Alcohol and alcoholism最新文献

Background: Developed over nine decades ago, the 12 Steps were intended to provide structured and clear guidelines to promote recovery from alcohol use. The steps are designed to help individuals find a sense of purpose, meaning, and hope. The 12 Steps are meant to be guides for an ongoing process or spiritual progress. A more concrete way of understanding the steps relative to spiritual principles may be instructive for those working the steps and seeking a fulfilling meaning and purpose for their lives.

Purpose: This paper provides a framework for understanding the 12 Steps in accord with four principles of spirituality: awareness, acceptance, interdependence, and self-transcendence.

Methodology: A matrix was developed using each of the four principles of spiritualty. Each word or phrase from each of the 12 Steps was assigned to one principle. Examples for key words or phrases were provided.

Results: Each of the 12 Steps are mapped to the four principles of spirituality, with annotations.

Conclusions: The resulting guide serves as a concrete and instructive guide to understanding the spiritual nature of the 12 Steps.

Introduction: Patients with alcohol use disorders have a high hospital re-admission rate, adding to the strain on the healthcare system. To address this issue, this study aimed to predict 28-day unplanned hospital re-admission for these patients.

Methods: From linked de-identified datasets, patients with alcohol use disorders who had hospital re-admissions between 2015 and 2018 were identified. Univariate and multiple logistic regression were conducted to select variables for inclusion in five machine learning models-logistic regression (baseline), random forest, support vector machine, long-short term memory and clinical bio bidirectional encoder representation of transformers (Clinical Bio-BERT)-to predict the 28-day re-admission.

Results: Eight hundred and sixty-nine patients with alcohol use disorders incurred 2254 hospital admissions. Patients aged 45-49 or 70-74 or 75-79 were 4-5 times more likely to be re-admitted than those in other age groups; males were 36% more likely than females; patients who use polysubstance were 3.3 times more likely than otherwise. Patients with "respiratory system disorders" or "hepatobiliary system and pancreas disorders" had 60% higher risk than otherwise. Interaction with emergency department or drug and alcohol service after discharge reduced the risk by 71% and 79%, respectively. The 10-variable Clinical Bio-BERT demonstrated the highest sensitivity (.724).

Discussion and conclusions: Patients with alcohol use disorders with the following characteristics were more likely to have unplanned re-admissions within 28 days: male, aged 45-49 or 70-74 or 75-79, with "respiratory system disorders" or "hepatobiliary system and pancreas disorders", or patients who use polysubstance. Interactions with emergency department or drug and alcohol service after discharge had reduced risk of hospital re-admission.

Aims: The current study aimed to identify possible measurement non-equivalence (i.e., bias) with respect to sex (proxy for gender), race/ethnicity, and intersectional identity (sex by race/ethnicity) and generate adjusted scores for the Alcohol Expectancy Questionnaire-Adolescent, Brief (AEQ-AB) in a sample of middle-school-aged Black, Latinx, and White youth.

Methods: Data were drawn from Follow-up 3 of the Adolescent Brain Cognitive Development Study, conducted from 2020-2022 (n = 8981; mean age = 12.91, SD = .65; 47.29% female; 15.02% Black, 22.95% Latinx, and 62.03% White). Moderated nonlinear factor analysis was applied to the 4-item Positive Expectancies and 3-item Negative Expectancies subscales.

Results: Analyses revealed non-equivalence with respect to both sex and race/ethnicity on the Positive Expectancies subscale and race/ethnicity on the Negative Expectancies subscale. AEQ-AB mean subscale scores were compared across groups pre- and post-adjustment for measurement non-equivalence. Adjusted scores revealed previously undetected higher positive expectancies in girls versus boys, a lower magnitude of differences in positive expectancies between racial/ethnic groups, previously observed higher negative expectancies among girls versus boys as non-significant, and even higher relative negative expectancies for Black and Latinx than White youth.

Conclusions: Collectively, our findings highlight the importance of establishing measurement equivalence broadly, and specifically for the AEQ-AB, and demonstrate the potential for measurement bias to underestimate or even mask the relative risk in girls and youth of color, which can impact assumptions about and attention to these marginalized groups.

