scholarly journals Estimating Long-Term Drinking Patterns for People with Lifetime Alcohol Use Disorder

2019 ◽  
Vol 39 (7) ◽  
pp. 765-780
Author(s):  
Carolina Barbosa ◽  
William N. Dowd ◽  
Arnie P. Aldridge ◽  
Christine Timko ◽  
Gary A. Zarkin

Background. There is a lack of data on alcohol consumption over time. This study characterizes the long-term drinking patterns of people with lifetime alcohol use disorders who have engaged in treatment or informal care. Methods. We developed multinomial logit models using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to estimate short-term transition probabilities (TPs) among the 4 World Health Organization drinking risk levels (low, medium, high, and very high risk) and abstinence by age, sex, and race/ethnicity. We applied an optimization algorithm to convert 3-year TPs from NESARC to 1-year TPs, then used simulated annealing to calibrate TPs to a propensity-scored matched set of participants derived from a separate 16-year study of alcohol consumption. We validated the resulting long-term TPs using NESARC-III, a cross-sectional study conducted on a different cohort. Results. Across 24 demographic groups, the 1-year probability of remaining in the same state averaged 0.93, 0.81, 0.49, 0.51, and 0.63 for abstinent, low, medium, high, and very high-risk states, respectively. After calibration to the 16-year study data ( N = 420), resulting TPs produced state distributions that hit the calibration target. We find that the abstinent or low-risk states are very stable, and the annual probability of leaving the very high-risk state increases by about 20 percentage points beyond 8 years. Limitations. TPs for some demographic groups had small cell sizes. The data used to calibrate long-term TPs are based on a geographically narrow study. Conclusions. This study is the first to characterize long-term drinking patterns by combining short-term representative data with long-term data on drinking behaviors. Current research is using these patterns to estimate the long-term cost effectiveness of alcohol treatment.

2007 ◽  
Vol 41 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Sophie C. Reid ◽  
Obioha C. Ukoumunne ◽  
Carolyn Coffey ◽  
Maree Teesson ◽  
John B. Carlin ◽  
...  

Objective: To examine the extent to which excessive drinking in young adults is associated with alcohol abuse and dependence. Method: Cross-sectional analyses were conducted using data from the eighth wave of the Victorian Adolescent Health Cohort Study, which comprised 1943 Victorians currently aged 24–25 years drawn from 44 secondary schools across the state in 1992. The main outcome measures of interest were short-term risk drinking status (based on daily alcohol consumption) and long-term risk drinking status (based on total weekly alcohol consumption). Results: Two out of 5 participants drank at moderate to high risk levels for short-term harm. Yet, because young people tend to drink on only 1–2 days a week, fewer (22%) were at moderate to high risk for long-term harm. Although 20% of the participants met criteria for a diagnosis of alcohol abuse or dependence, most of those in the moderate- to high-risk drinking categories were not diagnosed with either alcohol disorder. Conclusion: Excessive alcohol use in one or two sessions a week appears to be common in young Australian adults. While short- and long-term risky drinking is more common in those with an alcohol use disorder, the majority of moderate- and high-risk drinking is done by those who do not meet criteria for an alcohol use disorder.


2012 ◽  
Vol 24 (8) ◽  
pp. 1275-1283 ◽  
Author(s):  
Robert J. Tait ◽  
Davina J. French ◽  
Richard Burns ◽  
Kaarin J. Anstey

ABSTRACTBackground: Alcohol use disorders are associated with other mental health disorders in young adults, but there are few data on alcohol use and mental health outcomes in older adults, particularly the oldest old. This study examines the relationship between alcohol consumption and depressive symptoms.Methods: Data were collected from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project, which has pooled nine Australian longitudinal studies. Alcohol consumption was classified using standard drinks (10 g alcohol)/day as: abstinent, low risk (<0–≤2 standard drinks), long-term risk (>2–≤4) and short-term risk (>4). Probable depression was classified from harmonized scores on various standard instruments (e.g. Centre for Epidemiological Studies Depression scale).Results: Overall, 39,104 (86%) participants contributed data. Alcohol classification at baseline showed 7,526 abstinent, 28,112 low risk, 2,271 long-term risk, and 1,195 short-term risk participants. Age ranged from 45 to 103 year (median 60). Using generalized estimating equations (GEE), there were significant gender by alcohol and gender by age interactions, so the analysis was split by gender. Among males, the abstinent and short-term risk groups had increased likelihood of depression: in females the abstinent, long- and short-term risk groups had increased odds of depression. Increased odds of depression was also associated with former and current smoking, younger age-group, not being partnered, leaving school before age 15 and increasing levels of health-impaired walking, dressing, or bathing.Conclusion: The impact of alcohol use differs by gender, nevertheless those using higher levels of alcohol or who smoke should be screened for depression and may benefit from interventions.


