Alcohol availability as a predictor of youth drinking and driving: a hierarchical analysis of survey and archival data

BACKGROUND: Much attention has recently been directed toward developing preventive interventions to reduce drinking and driving through efforts to limit the numbers and locations of alcohol outlets at the community level. Although evaluations of these efforts have suggested linkages between alcohol outlets and problem outcomes, they have not addressed the linkage between outlets and drinking and driving among youth. The analysis reported here investigates the relationship between alcohol outlet densities and underage drinking and driving as self-reported on two telephone surveys conducted in California. METHODS: These analyses were based on data obtained from two telephone surveys conducted by the Prevention Research Center and archival data collected by the California Department of Alcoholic Beverage Control and the US Census Bureau. The sample for the first survey consisted of 15- to 20-year-old adolescents and young adults contacted by telephone, using a random digit dialing of exchanges in the greater San Francisco Bay Area. A second set of survey data was similarly collected by a random sample of households throughout California, and the Bay Area subset was also used for this analysis. RESULTS: At the individual level, older respondents were more likely to report drinking and driving and riding with drinking drivers, whereas females and Asians were less so. At the aggregate or city-level, alcohol outlet density, as measured by the number of on- and off-premises establishments licensed to sell alcohol, was associated with both drinking and driving and riding with drinking drivers. These effects were moderated by a number of individual level effects, with younger respondents and females more likely to be affected by outlet densities. CONCLUSIONS: The findings here provide support for the implementation of policies targeting alcohol outlet density reductions. Areas with large numbers of such outlets provide ample opportunities to youth for alcohol purchases.     

Rates of Help-Seeking in US Adults With Lifetime DSM-5 Eating Disorders: Prevalence Across Diagnoses and Differences by Sex and Ethnicity/Race

ObjectiveTo investigate, in a nationally representative sample of US adults, the prevalence of help-seeking in individuals with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) eating disorders (EDs) and to examine sex and ethnic/racial differences.Patients and MethodsThe 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N=36,309) included respondents who met the criteria for specific lifetime DSM-5 EDs and answered questions regarding help-seeking for their ED symptoms (anorexia nervosa [AN]: n=275; bulimia nervosa [BN]: n=91; and binge-eating disorder [BED]: n=256).ResultsThe prevalence (standard error) estimates of ever seeking any help for AN, BN, and BED were 34.5% (2.80%), 62.6% (5.36%), and 49.0% (3.74%), respectively. Adjusting for sociodemographic characteristics, men and ethnic/racial minorities (non-Hispanic blacks and Hispanics) were statistically significantly less likely to ever seek help for BED than were women or non-Hispanic whites, respectively. Hispanics also were significantly less likely to seek help for AN relative to non-Hispanic whites.ConclusionThis was the first study in a nationally representative sample of US adults to examine rates of help-seeking, including by sex and ethnic/racial differences, across DSM-5–defined EDs. These findings emphasize the need to develop strategies to encourage help-seeking among individuals with EDs, particularly among men and ethnic/racial minorities.     

酒依赖患者病情观察及护理干预

通过对56例酒依赖患者进行病情观察,制定相应的护理措施并实施,可以帮助患者减轻戒断症状及并发症,安全度过戒断期,从心理及生理上缓解或消除对酒的依赖,提高患者生活质量。     

An observational study of physiotherapists’ use of cognitive-behavioural principles in the management of patients with back pain and neck pain

Objectives

This study investigated the extent to which physiotherapists collaborating in a randomised trial comparing the McKenzie approach with a Solution Finding Approach (SFA) for back pain or neck pain involved patients in the consultation, and empowered patients to develop self-management strategies. The aims were to develop a tool for this purpose and to identify any observed differences between the consultations in these two approaches.

Design

An observational study, conducted within a randomised trial (McKABI trial).

Setting

Patients referred to seven National Health Service physiotherapy departments in West and East Yorkshire.

