Alcohol and alcoholism最新文献

Introduction: Empirical evidence of the buffering effect of social capital and its underlying psychosocial mechanisms on socio-economic inequalities in alcohol use disorder (AUD) symptoms is limited. As socio-economic disadvantages often go together with deficits in resources and considering social capital's beneficial effects on health, we hypothesized a stronger buffering (at high scores) and a cumulative disadvantaged effect (at low scores) of social capital on AUD symptoms among people reporting higher socio-economic disadvantage compared with their more advantaged counterparts. Additionally, we investigated whether this moderation effect was associated with drinking motives.

Method: Three-hundred and sixty-five young adults participated in a cross-sectional online questionnaire measuring all model variables. First, we tested a moderation model, including AUD symptoms (DV), perceived socio-economic disadvantage (IV), and social capital (moderator). Secondly, we tested a moderated mediation model, additionally including drinking motives as mediators of the moderation effect tested in the first model.

Results: In the case of high social capital, young adults reporting higher socio-economic disadvantage reported fewer AUD symptoms than their advantaged counterparts, which was associated with their lower endorsement of coping, enhancement, and social motives. When social capital was low, those reporting higher socio-economic disadvantages showed higher AUD symptoms than their advantaged counterparts, which was associated with their higher endorsement of coping motives only.

Conclusion: Social capital can buffer (at high levels) or aggravate (at low levels) socio-economic inequalities in AUD symptoms, and drinking for coping, enhancement, and social motives may explain why this happens.

Cytochrome P450 (CYPs) superfamily of enzymes metabolize thousands of endogenous and exogenous substrates including ethanol. Results: Cytochrome P4502E1 (CYP2E1) is involved in ethanol metabolism as part of the so-called microsomal ethanol metabolizing system, in the metabolism of fatty acids and some drugs such as acetaminophen and isoniazid, and in the activation of a variety of procarcinogens (PCs). Chronic ethanol consumption induces CYP2E1 which may result in an enhanced metabolism of these drugs to their toxic intermediates, and in the generation of carcinogens. In addition, ethanol oxidation increases and is associated with the generation of reactive oxygen species (ROS). This oxidative stress is an important driver for the development of alcohol-associated liver disease (AALD) and alcohol-mediated cancer (AMC). ROS may bind directly to proteins and to DNA. ROS may also lead to lipid peroxidation (LPO) with the generation of LPO products. These LPO products may bind to DNA forming etheno-DNA adducts. Cell culture studies as well as animal experiments have shown that CYP2E1 knock-out animals or the inhibition of CYP2E1 by chemicals results in a significant improvement of liver histology. CYP2E1 is also involved in pathogenesis of hepatic steatosis and fibrosis. More recent studies in patients with AALD have demonstrated an improvement of serum transaminase activities when CYP2E1 was inhibited by clomethiazole. In addition to its role in the generation of ROS, CYP2E1 also enhances the activation of PCs and decreases the level of retinol and retinoic acid in the liver. Conclusion: Inhibition of CYP2E1 may improve AALD and may inhibit AMC.

Aims: The COVID-19 pandemic had a demonstrated impact on parenting but little is known about how parental drinking, stress, and use of aggressive discipline (a parenting behavior associated with abusive parenting and negative outcomes for children) have changed over time. We examine rates of alcohol use, stress, and aggressive discipline at three time points during the COVID-19 pandemic and investigate what maternal, child, and time-varying factors predict weekly use of aggressive parenting.

Methods: We use longitudinal data from the Central Ohio Family Study (COFLS), including women (n = 234) with a child between the ages of 0-12 and recruited via Facebook, Craigslist.org, and word of mouth. Participants completed an on-line survey for 3 consecutive years beginning in April-May 2020 and 1 and 2 years later. Multilevel logistic regression models were used to examine use of aggressive discipline at the three time points, controlling for time-varying, and maternal and child characteristics.

Results: Past week use of aggressive discipline peaked in Wave 1 (35.9%) and decreased at Wave 2 (3.8%) and Wave 3 (28.2%; OR = .463; 95% CI: .369, .580). Parental stress (OR = 1.052; 95% CI: 1.010, 1.096), social isolation (OR = 1.412; 95% CI: 1.197, 1.668), social companionship (OR = 1.113; 95% CI: 1.007, 1.229), and frequency of drinking (OR = 1.049; 95% CI: 1.014, 1.085) were significantly related to higher odds of using aggressive discipline over the three waves.

Conclusions: Although rates of aggressive discipline declined, frequency of drinking and stress demonstrated a consistent pattern in relation to aggressive discipline during the COVID-19 pandemic.

Aims: To examine predictors of 30-day readmissions to acute hospitals in England for patients treated for alcohol withdrawal (AW).

Methods: Retrospective cross-sectional analysis of routine hospital administrative data (i.e. Hospital Episode Statistics-Admitted Patient Care records) for adults admitted to non-specialist hospitals in England 2017-18.