Author(s):  
Michael A. Cohn ◽  
Barbara L. Fredrickson

Positive emotions include pleasant or desirable situational responses, ranging from interest and contentment to love and joy, but are distinct from pleasurable sensation and undifferentiated positive affect. These emotions are markers of people's overall well-being or happiness, but they also enhance future growth and success. This has been demonstrated in work, school, relationships, mental and physical health, and longevity. The broaden-and-build theory of positive emotions suggests that all positive emotions lead to broadened repertoires of thoughts and actions and that broadening helps build resources that contribute to future success. Unlike negative emotions, which are adapted to provide a rapid response to a focal threat, positive emotions occur in safe or controllable situations and lead more diffusely to seeking new resources or consolidating gains. These resources outlast the temporary emotional state and contribute to later success and survival. This chapter discusses the nature of positive emotions both as evolutionary adaptations to build resources and as appraisals of a situation as desirable or rich in resources. We discuss the methodological challenges of evoking positive emotions for study both in the lab and in the field and issues in observing both short-term (“broaden”) and long-term (“build”) effects. We then review the evidence that positive emotions broaden perception, attention, motivation, reasoning, and social cognition and ways in which these may be linked to positive emotions' effects on important life outcomes. We also discuss and contextualize evidence that positive emotions may be detrimental at very high levels or in certain situations. We close by discussing ways in which positive emotions theory can be harnessed by both basic and applied positive psychology research.


Water ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 1804
Author(s):  
Cassi J. Gibson ◽  
Abraham K. Maritim ◽  
Jason W. Marion

Quantitatively assessing fecal indicator bacteria in drinking water from limited resource settings (e.g., disasters, remote areas) can inform public health strategies for reducing waterborne illnesses. This study aimed to compare two common approaches for quantifying Escherichia coli (E. coli) density in natural water versus the ColiPlate™ kit approach. For comparing methods, 41 field samples from natural water sources in Kentucky (USA) were collected. E. coli densities were then determined by (1) membrane filtration in conjunction with modified membrane-thermotolerant E. coli (mTEC) agar, (2) Idexx Quanti-Tray® 2000 with the Colilert® substrate, and (3) the Bluewater Biosciences ColiPlate kit. Significant correlations were observed between E. coli density data for all three methods (p < 0.001). Paired t-test results showed no difference in E. coli densities determined by all the methods (p > 0.05). Upon assigning modified mTEC as the reference method for determining the World Health Organization-assigned “very high-risk” levels of fecal contamination (> 100 E. coli CFU/100 mL), both ColiPlate and Colilert exhibited excellent discrimination for screening very high-risk levels according to the area under the receiver operating characteristic curve (~89%). These data suggest ColiPlate continues to be an effective monitoring tool for quantifying E. coli density and characterizing fecal contamination risks from water.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shahla Safari ◽  
Maryam Abdoli ◽  
Masoud Amini ◽  
Ashraf Aminorroaya ◽  
Awat Feizi

AbstractThis study aimed to evaluate the patterns of changes in obesity indices over time in prediabetic subjects and to classify these subjects as either having a low, moderate, and high risk for developing diabetes in the future. This study was conducted among 1228 prediabetics. The patterns of changes in obesity indices based on three measurements including first, mean values during the follow-up period, and last visit from these indices were evaluated by using the latent Markov model (LMM). The mean (standard deviation) age of subjects was 44.0 (6.8) years and 73.6% of them were female. LMM identified three latent states of subjects in terms of change in all anthropometric indices: a low, moderate, and high tendency to progress diabetes with the state sizes (29%, 45%, and 26%), respectively. LMM showed that the probability of transitioning from a low to a moderate tendency to progress diabetes was higher than the other transition probabilities. Based on a long-term evaluation of patterns of changes in obesity indices, our results reemphasized the values of all five obesity indices in clinical settings for identifying high-risk prediabetic subjects for developing diabetes in future and the need for more effective obesity prevention strategies.


