A gender-focused multilevel analysis of how country, regional and individual level factors relate to harm from others' drinking.

BACKGROUND: The aim of this study was to examine how gender, age and education, regional prevalence of male and female risky drinking and country-level economic gender equality are associated with harms from other people's drinking. METHODS: 24,823 adults in ten countries were surveyed about harms from drinking by people they know and strangers. Country-level economic gender equality and regional prevalence of risky drinking along with age and gender were entered as independent variables into three-level random intercept models predicting alcohol-related harm. FINDINGS: At the individual level, younger respondents were consistently more likely to report harms from others' drinking, while, for women, higher education was associated with lower risk of harms from known drinkers but higher risk of harms from strangers. Regional rate of men's risky drinking was associated with known and stranger harm, while regional-level women's risky drinking was associated with harm from strangers. Gender equality was only associated with harms in models in models that did not include risky drinking. CONCLUSIONS: Youth and regional levels of men's drinking was consistently associated with harm from others attributable to alcohol. Policies that decrease the risky drinking of men would be likely to reduce harms attributable to the drinking of others.

Efficacy and safety of vitamin C in the management of acute respiratory infection and disease: A rapid review.

BRIEF OVERVIEW: Current evidence from published systematic reviews indicate that oral intake of vitamin C may assist with symptoms of acute viral respiratory infections (ARI) by reducing fever and chills, relieving chest pain and assist in reducing symptoms of common cold-induced asthma. Intravenous (IV) vitamin C administration may reduce the need for vasopressor support and the duration of mechanical ventilations in critically ill patients in hospital. COVID-19 has similar signs and symptoms of ARI. Further studies involving patients with COVID-19, either through administration of oral vitamin C in mild cases or IV vitamin C in critical cases, would be advantageous to examine if it is safe and efficacious. VERDICT: Oral vitamin C may assist with the symptoms of acute respiratory viral infections (ARI) and common cold-induced asthma but no studies have been identified justifying oral vitamin C for the prevention or treatment of coronavirus infections including COVID-19. When taken at onset of ARI, oral vitamin C may reduce the duration of symptoms including fever, chest pain, chills and bodily aches and pains. It may also reduce the incidence of hospital admission and duration of hospital stays. For individuals admitted to hospital with community-acquired pneumonia, vitamin C may improve respiratory function in more severe cases. No major adverse events nor interactions were reported by either method of administration. However, there is an absence of high quality, contemporary clinical research examining this topic. Current evidence suggests further studies are needed to better understand the value of both oral and IV vitamin C for ARI, including COVID-19.

What did you drink yesterday? Public health relevance of a recent recall method used in the 2004 Australian National Drug Strategy Household Survey.

AIM: To (i) compare the Yesterday method with other methods of assessing alcohol use applied in the 2004 Australian National Drug Strategy Household Survey (NDSHS) in terms of extent of under-reporting of actual consumption assessed from sales data; and (ii) illustrate applications of the Yesterday method as a means of variously measuring the size of an Australian 'standard drink', the extent of risky/high-risk alcohol use, unrecorded alcohol consumption and beverage-specific patterns of risk in the general population. SETTING: The homes of respondents who were eligible and willing to participate. PARTICIPANTS: A total of 24 109 Australians aged 12 years and over. DESIGN: The 2004 NDSHS assessed drug use, experiences and attitudes using a 'drop and collect' self-completion questionnaire with random sampling and geographic (State and Territory) and demographic (age and gender) stratification. MEASURES: Self-completion questionnaire using quantity-frequency (QF) and graduated-frequency (GF) methods plus two questions about consumption 'yesterday': one in standard drinks, another with empirically based estimates of drink size and strength. RESULTS: The Yesterday method yielded an estimate of 12.8 g as the amount of ethanol in a typical Australian standard drink (versus the official 10 g). Estimated coverage of the 2003-04 age 12+ years per-capita alcohol consumption in Australia (9.33 ml of ethanol) was 69.17% for GF and 64.63% for the QF when assuming a 12.8 g standard drink. Highest coverage of 80.71% was achieved by the detailed Yesterday method. The detailed Yesterday method found that 60.1% of Australian alcohol consumption was above low-risk guidelines; 81.5% for 12-17-year-olds, 84.8% for 18-24-year-olds and 88.8% for Indigenous respondents. Spirit-based drinks and regular strength beer were most likely to be drunk in this way, low- and mid-strength beer least likely. CONCLUSIONS: Compared to more widely used methods, the Yesterday method minimizes under-reporting of overall consumption and provides unique data of public health significance. It also provides an empirical basis for taxing alcoholic beverages in accordance with their contributions to harm and can be used to complement individual-level measures such as QF and GF.

Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies.