Results: AW admissions were associated with digestive, circulatory, respiratory, and endocrine disorders and were of short duration (median 3 days). Of the 19 588 completed AW admissions examined in 2017-18, 3957 (20.2%) resulted in readmission within 30 days. The strongest predictors of 30-day readmission were being no fixed abode (Adjusted Odds Ratio (AOR) 1.81, 95%CI 1.44-2.26), prior discharge against medical advice (AOR 1.57, 95%CI 1.40-1.77), and greater Charlson comorbidity index total score (AOR 1.02, 95%CI 1.02-1.03).

Discussion: AW 30-day admissions are common and associated to complex case presentations that require high levels of community support on discharge. Hospital-based alcohol teams should prioritize strategies, which maximize medically managed AW, effective transitions to specialist community care including outreach teams and strong collaborations with physical and mental health outpatient services. Together with specialist initiatives within community mental health teams, assertive outreach, and homeless services 30-day readmissions may be minimized.

Aims: We sought to explore how acute alcohol exposure alters decision-making in rats performing an approach-avoid decision-making task. Increasing concentrations of alcohol were mixed with decreasing concentrations of sucrose to mimic mixed/sweetened alcoholic beverages.

Methods: Rats were trained on an apparatus in which different concentrations of sucrose were available in four different corners of the arena. During daily sessions, a tone signaled each trial start, followed by illumination (15 lux, blue LEDs) of a single corner port, indicating the potential availability of sucrose at that location. The rat (one rat per arena, both females and males) then chose to approach the lit corner to have the solution dispensed or avoid it, with no solution being dispensed. We examined how the decisions to pursue sucrose rewards shifted with the addition and subsequent removal of ethanol from the sucrose ports.

Results: Males were greatly affected by the introduction of alcohol into the task environment, shifting their approach preference to solutions containing higher alcohol concentrations rather than maintaining the prior preference for high-sucrose-concentration solutions. In contrast, females' choice patterns and task performance remained largely unchanged. We also explore a method for identifying changes in decision-making tendencies during and after alcohol consumption within individual subjects.

Conclusions: This research explores the introduction of alcohol in varying concentrations with sucrose solutions during an approach-avoid task, with male decision-making and behavioral patterns significantly impacted. We also explore a novel approach for identifying individual adaptations of decision-making behavior when alcohol becomes available, which could be expanded upon in future research.

Aims: Alcohol misuse may adversely impact health-promoting behaviors. Our objective was to evaluate health-related behaviors in people with HIV with alcohol misuse during the early phase of the COVID-19 pandemic, aiming to understand how alcohol misuse influences these behaviors during health-related emergencies.

Methods: Eighty people with HIV (64% male, 51 ± 11 years of age), enrolled in the ALIVE-Ex Study (NCT03299205), consented to a cross-sectional phone survey during the Louisiana stay-at-home order. Alcohol use, dietary intake, physical activity (PA), and emotional well-being over the previous week were assessed. Based on their pre-pandemic Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) score, participants were categorized into having alcohol misuse (AUDIT-C ≥ 3 female (F)/4 male (M)) or having no/low use (AUDIT-C < 3F/4M). Descriptive statistics, Spearman correlations, and crude and adjusted logistic regression models were estimated.

Results: Participants with alcohol misuse reported more alcohol use, more frequent meat and salty snack intake, and higher frequency of feeling tense and panicked over the previous week than people with HIV having no/low use (P < .05). Higher alcohol use was associated with more meat and salty snack intake, more frequent vigorous PA, higher PA level, and more emotional distress (P < .05).

Conclusions: Overall, participants having alcohol misuse and those reporting higher alcohol use during the stay-at-home order reported less healthy dietary patterns and more emotional distress, while engaging in more PA, compared to participants with lower alcohol use. These data suggest that during health-related emergencies, consideration of patients' prior and current alcohol use is necessary when encouraging healthy behavioral patterns.

Aims: Problem drinking in healthcare workers (HCWs) is highly relevant to study as it could result in personal suffering, as well as inefficiencies in health service delivery. This study aims to investigate the prevalence of nondrinking, drinking, and problem drinking and to investigate the comorbidity between drinking alcohol and mental illness (burnout and depression) among HCWs in Sweden.

Methods: This cross-sectional study draws on the 2022 Longitudinal Occupational Health survey in Healthcare Sweden of physicians, nurses, and nurse assistants in Sweden (N = 5966). Measures include levels of alcohol use assessed by the Cut, Annoyed, Guilty, and Eye Opener questionnaire, the 12-item Burnout Assessment Tool, and the Symptom CheckList-Core Depression. Multinomial Logistic regressions were used to investigate the likelihood of reporting nondrinking and problem drinking compared to drinking.

Results: The prevalence of problem drinking among Swedish HCWs was 3.7%. Only sex differences were observed for those with a problem drinking, with male nurses and nurse assistants being more likely to report problem drinking. Comorbidity was found between problem drinking and depression but not between problem drinking and burnout.

