drink less often but have more drinks per occasion, are more likely to drink in private settings (off-campus, dormitory, and fraternity parties), and pay less per drink than do of-age students. Correlates of underage binge drinking include residence in a fraternity or sorority (odds ratio [OR]=6.2), very easy access to alcohol (OR=3.3), obtaining drinks at lower prices (OR=2.1, for under $1 each or a set fee for unlimited drinks), and drinking beer (OR=9.5). CONCLUSIONS: Effective controls on price, access, and fraternity and off-campus parties, and reinforcing minimum drinking age laws are needed to reduce the high levels of binge drinking and related health and behavioral problems of underage students.     

Organisation and delivery of home care re‐ablement: what makes a difference?

Home-care re-ablement or 'restorative' services are a cornerstone of preventive service initiatives in many countries. Many English local authorities are transforming their former in-house home-care services to provide intensive, short-term re-ablement instead. The focus of this paper is on the organisation and content of re-ablement services and the features of their organisation and delivery that have the potential to enhance or detract from their effectiveness. Qualitative data were collected from five sites with well-established re-ablement services. Data included semi-structured interviews with senior service managers in each site; observation of 26 re-ablement visits to service users across the five sites (four to six in each site) and a focus group discussion with front-line staff in each site (in total involving 37 front-line staff). The data generated from all three sources were analysed using the framework approach. All five services had developed from selective pilot projects to inclusive 'intake' service, accepting almost all referrals for home-care services. A number of features were identified as contributing to the effectiveness of re-ablement services. These included: service user characteristics and expectations; staff commitment, attitudes and skills; flexibility and prompt intervention; thorough and consistent recording systems; and rapid access to equipment and specialist skills in the team. Factors external to the re-ablement services themselves also had implications for their effectiveness; these included: a clear, widely understood vision of the service; access to a wide range of specialist skills; and capacity within long-term home-care services. The paper argues that re-ablement can be empowering for all service users in terms of raising their confidence. However, the move to a more inclusive 'intake' service suggests that outcomes are likely to be considerably lower for service users who have more limited potential to be independent. The paper discusses the implications for practice.