Participants

The observational study collected data from 10 of the 28 physiotherapists participating in the McKABI trial.

Main outcome measures

The involvement and empowerment scales of the Involvement and Empowerment of Patients in Physiotherapy Assessment Rating Tool (IMPART).

Results

Although not widely used, physiotherapists employed significantly more patient involvement and empowerment strategies with the SFA compared with the McKenzie approach. The median (interquartile range)/total possible scores were: SFA 19 (18), McKenzie 10 (4.5)/60 for involvement; and SFA 27 (8), McKenzie 11 (10)/64 for empowerment.

Conclusions

Most physiotherapists were able to switch between the two approaches without significant overlap in techniques. Psychosocial questioning and goal-setting were under-utilised by most physiotherapists. Implementing the SFA protocol appeared to be more difficult than the McKenzie approach, possibly because the SFA was less reliant on a structured format. Physiotherapists may have required more training to enable them to deliver the SFA effectively. The IMPART was a reliable measure of physiotherapists’ involvement and empowerment strategies.     

酒精戒断综合征患者综合护理干预的对照研究

目的 探讨临床综合护理干预对酒精戒断综合征患者的临床疗效.方法 将60例酒精戒断性震颤谵妄患者随机分成综合护理干预组(研究组)和一般护理干预组(对照组),每组各30例.研究组在药物治疗的基础上配合一般性护理、心理护理、认知行为矫正、健康教育等措施;对照组只在药物治疗的基础上给予一般性护理措施.采用酒精戒断综合征评定量表、抑郁自评量表(SDS)、焦虑自评量表(SAS)、临床疗效总评量表(CGI)评定其疗效.结果 研究组戒断综合征评定量表和临床疗效总评量表(CGI)在治疗后第14天评分分别为(2.56±0.70),(3.10±0.20)分,对照组为(8.56±1.05),(4.10±0.20)分;抑郁自评量表(SDS)、焦虑自评量表(SAS)第14天的评分与对照组相比,均有统计学意义(P<0.01).结论 在药物治疗的基础上合并综合护理干预措施有助于提高酒精戒断综合征患者的疗效,巩固其康复效果.     

Predictors of educational outcomes of undergraduate nursing students in alcohol and drug education

This paper reports a study which aimed to evaluate the impact of an educational programme on alcohol and drug on knowledge acquisition, changes in attitude and intervention confidence skills of undergraduate nursing students and identify the influence of selected demographic variables on educational outcomes. Despite the high levels of morbidity and mortality resulting from substance misuse, few nurses have been adequately prepared to respond effectively. There remains a dearth of evidence on the educational interventions in alcohol and drug with undergraduate nursing students and this study intends to add a body of knowledge to this field. A quasi-experimental, pre-post-test design was used using with a purposive sample of four cohorts of undergraduate nursing students (n=110) in England. Pre-tests and post-tests after the educational intervention on alcohol and drug were administered to measure the educational outcomes. The data was collected between March 2002 and September 2003. The results showed the educational intervention on alcohol and drug had a significant impact on educational outcomes. There were significant differences between the pre-test and post-test knowledge mean score (t=-.4.61, d.f.=109, p=0.000), attitude (t=-2.36, d.f.=109, p=0.02) and intervention confidence skills (t=-9.75, d.f.=109, p=0.000). Within the multi-layered hypothesis, the results indicate that only ethnicity was found to have a significant influence on both knowledge acquisition (F(2,106)=6.59, p=0.002) and intervention confidence skills (F(2,106)=15.0, p=0.000). The study provides some evidence that a short intensive educational programme on alcohol and drug can be effective in improving educational outcomes. Further research should be undertaken with undergraduate nurses specialising in different branch of nursing.     

