酒精灌胃大鼠血浆中乙醇浓度变化

目的通过实验了解大鼠酒精灌胃后体内乙醇代谢的特点,为建立大鼠乙醇中毒所致慢性酒精性肝病模型提供依据。方法雄性Wistar大鼠30只,随机分成三个剂量组。实验大鼠以50%的酒精按各组剂量给予灌胃,灌胃后分别于第0.5、1、1.5、2、2.5、3、5、10h经眼眶静脉丛采集大鼠血标本,以乙醇脱氢酶法测定血浆中乙醇浓度。结果对各时段点乙醇浓度测定分析,大鼠摄入酒精后乙醇浓度的高峰均出现在灌胃后1~1.5h处,随后开始缓慢下降,代谢曲线与醉酒表现一致。结论酒精灌胃剂量小于8g/kg是比较安全的,灌胃后1~1.5h达到代谢吸收高峰期,10h后醉酒状态基本恢复,这为制备大鼠酒精性肝病模型提供理论依据。     

Deeper Processing Is Associated With Support for Policies to Reduce Obesity

Health communication researchers have become increasingly interested in factors that predict support for health-related policy. Previous studies have shown that judgments about issues that are influenced by political ideology can be modified by the depth with which receivers process messages related to that issue. In this study, we test whether the same pattern is found for causal attributions about obesity and, ultimately, support for policies to reduce obesity. A national, random sample of U.S. adults read a story about both individual and societal causes of obesity. The longer the time participants spent on the study, and the more words they generated in a thought-listing procedure (operationalizations of depth of processing), the more likely participants were to support policies to reduce obesity, a traditionally liberal position. The same measures of depth of processing did not influence causal explanation of obesity overall, but the more time political moderates spent on the study, the more likely they were to both attribute societal explanations for obesity’s causes and to support policies to combat obesity. We conclude with a discussion of this study’s application to health communication campaigns and future research directions.     

空顶气相色谱外标法测定全血乙醇含量

目的改进全血中乙醇含量测定的方法。方法采用顶空气相色谱外标法测定,峰面积定量,保留时间定性。结果本法质量浓度在0.0～160.0 mg/100 ml,加标回收率在97.0%～103.0%。结论本法操作步骤简单、快速,线性关系良好,灵敏度高,适用于全血中乙醇含量的测定。     

Alcohol Environments and Disparities in Exposure Associated With Adolescent Drinking in California