Background and aims: Studies on the commercial determinants of health (CDoH) are rapidly growing in Western countries. Nevertheless, despite the ubiquity of transnational alcohol corporations (TNACs)-a leading harmful commodity industry-in Nigeria and across Africa, few studies have focused specifically on alcohol marketing as a CDoH. TNACs in Nigeria and other low-resource settings deploy diverse and aggressive marketing strategies to mitigate the decline in youth drinking in many Western countries. Yet, no study to date has contextualised alcohol marketing as a CDoH and its impact on young people's drinking. This study explores the awareness and impact of alcohol advertising and promotion on young people's drinking behaviours in Benin, Nigeria.

Methods: We collected data through three focus group discussions (n = 26) and 53 semi-structured interviews with 18-24-year-old adolescents and young adults. Data were analysed thematically.

Results: The findings show that participants were exposed to alcohol marketing on TV, radio, and social media and demonstrated a high awareness of various other alcohol promotional strategies. Participants acknowledged the persuasive influence of alcohol marketing in trying new products and changing brands temporarily and permanently. Celebrity advertising and endorsement through sports were also recounted as an impactful alcohol marketing strategy. Furthermore, quantity deals, discount sales, and other promotional strategies, facilitated impulse buying and heavy drinking.

Conclusions: The findings demonstrate how alcohol marketing in Nigeria is a major pervasive and harmful CDoH. Policymakers are encouraged to implement policies to mitigate the impact of alcohol marketing through prevention and intervention strategies, including marketing regulation and enforcement.

Background: Alcohol consumption among women of reproductive age is a growing concern in India, with significant implications for reproductive health. Despite evidence linking alcohol use to suboptimal contraceptive behaviors, research on the patterns and determinants of contraceptive use remains limited.

Methods: Data from 6626 married women aged 15-49 years who reported alcohol consumption and 468 142 who did not were drawn from the National Family Health Survey-5 (2019-2021). Contraceptive use was classified by the World Health Organization's effectiveness levels. Alcohol consumption was examined by type (homemade, country liquor, Indian Made Foreign Liquor), frequency (daily, weekly, less than weekly), and duration. Covariates included age, education, wealth, residence, parity, and tribal status. Ordinal logistic regression was used to identify predictors of contraceptive use.

Results: Alcohol use was associated with lower odds of effective contraceptive use (aOR = .86, 95% CI: .82-0.90)-31.18% reported no contraceptive use, while 75.09% used very effective or effective methods, primarily female sterilization (45.44%) and oral contraceptives (19.32%). Homemade alcohol users showed the highest prevalence of effective methods (82.76%), while IMFL consumers reported higher non-use (33.44%). Those who drink daily relied more on effective methods compared to less frequent drinkers. Education and wealth were significant predictors among all women but not in those who drink alcohol. State-wise variations were notable, with low rates of contraceptive use in Meghalaya (18.52%) and high rates in Sikkim (81.72%).

Conclusion: Integrated family planning and alcohol screening and brief intervention services are needed, especially in underserved regions.

In this retrospective study of 251 300 patient encounters at Veterans Administration Emergency Departments associated with alcohol intoxication per blood testing or ICD 9/10 coding, we found that 79% of these patients had positive Alcohol Use Disorders Identification Test-Consumption screens within 6 months of their visit. Therefore, we propose that presentation to an emergency department with any detectable ethanol concentration should prompt intervention accordingly.

Aims: This integrative review aims to synthesize and update the current literature on mHealth applications and devices, such as smartphones, wearables, and breathalyzers, in alcohol use disorder (AUD) monitoring. It discusses the evolution of these tools, the current level of evidence, and facilitators and barriers to their implementation in research and interventions. The future potential for personalized interventions is also explored.

Methods: Integrative review. Three databases-PubMed, Web of Science, and PsycINFO-were used to identify quantitative and qualitative English written publications between 2014 and 2024, using terms related to mHealth, remote monitoring, and AUD. Results were extracted and comprehensively presented by topic.

Results: Fifty-eight studies were included in the synthesis. Smartphones, mobile phones, breathalyzers, and wearables with transdermal sensors are the most frequently used devices for remote monitoring. The included studies demonstrated varying levels of development and evidence across devices. Ecological Momentary Assessment via smartphones was the most frequently used and, along with breathalyzers, was successfully applied in clinical trials involving interventions. Wearables were scarcely tested in interventions. Challenges related to adherence and psychological factors remain in a longer period of monitoring. Incipient use of predictive models integrating ongoing data shows promise in informing care providers and optimizing intervention delivery.