BACKGROUND: There is a recent and growing research literature on alcohol use and related harms among transgender and other gender minority populations; however, current definitions and measures of hazardous drinking do not consider the complexity of physiological sex characteristics and socially constructed gender, raising doubts regarding their validity, applicability, and use with these populations. To address this, we reviewed current research on alcohol-related outcomes in transgender populations and critically summarized key issues for consideration in future research. METHODS: We conducted a systematic review of transgender alcohol research in English language, peer-reviewed journals, published 1990-2017, and extracted key details (e.g., sample composition, alcohol measures, results). RESULTS: Forty-four studies met all inclusion criteria for the review, the majority of which were conducted in the United States. The prevalence of hazardous drinking was high; however, estimates varied widely across studies. We noted frequent methodological weaknesses, including few attempts to differentiate sex and gender, poor attention to appropriate definitions of hazardous drinking, and reliance on cross-sectional study designs and non-probability sampling methods. CONCLUSION: Given findings that suggest high need for ongoing public health attention, we offer recommendations to improve future alcohol studies with transgender and other gender minority populations, such as being explicit as to whether and how sex and/or gender are operationalized and relevant for the research question, expanding the repertoire of alcohol measures to include those not contingent on sex or gender, testing the psychometric performance of established screening instruments with transgender populations, and shifting from descriptive to analytic study designs.

Effects of depression and social integration on the relationship between alcohol consumption and all-cause mortality.

AIMS: This study was designed to assess the potentially confounding influences of social integration and depression on the form of the relationship between alcohol consumption and all-cause mortality. DESIGN, PARTICIPANTS AND MEASUREMENT: Respondents from the 1984 US National Alcohol Survey (N = 5177) were followed by searching the National Death Index (NDI) through 1995; 540 were identified as deceased. Predictor variables in a Cox proportional hazards model included gender, ethnicity, marital status, income, smoking, age and alcohol consumption (volume and patterns). Two social variables and their interactions with alcohol consumption were added, the Center for Epidemiological Studies Depression (CES-D) scale and an eight-item social isolation scale. FINDINGS: The J-shaped risk curve for all-cause mortality by volume was approximated for men but not significantly for women. In addition heavy drinking occasions independently contributed to mortality in men. Low social integration (bottom 12%) had no significant effects on mortality or on the relationship between alcohol consumption and mortality curve. Inclusion of the interaction between alcohol consumption and depression proved significant for heavy male drinkers (> six drinks on average per day) and for female former drinkers with heavy drinking occasions. In both cases, the respective subgroup, which additionally was depressed, had about four times the risk of a life-time abstainer. CONCLUSIONS: The relationship of alcohol consumption to 11-year all-cause mortality in a general population indicated little confounding effect of social isolation, but revealed important interactions with depression for heavy male drinkers and heavy female ex-drinkers.

Intoxication before last sexual intercourse and HIV risk behavior among men and women in Uganda: Evidence from a nationwide survey.

AIMS: To establish the prevalence of intoxication before sex and its association with risky sexual behavior. DESIGN: The data were from the 2006 Uganda Demographic and Health Survey which had been designed for a cross-sectional descriptive study. SETTING: The study covered the whole country-Uganda. PARTICIPANTS: The respondents were 6,253 women and 1,804 men who had ever had sex. MEASUREMENTS: The key independent variable was intoxication before last sexual intercourse while the major outcome variables were condom use and sex with non-regular partners. Weighted prevalence of intoxication was computed and multivariable logistic regression was applied to assess the independent association of intoxication with risky sexual behavior. FINDINGS: Twelve percent of men and 16% of women reported having been intoxicated before last sexual intercourse. Of the women who reported intoxication before last sexual intercourse, 78% said it was their partners who were intoxicated. Of the men who reported intoxication, 83% said it was they themselves who were intoxicated. Intoxication of the men was associated with having sex with non-regular partners (OR=1.78, 95%CI: 1.04-3.03) and having unprotected sex (OR=1.71, 95%CI: 1.07-2.73). Women who were intoxicated were less likely to have been with non-regular partners (OR=0.55, 95%CI: 0.32-0.95). The women whose partners were intoxicated before last sexual intercourse were more likely to report having had unprotected sex (OR=1.55, 95%CI: 1.12-2.15). CONCLUSION: HIV prevention mechanisms should address intoxication before sex. More effort is needed to find ways of helping women avoid unprotected sex with intoxicated partners.

Concern about family members' drinking and cultural consistency: A Multi-Country GENACIS Study.

The data analysed come from the GENACIS project (Gender, Alcohol and Culture: an International Study) and involve population surveys for 18 countries (total N = 34,916) from five WHO Regions: African (Nigeria and Uganda); Americas (Argentina, Costa Rica, Uruguay and United States); European (Czech Republic, Denmark, Finland, Germany, Hungary, Iceland, Spain, Sweden, and UK); South-East Asian (India, Sri Lanka); and Western Pacific (Japan). The paper studies gender and country differences in the relationship between social pressure to drink less experienced by individuals, considering seeking help for alcohol problems, and alcohol consumption and problem levels (AUDIT). In most countries for both men and women, informal control was applied most often by the spouse or partner, while reporting such controls from any source seemed more common in low- and middle-income countries. In all countries studied, men reported substantially more social control efforts than women. The hypothesis was not maintained that drinking control and help seeking was more common for heavier drinkers and those with more drinking-related harms. However, there appeared to be a relationship between a country's aggregate level of drinking and the extent to which social control efforts were reported. Higher correlations between drinking and problem levels on the one hand, and spouses' and other family members' concerns on the other, may be suggestive of a cultural consistency in societal responses to drinking and alcohol-related problems.