Objectives. We investigated sociodemographic disparities in alcohol environments and their relationship with adolescent drinking.Methods. We geocoded and mapped alcohol license data with ArcMap to construct circular buffers centered at 14 595 households with children that participated in the California Health Interview Survey. We calculated commercial sources of alcohol in each buffer. Multivariate logistic regression differentiated the effects of alcohol sales on adolescents'' drinking from their individual, family, and neighborhood characteristics.Results. Alcohol availability, measured by mean and median number of licenses, was significantly higher around residences of minority and lower-income families. Binge drinking and driving after drinking among adolescents aged 12 to 17 years were significantly associated with the presence of alcohol retailers within 0.5 miles of home. Simulation of changes in the alcohol environment showed that if alcohol sales were reduced from the mean number of alcohol outlets around the lowest-income quartile of households to that of the highest quartile, prevalence of binge drinking would fall from 6.4% to 5.6% and driving after drinking from 7.9% to 5.9%.Conclusions. Alcohol outlets are concentrated in disadvantaged neighborhoods and can contribute to adolescent drinking. To reduce underage drinking, environmental interventions need to curb opportunities for youth to obtain alcohol from commercial sources by tightening licensure, enforcing minimum-age drinking laws, or other measures.Despite federal, state, and local interventions, underage drinking continues to be a serious problem. A national survey found that 17.6% of adolescents drank alcohol in the past 30 days, 11.1% were binge drinkers, and 2.7% were heavy drinkers.¹ Health and social problems associated with youths'' drinking include motor vehicle crashes,^2,3 violence,⁴ risky sexual behaviors,^5,6 assault and rapes,⁷ and brain impairment.^8–11 Adolescent alcohol use has substantial societal costs.¹² Drinking at an early age also increases the risk of addiction and other alcohol-related problems in adulthood.^13–15 In 2007, the surgeon general responded to this problem in the Call to Action to Prevent and Reduce Underage Drinking, which emphasized environmental contributions to the problem.¹⁶Underage drinkers obtain their alcoholic beverages from a variety of sources, including parents'' stocks, friends, parties, and commercial outlets.¹⁷ In 1 study, buyers who looked underage were able to purchase alcohol with high success rates from both on-site (for consumption on the premises, such as bars and restaurants) and off-site (for consumption elsewhere, such as liquor stores) establishments.^18,19 Sales to minors have been found to be significantly associated with the percentage of Hispanic residents in a neighborhood and with population density.²⁰As long as adolescents can obtain alcohol from commercial sources, neighborhood outlets are likely to play a role in underage drinking. Rhee et al. argued that environment plays an essential role in drinking initiation and that genetics are important in developing alcohol dependence.²¹ Perceived alcohol availability was significantly associated with higher levels of alcohol consumption among young men²² and with drinking in public locations for adolescent girls.²³ Density of outlets for alcohol in cities was associated with youths'' drinking and driving and with riding in a car driven by a person under the influence of alcohol.²⁴Differences in alcohol environments may exacerbate health disparities across sociodemographic groups. LaVeist and Wallace found that in Baltimore, MD, predominantly Black and low-income census tracts have more liquor stores per capita than do tracts of other race and income groups.²⁵ Gorman and Speer found retail liquor outlets abundantly located in poor and minority neighborhoods in a city in New Jersey.²⁶ Only 1 national study has been published, and it reported higher densities of liquor stores in zip codes with higher percentages of Blacks and lower-income non-Whites.²⁷ That study covered all urban areas in the United States, but the urban zip codes had a mean land area of 40.1 square miles and a mean population of 21 920 persons,²⁷ arguably too large to represent neighborhoods. Even census tracts may be too large and too dissimilar to capture neighborhood effects: in Los Angeles County they can range from 0.04 square miles to 322 square miles.The objectives of this study were (1) to describe the quantity and geographic pattern of alcohol retailers in small areas around individual homes and (2) to examine relationships between alcohol environments and adolescent drinking. We analyzed data from the entire state of California to investigate the effects of spatial accessibility on alcohol sales to adolescents.     

Off-Premise Alcohol Sales Policies, Drinking, and Sexual Risk Among People Living With HIV

Drinking among HIV-positive individuals increases risks of disease progression and possibly sexual transmission. We examined whether state alcohol sales policies are associated with drinking and sexual risk among people living with HIV. In a multivariate analysis combining national survey and state policy data, we found that HIV-positive residents of states allowing liquor sales in drug and grocery stores had 70% to 88% greater odds of drinking, daily drinking, and binge drinking than did HIV-positive residents of other states. High-risk sexual activity was more prevalent in states permitting longer sales hours (7% greater odds for each additional hour). Restrictive alcohol sales policies may reduce drinking and transmission risk in HIV-positive individuals.More than 1 million people in the United States are living with HIV,¹ and about 56 000 people are newly infected each year.² Approximately one half of those who have had positive test results for HIV drink alcohol; about 1 in 6 regularly binge drinks.³ Drinking in this population is associated with poor treatment adherence,^4,5 disease progression,^6–8 and spread of the virus through risky sexual activity.^9–12Thus, reducing drinking and problem drinking among HIV-positive individuals is an important public health goal. Alcohol sales policies may be 1 tool for accomplishing this. Research has linked geographic variations in off-premise alcohol sales practices (e.g., regulations regarding the sale of alcohol in stores) to drinking and drinking problems in the general population.¹³ Other types of alcohol regulation have been linked to sexual health.^14–16 Sales policies may influence drinking and sexual activity by making purchases inconvenient or affecting where and when people drink.^17–20 We investigated (1) whether findings linking off-premise sales policies to drinking extend to those living with HIV (who have unique demographic characteristics, drinking patterns, and life circumstances) and (2) whether off-premise sales policies predict sexual risk behavior in this group.     