2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
HY Wang ◽  
R Zhang ◽  
ZX Cai ◽  
KF Dou

Abstract Funding Acknowledgements Type of funding sources: None. Background Recent emphasis on reduced duration and/or intensity of antiplatelet therapy following PCI irrespective of indication for PCI may fail to account for the substantial risk of subsequent nontarget lesion events in acute coronary syndrome (ACS) patients. This study sought to investigate the benefits and risks of extended-term (&gt;12-month) DAPT as compared with short-term DAPT in high-risk "TWILIGHT-like" ACS patients undergoing PCI. Methods All consecutive patients fulfilling the "TWILIGHT-like" criteria undergoing PCI from January 2013 to December 2013 were identified from the prospective Fuwai PCI Registry. High-risk "TWILIGHT-like" patients were defined by at least 1 clinical and 1 angiographic feature based on TWILIGHT trial selection criteria. The present analysis evaluated 4,875 high-risk "TWILIGHT-like" patients with ACS who were event-free at 12 months after PCI. The primary outcome was the composite of all-cause death, myocardial infarction (MI), or stroke at 30 months while BARC type 2, 3, or 5 bleeding was key secondary outcome. Results Extended DAPT compared with shorter DAPT reduced the composite outcome of all-cause death, MI, or stroke by 63% (1.5% vs. 3.8%; HRadj: 0.374, 95% CI: 0.256 to 0.548; HRmatched: 0.361, 95% CI: 0.221-0.590). The HR for cardiovascular death was 0.049 (0.007 to 0.362) and that for MI 0.45 (0.153 to 1.320) and definite/probable stent thrombosis 0.296 (0.080-1.095) in propensity-matched analyses. Rates of BARC type 2, 3, or 5 bleeding (0.9% vs. 1.3%; HRadj: 0.668 [0.379 to 1.178]; HRmatched: 0.721 [0.369-1.410]) did not differ significantly in patients treated with DAPT &gt; 12-month or DAPT ≤ 12-month. The effect of long-term DAPT on primary and key secondary outcome across the proportion of ACS patients with 1-3, 4-5, or 6-9 risk factors showed a consistent manner (Pinteraction &gt; 0.05). Conclusion Among high-risk "TWILIGHT-like" patients with ACS after PCI, long-term DAPT reduced ischemic events without increasing clinically meaningful bleeding events as compared with short-term DAPT, suggesting that extended DAPT might be considered in the treatment of ACS patients who present with a particularly higher risk for thrombotic complications. Abstract Figure.


Brachytherapy ◽  
2012 ◽  
Vol 11 (4) ◽  
pp. 250-255 ◽  
Author(s):  
Nathan Bittner ◽  
Gregory S. Merrick ◽  
Wayne M. Butler ◽  
Robert W. Galbreath ◽  
Jonathan Lief ◽  
...  

2017 ◽  
Vol 41 (3) ◽  
pp. 237-242 ◽  
Author(s):  
Kerri Coomber ◽  
Richelle Mayshak ◽  
Ashlee Curtis ◽  
Peter G. Miller

Author(s):  
William V Lechner ◽  
Natasha K Sidhu ◽  
Jackson T Jin ◽  
Ahmad A Kittaneh ◽  
Kimberly R Laurene ◽  
...  

Abstract Background The COVID-19 pandemic has created disruptions to daily life resulting in wide-spread unemployment and psychological distress. Recent studies have reported high rates of alcohol use during this time; however, longitudinal data remain scarce and factors associated with increases in high-risk drinking observed over time are unknown. Aims The current study examined changes in high-risk drinking patterns across four 7-day observation periods, prior to and following a university wide campus closure. Additionally, factors associated with changes in alcohol use patterns were examined including financial distress, psychological distress, impact of racial tensions and virus-related fears. Method Students (N = 1001) in the Midwestern USA completed repeated assessments between March and June 2020. Each survey included a timeline follow-back measure of alcohol use. Pandemic-related distress spanning several factors was assessed at the final follow-up. Results Risky drinking patterns increased significantly over time. Overall, psychological distress and impact of racial tensions were associated with higher rates of risky drinking, whereas COVID-19-related fears were associated with lower rates. However, only financial-related distress was associated with an increase in risky drinking patterns over time. Conclusions Increased risky drinking patterns observed in the current study may signal problems that are likely to persist even after the direct impact of the COVID-19 pandemic on daily life ends. Individuals experiencing financial distress may represent a particularly high-risk group. Interventions targeting the cross-section of job loss, financial stress and problematic alcohol use will be important to identify.


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