Conclusions: Evidence supporting mHealth tools for AUD remains uneven across device types. While smartphones and breathalyzers show greater clinical applicability, wearables and passive sensing remain exploratory. Robust, comparative research is needed to guide effective selection and integration into care.

Background: Lithuania, a European country, has a history of high alcohol consumption per capita. To reduce harm, Lithuania has implemented the World Health Organization 'best buys' for alcohol control policies, notably two taxation policies in 2008 and 2017. Taxation may affect segments of the population differently; to explore this question, we investigated the effects on liver cirrhosis.

Aims: To analyze the effect of taxation on liver cirrhosis hospitalizations and mortality across four age groups in Lithuania.

Methods: Using a general additive mixed model, we tested taxation on monthly hospitalization and mortality rates between 2001 and 2022 (n = 264 months) across four age groups (young adults: 15-34, middle-aged adults: 35-54, older adults: 55-74, and seniors: 75+ years of age, respectively). We computed standardized hospitalizations and mortality rates (admissions and deaths per 100 000 people) based on summed counts of alcoholic liver disease and fibrosis and cirrhosis of the liver according to the International Classification of Diseases 10th Revision.

Findings: Taxation was associated with the largest downward trend in liver cirrhosis mortality among middle-aged and older adults, equivalent to two fewer deaths per 100 000 individuals. In older adults and seniors, taxation was associated with downward trends in hospitalizations, but effects were less robust.

Conclusion: Taxation may lead to decreases in liver cirrhosis mortality across all age groups but appears to be less consistently impactful for hospitalizations. Younger and middle-aged individuals may experience increased hospitalizations. Taxation appears to impact subsections of the population differently.

Background and aims: Despite the critical importance of alcohol abstinence for patients with advanced liver disease, rates of returning to alcohol remain high and engagement with relapse prevention interventions is low. This study explores the potential barriers to relapse prevention in these patients.

Methods: Semi-structured interviews were conducted with patients who had alcohol-related cirrhosis or alcohol-associated hepatitis. Interviews took place during a hospital admission. The study methodology was informed by a constructivist grounded theory approach.

Results: Thirty-three participants were recruited from two sites. Participants had a mean age of 52 (range 30-60) and there were 10 female participants (30%). Most participants were actively drinking alcohol at time of admission (n = 26) and 16 participants were interviewed during their index admission with alcohol-related liver disease.A renewed understanding of the health risk posed by future alcohol made participants confident that they would not return to alcohol use and participants felt that the most important factor in relapse prevention was their own motivation and willpower. However, many rejected the identity label of 'alcoholic' and drew a distinction between themselves and 'bad drinkers'. These factors combined to create a barrier to relapse prevention therapies, since participants felt these were neither appropriate nor necessary for them.

Conclusions: Enhanced self-efficacy, a belief in the importance of willpower, and a rejection of the alcoholic identity can together act to reduce engagement in relapse prevention in patients with advanced liver disease. Relapse prevention interventions should be reframed or redesigned to address these barriers.

Aims: Sexual trauma is a known risk factor for both sleep problems and alcohol use. Understanding the complex comorbidity of these three concerns, including potential factors that may mitigate or exacerbate their relationship, is important to improve clinical care. Religiosity may serve as a protective factor for trauma-related outcomes, alcohol use, and sleep quality but also may exacerbate the relationship between sexual trauma and alcohol use. The current study examined whether alcohol use mediates the relationship between sexual trauma and sleep problems and whether religiosity moderates this indirect effect.

Methods: Data from 158 participants (Mage = 43.8, SD = 12.0; 32.3% cisgender women, 67.7% cisgender men) were drawn from eligibility screening assessments from three studies on alcohol use and/or post-traumatic stress disorder. Data were analyzed using mediation and moderated mediation analyses.

Results: Alcohol use did not mediate the relationship between sexual trauma and sleep quality (95% Boot CI [-0.07, 0.95]). However, when considering the role of religiosity, formal religious practices (but not God consciousness) moderated the indirect effect of sexual trauma on sleep quality through alcohol use (β = 0.89, 95% Boot CI [0.21, 1.92]). Specifically, the conditional indirect effect was significant for individuals with high levels of formal religious practices relative to individuals with low or average levels.

Conclusions: Sexual trauma was associated with poorer sleep quality due to heavier alcohol use when individuals had higher levels of formal religious practices. Findings have implications for assessment and treatment of comorbid trauma histories, alcohol use, and sleep problems.NCT02884908; NCT04210713.