County-Level Poverty Is Equally Associated With Unmet Health Care Needs in Rural and Urban Settings

Context: Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Purpose: Compare the association between regional poverty with self-reported unmet need, a marker of health care access, by rural/urban setting. Methods: Multilevel, cross-sectional analysis of a state-representative sample of 39,953 adults stratified by rural/urban status, linked at the county level to data describing contextual characteristics. Weighted random intercept models examined the independent association of regional poverty with unmet needs, controlling for a range of contextual and individual-level characteristics. Findings: The unadjusted association between regional poverty levels and unmet needs was similar in both rural (OR = 1.06 [95% CI, 1.04-1.08]) and urban (OR = 1.03 [1.02-1.05]) settings. Adjusting for other contextual characteristics increased the size of the association in both rural (OR = 1.11 [1.04-1.19]) and urban (OR = 1.11 [1.05-1.18]) settings. Further adjustment for individual characteristics had little additional effect in rural (OR = 1.10 [1.00-1.20]) or urban (OR = 1.11 [1.01-1.22]) settings. Conclusions: To better meet the health care needs of all Americans, health care systems in areas with high regional poverty should acknowledge the relationship between poverty and unmet health care needs. Investments, or other interventions, that reduce regional poverty may be useful strategies for improving health through better access to health care.     

Patient-Related Factors Associated With Depressive State in Caregivers of Patients With Dementia at Home

ObjectvesTo identify patient-related factors associated with depressive state in caregivers of patients with dementia, we investigated the caregivers' and patients' characteristics in relation to the depressive state in their caregivers.DesignProspective hospital-based cohort study.SettingTwo memory clinics in Japan.ParticipantsOutpatients with dementia (n = 135) and their caregivers at home.MeasurementsThe outpatients and their caregivers were divided into 2 groups according to the Center for Epidemiologic Studies Depression Scale for caregivers. To identify the patient-related factors that cause depressive state in caregivers, Mini-Mental State Examination (MMSE), the Physical Self-Maintenance Scale for fundamental activities of daily living (ADL), and the instrumental ADL scale (IADL) scores for instrumental ADL and the neuropsychiatric inventory (NPI) subscale score for behavioral and psychological symptoms of dementia were compared between the 2 groups. We used logistic regression to determine the independent predictors of caregiver depressive state.ResultsThere was no significant difference in MMSE score between the 2 groups. Logistic regression analysis revealed that the depressive state in caregivers was related with IADL score and delusion in NPI subscale of patients.ConclusionsDepressive state in caregivers was independent of the decline in cognitive function in patients with dementia but was associated with decline in instrumental ADL and severity of delusion.     

School Factors Associated With the Implementation of Integrated Pest Management‐Related Policies and Practices

BACKGROUND

Schools are particularly vulnerable to pests, but integrated pest management (IPM) can address pest problems. This study describes IPM policies and practices and the extent to which they are associated with school characteristics.

METHODS

We analyzed data from the 2014 School Health Policies and Practices Study, a nationally representative survey of schools in the United States (N = 568, response rate = 69%). Pairwise comparisons assessed differences in pest prevention strategies by school characteristics.

RESULTS

Nationwide, 55.3% of schools conducted campus‐wide inspections for pests at least monthly; 35.6% of schools notified staff, students, and families prior to each application of pesticides; and 56.1% of schools required custodial or maintenance staff to receive training on pest management practices that limit the use of pesticides. During the 12 months before the study, 46.5% of schools almost always or always used spot treatments and baiting rather than widespread applications of pesticides, and 36.8% of schools almost always or always marked indoor and outdoor areas that had been treated with pesticides. No clear pattern emerged for school characteristics associated with IPM policies and practices.

CONCLUSIONS

The variation in implementation of IPM‐related policies and practices suggest opportunities for targeted education among school staff about IPM principles.

     

State School Policies and Youth Obesity

The objective of this study was to examine relations between state-level school policies and childhood obesity for youth ages 10–17 years. Secondary analysis of the 2003–2006 School Nutrition Environment State Policy Classification System, 2003–2007 Physical Education Related State Policy Classification System, and 2003 and 2007 National Surveys of Children’s Health was performed. Eleven nutrition and 5 physical education (PE) domains were examined for elementary (ES), middle (MS), and high school (HS) children. Logistic regression models examined the association of policies on obesity prevalence in 2007 as well as change scores for the policy assessments. Scores for 5 of 11 nutrition domains and 4 of 5 PE domains increased between 2003 and 2006–2007. Controlling for individual, family and neighborhood factors, nutrition policies were positively associated with the odds of 2007 obesity in 3 ES and 2 MS domains and negatively associated with 1 HS domain. Adjusted positive associations also were observed between 2 ES and 1 MS PE policy domains and 2007 obesity. Controlling for covariates, nutrition policy change scores showed positive associations between increases in 1 ES and 1MS domain, and negative associations with 1 ES and 1 HS domain and 2007 obesity. PE policy change scores showed positive adjusted associations between increases in 2 ES, 2 MS and 1 HS domains and 2007 obesity. The findings indicate that state-level school health policies are associated with childhood obesity after adjusting for related factors, suggesting that states with higher obesity levels have responded with greater institution of policies.     