Ten-year trends and differences in alcohol consumption among black and white female undergraduates

Background: Few studies have explored changing patterns of alcohol consumption among young females and differences based on race/ethnicity. Objective: This study examined differences in alcohol consumption between black and white undergraduate females and compared trends in three different measures of alcohol consumption over a 10-year period from 2004 to 2014. Methods: The CORE Alcohol and Drug Survey was used to collect data from female undergraduates attending a public university in the northeastern USA. Classes were randomly selected into the sample; class acceptance was 68% and student participation was 96%. The chi-square test examined differences between groups and the Cochrane Armitage Test for Trend assessed changes over time. Results: In 2014, for every measure of alcohol consumption examined, a significantly larger percentage of white females engaged in the behavior compared to black females. Trend analysis from 2004 to 2014 demonstrated a narrowing of this gap. Controlling for age, any alcohol use in past 30 days and binge drinking in the past 2 weeks increased significantly for black females 21 years or older. Any alcohol use in the past 30 days decreased significantly for white females under 21 years. Conclusion: These findings introduce many questions which should be explored through additional research.     

乙醇对大鼠血管内皮细胞的促凋亡作用

目的 探讨乙醇对大鼠血管内皮细胞的促凋亡作用.方法 乙醇灌胃制备大鼠实验模型,选用平铺内皮细胞,苏木素-伊红染色染色、末端脱氧核苷酸转移酶介导的-生物素平移末端标记和分光光度法了解乙醇对大鼠血管内皮细胞的促凋亡作用.结果 正常对照组未见凋亡细胞,而实验各组均可见凋亡细胞,其凋亡率有时间依赖性;实验各组血清中丙二醛含量显著增加和总抗氧化能力显著降低,其值具有时间依赖性.结论 过量乙醇使体内氧化-抗氧化系统严重失衡可导致内皮细胞凋亡.     

Binge alcohol treatment increases vertebral bone loss following ovariectomy: compensation by intermittent parathyroid hormone

BACKGROUND: Postmenopausal estrogen deficiency and alcohol abuse are known risk factors for osteoporosis. Previous studies of the combined effect of alcohol and ovariectomy on bone loss using chronic alcohol-feeding models have not demonstrated additional alcohol-induced bone loss in ovariectomized (OVX) animals. Binge alcohol treatment causes rapid bone loss in male rats. We hypothesized that binge alcohol would cause additional bone loss in OVX rats. METHODS: Ninety-six adult (400 g) female Sprague-Dawley rats (48 sham-operated and 48 OVX, pair fed) were randomly divided into 4 treatment groups: (a) saline-treated, (b) binge alcohol-treated (3 g/kg alcohol as a 20% weight to volume alcohol/saline solution, intraperitoneal (IP), 3 times per week), (c) parathyroid hormone (PTH)-treated (80 microg/kg, SC, 5 d/wk), and (d) binge alcohol plus PTH. Rats were treated for either 2 or 4 weeks. Following treatment periods, blood was collected for alcohol concentration (BAC) measurements; lumbar vertebrae were removed for bone mineral density (BMD) levels, trabecular microarchitecture assessment, and vertebral compressive strength analysis. RESULTS: Peak binge BACs averaged 300 mg/dL. Alcohol and OVX decreased cancellous BMD: alcohol and OVX treatment in combination caused additional cancellous BMD loss and significant cortical BMD reductions. Compressive strength was also decreased by OVX and alcohol. Combination treatment resulted in further declines in bone strength. Micro-CT analysis revealed a significant effect of combined OVX and alcohol treatment resulting in decreased trabecular bone volume/total volume (BV/TV). Intermittent PTH administration compensated for losses of BMD, compressive strength, and restored BV/TV deficits caused by OVX, alcohol, or their combination. CONCLUSIONS: Bone loss following OVX can be significantly increased by concurrent binge alcohol treatment. The effects of alcohol and OVX are compensated by concurrent intermittent treatment with PTH. These results suggest that postmenopausal women who abuse alcohol may place their skeleton at additional risk for osteoporotic fracture.