Conclusions: This study demonstrated that ~3.7% of Swedish HCWs had problem drinking and that those also had a higher likelihood of reporting depression but not burnout. Results contribute to new knowledge about the use of alcohol and comorbidities with depression and burnout among HCWs in Sweden. Findings could benefit employers in implementing preventive and tailored strategies to preserve the psychosocial well-being of HCWs.

Aims: Magnetic resonance imaging (MRI) studies have identified brain structural predictors of treatment response in individuals with alcohol use disorder (AUD) but with varying findings and primarily in male veterans. The present study investigated cortical surface area and thickness (CT) as predictors of brief intervention response in community-based adults with AUD.

Methods: Sixty-five non-treatment-seeking adults with AUD (44.6% male, aged 33.2 ± 1.3 years) underwent an MRI and received a brief intervention comprising personalized feedback and motivational interviewing, with follow-up ~6-8 weeks later to quantify changes in drinks/week (DPW), the primary outcome. Eighteen bilateral a priori regions of interest (ROIs) were used to predict DPW at follow-up, adjusting for baseline drinking. Significant predictors were examined with secondary outcomes, percent drinking and heavy drinking days, and in relation to out-of-scanner measures of impulsivity and comorbidities.

Results: Participants exhibited significant decreases in alcohol consumption in response to the brief intervention. Eight bilateral CT ROIs in the frontal, temporal, and occipital lobes, most notably medial orbitofrontal, middle temporal, and lateral occipital gyri, predicted DPW; however, only three predicted the secondary outcomes. Significant associations were observed between CT in frontal and occipital regions and impulsivity (delay discounting, lack of premeditation), executive functioning, anxiety, and stress.

Conclusions: Thinner frontal, temporal, and occipital ROIs predicted poorer brief intervention response, with notable overlap with brain regions previously implicated in AUD. Clarifying whether these regions reflect premorbid or acquired differences and, if the latter, the potential for recovery of cortical gray matter following drinking reductions are future priorities.

Background: Gabapentin, an anticonvulsant medication, has been proposed as a treatment for alcohol use disorder (AUD). A multisite study tested gabapentin enacarbil extended-release (GE-XR; 600 mg/twice a day), a prodrug formulation, combined with a computerized behavioral intervention, for AUD. In this multisite trial, the gabapentin GE-XR group did not differ significantly from placebo on the primary outcome of percent of subjects with no heavy drinking days. Despite the null findings, there is considerable interest in using machine learning methods to identify responders to GE-XR. The present study applies interaction tree machine learning methods to identify positive and iatrogenic (i.e. individuals who responded better to placebo than to GE-XR) treatment responders in the trial.

Methods: Baseline characteristics taken from the multisite trial were examined as potential moderators of treatment response using qualitative interaction trees (QUINT; N = 338; 223 M/115F). QUINT models are an exploratory decision tree approach that iteratively splits the data into leaves based on predictor variables to maximize a specific criterion.

Results: Analyses identified key factors that are associated with the efficacy (or iatrogenic effects) of GE-XR for AUD. Such factors are baseline drinking levels, motivation for change, confidence in their ability to reach drinking goals (i.e. self-efficacy), cognitive impulsivity, and baseline anxiety levels.

Conclusion: Baseline drinking levels and anxiety levels may be associated with the protracted withdrawal syndrome, previously implicated in the clinical response to gabapentin. However, these analyses underscore motivation for change and self-efficacy as predictors of clinical response to GE-XR, suggesting these established constructs should receive further attention in gabapentin research and clinical practice. Multiple studies using different machine learning methods are valuable as these novel analytic tools are applied to medication development for AUD.

Aims: Methanol poisoning is a tragic and avoidable health emergency that threatens life and often leads to irreversible disability. It primarily occurs when people unwittingly consume beverages contaminated with the chemical compound under the guise of alcoholic spirits. Although reliable data on its burden are unavailable, methanol poisoning is thought to be increasing globally, particularly in low- and middle-income countries. Current scholarship related to methanol poisoning draws almost exclusively from clinical and epidemiological research traditions. In this article, and in the absence of anthropological scholarship examining methanol poisoning specifically, we provide a narrative review of anthropological and social science literature that bears on this growing phenomenon.

Methods: We bring key areas of anthropological thought and inquiry that coalesce around the social phenomenon of methanol poisoning in conversation with the clinical and epidemiological scholarship.

Results: We begin with a biographical account of methanol, an unlikely character which has become omnipresent in the material world. We then turn to a social scientific examination of alcohol consumption, to which methanol poisoning is tethered. We pay special attention to alcohol consumption in Muslim-majority settings, where alcohol is often proscribed, but methanol-related incidents are common. Subsequently, we examine the scholarship related to health systems and technologies, which come to bear on diagnostic and treatment encounters for those who have consumed toxic alcohol.

Conclusion: We argue that anthropological perspectives are urgently needed to contribute to a fuller understanding of methanol poisoning and to design socially sensitive clinical and public health responses to address this avertable scourge.