Prenatal Stress Exposure and Post-traumatic Stress Disorder Associated With Risk of Postpartum Alcohol Misuse Among Women Veterans

ObjectivesMaternal alcohol misuse during the postpartum period is associated with negative maternal and infant outcomes. This study examined whether greater stress exposure in the year before the baby's birth and maternal post-traumatic stress disorder (PTSD) were associated with postpartum alcohol misuse among a sample of women veterans. Maternal PTSD was also examined as a moderator of the association between stress exposure and postpartum alcohol misuse.MethodsData were drawn from the Center for Maternal and Infant Outcomes Research in Translation study, a multisite prospective cohort study of pregnant and postpartum women veterans. Interviews were conducted within 12 weeks after birth. At this post-birth interview, women reported whether they experienced stressful events (e.g., loss of job, military deployment, separation/divorce) in the year before birth. PTSD diagnosis and postpartum scores on the Alcohol Use Disorders Identification Test (AUDIT-C) were derived from the Department of Veterans Affairs medical records.ResultsModels testing main and interaction effects showed a statistically significant association of both PTSD (p = .02) and stress exposure (p = .04), as well as significant interaction of PTSD and stress exposure (p = .03) with AUDIT-C scores postpartum, after controlling for marital status, age, and race. Specifically, compared with women without PTSD, those with PTSD had higher overall AUDIT-C scores postpartum, regardless of stress exposure. For women without PTSD, more stress exposure before birth was associated with higher AUDIT-C scores during the postpartum phase.ConclusionsPTSD diagnosis and life stressors before infant birth predicted maternal alcohol misuse during the postpartum period. Identifying such risk factors is an initial step in preventing alcohol misuse, with the goal of enhancing postpartum health for the birthing parent and infant.     

Child Poverty and Health: The Role of Income Support Policies

Policy Points

• Child poverty is associated with both short- and long-term health and well-being, and income support policies can be used to improve child health.
• This article reviews the types of income support policies used in the United States and the evidence of the effectiveness of these policies in improving child health, highlighting areas for future research and policy considerations specific to income support policies.

     

Socio-Environmental Factors Associated With Pubertal Development in Female Adolescents: The Role of Prepubertal Tobacco and Alcohol Use

PurposeAlcohol administered to laboratory animals has been shown to suppress puberty-related hormones and delay puberty by interfering with ovarian development and function. The effects of early substance use on human pubertal development are relatively unexplored.MethodsThis cross-sectional study of 3,106 female adolescents, aged 11–21 years, evaluated the association between prepubertal alcohol and tobacco use and the onset of puberty. Ages at initial breast development, body hair growth, and menarche were self-reported. Prepubertal alcohol and tobacco use were defined as the age at first use before the age of pubertal development and accompanied by regular use. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard models. Logistic regression was used to estimate the association between substance use and delayed puberty, defined as lack of breast development by the age of 13 years.ResultsUnadjusted models indicated prepubertal tobacco use was associated with a longer time required for breast development (HR = 0.74; 95% CI, 0.65–0.85) and body hair growth (HR = 0.81; 95% CI, 0.71–0.93). Prepubertal alcohol use was associated with late breast development (HR = 0.71; 95% CI, 0.57–0.88). The direction of the observed associations remained consistent after adjusting for covariates, but the magnitude of effects were attenuated and the upper bound of the 95% CIs exceeded the null value. Girls who used alcohol before puberty had four times the odds of having delayed puberty (OR = 3.99; 95% CI, 1.94–8.21) as compared with nonusers.ConclusionThe results of this study suggest that the endocrine-disrupting effects of alcohol and tobacco use may alter the timing of pubertal development. These cross-sectional findings warrant further investigation.     

Enrollment in Physical Education Is Associated With Health-Related Behavior Among High School Students

BACKGROUND: Physical education (PE) plays a critical role in the healthy development of youth; however, the influence of PE classes in helping to provide students with health-related behavior patterns is not clear. This study aims to analyze whether participation in PE classes is associated with health-related behavior among high school students. METHODS: A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors. RESULTS: Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28–30% higher likelihood of reporting lower TV viewing during week days. CONCLUSIONS: Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students.